Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Research Publication 2
Title Publication Date/Location
Surveillance Snapshot: Cervical Screening among U.S. Military Servicewomen in the Millennium Cohort Study, 2003–2015 Medical Surveillance Monthly Report 2020 Jul;27(7):15

Matsuno RK, Porter B, Warner SG, Wells N for the Millennium Cohort Study Team

Across a 13 year period (2003-2015), the percentage of U.S. service women who were up-to-date with cervical cancer screening peaked in 2010, then declined. Screening was generally highest among Air Force personnel and lowest among Navy personnel. Being up-to-date was higher for servicewomen who had initiated the HPV vaccine than for women who had not.

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Surveillance Snapshot: Human Papillomavirus Vaccination Among U.S. Active Component Service Members in the Millennium Cohort Study, 2006–2017 Medical Surveillance Monthly Report 2019 Jun;26(6):18

Matsuno RK, Porter B, Warner SG, Wells N

Among a sample of active component members under the age of 26, (22,387 service women and 31,705 service men), service more women (37.8%) were more likely than service men (3.9%) to initiate receiving the HPV vaccine. Among those who initiated the vaccine, 40.2% of women and 23.1% of men were adherent to receiving all 3 doses within 1 year. Members of the Air Force and those in healthcare occupations had higher percentages of HPV vaccine initiation and adherence.

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Survey response over 15 years of follow-up in the Millennium Cohort Study BMC Medical Research Methodology 2023 Sep 9 | doi: 10.1186/s12874-023-02018-z

Kolaja CA, Belding JN, Boparai SK, Castañeda SF, Geronimo-Hara TR, Powell TM, Tu XM, Walstrom JL, Sheppard BD, Rull RP; Millennium Cohort Study Team

Across a 3-15 year follow-up period, the average response rate among almost 198,833 Millennium Cohort Study participants was 60%. Factors associated with follow-up survey response over time included increased educational attainment, married status, female sex, older age, military deployment, greater life stress, and poorer mental/physical health status.

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The Association of Predeployment and Deployment-Related Factors on Dimensions of Postdeployment Wellness in US Military Service Members The American Journal of Health Promotion 2013;28:2, 56-66

Bagnell ME, LeardMann CA, McMaster HS, Boyko EJ, Smith B, Granado, NS, and Smith TC

This study found that the majority of participants were well post-deployment, and military factors associated with post-deployment wellness included not experiencing combat and being trained as a combat specialist. Modifiable factors significantly associated with post-deployment wellness were also detected, including normal BMI, not smoking, and being physically active.

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The bi-directional relationship between post-traumatic stress disorder and obstructive sleep apnea and/or insomnia in a large U.S. military cohort Sleep Health 2022 December | doi: 10.1016/j.sleh.2022.07.005

Chinoy ED, Carey FR, Kolaja CA, Jacobson IG, Cooper AD, Markwald RR

Study findings indicate a bi-directional relationship between the development of sleep disorders and PTSD. Military-related factors associated with new onset PTSD or sleep disorders, such as combat deployment, recent military separation, and rank, should be considered in prevention efforts for sleep disorders and PTSD.

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The Effect of Combat Exposure on Financial Problems International Review of Economics and Finance 2022 May | doi: 10.1016/j.iref.2022.02.042

Ackerman A, Porter, B

This paper examined whether combat exposure led to new-onset financial problems and financial stress among 64,508 veterans using 2001-2016 data from the Millennium Cohort Study. The average predicted probability of developing a new major financial problem (such as bankruptcy) and greater financial stress increased 0.44% (21% relative to the mean probability) following a single combat exposure and increased 0.90% (43% relative to the mean probability) following multiple combat exposures. The likelihood of financial decline resulting from combat exposure were greater for veterans with poorer pre-deployment mental or physical health, veterans in enlisted ranks, and younger veterans between the ages of 26 and 36. These results translate to a crude cost estimate of lost productivity of at least $41 million and up to 3,629 bankruptcies for the 2.7 million veterans (1.34 per 1,000) deployed from 2001 through 2016.

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The effect of combat exposure on veteran homelessness Journal of Housing Economics Information 2020 Sept; 49,101711

Ackerman A, Porter B, Sullivan R

Homelessness is a serious problem among veterans, but how military service contributes to the risk of homelessness is unclear. This study examined the impact of witnessing another's death (a proxy for combat) on likelihood of reporting homelessness. One exposure was associated with a 0.6% increase in homelessness. Extrapolated to the overall population, combat exposure is expected to contribute to 4,600 instances of homeless veterans.

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The Effects of Exposure to Documented Open-Air Burn Pits on Respiratory Health Among Deployers of the Millennium Cohort Study Journal of Occupational and Environmental Medicine 2012 June;54(6):708-716

Smith B, Wong CA, Boyko EJ, Phillips CJ, Gackstetter GD, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

Burn pit exposure within 3 or 5 miles was not associated with newly reported asthma, chronic bronchitis or emphysema, or self-reported respiratory symptoms. In general, these findings do not support an elevated risk for respiratory outcomes among personnel deployed within proximity of documented burn pits in Iraq. Increased symptom reporting, however, was observed among Air Force deployers located within 2 miles of Joint Base Balad, though this finding was marginally significant with no evidence of trend.

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The Epidemiology of Irritable Bowel Syndrome in the US Military: Findings from the Millennium Cohort Study American Journal of Gastroenterology 2016;111:93-104

Riddle MS, Welsh M, Porter CK, Nieh C, Boyko EJ, Gackstetter GD, Hooper TI

This study describes the incidence of irritable bowel syndrome (IBS) and its association with antecedent infectious gastroenteritis among Millennium Cohort Study participants using survey data and post-deployment health assessments and medical encounter data in the military health system. Consistent with other studies, the risk of IBS increased after acute enteric infection. Novel findings included increased risk of incident IBS among those with post-traumatic stress disorder (PTSD) and preceding life stressors, as well as stronger associations between infectious gastroenteritis and IBS among those with antecedent depression or anxiety. These results reinforce the need to prevent acute gastrointestinal infections and their chronic consequences among our Service members. Additional studies on the underlying biopsychosocial mechanisms of IBS may help to explain these findings.

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The Impact of Deployment Experience and Prior Healthcare Utilization on Enrollment in a Large Military Cohort Study BMC Medical Research Methodology 2013 Jul 11;13:90

Horton JL, Jacobson IJ, Littman AJ, Alcaraz JE, Smith B, and Crum-Cianflone NF

This study compared the characteristics of invited subjects (responders and nonresponders) prior to the enrollment cycle. Military personnel who deployed in support of OIF/OEF and those who presented for routine outpatient care were significantly more likely to enroll in a longitudinal cohort study examining their health and military experiences, while those with baseline mental disorders or longer hospital stays were less likely to enroll. These findings, which controlled for demographic and other potential confounders, suggest differential enrollment by deployment experience and health status, and may help guide recruitment efforts in future studies.

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