Increased Prevalence of Overweight and Obesity and Incidence of Prediabetes and Type 2 Diabetes During the COVID-19 Pandemic, Active Component Service Members, U.S. Armed Forces, 2018 to 2021

This study evaluated trends in the prevalence of overweight, obesity, and diabetes among active component service members between 2018 and 2021, before and after the start of the COVID-19 pandemic. This study also investigated the incidence of prediabetes and type 2 diabetes mellitus (T2DM) diagnoses during the same period. Between 2018 and 2021, the prevalence of obesity among active component service members who completed a Periodic Health Assessment (PHA) increased from 16.1% to 18.8%. The incidence of prediabetes increased from 588.2 to 763.8 cases per 100,000 person-years (p-yrs), and the incidence of T2DM increased from 55.5 to 69.6 per 100,000 p-yrs. The largest relative increases in obesity prevalence were in the youngest (<30 years) age categories. Navy members and Hispanic service members experienced the largest absolute and relative increases in rates of new diabetes diagnoses. These findings indicate that during the COVID-19 pandemic active component service members experienced increased prevalence of obesity, prediabetes, and diabetes. Evaluation of lifestyle factors associated with these chronic diseases among service members may be useful to enhance deployment readiness and operational effectiveness.

Differences in Disease Non-battle Injury Between Combatant Commands.

INTRODUCTION: Disease and non-battle injury (DNBI) have historically been a major or primary medical burden in expeditionary military populations. The United States has multiple deployed populations conducting operations across the world. This study aims to determine if DNBI rates are different between military populations by comparing the United States Africa Command (USAFRICOM) and United States Central Command (USCENTCOM) areas of responsibility. MATERIALS AND METHODS: The study period was from January 1, 2017 to December 31, 2021. Individual evacuation data including date, necessary specialty care, and combatant command (CCMD) were acquired via United States Transportation Command Regulating and Command & Control Evacuation System. Total population data was acquired from USAFRICOM and USCENTCOM headquarters. Total inpatient and outpatient encounters at each CCMD were acquired via Theater Medical Data Store. The proportions and evacuation rates of DNBI types within USAFRICOM and USCENTCOM were compared. RESULTS: USCENTCOM had significantly higher proportions of outpatient and inpatient services for mental disorders, musculoskeletal diseases, and neurologic conditions compared to USAFRICOM. USCENTCOM had a significantly lower evacuation rate compared to USAFRICOM for every year analyzed: 2017 (P-value < .0001; relative risk [RR] = 0.834; 95% CI = 0.80-0.87), 2018 (P-value < .0001; RR = 0.818; 95% CI = 0.78-0.85), 2019 (P-value < .0001; RR = 0.785; 95% CI = 0.75-0.82), 2020 (P-value < .0001; RR = 0.889; 95% CI = 0.84-0.94), and 2021 (P-value < .0001; RR = 0.868; 95% CI = 0.83-0.91). CONCLUSIONS: The evacuation rates of different categories of DNBI vary between CCMDs. There will be CCMD-specific factors that impact the effectiveness of initiatives to reduce the DNBI burden.

Global Health Engagement: Leveraging New Technology and Multilateral Partnerships During the COVID-19 Pandemic.

United States government global health engagements range from delivering aid, to medical skill certification, and building multilateral partnerships with key leaders. This article discusses three critical questions to consider when planning engagements during pandemics. By expanding virtual programming, and including SARS-CoV-2 mitigation measures with in-person events, we can enhance support to partner nations through medical engagements.