Family Overview

Voice of the Military Family: Using Survey Methodology to Understand the Impact of Military Service on Family Health and Well-Being
Hope M. McMaster, PhD1; Kari E. Sausedo, MA1; Cynthia A. LeardMann, MPH1; Isabel G. Jacobson, MPH1; Nisara S. Granado, MPH, PhD1; Besa Smith, MPH, PhD1;
Beverly D. Sheppard, BS1; John A. Fairbank, PhD2; Charles Marmar, MD3; William E. Schlenger, PhD4; and Tyler C. Smith, MS, PhD1; for the Millennium Cohort Study Team
1DoD

Center for Deployment Health Research, Naval Health Research Center, San Diego, CA; 2Duke University Medical Center; Durham, NC; 3New York University Langone Medical Center, New York, NY; 4Abt Associates Inc., Durham, NC

Abstract
The Millennium Cohort Family Study will be the largest prospective study in military
history designed to assess the interrelated health effects of military service and
deployment on service members, spouses, and their children. The study team
anticipates enrolling 10,000 spouses, of whom approximately half will be married to
service members who have deployed in support of the operations in Iraq and
Afghanistan. Participants will complete a web-based questionnaire covering
mental/physical health, relationship quality, deployment/reunion, and service
utilization. In addition, data will be linked to medical records collected and maintained
by the DoD and Department of Veterans Affairs that include inpatient/outpatient care,
pharmacology, and other data. The Millennium Cohort Family Study offers a unique
opportunity to explore the interdependence of spouses’ experiences and their impact
on family health and well-being. A comprehensive understanding of the challenges
faced by military families provides a vehicle to create truly effective interventions and
support mechanisms.

Background
●

The Millennium Cohort Study was
launched in 2001 in collaboration
with all US military services and
the Department of Veterans
Affairs, prior to the conflicts in
Iraq and Afghanistan

Objectives
●

Explore the impact of military service on the health and well-being of service members
and their families

●

Assess the importance of family support and other factors on positive and negative
health outcomes

●

Examine new-onset diseases and conditions among military spouses and children

●

Inform policy makers and guide prevention measures that positively impact military
families

2001

2004

2007

2010

●

It is estimated that 25% of the invitees will enroll in the Millennium Cohort Study and that 65%
of the married members will grant permission to contact their spouse (n ~ 20,313)

2019

• Large cost savings are

2022

• Participants will receive their
choice of a $10 gift card to one of
over 50 vendors

2nd
enrollment
N = 31,110

2004 Cohort: 2nd Enrollment
2007 Cohort: 3rd Enrollment
2010 Cohort: 4th Enrollment
4th
enrollment
N ~ 62,500
~10,000 spouses

Invite 250,000 active-duty, Reserve, and National Guard service members with 2-5 years of
service, oversampling for female and married personnel, to enroll in the fourth panel of the
Millennium Cohort Study in 2010/2011
Of the 250,000 invitees, half are married

2016

2001 Cohort: 1st Enrollment

Methods

●

2013

associated with online enrollment

1st
enrollment
N = 77,047

3rd
enrollment
N = 43,440

●

Online Participation

Millennium Cohort Family Study Enrollment Timeline

www.familycohort.org

2010 Family Cohort

Measured Health Outcomes and Impact
Main Survey Topics:
●

Summary of Participants

●
●

Enrollment Design
●

●

The Millennium Cohort Study has now enrolled over 151,000
service members that are surveyed every 3 years to examine
how deployment and military occupational exposures affect
the long-term health of military members and veterans
●

●

●

Family relationships can be a source of
support or stress for service members

●

50% of the referred spouses are expected to enroll in the Family Study
● n ~ 10,000
 Approximately half will be married to service members who have deployed in
support of the operations in Iraq and Afghanistan

“You're heroes just as much as our men
and women in uniform -- the spouses
who stay behind, with all the pride of
being a military wife or husband, but
with also the fears and the anxiety that
come when the person you love the
most in the world is in harm's way.” Michelle Obama speaking at Camp
Pendleton, CA June 20, 2010

●

50%

50%
Married
n = 125,000

Longitudinal Contact

However, few epidemiologic studies have
examined the impact of deployment on
family members and family functioning
In order to broaden our understanding
and ability to address needs, a Family
Cohort has been added to the 2010
Millennium Cohort enrollment cycle to
assess the interrelated health effects of
military service and deployment on
service members, spouses, and coresident children

●

Military personnel with 2-5 years
(24-60 months) of service*
N = 250,000

80%

●

Not Married
n = 125,000
20%

Men
n = 100,000

●

Women
n = 25,000

80%
Men
n = 100,000

●

20%
Women
n = 25,000

Married Military personnel with 2-5 years (24-60 months) of service
N = 125,000

25% estimated to enroll in the Millennium Cohort Study
n = 31,250

Magnet Photo Frame

65% estimated to give permission to contact spouse
n ~ 20,313
50% estimated to respond
n ~ 10,000 spouses enrolling in the Millennium Cohort Family Study

Postcards and Study Updates will be sent to participants to promote
Family Cohort identity, as well as to encourage participants to
complete the survey and update their contact information

*Additional

Defense Manpower Data Center (DMDC) specifications: Members must have
complete data on social security number, first name, last name, date of birth, sex, race/ethnicity,
service branch, component, pay grade, and marital status

Demographic information
General health (including sleep)
Spouse, family, child, and service
member stress
Impact of deployment and military service
Family cohesion, expressiveness,
and conflict
Child behavioral, developmental and
general health
Health services
Alcohol and tobacco use
Military specific questions for
active-duty spouses

Research will inform policy makers and
guide intervention and prevention
strategies related to:
●
●
●
●
●
●
●

Family member resilience
Deployment-related stress
Family support dynamics
Service member and family well-being
Force readiness
Military separation
Barriers to care

Acknowledgements
The Millennium Cohort Study team includes Melissa Bagnell, Gina Creaven, James Davies, Gia Gumbs, Nisara Granado, Lesley Henry,
Dennis Hernando, Jaime Horton, Isabel Jacobson, Kelly Jones, Lauren Kipp, Cynthia LeardMann, Travis Leleu, Gordon Lynch, Jamie
McGrew, Hope McMaster, Stacie Nguyen, Amanda Pietrucha, Teresa Powell, Kari Sausedo, Amber Seelig, Beverly Sheppard, Besa
Smith, Tyler Smith, Katherine Snell, Steven Speigle, Marleen Welsh, Micha Wheeler; Martin White, James Whitmer, and Charlene Wong,
from the Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, CA; Paul Amoroso,
from the Madigan Army Medical Center, Tacoma, WA; Edward Boyko, from the Seattle Epidemiologic Research and Information Center,
Veterans Affairs Puget Sound Health Care System, Seattle, WA; Gary Gackstetter, from the Department of Preventive Medicine and
Biometrics, Uniformed Services University of the Health Sciences, Bethesda, and the Analytic Services (ANSER), Arlington, VA; Gregory
Gray, from the College of Public Health, University of Iowa, Iowa City, IA; Tomoko Hooper, from the Department of Preventive Medicine
and Biometrics, Uniformed Services University of the Health Sciences, Bethesda; James Riddle and Timothy Wells, from the US Air
Force Research Laboratory, Wright-Patterson Air Force Base, OH; and Margaret Ryan from the Naval Hospital Camp Pendleton, Camp
Pendleton, CA.
Additionally, the authors thank Scott Seggerman from the Management Information Division, US Defense Manpower Data Center,
Seaside, CA; Michelle Stoia from the Naval Health Research Center; and all the professionals from the US Army Medical Research and
Materiel Command, especially those from the Military Operational Medicine Research Program, Fort Detrick, MD. We appreciate the
support of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD.
The views expressed in this research are those of the authors and do not necessarily reflect the official policy or position of the
Department of the Navy, Department of the Army, Department of the Air Force, Department of Veterans Affairs, Department of Defense, or
the US Government. Human subjects participated in this study after giving their free and informed consent. This research has been
conducted in compliance with all applicable Federal Regulations governing the Protection of Human Subjects in Research.

We are indebted to the Millennium Cohort Study
members for their continued participation!

MOMRP
Science to Soldier

Formatted for the 13th Annual Force Health Protection Conference, 10-13 Aug 2010, Phoenix, AZ