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This study estimates the effect of deployment location and length on the risk of being diagnosed with PTSD, relative to what it would be from the normal military operations; and examines the comorbidity distribution within the PTSD population. We use a random sample of active-duty personnel serving between 2001 and 2006. We identify PTSD cases from TRICARE medical records and link deployment information from Contingent Tracking System. We estimate logistic regressions to assess the effect of deployment intensity on the rate of PTSD. Among the enlisted population, comparing to those in other duties around the world, deployment to Iraq/Afghanistan increases the odds of developing PTSD substantially, with the largest effect observed for the Navy (OR=9.06, p<0.01) and the smallest effect for the Air Force (OR=1.25, p<0.01). A deployment longer than 180 days increases the odds of PTSD by 1.11 times to 2.84 times, depending on the service, compared to a tour under 120 days. For the Army and the Navy, a deployment to Iraq/Afghanistan further exacerbates the adverse effect of tour length. We observe similar adverse effects among the officers although the magnitude of the deployment effect is smaller. ; Approved for public release; distribution is unlimited.

A firm's decision to drop the offer of employer-sponsored insurance (ESI), reduce eligibility for ESI, or significantly increase employee costs would have serious implications for the health insurance status of currently covered low-income workers. The authors find that at least a third of currently covered low-income workers do not have affordable insurance options outside of the group market. Furthermore, a simulation analysis shows that 54 percent of those workers would become uninsured if their employers were to drop ESI. This would result in an additional 1 million uninsured adults if 10 percent of low-income workers lost their ESI offer, and at least 350,000 uninsured adults if 10 percent of workers in firms with fewer than 100 employees (the firms most likely to drop coverage) lost their ESI. The authors also find that expanding public programs to cover low-income workers would reduce the high uninsurance rate by half, but substantial minorities would remain uninsured.

As requested by OPNAV N17, we conduct an empirical investigation into unit-level variations and peer influences of destructive behaviors in the U.S. military, with a particular emphasis on the Navy and the Marine Corps. We assembled a comprehensive individual-level database that includes demographic, service, unit, and medical information on all active-duty service members from 2003 to 2015. We pursued three aims: 1) to study the relationship between unit composition and unit-level incidences of destructive behaviors, 2) to identify units at "high-risk" of destructive behaviors, and 3) to study how peers within a unit influence each other to engage in destructive behaviors. Among our key findings are: that the vast majority of units in each quarter have at least one member who engages in a destructive behavior; that we can empirically identify high-risk units that have particularly high incidences of multiple destructive behaviors; and that peers meaningfully influence each other's decisions to engage in destructive behaviors, especially among the younger and enlisted personnel. These results can guide military policy-makers toward more informed choices about the optimal allocation of resources between individual- and unit-level interventions to reduce the prevalence of destructive behaviors, and our methodologies can serve as a basis for future research in this area. ; OPNAV N7 ; Prepared for: OPNAV N17B ; OPNAV N17 ; Approved for public release; distribution is unlimited.

The article of record as published may be found at http://dx.doi.org/10.1186/s40359-017-0201-4 ; Psychological health is vital for effective employees, especially in stressful occupations like military and public safety sectors. Yet, until recently little empirical work has made the link between requisite psychological resources and important mental health outcomes across time in those sectors. In this study we explore the association between 14 baseline psychological health attributes (such as adaptability, coping ability, optimism) and mental health outcomes following exposure to combat deployment. ; Naval Postgraduate School Human Research Protection Program ; NPS.2015.0014-CR02-EP4-A.

We study the impact of legal access to alcohol on a range of behavioral and physical outcomes of U.S. Army soldiers in a regression discontinuity design. The wealth of novel data collected by the military on cognitive ability, psychological health, and family history allows us to explore how impacts vary with risk factors for alcohol consumption. Overall, we observe a large and significant increase in drinking after the 21st birthday, but the increases are largest amongst those who were depressed, had a family history of mental health problems, had better coping ability, and had higher cognitive ability. Despite the large increase in consumption, we do not find any meaningful impacts of legal access to alcohol - overall or in any sub-group - on any of the short-term outcomes we observe, including suicidal tendencies, depression, tobacco use, physical fitness, psychological health, deployability, smoking, and job-related infractions. Acknowledging the limitations for extrapolation out of sample, we discuss the policy implications of our results.