Executive SummaryIntroductionCompare the Health of Those Who Have Served ReportDesignFindingsCore MeasuresBehaviorsPolicyClinical CareHealth OutcomesAppendixData Sources and MeasuresMethodologyLimitationsCrude RatesThe TeamAdvisory Group
America’s Health Rankings Health of Those Who Have Served Report was developed with guidance from a panel of experts representing military, veteran, and public health organizations who informed the selection of health measures and other methodological features of the report. Visit the Advisory Group page for more information on the expert panel.
This study builds on data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS), the world’s largest, annual population-based telephone survey system tracking health conditions and risk behaviors in America since 1984. With an annual sample of nearly half a million, BRFSS also has one of the most robust samples of individuals who have ever served in active duty (nearly 60,000 annually).
The selection of the 24 BRFSS indicators that make up America’s Health Rankings® Health of Those Who Have Served Report was driven by three factors:
- Overall measures represent health conditions, behaviors, and care issues most pertinent to those who have ever served on active duty.
- Individual measures have sufficient sample and cell sizes to assure reliable estimates for those who have served and not served by age, gender, race and ethnicity, and income.
- Each selected measure is amenable to change. In other words each measure can be modified by policy or intervention to see measurable change or improvement.
With the change in BRFSS survey methodology in 2011, data prior to this year cannot be compared with more recent years. As such, estimates generated for this report serve as an important benchmark for subsequent years.
This report utilizes four years of data, 2011 to 2014, which were weighted and pooled into two-year periods (yielding a total sample of nearly one million per period) and are presented as follows:
- Baseline 2011 to 2012: provides a baseline by which to compare trends over time; and
- Current 2013 to 2014: provides the most current year’s data and an opportunity to measure change since the baseline year.
Those who have served on active duty are generally older than those who have not served. For example in 2014, 75% of veterans were 55 years or older, as compared with only 34% of non-veterans in this age group. The BRFSS sample also follows a similar age distribution. To prevent age from skewing results, the BRFSS data were age-adjusted to a U.S. Standard Population. This assumes that both groups have the same age structure, leading to fairer, more realistic comparisons. Age-adjusted prevalence estimates should be understood as relative estimates, not as actual measures of burden.