Unfit for Service: The Implications of Rising Obesity for U.S. Military Recruitment

This paper contributes to the literature on the labor market consequences of unhealthy behaviors and poor health by examining a previously underappreciated consequence of the rise in obesity in the United States: challenges for military recruitment. Specifically, this paper estimates the percent of the U.S. military-age population that meets, and does not meet, current active duty enlistment standards for weight-for-height and percent body fat for the U.S. Army, using data from the series of National Health and Nutrition Examination Surveys that spans 1959-2008. We calculate that the percentage of military-age adults ineligible for enlistment because they are overweight and overfat doubled for men and tripled for women during that time. We document disparities across race, education, and age in meeting the standards, and finds that a further rise of just 1% in weight and body fat would further reduce eligibility for military service by over 600,000 men and 1 million women of military age. The paper concludes with a discussion of the implications for military recruitment and military policy.military, obesity, labor

Unfit for Service: The Implications of Rising Obesity for U.S. Military Recruitment

Excess body weight or body fat hinders performance of military duties. As a result, the U.S. military has weight-for-height and percent body fat standards for enlistment. This paper estimates the number and percent of military-age civilians who meet, and do not meet, the current active duty enlistment standards for weight and body fat for the four major armed services (Army, Navy, Air Force, Marine Corps), using data from the full series of National Health and Nutrition Examination Surveys that spans 1959-2008. We find that the percent of civilian military-age men and women who satisfy current military enlistment standards for weight-for-height and percent body fat has fallen considerably. This is due to a large increase in the percentage who are both overweight and overfat, which roughly doubled for men and more than tripled for women between 1959-62 and 2007-08. As of 2007-08, 5.7 million men (11.70%) and 16.5 million women (34.65%) of military age exceed the U.S. Army’s enlistment standards for weight-for-height and percent body fat. The implications of rising obesity for the U.S. military are especially acute given its recent difficulties in recruiting a sufficient number of new high quality service members in the midst of combat operations overseas.

How Has the Opioid Crisis Affected Health, Health Care Use, and Crime in the United States?

The U.S. opioid crisis is the deadliest drug crisis in the nation’s history and is not abating. This brief summarizes what is known about the relationships between opioid misuse, health, healthcare use, and crime. The authors show that the opioid crisis has led to worsening health, increased mortality, increased healthcare use, and modest increases in crime. In addition, the policies designed to curb opioid misuse and its associated harms have had only limited success

More or Less of Me and You : Self-Relevance Augments the Effects of Item Probability on Stimulus Prioritization

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Intended and Unintended Effects of E-cigarette Taxes on Youth Tobacco Use

Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has prompted aggressive regulation by state and local governments. Between 2010 and 2019, ten states and two large counties adopted ENDS taxes. Applying a continuous treatment difference-in-differences approach to data from two large national datasets (Monitoring the Future and the Youth Risk Behavior Surveillance System), this study explores the impact of ENDS taxes on youth tobacco use. We find that ENDS taxes reduce youth e-cigarette consumption, with estimated e-cigarette tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax elasticities, suggesting economic substitution between cigarettes and e-cigarettes for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may more than fully offset any public health gains

A Randomized Trial to Identify Accurate and Cost-Effective Fidelity Measurement Methods for Cognitive-Behavioral Therapy: Project FACTS Study Protocol

Background: This randomized trial will compare three methods of assessing fidelity to cognitive-behavioral therapy (CBT) for youth to identify the most accurate and cost-effective method. The three methods include self-report (i.e., therapist completes a self-report measure on the CBT interventions used in session while circumventing some of the typical barriers to self-report), chart-stimulated recall (i.e., therapist reports on the CBT interventions used in session via an interview with a trained rater, and with the chart to assist him/her) and behavioral rehearsal (i.e., therapist demonstrates the CBT interventions used in session via a role-play with a trained rater). Direct observation will be used as the gold-standard comparison for each of the three methods. Methods/design: This trial will recruit 135 therapists in approximately 12 community agencies in the City of Philadelphia. Therapists will be randomized to one of the three conditions. Each therapist will provide data from three unique sessions, for a total of 405 sessions. All sessions will be audio-recorded and coded using the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale. This will enable comparison of each measurement approach to direct observation of therapist session behavior to determine which most accurately assesses fidelity. Cost data associated with each method will be gathered. To gather stakeholder perspectives of each measurement method, we will use purposive sampling to recruit 12 therapists from each condition (total of 36 therapists) and 12 supervisors to participate in semi-structured qualitative interviews. Discussion: Results will provide needed information on how to accurately and cost-effectively measure therapist fidelity to CBT for youth, as well as important information about stakeholder perspectives with regard to each measurement method. Findings will inform fidelity measurement practices in future implementation studies as well as in clinical practice. Trial registration: NCT02820623, June 3rd, 2016

Resolving issues with environmental impact assessment of marine renewable energy installations

Growing concerns about climate change and energy security have fueled a rapid increase in the development of marine renewable energy installations (MREIs). The potential ecological consequences of increased use of these devices emphasizes the need for high quality environmental impact assessment (EIA). We demonstrate that these processes are hampered severely, primarily because ambiguities in the legislation and lack of clear implementation guidance are such that they do not ensure robust assessment of the significance of impacts and cumulative effects. We highlight why the regulatory framework leads to conceptual ambiguities and propose changes which, for the most part, do not require major adjustments to standard practice. We emphasize the importance of determining the degree of confidence in impacts to permit the likelihood as well as magnitude of impacts to be quantified and propose ways in which assessment of population-level impacts could be incorporated into the EIA process. Overall, however, we argue that, instead of trying to ascertain which particular developments are responsible for tipping an already heavily degraded marine environment into an undesirable state, emphasis should be placed on better strategic assessment.Publisher PDFPeer reviewe

Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal Health

Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH)'s experience in setting and meeting priorities

Be Free? The European Union's post-Arab Spring Women's Empowerment as Neoliberal Governmentality

This article analyses post-Arab Spring EU initiatives to promote women's empowerment in the Southern Mediterranean region. Inspired by Foucauldian concepts of governmentality, it investigates empowerment as a technology of biopolitics that is central to the European neoliberal model of governance. In contrast to dominant images such as normative power Europe that present the EU as a norm-guided actor promoting political liberation, the article argues that the EU deploys a concept of functional freedom meant to facilitate its vision of economic development. As a consequence, the alleged empowerment of women based on the self-optimisation of individuals and the statistical control of the female population is a form of bio-power. In this regard, empowerment works as a governmental technology of power instead of offering a measure to foster fundamental structural change in Middle Eastern and North African (MENA) societies. The EU therefore fails in presenting and promoting an alternative normative political vision distinct from the incorporation of women into the hierarchy of the existing market society