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

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

Economic Conditions at School Leaving and Sleep Patterns Across the Life Course

We use data drawn from the National Longitudinal Survey of Youth 1979 Cohort to study the effects of leaving school in an economic downturn on sleep quality and quantity. We account for the potential endogeneity of economic conditions at school leaving using instrumental variables based on birth year and early state of residence. We find that men who leave school in an economic downturn initially experience lower quality sleep, but these men are able to experience improved sleep quality over time. Women who leave school in an economic downturn experience better sleep quality, although the effect emerges over time. We find that leaving school in an economic downturn increases sleep quantity among men and women. We document heterogeneity by work type.12 month embargo; Published online: 29 April 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Personality disorders, alcohol use, and alcohol misuse

Personality disorders (PDs) are psychiatric conditions that manifest early in life from a mixture of genetics and environment, are highly persistent, and lead to substantial dysfunction for the affected individual and those with whom s/he interacts. In this study we offer new information on the associations between PDs and alcohol use/misuse. Specifically, we consider all 10 PDs recognized by the American Psychiatric Association; carefully address important sources of bias in our regression models; and study heterogeneity across PDs, drinking pattern, and gender. To investigate the relationships between PDs and alcohol consumption we analyze data from the 2004/2005 National Epidemiological Survey of Alcohol and Related Conditions (N=34,653). We construct measures of any drinking, drinking quantity, and patterns of misuse that could lead to significant social costs including drinking to intoxication, driving after drinking, drinking during the day, and alcohol abuse/dependence. Results show that persons with PDs are significantly more likely to use and misuse alcohol, although associations vary across gender. Moreover, antisocial, borderline, histrionic, and narcissistic PDs display the strongest links with alcohol use and misuse, and the relationships are strongest among the heaviest drinkers. These findings have important public health implications and underscore the potential social costs associated with mental health conditions

Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers

We examine how substance use disorder (SUD) treatment providers respond to private insurance expansions induced by state equal coverage (‘parity’) laws for SUD treatment vis-à-vis general healthcare services. Economic theory suggests that such laws will lead to changes in provider behaviors. We use data on licensed specialty SUD treatment providers in the United States between 1997 and 2010 in a differences-in-differences analysis. During this period, 12 states implemented laws that require equality in coverage for SUD treatment. Following the passage of a state parity law we find that providers are less likely to participate in public markets, are less likely to offer price discounts to patients, and increase the quantity of healthcare provided. Further we find evidence that treatment intensity declines following passage of a parity law and heterogeneity in effects across ownership status

Health Insurance Expansions and Providers’ Behavior: Evidence from Substance-Use- Disorder Treatment Providers

We examine how substance-use-disorder (SUD) treatment providers respond to private-insurance expansions induced by states’ equal coverage (parity) laws for SUD treatment vis-à-vis general health care services. Economic theory suggests that such laws will lead to changes in providers’ behaviors. We use data on licensed specialty SUD treatment providers in the United States between 1997 and 2010 in a differences-in-differences analysis. During this period, 12 states implemented laws that require equality in coverage for SUD treatment. Following the passage of a state parity law, we find that providers are less likely to participate in public markets, are less likely to offer price discounts to patients, and increase the quantity of health care provided. Further, we find evidence of decreases in treatment intensity following passage of a parity law and of heterogeneity in effects across ownership status