U.S. Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, MD 21010, USA.
Knowesis LLC, Fairfax, VA 22031, USA.
Mil Med. 2021 Aug 28;186(9-10):e988-e995. doi: 10.1093/milmed/usaa511.
Understanding how soldiers die after separation from military service, particularly those who die shortly after separating from service, may help to identify opportunities to ease transitions to civilian life.
Mortality data were analyzed for male U.S. Army soldiers who died within 18 months of their separation from service (from 1999 to 2011). Descriptive statistics were calculated for natural, accidental, suicidal, homicidal, undetermined, and legal/operation of war deaths and were stratified by age, component, time in service, and type of discharge. Crude and age-adjusted mortality rates, standardized for all years using the 2004 Regular Army population, were also calculated. The Public Health Review Board of the U.S. Army Public Health Center approved this study as Public Health Practice.
Of the 1,884,653 male soldiers who separated from service during the study period, 3,819 died within 18 months of separation. A majority of all separations were Reserve or National Guard (58%), and 62% of decedents were in the Reserve or National Guard. Deaths from natural causes (38%) were the most common, followed by accident deaths (34%), suicides (20%), homicides (6%), undetermined deaths (2%), and legal/operation of war deaths (<1%). For overall mortality, age-adjusted rates were higher among the male U.S. population when compared to male soldiers who had separated from the Army.
The time period immediately following separation from the Army presents a unique challenge for many soldiers. Developing more effective pre-separation prevention programs that target specific risks requires knowing the causes of death for natural deaths, suicides, and accidents. Over half of all deaths occurring shortly after separation from service are preventable. Continued surveillance of specific causes of preventable deaths following separation can improve pre-separation prevention programs and transitions to post-service care.
了解军人退役后死亡的原因，尤其是那些退役后不久就死亡的军人，可能有助于发现缓解向平民生活过渡的机会。
对 1999 年至 2011 年间退役后 18 个月内死亡的美国陆军男性士兵的死亡数据进行了分析。计算了自然死亡、意外死亡、自杀死亡、他杀死亡、原因不明死亡和合法/作战死亡的描述性统计数据，并按年龄、组成部分、服役时间和退役类型进行了分层。还计算了使用 2004 年常规陆军人口进行所有年份标准化的粗死亡率和年龄调整死亡率。美国陆军公共卫生中心公共卫生审查委员会批准了这项研究，将其作为公共卫生实践。
在研究期间，有 1884653 名男性士兵退役，其中 3819 人在退役后 18 个月内死亡。大多数退役士兵都是预备役或国民警卫队（58%），而 62%的死者是预备役或国民警卫队。自然原因（38%）导致的死亡最为常见，其次是意外死亡（34%）、自杀（20%）、他杀（6%）、原因不明死亡（2%）和合法/作战死亡（<1%）。与已经从陆军退役的男性士兵相比，男性美国人口的整体死亡率调整后更高。
从军队退役后的这段时间对许多士兵来说是一个独特的挑战。制定更有效的退役前预防计划，针对特定风险，需要了解自然死亡、自杀和事故的死亡原因。在退役后不久发生的所有死亡中，有一半以上是可以预防的。继续监测退役后可预防死亡的具体原因，可以改善退役前预防计划和向退役后护理的过渡。
