title: Risk factors for medical disability in U.S. enlisted Marines: fiscal years 2001 to 2009.
abstract: OBJECTIVE
  To assess factors associated with medical disability in the U.S. Marine Corps.
  
  
  METHODS
  Case-control study enrolling 11,554 medical disability cases of U.S. enlisted Marines referred to the Physical Evaluation Board fiscal year 2001 to 2009 and 42,216 controls frequency matched to cases in a 4:1 ratio on year of accession into the service were analyzed utilizing bivariate and multivariate logistic regression analysis.
  
  
  RESULTS
  Increased age and body mass index at accession were associated with higher odds of medical disability. Females (odds ratio adjusted [OR(adj)] = 1.3, 95% confidence interval [CI] = 1.2-1.3) have higher odds of disability than males. "Healthy Warrior Effect" was observed in that those who deployed (OR(adj) = 0.48, 95% CI = 0.46-0.50) had decreased odds of medical disability than those who did not deploy. Medical waivers at accession (OR(adj) = 1.12, 95% CI = 1.01-1.23) increased the odds of medical disability.
  
  
  CONCLUSIONS
  Continued surveillance of the disability evaluation system is needed to help develop preventive measures and to help policy makers establish evidence-based policies on accession, deployment, and retention standards over the lifecycle of service members.
authors.affiliation: Preventive Medicine Department, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Sikorski
authors.forename: Maura A
authors.initials: MA
authors.lastname: Emerson
authors.forename: David N
authors.initials: DN
authors.lastname: Cowan
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015989:Healthy Worker Effect; D006801:Humans; D016015:Logistic Models; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult