title: Risk factors for accident death in the U.S. Army, 2004-2009.
abstract: BACKGROUND
  Accidents are one of the leading causes of death among U.S. active-duty Army soldiers. Evidence-based approaches to injury prevention could be strengthened by adding person-level characteristics (e.g., demographics) to risk models tested on diverse soldier samples studied over time.
  
  
  OBJECTIVE
  To identify person-level risk indicators of accident deaths in Regular Army soldiers during a time frame of intense military operations, and to discriminate risk of not-line-of-duty from line-of-duty accident deaths.
  
  
  METHODS
  Administrative data acquired from multiple Army/Department of Defense sources for active duty Army soldiers during 2004-2009 were analyzed in 2013. Logistic regression modeling was used to identify person-level sociodemographic, service-related, occupational, and mental health predictors of accident deaths.
  
  
  RESULTS
  Delayed rank progression or demotion and being male, unmarried, in a combat arms specialty, and of low rank/service length increased odds of accident death for enlisted soldiers. Unique to officers was high risk associated with aviation specialties. Accident death risk decreased over time for currently deployed, enlisted soldiers and increased for those never deployed. Mental health diagnosis was associated with risk only for previous and never-deployed, enlisted soldiers. Models did not discriminate not-line-of-duty from line-of-duty accident deaths.
  
  
  CONCLUSIONS
  Adding more refined person-level and situational risk indicators to current models could enhance understanding of accident death risk specific to soldier rank and deployment status. Stable predictors could help identify high risk of accident deaths in future cohorts of Regular Army soldiers.
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lisa
authors.initials: L
authors.lastname: Lewandowski-Romps
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Christopher
authors.initials: C
authors.lastname: Peterson
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Berglund
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Stacey
authors.initials: S
authors.lastname: Collins
authors.affiliation: U.S. Army Institute of Public Health, Aberdeen Proving Ground.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Cox
authors.affiliation: U.S. Army Institute of Public Health, Aberdeen Proving Ground.
authors.forename: Keith
authors.initials: K
authors.lastname: Hauret
authors.affiliation: U.S. Army Institute of Public Health, Aberdeen Proving Ground.
authors.forename: Bruce
authors.initials: B
authors.lastname: Jones
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Colter
authors.initials: C
authors.lastname: Mitchell
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Nansook
authors.initials: N
authors.lastname: Park
authors.affiliation: National Institute of Mental Health, Uniformed Services University School of Medicine, Bethesda, Maryland.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla; Veterans Affairs San Diego Healthcare System, San Diego, California.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, Maryland.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan. Electronic address: sheering@umich.edu.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Heeringa
mesh_terms: D000056:Accident Prevention; D000062:Accidents, Occupational / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data; D000328:Adult; D002423:Cause of Death; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology