title: Mortality surveillance in the U.S. Army, 2005-2011.
abstract: OBJECTIVE
  Mortality rates in the U.S. Army from 2005 to 2011 were examined over time and compared to the U.S. general population.
  
  
  METHODS
  Cases were U.S. Army Soldiers (active duty or activated National Guard/Reserve) with dates of death between 2005 and 2011 and between 18 and 64 years of age in the Department of Defense Medical Mortality Registry. Age- and sex-adjusted annual mortality rates (AR) were calculated for each category of death and examined via linear regression. Proportions of underlying causes of death were also examined.
  
  
  RESULTS
  The trend in AR in the U.S. Army significantly decreased for combat deaths, the average annual percent change (AAPC) = 15.2% decrease in the log of the rate (LAR); p = 0.04 and accident deaths, AAPC = 5.4% decrease in the LAR; p = 0.002 and significantly increased for suicides, AAPC = 10.6% increase in the LAR; p = 0.001. The trend in AR for suicides for the Army was significantly different compared to the U.S. general population, AAPC = 11.0% increase in the LAR; p < 0.001.
  
  
  CONCLUSIONS
  Trends in rates of combat deaths and accident deaths declined although rates of suicides increased. The Army suicide rate increased in comparison to the United States. 70% of accident deaths were transportation related. Almost 70% of suicides and homicides were firearm related.
authors.affiliation: Behavioral Health Surveillance Section, Behavioral and Social Health Outcomes Program (BSHOP) Epidemiology & Disease Surveillance Portfolio (EDS) Army Institute of Public Health (AIPH),U.S. Army Public Health Command (USAPHC), 5158 Blackhawk Road, E1570, Aberdeen Proving Ground-Edgewood Area (APG-EA), MD 21010.
authors.forename: Brent E
authors.initials: BE
authors.lastname: Mancha
authors.affiliation: Behavioral Health Surveillance Section, Behavioral and Social Health Outcomes Program (BSHOP) Epidemiology & Disease Surveillance Portfolio (EDS) Army Institute of Public Health (AIPH),U.S. Army Public Health Command (USAPHC), 5158 Blackhawk Road, E1570, Aberdeen Proving Ground-Edgewood Area (APG-EA), MD 21010.
authors.forename: Eren Youmans
authors.initials: EY
authors.lastname: Watkins
authors.affiliation: Behavioral Health Surveillance Section, Behavioral and Social Health Outcomes Program (BSHOP) Epidemiology & Disease Surveillance Portfolio (EDS) Army Institute of Public Health (AIPH),U.S. Army Public Health Command (USAPHC), 5158 Blackhawk Road, E1570, Aberdeen Proving Ground-Edgewood Area (APG-EA), MD 21010.
authors.forename: Jerrica N
authors.initials: JN
authors.lastname: Nichols
authors.affiliation: Mortality Surveillance Division, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover Air Force Base, DE 19902-5051.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Seguin
authors.affiliation: Behavioral Health Surveillance Section, Behavioral and Social Health Outcomes Program (BSHOP) Epidemiology & Disease Surveillance Portfolio (EDS) Army Institute of Public Health (AIPH),U.S. Army Public Health Command (USAPHC), 5158 Blackhawk Road, E1570, Aberdeen Proving Ground-Edgewood Area (APG-EA), MD 21010.
authors.forename: Amy Millikan
authors.initials: AM
authors.lastname: Bell
mesh_terms: D000059:Accidents / Q000401:mortality; D000293:Adolescent; D000328:Adult; D002423:Cause of Death / Q000639:trends*; D005260:Female; D006708:Homicide / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D011159:Population Surveillance; D013405:Suicide / Q000639:trends; D014481:United States / Q000453:epidemiology; D014857:Warfare; D055815:Young Adult