Cohort profile update: the US Millennium cohort study-evaluating the impact of military experiences on service members and Veteran health
Abstract: This paper provides an update to the original cohort profile paper published a decade ago. The Millennium Cohort Study is the largest, longest-running, prospective study of current and former United States (US) military personnel and is sponsored by the US Departments of Defense (DoD) and Veterans Affairs (VA). While the original study aim, evaluating the health impact of serving in the military, has remained consistent, the spectrum of research topics has expanded to include areas such as social determinants of health. 260 228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years); participants are surveyed every 3-5 years. The original 21-year follow-up period was extended through 2068 to examine health across the lifespan. Longitudinal survey data are linked to data from DoD, VA, and external sources (e.g. medical records, deployment histories, vital statistics, and geospatial data).
Abstract: IMPORTANCE: Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated. OBJECTIVE: To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. DESIGN: Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics. SETTING: VHA outpatient setting. PARTICIPANTS: Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived