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Minority service members experience behavioral health disparities, but patterns vary

• Racial/ethnic minority service members report mostly lower rates of behavioral health problems relative to white service members, although non-Hispanic black and Asian service members are more likely than non-Hispanic whites to report a suicide attempt.
• Military women exhibit greater prevalence of mental health conditions but lower prevalence of substance use problems relative to military men.
• Sexual-minority service members report the greatest number of disparities; these are largely accounted for by sociocultural stressors.
• Different patterns of behavioral health disparities are observed for gay/lesbian service members compared with bisexual service members.

Minority–majority group differences in behavioral health in the military are similar to those in the civilian world, but there are a small number of differences

• Non-Hispanic black and Hispanic service members have higher rates of suicide attempts than their white peers, whereas an opposite pattern was found among racial/ethnic minority civilians relative to their white peers.
• For some outcomes, both military and civilian racial/ethnic minority groups have lower rates than their white peers.
• Gender disparities in the civilian world are mirrored in the military, with both civilian and military women being more likely than men to report mental health problems and less likely to abuse alcohol and use tobacco products.
• Sexual-minority groups in both the military and civilian worlds have higher rates of heavy drinking relative to their heterosexual peers, but this disparity is even greater in the military.

Behavioral health disparities, in which socially disadvantaged groups—such as racial/ethnic minorities, women, and sexual-orientation minorities—experience greater risk for certain mental health and substance use problems, are well documented in the general population. Less is known about whether similar behavioral health disparities exist among military service members. The U.S. Department of Defense (DoD) desires to understand whether the behavioral health disparities seen in the civilian population also exist in the military, as this knowledge is important to helping DoD target its efforts to address the needs of service members and improve force readiness.

To investigate this issue, the authors examined (1) whether minority-group service members are more likely to experience mental health and substance use problems relative to their majority counterparts in the military and (2) whether minority–majority group differences in behavioral health in the military are similar to or different from those in the civilian population.

The authors used data from the 2015 Health Related Behaviors Survey, the 2015 National Survey on Drug Use and Health, the 2015 and 2016 Behavioral Risk Factor Surveillance System, and the 2015 National Health and Nutrition Examination Survey. Behavioral health outcomes include mental health (e.g., depression, suicide behaviors, posttraumatic stress disorder) and substance use (e.g., problematic alcohol use, tobacco use) conditions.

• Chapter One

  Introduction

• Chapter Two

  Literature Review: Minority Group Differences in Behavioral Health Outcomes

• Chapter Three

  Factors Related to Military Minority Group Differences in Behavioral Health Outcomes

• Chapter Four

  Military Versus Civilian Comparisons in Behavioral Health Outcomes

• Chapter Five

  Key Findings and Policy Implications

• Appendix A

  Methodology

• Appendix B

  Mental Health Care Service Utilization Among Minority Active Duty Service Members