Military Families with Members with Special Health Care Needs

Background/Purpose: The Department of Defense and Veteran’s Administration report that there are approximately 23 million people, roughly 7% of the population, who are either veterans or current military members. The Centers for Disease Control and Prevention report that there are approximately 56.7 million individuals, roughly 17% of the population, with disabling special health care needs (SHCN). Despite the prevalence of these two groups, coupled with the increased likelihood for military service members and veterans to experience disability, research has not explored the overlap of these two populations. Extrapolating from the above estimates, military families experiencing a SHCN could represent 1% of the population—an estimated 3.2 million people.  To accurately address the needs of this population, an understanding of who these families are, including their familial composition, is warranted to identify appropriate intervention services.

This study seeks to investigate the intersectionality of families with a military connection and families experiencing SHCN and to describe composition differences among families in the US who have a connection to the US military, have a member with SHCN, and families experiencing both. 

Methods: This descriptive study utilizes the 2013 National Health Interview Survey (NHIS) family module to identify how the population of military families experiencing SHCN compares in composition to the overall population. The NHIS includes over 42,000 families—over 2,200 of whom identified as military-connected. The NHIS surveys civilians living outside of institutional settings.  Active duty military members are excluded from the survey, but their families are included, making it appropriate for a preliminary investigation into the intersectionality of military families experiencing SHCN.

Military connectedness was measured through access to military health insurance.  SHCN were measured through limitations including but not limited to memory, mobility, and physical activity.  Differences across these groups in family size, family composition, and family age (i.e., indicators of individuals aged 65 or older, or under 18) were examined through χ² and t-tests.

Comparative tests (I.e., χ² and t-tests) were performed to identify how the population of military families with family members with SHCN compares in composition to the overall population.

Results: While the NHIS under-samples military members (5.2% compared to the 7% previously reported), over 2% (double the expected proportion) of the sample was identified as both military-connected and experiencing SHCN. Military-connected families more frequently (+14%) reported having a family member with SHCN than families without a military connection (χ²[1] = 213.708, p < .001).  Families experiencing SHCN were more often military-connected if there was a member over 65 years of age in the home (χ²[1] = 450.553, p < .001), but less often if a member was under 18 years of age (χ²[1] = 114.582, p < .001).

Conclusions/Implications:  Findings indicate that military-connected families experiencing SHCN differ from families with either a member with SHCN or military connectedness.  There are concerns that military families may under-report SHCN due to service related stigma and career interference.  While programs exist, military families may not receive sufficient services. Knowledge of family composition may help practitioners identify appropriate services.