{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T17:48:11Z","timestamp":1785865691773,"version":"3.56.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100003896","name":"the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Department of War"},{"name":"the Departments of the Army, Navy, or Air Force. Mention of trade names"},{"name":"the U.S. Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In 2016, all military occupational specialties in the United States Marine Corps (USMC) were opened to women, including ground combat roles. Limited service-specific data exist regarding musculoskeletal injury (MSKI) and behavioral health (BH) outcomes among female Marines. This study evaluates the prevalence and risk of MSKI and BH diagnoses among female Marines in ground combat specialties (GCSs) compared with non-ground combat specialties (NGCSs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cross-sectional analysis of all active duty female Marines from 2016 to 2023 using Military Health System data. MSKI and BH diagnoses were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Women with pregnancy-related diagnoses during or within 12 months before the study period were excluded. Multivariable logistic regression models were used to assess associations between occupational specialty and MSKI or BH diagnoses, adjusting for age, race and ethnicity, rank, body mass index, tobacco use, and alcohol\/substance use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 30,280 active duty female Marines were identified for inclusion between January 2016 to December 2023; of whom 218 (0.7%) were in the GCS. The majority of females in the GCS were between the ages of 18-23 (58.7%), of White race (70.6%), and in an enlisted rank (78.9%). The prevalence of women in a GCS increased over the study period, from 16.9 per 1,000 in 2016 to 21.5 per 1,000 in 2023. Female Marines in GCS had no significant odds of MSKI diagnosis (OR = 1.09, 95% CI,\u2009=\u20090.80-1.49) or BH disorder (OR = 0.96, 95% CI,\u2009=\u20090.70-1.30) when compared to those in a non-GCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among active duty female Marines, assignment to a GCS was not associated with increased risk of MSKI or BH diagnoses. Despite occupational integration, the overall burden of MSKI and BH conditions remains substantial, underscoring the need for continued surveillance and targeted prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag355","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:18:51Z","timestamp":1785237531000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Female Marines in the Ground Combat Element and Its Association With Musculoskeletal Injuries and Behavioral Health Disorders, 2016-2023"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3794-1333","authenticated-orcid":false,"given":"Katelyn","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Laboratory Animal Resources, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri","family":"Bortz","sequence":"additional","affiliation":[{"name":"School of Medicine, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6660-1229","authenticated-orcid":false,"given":"Amanda","family":"Banaag","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]},{"name":"Henry M. Jackson Foundation for the Advancement in Military Medicine, Inc. , Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1377-8615","authenticated-orcid":false,"given":"Tracey P\u00e9rez","family":"Koehlmoos","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"2026080412431404800_usag355-B1","author":"U.S. Department of Defense","year":"2024"},{"key":"2026080412431404800_usag355-B2","author":"U.S. Department of the Navy; U.S. Marine Corps","year":"1997"},{"key":"2026080412431404800_usag355-B3","first-page":"1","author":"Stremlow","year":"1986"},{"key":"2026080412431404800_usag355-B4","author":"Marine Corps History Division"},{"key":"2026080412431404800_usag355-B5","author":"U.S. Government Printing Office"},{"key":"2026080412431404800_usag355-B6","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1111\/gwao.12835","article-title":"Badass marines: resistance practices against the introduction of women in the Dutch military","volume":"29","author":"Van Douwen","year":"2022","journal-title":"Gender Work Organ"},{"key":"2026080412431404800_usag355-B7","author":"Moore"},{"key":"2026080412431404800_usag355-B8","author":"Schaefer"},{"key":"2026080412431404800_usag355-B9","author":"Military OneSource"},{"key":"2026080412431404800_usag355-B10","doi-asserted-by":"publisher","first-page":"e1024\u20139","DOI":"10.1093\/milmed\/usac022","article-title":"Comparison of musculoskeletal injury and behavioral health diagnoses among U.S. Army active duty servicewomen in ground combat and non-ground combat military occupational specialties","volume":"187","author":"Phillips","year":"2022","journal-title":"Mil Med"},{"key":"2026080412431404800_usag355-B11","author":"Desrosiers"},{"key":"2026080412431404800_usag355-B12","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1080\/08995605.2012.695255","article-title":"Stressors experienced by women within marine corps families: a qualitative study of discourse within an online forum","volume":"24","author":"Jennings-Kelsall","year":"2012","journal-title":"Mil Psychol"},{"key":"2026080412431404800_usag355-B13","doi-asserted-by":"publisher","first-page":"e1698","DOI":"10.1093\/milmed\/usaf642","article-title":"Comparison of musculoskeletal injury and behavioral health diagnoses among United States army active duty servicewomen in ground combat versus non-ground combat specialties: an update (2020-2023)","volume":"191","author":"Henkenius","year":"2026","journal-title":"Mil Med"},{"key":"2026080412431404800_usag355-B14","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa040603","article-title":"Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care","volume":"351","author":"Hoge","year":"2004","journal-title":"N Engl J Med"},{"key":"2026080412431404800_usag355-B15","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaf621","article-title":"Trends in upper extremity injuries in female marines following the addition of the pull-up as a physical fitness test event","author":"Arnold","journal-title":"Mil Med"},{"key":"2026080412431404800_usag355-B16","doi-asserted-by":"publisher","first-page":"e1784","DOI":"10.1093\/milmed\/usad470","article-title":"The impact of the COVID-19 pandemic on the military health system\u2019s care of military sexual assault","volume":"189","author":"Lorei","year":"2024","journal-title":"Mil Med"},{"key":"2026080412431404800_usag355-B17","doi-asserted-by":"publisher","first-page":"e1461\u201371","DOI":"10.1093\/milmed\/usaa027","article-title":"Musculoskeletal injuries and United States army readiness part I: overview of injuries and their strategic impact","volume":"185","author":"Molloy","year":"2020","journal-title":"Mil Med"},{"key":"2026080412431404800_usag355-B18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/milmed\/usae308","article-title":"Musculoskeletal injuries in female U.S. active duty service members: prevalence\/incidence, health care utilization, and cost analysis spanning fiscal years 2016\u20132021","volume":"189","author":"Colahan","year":"2024","journal-title":"Mil Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag355\/70481585\/usag355.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag355\/70481585\/usag355.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:43:22Z","timestamp":1785861802000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag355\/8751208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":18,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag355","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"article-number":"usag355"}}