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Cutting-edge interactive disease surveillance maps support Combatant Commands

This image shows Middle East respiratory syndrome coronavirus particle envelope proteins immunolabeled with rabbit HCoV-EMC/2012 primary antibody and goat anti-rabbit 10-nanometer gold particles. (National Institute of Allergy and Infectious Disease photo) This image shows Middle East respiratory syndrome coronavirus particle envelope proteins immunolabeled with rabbit HCoV-EMC/2012 primary antibody and goat anti-rabbit 10-nanometer gold particles. (National Institute of Allergy and Infectious Disease photo)

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Armed Forces Health Surveillance Branch | Integrated Biosurveillance | Global Emerging Infections Surveillance | Combat Support

As an organization that receives countless streams of data and information, the staff at the Armed Forces Health Surveillance Branch (AFHSB) knows quite a bit about the global threats posed by known and emerging infectious diseases of military relevance. Today, AFHSB’s Integrated Biosurveillance (IB) Section is taking revolutionary steps to produce even more relevant, user-driven health surveillance products that enable its customers, especially the U.S. Combatant Commands, to focus on what they need to know to provide a medically ready military force in peace and wartime.

Interactive surveillance maps created by the Armed Forces Health Surveillance Branch show the global threats posed by endemic and emerging infectious diseases that help Combatant Commands provide a medically ready military force.Interactive surveillance maps created by the Armed Forces Health Surveillance Branch show the global threats posed by endemic and emerging infectious diseases that help Combatant Commands provide a medically ready military force.

 

AFHSB recently released new, web-based interactive disease surveillance maps that allow Combatant Commanders to zoom to an area of interest, click on individual points, and extract exactly what they need to know about a particular disease event. The accompanying text can contain relevant links, sources, and images in their native, high resolution format. With the click of a button, an analyst can instantly upload data from his or her terminal in Washington, D.C., for a decision-maker stationed in Germany, with information that is specifically tailored for that organization’s needs.

As part of the Defense Health Agency’s role as a combat support agency, “it is vital for AFHSB to provide timely health surveillance information to the Combatant Commands with the appropriate flexibility and agility required to support Force Health Protection decisions,” said Mr. Juan Ubiera, chief of the IB section. “These dynamic products provide Department of Defense leaders with a large amount of information in a manner that supports both rapid operational decisions and a deeper understanding of what's going on.”

AFHSB’s latest product in this gallery is The Avian Influenza Epidemic. This product leverages data from near real-time disease reporting systems along with geocoding capabilities to present an emerging picture of the avian influenza A (AI) virus subtypes currently affecting avian populations globally. An overlay of the global flight paths of the wild birds that carry AI viruses enables the viewer to connect outbreaks of particular AI subtypes to the migratory routes that may have facilitated their introduction. This product also depicts human cases of infection with novel and variant influenza A viruses, conveying Defense Department relevance of these occurrences through an in-house designed infographic, all within a dynamic environment.

This new release joins other products in the IB interactive gallery such as The MERS-CoV Epidemic, an interactive surveillance product that guides the user through the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in a new and captivating format. Users will also find surveillance products on the 2014 Ebola outbreak in West Africa and the emergence of the Chikungunya virus in the Americas.

To create these visualizations, AFHSB is implementing leading-edge, commercial-off-the-shelf tools designed by Esri, a geospatial service provider. Our analysts are able to standardize and edit data directly from their desktops; with a few keystrokes, the data are sent to the cloud, instantly updating our products with the latest information. This represents a major leap forward from AFHSB’s current email-based distribution system.

“This type of product and [the] attractive and easy to read visuals are very useful for the education of leadership and others in our division on the importance of avian influenza,” Dr. Jennifer Steele, the Infectious Disease Subject Matter Expert for U.S. European Command after previewing The Avian Influenza Epidemic product. “The maps and graphics help explain why [avian influenza] elsewhere in the world and in other species is important from a human health and operational perspective.” 

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Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2016

Infographic
6/19/2017
Did you know  … ? In 2016, essential hypertension accounted for 52,586 encounters for health care among 29,612 active component service members in the U.S. Armed Forces. Of all cardiovascular diseases, essential hypertension is by far the most common specific condition diagnosed among active duty service members. Untreated hypertension increases the risks of subsequent ischemic heart disease (heart attack), cerebrovascular disease (stroke), and kidney failure. CHART: Healthcare burdens attributable to cardiovascular diseases, active component, U.S. Armed Forces, 2016 Major condition: •	For all other cardiovascular the number of medical encounters was 70,781, Rank 29, number of individuals affected was 35,794 with a rank of 30. The number of bed days was 4,285 with a rank of 21. •	For essential hypertension the number of medical encounters was 52,586, rank 35, number of individuals affected was 29,612 with a rank of 35. The number of bed days was 151 with a rank of 86. •	For cerebrovascular disease the number of medical encounters was 7,772, rank 79, number of individuals affected was 1,708, with a rank of 96. The number of bed days was 2,107 with a rank of 32. •	For ischemic heart disease the number of medical encounters was 6,629, rank 83, number of individuals affected 2,399 with a rank of 87. The number of bed days was 1,140 with a rank of 42. •	For inflammatory the number of medical encounters was 2,221, rank 106, number of individuals affected 1,302 with a rank of 97. The number of bed days was 297 with a rank of 72. •	For rheumatic heart disease the number of medical encounters was 319, rank 125, number of individuals affected 261, with a rank of 121. The number of bed days was 2 with a rank of 133. Learn more about healthcare burdens attributable to various diseases and injuries by visiting Health.mil/MSMRArchives. #LoveYourHeart Infogaphic graphic features transparent graphic of a man’s heart illuminated within his chest.

This infographic documents healthcare burdens attributable to cardiovascular diseases among active component, U.S. Armed Forces in 2016.

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Viral Hepatitis B, Active Component, U.S. Armed Forces, 2007 – 2016

Infographic
6/19/2017
Hepatitis B virus (HBV) is a liver infection that can cause both acute and chronic disease in affected individuals. HBV is transmitted when the blood, serum or another body fluid from an infected individual enters the body of someone who is not infected. This report estimates the frequencies, incidence rates, trends, and correlates of risk of acute and chronic HBV infections among active component U.S. military members during 2007- 2016. Findings: During 2007 – 2016, there were 1,258 and 1,259 incident diagnoses of acute and chronic hepatitis B virus (HBV) infection, respectively. The overall incidence rates of both diagnoses were both 10.0 per 100,000 person-years (p-yrs.). 1 of 10 acute cases and nearly 1 of 5 chronic cases had at least 1 HBV-related hospitalization. The rates of hospitalized cases of acute hepatitis B decreased by 53.1% over the 10-year period. The graph shows the number of individuals diagnosed as bar graphs and incidence rates per 100,000 p-yrs. as line graphs. Key chart includes: blue for number of acute hepatitis B individuals, beige for number of chronic hepatitis B individuals, dash lines as rate of chronic hepatitis B incidence rates, and dotted line to show the acute hepatitis B incidence rates. High risk of acute hepatitis B:  •	Female •	Asian/Pacific Islander and non-Hispanic black service members •	Navy members •	Personnel working in healthcare occupations •	Recruits and service members with no history of deployment High risk of chronic hepatitis B: •	Female •	Asian/Pacific Islander, “Other” ethnicity, and non-Hispanic black service members •	Navy and Army service members •	Personnel working in healthcare occupations •	Non-recruit status Learn more about HBV infection in the U.S. military at Health.mil/MSMR Image of small male figure displays on the infographic and his liver is highlighted. Also pictured are male and female stick figures to depicting military members.

This infographic documents the frequencies, incidence rates, trends, and correlates of risk of acute and chronic HBV infections among active component U.S. military members during 2007-2016.

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Risk Factors for Tinea Pedis Infections (Athlete’s Foot) among U.S. Armed Forces

Infographic
6/19/2017
Athlete’s foot is a chronic fungal infection of the feet and toes that is common among military service members. Risk factors for infection include: •	High-intensity training •	Heavy sweating •	Protracted shoe/boot wearing •	Less frequent sock changes During field training exercises or deployment, service members may be exposed to additional risk factors for athlete’s foot including hot and humid ambient weather, poor skin hygiene, and close-quarter living. The condition’s most common clinical presentation is infection in the space between the toes. If left untreated this pattern of infection may cause… •	Softening and breaking down of skin resulting from prolonged exposure to moisture (maceration) •	Reddening of skin caused by congestion of the capillaries in the lower layers of the skin (erythema) •	Fissures of the skin These changes in the skin increase the risk of cellulitis, a serious bacterial infection of the skin capable of spreading to other parts of the body. Read this brief report “Tinea Pedis, Active Component, U.S. Armed Forces, 2000 – 2016,” which summarizes the impact of the condition among U.S. active component service members. Access the report in MSMR Vol. 24 No. 5 – May 2017 at Health.mil/MSMR.  Background graphic of the infographic is a pair of feet diagnosed with athlete’s foot but instead of showing breakage of skin we see the leg and foot of a military service member walking through water.

This infographic documents the risk factors for tinea pedis infections (athlete’s foot).

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Tinea Pedis (Athlete’s Foot) U.S. Armed Forces, 2000-2016

Infographic
6/19/2017
Athlete’s foot is a common problem among military service members. Known by the medical term, Tinea Pedis, the condition causes a chronic fungal infection of the feet and toes. It is the most common dermatophyte infection among adults. Up to 25% of the global population is affected by tinea pedis at any given time. Findings: During the 17-year surveillance period there were a total of 193,432 medical encounters for tinea pedis. Of these total encounters, 91% were ambulatory visits. Of 459 hospitalization records that contained diagnoses of athlete’s foot during the surveillance period, a total of 275 (59.9%) had a primary diagnosis of cellulitis or abscess of the foot or leg during the incident tinea pedis hospitalization. Where this information displays two feet are seen. The pie chart shows in an orange pie slice the 59.9% or 275 military service members that had a primary diagnosis of cellulitis or abscess of the foot or leg during the incident tinea pedis hospitalization. The rest of the pie chart shows in purple the 184 other hospitalization records. Background of the pie chart shows a foot.  High Risks for tinea pedis infections: •	Males – overall incident rate 17.4% higher than females •	Service members younger than 20 years of age •	Black, non-Hispanic and Hispanic service members •	Junior enlisted service members Given these costs, prevention efforts such as training and education about foot and skin health warrant continual emphasis, especially during initial entry training and in preparation for field exercises and deployments to warm locations. Learn more at Health.mil/MSMR Top of image shows foot with tinea pedis (athlete’s foot).

This infographic summarizes the counts, rates, trends and demographic characteristics of diagnoses of tinea pedis among U.S. active component service members during 2000 -2016.

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Zika in the Americas: June 15, 2017

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6/15/2017

This is a biosurveillance summary of Zika in the Americas as of June 14, 2017. As of 1300 on 14 JUN 2017, there have been 174 confirmed Zika virus (ZIKV) disease cases (see table) since the first case was reported in JAN 2016.

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H7N9: June 7, 2017

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This is a biosurveillance summary of Avian Influenza A (H7N9) Surveillance #77: June 7, 2017, as reported by the Armed Forces Health Surveillance Branch. As of 7 JUN, the total influenza A (H7N9) human case count since the fifth seasonal epidemic of H7N9 began on 1 OCT 2016 is 889 (+20) cases with at least 239 (+1) deaths. Read more:

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Medical Encounters for Tobacco Dependence, U.S. Armed Forces 2015 and 2016

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5/30/2017
•	In 2016, there were 11,617 medical encounters for tobacco dependence with 7,209 individuals affected from the U.S. Armed Forces. •	In 2015, there were 16,985 medical encounters for tobacco dependence, with 10,244 individuals affected from the U.S. Armed Forces. PIE CHART: •	10,244 individuals affected from the U.S. Armed Forces in 2015. •16,985 medical encounters for tobacco dependence in 2015. •7,209 individuals affected from the U.S. Armed Forces in 2016. •11,617 medical encounters for tobacco dependence in 2016.  That’s a 31.60% decrease of medical encounters; 29.63% less individuals affected from the U.S. Armed Forces between 2015 and 2016. Background behind pie chart shows used cigarettes on the ground.  Don’t forget to text MIL to 47848 on World No Tobacco Day (May 31st) to receive advice on being tobacco free. This is a great resource for service members wanting to quit tobacco. Pictured below this text is a service member sending a text message for tips on quitting tobacco. #JoinTheMovement #NoTobacco Source: Defense Health Agency, Armed Forces Health Surveillance Branch. Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2016. MSMR. 2017; 24 (4): 2-8. Source: Defense Health Agency, Armed Forces Health Surveillance Branch. Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2015. MSMR. 2016; 23(4): 2-7.

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Global Influenza Summary: May 28, 2017

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Healthcare Burdens Attributable to Various Mental Disorders, U.S. Armed Forces 2016

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5/25/2017
Did you know…? In 2016, mood disorders and substance abuse accounted for 25.9% of all hospital days. Together, four mental disorders – mood, substance abuse disorders, adjustment, and anxiety – and two maternal conditions – pregnancy complications and delivery – accounted for 53.6% of all hospital bed days. And 12.4% of all hospital bed days were attributable to injuries and poisonings. Here are the mental disorders that affected U.S. Armed Forces in 2016: Pie Chart titled Bed days for mental disorders in 2016: •	Mood Disorder (46,920 bed days) – the orange pie slice. •	Substance Abuse Disorders (44,746 bed days) – the blue pie slice. •	Adjustment Disorder (30,017 bed days) – the purple pie slice. •	Anxiety Disorder (20,458 bed days) – the gray pie slice. •	Psychotic Disorder (6,532 bed days) – the light blue pie slice. •	All other mental disorders (3,233 bed days) – the violet pie slice. •	Personality disorder (2,393 bed days) – the forest green pie slice. •	Somatoform (552 bed days) – the lime green pie slice. •	Tobacco dependence (2 bed days) – the white pie slice. Bar graph shows percentage and cumulative percentage distribution, burden “conditions” that accounted for the most hospital bed days, active component, U.S. Armed Forces 2016.  % of total bed days (bars) for mood disorder, substance abuse disorders, adjustment disorder, pregnancy complications; delivery; anxiety disorder; head/neck injuries, all other digestive diseases, other complications NOS; other back problems, all other signs and symptoms; leg injuries, all other maternal conditions; all other neurologic conditions; all other musculoskeletal diseases; all other skin diseases;  back and abdomen; appendicitis; all other infectious and parasitic diseases; all other cardiovascular diseases; all other mental disorders; all other respiratory diseases; arm/shoulder injuries; poisoning, drugs; foot/ankle injuries; other gastroenteritis and colitis; personality disorder; lower respiratory infections; all other genitourinary diseases; all other malignant neoplasms; cerebrovascular disease.  See more details on this bar graph in the Medical Surveillance Monthly Report (MSMR) April 2017 Vol. 24 No. 4 report, page 4. This annual summary for 2016 was based on the use of ICD-10 codes exclusively. Read more on this analysis at Health.mil/MSMR. #LetsTalkAboutIt Background of graphic is a soldier sitting on the floor in a dark room.

This infographic documents the mental disorders that affected U.S. Armed Forces in 2016.

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Erectile Dysfunction among Male Active Component Service members

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5/25/2017
Erectile dysfunction (ED) is defined as the persistent inability to achieve and sustain an erection that is adequate for sexual intercourse. ED can result from a problem with any of the above: •	Hormones •	Emotions •	Nerves •	Muscles •	Blood vessels These factors are required for an erection include. Picture is a brain (left) and a male figure (right) showing the heart and main arteries of the body. The top three most common ED diagnoses are: 1.	Psychosexual dysfunction 2.	Hypoactive sexual desire disorder 3.	Male orgasmic disorder Image shows a couple outside together during sunset. House displays in background. Causes of ED (Shows cut out of male body highlighting areas of the body where causes happen) •	Unrealistic sexual expectations •	Depression/ Anxiety/ Stress or other mental health issues •	High blood pressure •	Diabetes •	Obesity •	Injuries that affect the pelvic area or spinal cord •	Low testosterone •	Aging, Substance Abuse Demographics: •	Incidence rate of erectile dysfunction are higher among black, non-Hispanic servicemen when compared to other race/ethnicity groups. •	Black non-Hispanic service members have higher incidence rates of several conditions known to be risk factors for erectile dysfunction, including hypertension, obesity and diabetes. •	Separated, divorced and widowed servicemen had a higher incidence rate of ED than servicemen never married. •	Servicemen never deployed had the highest crude incidence rate of erectile dysfunction. Get the facts •	Erectile dysfunction is the most common sexual complaint reported by men to healthcare providers •	Among male service members nearly half of erectile dysfunction cases related predominantly or exclusively to psychological factors. •	Incidence rates of psychogenic erectile dysfunction are greater than organic erectile dysfunction for service members. •	Organic erectile dysfunction can result from physical factors such as obesity, smoking, diabetes, cardiovascular disease or medication use. •	Highest incidence rates were observed in those aged 60 years or older. •	Those 40 years or older are most commonly diagnosed with erectile dysfunction. Effective against erectile dysfunction •	Regular exercise  ( Shows soldier running) •	Psychological counseling (Shows two soldiers engaging in mental health counseling. They are seating on a couch).  •	Quit smoking ( shows lit cigarette)  •	Stop substance abuse ( Shows to shot glasses filled with alcohol) •	Nutritional supplements ( Shows open pill bottle of supplements) •	Surgical treatment ( Shows surgical instruments) Talk to your partner Although Erectile Dysfunction (ED) is a difficult issue for sex partners to discuss, talking openly can often be the best way to resolve stress and discover underlying causes. If you are experiencing erectile dysfunction, explore treatment options with your doctor. Learn more about ED by reading ‘Erectile Dysfunction Among Male Active Component Service Members, U.S. Armed Forces, 2004 – 2013.’ Medical Surveillance Monthly Report (MSMR) Vol. 21 No. 9 – September 2014 at www.Health.mil/MSMRArchives. Follow us on Twitter at AFHSBPAGE. #MensHealth

Erectile dysfunction (ED) is defined as the persistent inability to achieve and sustain an erection that is adequate for sexual intercourse. This infographic provides details on the ways ED impacts male active component services members of the U.S. Armed Forces.

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Medical encounters, by condition, U.S. Armed Forces 2016

Infographic
5/25/2017
This infographic documents the three burden of disease related conditions that accounted for the most medical encounters among the active component of the U.S. Armed Forces in 2016. LONG FORM: In 2016, the three burden of disease related conditions accounted for the most medical encounters were: •	Other back problems •	All other musculoskeletal diseases •	Knee injuries Altogether they accounted for 25.1% of all illness-and injury-related medical encounters overall. More Findings The top nine conditions that accounted for the most medical encounters accounted for 53.1% of all illness-and-injury –related medical encounters overall. In general, the conditions that accounted for the most medical encounters were predominantly musculoskeletal disorders such as the back) injuries to the knee, arm, shoulder, foot or ankle, and mental disorders like anxiety and adjustment conditions. View more findings at www.Health.mil/MSMR    Graphic details This graphic displays the musculoskeletal of a male service member’s body to show the bones of the back and knees.

This infographic documents the three burden of disease related conditions that accounted for the most medical encounters among the active component of the U.S. Armed Forces in 2016.

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Accidental Drownings Among U.S. Service Members

Infographic
5/25/2017
Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. Increase your awareness today to lower your risks: Drowning prevention: Water-related recreational activities in or near water can be potentially dangerous – particularly for non-swimmers and weak swimmers – in hazardous conditions and settings (e.g., storms, currents, riptides), and when safety measures are not observed. Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. Here are four ways you can prevent unintentional drowning: •	Wear life jackets. •	Take swim lessons to become a stronger swimmer. •	Swim with a buddy; never swim alone. •	Be knowledgeable of water environments you are in. Increase your awareness and lower your risks by reading the Medical Surveillance Monthly Report (MSMR) Vol. 22 No. 6 – June 2015 report “Update: Accidental drownings, active component, U.S. Armed Forces, 2005 – 2014 at www.Health.mil/MSMR  #SwimSafe Follow us on Twitter for more information at AFHSBPAGE. Also check out hashtag #SwimSafe. Source: Defense Health Agency, Armed Forces Health Surveillance Branch. Graphic shows: •	Man swimming in pool •	Mom with three children swimming in pool. •	Woman swimming in pool

Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. This infographic provides swim safety information to help increase awareness and lower the risks of accidental drownings among service members.

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H7N9: May 24, 2017

Report
5/24/2017

This is a biosurveillance summary of Avian Influenza A (H7N9) Surveillance #76: May 24, 2017, as reported by the Armed Forces Health Surveillance Branch. As of 24 MAY, the total influenza A (H7N9) human case count since the fifth seasonal epidemic of H7N9 began on 1 OCT 2016 is 869 (+40) cases with at least 238 (+12) deaths. Read more:

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Hospitalizations By Gender, Active Component, U.S. Armed Forces, 2016

Infographic
5/18/2017
In 2016, there were 68,189 records of hospitalizations of active component members of the U.S. Army, Navy, Air Force, and Marine Corps. The annual hospitalization rate (all causes) for 2016 was 52.9 per 1,000 service member person-years (p-yrs) and was the lowest rate reported within the last 10 years covered in this report. This graphic documents the frequencies, rates, trends, and distributions of hospitalizations of active component members of the U.S. Army, Navy, Air Force, and Marine Corps by gender during calendar year 2016. Findings •	In 2016, the hospitalization rate (all causes) among females was more than three times that of males (hospitalization) rate, overall: females were 130,9 per 1,000 p-yrs; males were 38.3 per 1,000 p-yrs). •	Excluding pregnancy and delivery, the rate of hospitalizations among females (56.1 per 1,000 p-yrs) was 46.7% higher than among males. •	Hospitalization rates were higher among females than males for mental disorders (RD: 8.0 per 1,000 p-yrs). Most Frequent Diagnoses Pie Chart - Males •	In 2016, adjustment disorder was the most frequent discharge diagnosis among males (n=3,768) which is color coded in a transparent gray on the pie chart. Man holding his head is displayed in a circle with the number 3,768 displayed. •	Alcohol depen¬dence was (n=1,656) which is color coded in blue on the pie chart. Person holding alcohol is displayed behind this number. •	Major depressive disor¬der was (n=1,308) which is color coded in green on the pie chart.  Two soldiers on couch discussing mental health counseling display. •	Acute appendicitis was (n=1,091) which is color coded in yellow on the pie chart.  Doctor performing surgery displays behind the number. •	Post-traumatic stress disorder (PTSD) was (n=832) which is color coded in orange on the pie chart. Man holding the side of his head displays behind the numbers. Most Frequent Diagnoses – Females •	In 2016, pregnancy- and delivery- related conditions represented four of the top five leading causes of hospitalizations among females and accounted for 57.2% of all hospitalizations of females. •	The top four discharge diagnoses in this condition category included first-and second degree perineal laceration during delivery ( n= 1,254 and n=1,177, respectively). The total on pie chart is seen as 2,431 for first – and second-degree perineal laceration during delivery. Pregnant soldier is seen behind number.  Pie slice for this category is gray in display. •	Post-term (late) pregnancy (n=1,226) shows pregnant woman in blue dress behind number. Pie slice for this category is blue in display. •	Abnormality in fetal heart rate and rhythm ( n= 1,092). Heart monitor displays behind number. Pie slice for this category is green in display. •	Other than pregnancy – and delivery-related diagnoses, leading causes of hospitalizations among females were adjustment disorder (n=1,158).  Female military members display behind number. Pie slice is yellow in display. •	Major depressive disorder [single episode unspecified] (n=471) show females in the U.S. Army behind number. Pie slice for this category is orange in display.  Overall graphic background is transparent with an emergency entrance display. Learn more about hospitalizations by gender among the active component of U.S. Armed Forces at www.health.mil/MSMR

This graphic documents the frequencies, rates, trends and distributions of hospitalizations among active component members of the U.S. Army, Navy, Air Force, and Marine Corps by gender during calendar year 2016.

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Absolute and Relative Morbidity Burdens Attributable to various illnesses and injuries: Non-service member beneficiaries of the Military Health System, 2016

Infographic
5/18/2017
Individuals who are eligible for care through the Military Health System (MHS) are known as beneficiaries. MHS beneficiaries include family members of active component service members, the National Guard and Reserve service members, retirees and eligible family members of retirees. In 2016, there were approximately 9.4 million beneficiaries eligible for health care in the MHS. Findings: •	In 2016, a total of 6,589,843 non-service member beneficiaries of the MHS had 86,486,080 medical encounters. •	On average, each individual who accessed care from the MHS had 13.1 medical encounters over the course of the year. •	The top three morbidity-related categories accounted for 34.5% of all medical encounters. Top Three Morbidity-Related Categories Pie Chart •	Injuries and poisonings (10.5%) – pie slice shown in the color of lavender.  •	Signs, symptoms, and ill-defined conditions (11.9%) – pie slice shown in green. •	Musculoskeletal diseases (12.2%) - pie slice shown in dark blue. •	Orange of pie chart indicates the other morbidity related categories (make up approximately 65.4% of the pie chart). Signs, symptoms, and ill-defined conditions, injuries and poisonings, and disorders of the sense organs were the illness/injury categories that affected the most individuals (44.9%, 34.7%, and 30.3% of all beneficiaries who received any care, respectively). Learn more at Health.mil/MSMR Other images seen on graphic:  Father and baby daughter at medical appointment with a family doctor from the MHS.

Individuals who are eligible for care through the Military Health System (MHS) are known as MHS beneficiaries. This graphic provides information on the absolute and relative morbidity burdens attributable to various illnesses and injuries among non-service member beneficiaries of the MHS in 2016.

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Armed Forces Health Surveillance Branch
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