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1 1 (December 22, 2020)

handle is hein.crs/goveabp0001 and id is 1 raw text is: L Con ressional Research Service December 22, 2020 Obesity in the United States and Effects on Military Recruiting Background Congress has a sustained interest in maintaining capable military forces. To this end, a population of healthy and eligible recruits is important to sustain the military services and meet the annual requirements established by Congress. Though many aspects of health are important, a 2016 Department of Defense (DOD) report found that obesity was one of the main disqualifiers from joining U.S. military service. Obesity in the United States is not a new issue. A report published in Health Economics in 2012 estimated that the percentage of military-age adults ineligible for enlistment because of excessive body fat more than doubled for men and tripled for women during 1959-2008. Since 2008, the percentage of obese youth has continued to increase. The increasing proportion of obese American youth reduces the pool of eligible military recruits. This trend may pose particular challenges with recruiting highly-qualified individuals to service in the U.S. Armed Forces. Obesity in the United States The U.S. Centers for Disease Control and Prevention (CDC) defines obesity in children (2 to 19 years of age) as those with a body mass index (BMI) at or above the 95th percentile for BMI based on the child's age and sex. For adults, CDC classifies obesity as those with a BMI of 30 or greater. Though BMI-the ratio of weight in kilograms divided by height in meters squared-does not measure body fat directly, it is strongly associated with direct measurements of body fat and adverse health outcomes. In 2017-2018, the most recent years for which CDC adult data are available, obesity prevalence-the proportion of the population who have obesity in a given time period- was 42% in adults (age 20 years or older). Among adolescents (age 12 to 19 years old), obesity prevalence was 21% in 2015-2016, the most recent years for which CDC childhood obesity data are available. These CDC estimates are from National Health and Nutrition Examination Survey (NHANES) data. NHANES consists of participant interviews and physical examinations. Obesity affects some populations more than others. For example, in 2015-2016, obesity prevalence was 26% among Hispanic children and 22% among non-Hispanic Black children, compared to 14% in non-Hispanic White children. In adults, in 2017-2018, non-Hispanic Black adults had the highest prevalence of obesity (50%), followed by Hispanic adults (45%), and non-Hispanic White adults (42%). Based on geographic location, adult obesity prevalence was highest (greater than 35% of the overall U.S. population) in Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia (see Figure 1). The Midwest (34%) and the South (33%) were the two regions that represented the highest prevalence of obesity. Figure I. Prevalence of Self-Reported Obesity among U.S. Adults by State and Territory, 2019 Source: CDC, Adult Obesity Prevalence Maps, found at https://www.cdc.gov/obesity/data/prevalence-maps.html. Note: Data based on the Behavioral Risk Factor Surveillance System (BRFSS), the world's largest, on-going telephone health survey system. Milita Recruiting Efforts DOD Instruction 1304.26 establishes minimum physical standards for recruitment and retention; the military services can also include additional requirements. Military physical standards began in 1775. The military services issued the first weight standards in 1887 for men and in 1942 for women. The original function of these standards was to exclude underweight individuals. In recent decades, however, far more applicants for military service have been found to be unfit for duty for being overweight. Since the 1970s, disqualification from joining the military based on inability to meet established weight standards has risen. A RAND Corporation analysis of the evolution of the all-volunteer force discusses increasing physical disqualification rates as the draft was being phased out in 1972. The Services currently use a body composition test based on height and weight to determine body fat percentages. Alternatively, measurements at the waist and neck are also used to calculate body fat percentages in the military. To meet annual personnel goals and fill entry-level positions, the military services recruit approximately 175,000 new active duty enlisted servicemembers every https://crsreports.congress.gov

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