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1.  The Health of the American Slave Examined by Means of Union Army Medical Statistics 
The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.
PMCID: PMC2561819  PMID: 3881595
2.  Risk Exposures in Early Life and Mortality at Older Ages: Evidence from Union Army Veterans 
Population and development review  2009;35(2):275-295.
This study examines the relation between risk exposures in early life and hazard of mortality among 11,978 Union Army veterans aged 50 and over in 1900. Veterans’ risk exposures prior to enlistment–as approximated by birth season, country of origin, residential region, city size, and height at enlistment–significantly influence their chance of survival after 1900. These effects are robust irrespective of whether or not socioeconomic well-being circa 1900 has been taken into account; however, they are sensitive to the particular age periods that have been selected for survival analysis. Whereas some of the effects such as being born in Ireland and coming from big cities became fully unfolded in the first decade after 1900 and then dissipated over time, the effects of birth season, being born in Germany, residential region in the U.S., and height at enlistment were more salient in the post-1910 periods. Height at enlistment shows a positive association with risk of mortality in the post-1910 periods. Compared to corresponding findings from more recent cohorts, the exceptional rigidity of the effects of risk exposures prior to enlistment on old-age mortality among the veterans highlights the harshness of living conditions early in their life.
PMCID: PMC2832117  PMID: 20209063
3.  Health, Information, and Migration: Geographic Mobility of Union Army Veterans, 1860–1880 
The journal of economic history  2008;68(3):862-899.
This article explores how injuries, sickness, and the geographic mobility of Union Army veterans while in service affected their postservice migrations. Wartime wounds and illnesses significantly diminished the geographic mobility of veterans after the war. Geographic moves while carrying out military missions had strong positive effects on their postservice geographic mobility. Geographic moves while in service also influenced the choice of destination among the migrants. I discuss some implications of the results for the elements of self-selection in migration, the roles of different types of information in migration decisions, and the overall impact of the Civil War on geographic mobility.
PMCID: PMC2838394  PMID: 20234796
4.  Military positions and post-service occupational mobility of Union Army veterans, 1861–1880 
Explorations in economic history  2007;44(4):680-698.
Although the Civil War has attracted a great deal of scholarly attention, little is known about how different wartime experiences of soldiers influenced their civilian lives after the war. This paper examines how military rank and duty of Union Army soldiers while in service affected their post-service occupational mobility. Higher ranks and non-infantry duties appear to have provided more opportunities for developing skills, especially those required for white-collar jobs. Among the recruits who were unskilled workers at the time of enlistment, commissioned and non-commissioned officers were much more likely to move up to a white-collar job by 1880. Similarly, unskilled recruits assigned to white-collar military duties were more likely to enter a white-collar occupation by 1880. The higher occupational mobility of higher-ranking soldiers is likely to have resulted from disparate human capital accumulations offered by their military positions rather than from their superior abilities.
PMCID: PMC2838376  PMID: 20234792
Military service; Civil War; Rank; Duty; Human capital; Training; Occupational mobility; Union Army; Veteran
5.  Wealth Accumulation and the Health of Union Army Veterans, 1860–1870 
The journal of economic history  2005;65(2):352-385.
How did the wartime health of Union Army recruits affect their wealth accumulation through 1870? Wounds and exposure to combat had strong negative effects on subsequent savings, as did illnesses while in the service. The impact of poor health was particularly strong for unskilled workers. Health was a powerful determinant of nineteenth-century economic mobility. Infectious diseases’ influences on wealth accumulation suggest that the economic gains from the improvement of the disease environment should be enormous. The direct economic costs of the Civil War were probably much greater than previously thought, given the persistent adverse health effects of wartime experiences.
PMCID: PMC2840618  PMID: 20300440
6.  Occupational Career and Risk of Mortality among Union Army Veterans 
Social science & medicine (1982)  2009;69(3):460-468.
Previous studies have extended the traditional framework on occupational disparities in health by examining mortality differentials from a career perspective. Few studies, however, have examined the relation between career and mortality in a historical U.S. population. This study explores the relation between occupational career and risk of mortality in old age among 7,096 Union Army veterans who fought the American Civil War in the 1860s. Occupational mobility was commonplace among the veterans in the postbellum period, with 54 percent of them changing occupations from the time of enlistment to 1900. Among veterans who were farmers at enlistment, 46 percent of them changed to a non-farming occupation by the time of 1900. Results from the Cox Proportional Hazard analysis suggest that relative to the average mortality risk of the sample, being a farmer at enlistment or circa 1900 are both associated with a lower risk of mortality in old age, although the effect is more salient for veterans who were farmers at enlistment. Occupational immobility for manual labors poses a serious threat to chance of survival in old age. These findings still hold after adjusting for the effects of selected variables characterizing risk exposures during early life, wartime, and old age. The robustness of the survival advantage associated with being a farmer at enlistment highlights the importance of socioeconomic conditions early in life in chance of survival at older ages.
PMCID: PMC2852134  PMID: 19552993
Career; Occupational Mobility; Mortality; Union Army Veterans; USA
7.  Testing the influenza–tuberculosis selective mortality hypothesis with Union Army data⋆ 
Social science & medicine (1982)  2009;68(9):1599-1608.
Using Cox regression, this paper shows a weak association between having tuberculosis and dying from influenza among Union Army veterans in late nineteenth-century America. It has been suggested elsewhere [Noymer, A. and M. Garenne (2000). The 1918 influenza epidemic’s effects on sex differentials in mortality in the United States. Population and Development Review 26(3), 565–581.] that the 1918 influenza pandemic accelerated the decline of tuberculosis, by killing many people with tuberculosis. The question remains whether individuals with tuberculosis were at greater risk of influenza death, or if the 1918/post-1918 phenomenon arose from the sheer number of deaths in the influenza pandemic. The present findings, from microdata, cautiously point toward an explanation of Noymer and Garenne’s selection effect in terms of age-overlap of the 1918 pandemic mortality and tuberculosis morbidity, a phenomenon I term “passive selection”. Another way to think of this is selection at the cohort, as opposed to individual, level.
PMCID: PMC2677170  PMID: 19304361
USA; Influenza; Tuberculosis; Selection; Mortality; Historical demography; Historical epidemiology; Union Army veterans
8.  Pensions and Retirement Among Black Union Army Veterans 
The journal of economic history  2010;70(3):567-592.
I examine the effects of an unearned income transfer on the retirement rates and living arrangements of black Union Army veterans. I find that blacks were more than twice as responsive as whites to income transfers in their retirement decisions and 6 to 8 times as responsive in their choice of independent living arrangements. My findings have implications for understanding racial differences in rates of retirement and independent living at the beginning of the twentieth century, the rise in retirement prior to 1930, and the subsequent convergence in black-white retirement rates and living arrangements.
PMCID: PMC3004158  PMID: 21179379
9.  Health, Wartime Stress, and Unit Cohesion: Evidence From Union Army Veterans 
Demography  2010;47(1):45-66.
We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous.
PMCID: PMC3000013  PMID: 20355683
10.  Socioeconomic Differences in the Health of Black Union Army Soldiers 
Social science history  2009;33(4):427-457.
This paper investigates patterns of socioeconomic difference in the wartime morbidity and mortality of black Union Army soldiers. Among the factors that contributed to a lower probability of contracting and dying from diseases were (1) lighter skin color, (2) a non-field occupation, (3) residence on a large plantation, and (4) residence in a rural area prior to enlistment. Patterns of disease-specific mortality and timing of death suggest that the differences in the development of immunity against diseases and in nutritional status prior to enlistment were responsible for the observed socioeconomic differences in wartime health. For example, the advantages of light-skinned soldiers over dark-skinned and of enlisted men formerly engaged in non-field occupations over field hands resulted from differences in nutritional status. The lower wartime mortality of ex-slaves from large plantations can be explained by their better-developed immunity as well as superior nutritional status. The results of this paper suggest that there were substantial disparities in the health of the slave population on the eve of the Civil War.
PMCID: PMC3427919  PMID: 22933827
11.  An Occupational Health Nursing Computer Application in Medical Care: An Army Approach 
Occupational health nursing has become an increasingly important specialty in the field of nursing during this century. In the broadest concept, occupational health is concerned with all factors which influence the health of people at work. Nurses, as well as other health care professionals, are attempting to apply the evolving technology of the computer to direct client care applications in the workplace. One such relevant use of the computer has been that of targeted disease surveillance in an occupational health setting. This paper will address the process utilized by community health nurses to assess, plan, implement and evaluate a computerized disease surveillance program in an occupational health setting. The program was a joint effort between the United States Army Medical Department Activity, Fort Irwin, California and the Epidemiology Consultant Service of the Division of Preventive Medicine, the Walter Reed Army Institute of Research, Washington, DC. (WRAIR).
PMCID: PMC2578424
British Medical Journal  1905;2(2340):1211-1213.
PMCID: PMC2322683  PMID: 20762362
18.  The Reliability and Validity of the Self-Reported Drinking Measures in the Army’s Health Risk Appraisal Survey 
The reliability and validity of self-reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown.
We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol-related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen’s κ and Pearson’s r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol-related hospitalizations and alcohol-related separations from the Army, respectively.
A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over- or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach’s α = 0.69 and test-retest reliability associations in the 0.75–0.80 range for most items over 2- to 30-day interims between surveys. The alcohol measures showed good criterion-related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol-related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol-related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77).
The Army’s HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration.
PMCID: PMC2141695  PMID: 12766628
Alcohol; Military; Reliability; Validity; Survey
19.  Suicide and the United States Army: Perspectives from the Former Psychiatry Consultant to the Army Surgeon General 
Editor’s note:
The suicide rate of active-duty soldiers doubled between 2003 and 2010. In response, the Department of Defense and the United States Army improved their data collection methods to better understand the causes of military suicides. As retired colonel Dr. Elspeth Cameron Ritchie writes, unit history and the accumulation of stressors—from relationship problems to chronic pain—are significant suicide risk factors among soldiers. But, she argues, Army officials must use this knowledge to design more-effective strategies for suicide reduction, including limiting access to weapons, especially post-deployment, and better connecting soldiers with their communities.
PMCID: PMC3574805  PMID: 23447787
23.  Henry Marshall (1775-1851) and the health of the British Army. 
Medical History  1970;14(3):260-276.
PMCID: PMC1034058  PMID: 4921978

Results 1-25 (27973)