America's Health Rankings, United Health Foundation Logo
Health risk behaviors such as smoking, excessive drinking, and substance misuse, can elevate risk for chronic disease, disability, and premature mortality over time. Certain unhealthy behaviors, such as insufficient sleep, are also associated with mental illness. Other behaviors, such as excessive drinking or tobacco use, may be coping responses to psychological distress.
This year’s study includes seven measures of behaviors, with opioid misuse and smokeless tobacco use added as new measures. Findings reveal that those who have served continue to report significantly higher overall rates of excessing drinking, insufficient sleep, smoking, and smokeless tobacco use. And while the rate of physical inactivity remains significantly lower among those who have served, the overall rate of obesity is not significantly different between those who have and have not served. Overall rates of opioid misuse also do not differ between those who have and have not served.
How Have Behaviors Changed Since 2011-2012 for Those Who Have Served? Encouraging Improvements: - Smoking declined by 15% from 23.5% to 19.9% among those who have served. Among 18-25 year olds with service, smoking dropped by 41% from 30.3% to 17.9%. - Excessive drinking decreased by 9% from 23.4% to 21.4% among those who have served. - Physical inactivity and obesity rates declined among 18-25 year olds who have served by 28% and 17%, respectively.
However, the report documents important differences by age, race/ethnicity, and other demographic factors between those who have and have not served:
  • Whites who have served have significantly higher rates of excessive drinking (22.8% vs. 21.2%), insufficient sleep (40.0% vs. 33.0%), obesity (28.9% vs. 27.6%), smoking (20.8% vs. 18.4%), and smokeless tobacco use (10.7% vs. 4.3%) than whites who have not served.
  • Many minority groups are also more likely to report unhealthy behaviors than their peers who have not served. Hispanics who have served, for example, report significantly higher rates of excessive drinking (21.9% vs. 16.5%), insufficient sleep (46.7% vs. 32.8%), smoking (16.5% vs. 11.9%), and smokeless tobacco use (5.8% vs. 1.9%) than Hispanics who have not served.
  • Asians who have served report roughly twice the rate of smoking (15.0% vs. 6.4%) and obesity (16.0% vs. 9.8%) than Asians who have not served.
  • Rates of physical inactivity (8.1% vs. 16.9%) and obesity (8.6% vs. 18.2%) are significantly lower among 18-25 year olds who have served than those who have not. However, this cohort is more likely to have higher rates of other unhealthy behaviors such as excessive drinking (32.0% vs. 26.4%), insufficient sleep (45.1% vs. 32.7%), and smoking (17.9% vs. 14.8%). Smokeless tobacco use is also four times higher among 18-25 year olds who have served than those who have not (16.9% vs. 4.6%).
  • With age, those who have served are significantly more likely to be obese than those who have not served. For example, rates are significantly higher among those 35-49 years (35.7% vs. 33.0%) and 50+ years (33.3% vs. 30.5%).
  • Unhealthy behaviors such as excessive drinking, insufficient sleep, smoking, and smokeless tobacco use are generally higher among those who have served than those who have not served, at all levels of income and education.