Mission readiness through equity: Insights into the impact of the COVID-19 pandemic on the United States military
The coronavirus disease 2019 (COVID-19) pandemic magnified long-standing disparities in health care. Among the general population, racial/ethnic minorities often face disproportional barriers, such as poverty, reduced health literacy, a generational mistrust of health-care institutions, and limited access to health care, contributing to the disparities reported in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and outcomes. Racial/ethnic minorities in the military comprise nearly 43% of active-duty service members and face disproportionate health burdens influenced by systemic and individual factors. As a result, minority service members within the military health system had similar rates of SARS-CoV-2 testing compared to those of white service members. Reports have found that while the rates of testing are similar, SARS-CoV-2 infection remained disproportionately higher among Black and Hispanic service members. This perspective examines disparities in the United States military, focusing on the role of social determinants of health, comorbidities, risk factors, and access to care in shaping COVID-19 health outcomes.
- Warrior L, Kim CY, Burdick DJ, et al. Leading with inclusion during the COVID-19 pandemic: Stronger together. Neurology. 2020;95(12):537-542. doi: 10.1212/WNL.0000000000010641
- Sukumaran P, Millington D, Blackburn A, Asin SN. The relationship between pre-pandemic comorbidities with SARS-CoV-2 infections and hospitalizations in black versus white military service members: A retrospective study. Mil Med. 2024;189(Suppl 3):814-822. doi: 10.1093/milmed/usae294
- Young JM, Stahlman SL, Clausen SS, Bova ML, Mancuso JD. Racial and ethnic disparities in COVID-19 infection and hospitalization in the active component US military. Am J Public Health. 2021;111(12):2194-2201. doi: 10.2105/ajph.2021.306527
- Piro L, Luo H, Jones K, Lazorick S, Cummings DM, Saeed SA. Racial and ethnic differences among active-duty service members in use of mental health care and perceived mental health stigma: Results from the 2018 health related behaviors survey. Prev Chronic Dis. 2023;20:E85. doi: 10.5888/pcd20.220419
- Sercy E, Stewart L, Craig-Kuhn MC, et al. Patterns and predictors of COVID-19 vaccine uptake among U.S. Active duty service members, 2020-2022: Implications for future pandemics. Mil Med. 2025;190(5-6):1243-1252. doi: 10.1093/milmed/usaf004
- Lang MA, Stahlman S, Wells NY, et al. Disparities in COVID-19 vaccine initiation and completion among active component service members and health care personnel, 11 December 2020-12 March 2021. MSMR. 2021;28(4):2-9.
- Silaghi-Dumitrescu R, Patrascu I, Lehene M, Bercea I. Comorbidities of COVID-19 patients. Medicina (Kaunas). 2023;59(8):1393-1393. doi: 10.3390/medicina59081393
- Feyman Y, Avila CJ, Auty S, et al. Racial and ethnic disparities in excess mortality among U.S. Veterans during the COVID‐19 pandemic. Health Serv Res. 2023;58(3):642-653. doi: 10.1111/1475-6773.14112
- Lukowsky LR, Der-Martirosian C, Dobalian A. Disparities in excess, all-cause mortality among black, hispanic, and white veterans at the U.S. Department of veterans affairs during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19(4):2368. doi: 10.3390/ijerph19042368
- Ortega P, Martínez G, Diamond L. Language and health equity during COVID-19: Lessons and opportunities. J Health Care Poor Underserved. 2020;31(4):1530-1535. doi: 10.1353/hpu.2020.0114
- Moon I, Han J, Kim K. Determinants of COVID-19 vaccine hesitancy: 2020 California health interview survey. Prev Med Rep. 2023;33:102200. doi: 10.1016/j.pmedr.2023.102200