Healthy Military Communities > Partnership Guide for Public Health Professionals > Step 4: Get Ideas for Partnership
Partnership Guide for Public Health Professionals
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Step 4: Get Ideas for Partnership
This section offers specific ideas for how State Health Departments and partners can adapt programming to be more inclusive of Service members, veterans, and families. While the examples below highlight physical activity, nutrition, and tobacco control activities, there is significant opportunity for collaboration on other health topics such as chronic disease prevention and management (e.g., National Diabetes Prevention Program, The Arthritis Foundation’s Walk with Ease program, dental health, violence and sexual assault prevention, substance misuse, and mental health. Referencing the Total Force Fitness model for active duty can help place these and other topics into the military context.
Partnering Around Physical Activity
Service members must be physically fit to maintain deployability, improve mental health and acuity, and reduce the impact of illness and injuries. Depending on the Service member’s military occupational specialty (MOS), higher levels of physical fitness may be necessary. Despite requirements to maintain physical fitness, there remain challenges to doing so, especially for Service members with the reserve components who often do not live close to military installations with fitness facilities.
The CDC’s infographic, Unfit to Serve, outlines how physical inactivity impacts national security:
- Only 2 in 5 young adults are both weight-eligible and adequately active to enlist
- Active-duty soldiers with obesity were 33% more likely to get musculoskeletal injuries
- Physical inactivity is associated with costly basic training discharge across the services
Partnership Ideas to Increase Physical Activity
- Provide subject matter expertise and/or partners’ expertise to military installations to support the physical activity-related sections in DoD’s United Facilities Criteria— Installation Master Planning guidance (e.g., “Healthy Community Planning,” “Connected Transportation Networks,” and “Horizontal and Vertical Mixed Use”). This is a recommendation from the Military Sector of the Physical Activity Alliance’s National Physical Activity Plan. The plan presents strategies that the DoD and VA can implement to promote physical activity.
- Work with K-12 schools both on installations and near military installations to promote comprehensive physical education. There are 50 military-operated schools on installations in seven states in the U.S. Use the DoD Education Activity (DoDEA) search page to find schools, contact information, and links to school websites. Prepare for meetings with DoDEA schools by reviewing their physical activity guidelines in advance.
- Partner with Military Childcare System (MCS) providers to help them meet national Caring for Our Children High Impact Obesity Prevention Standards related to nutrition and physical activity in early care and education (ECE) program using CDC’s Spectrum of Opportunities. To find providers on military installations, use MCS’s search tool.
- Implement or support activities listed on CDC’s Physical Activity and Military Readiness webpage.
- Promote Active People, Healthy NationSM by prioritizing approaches that support an active and healthy community. These approaches will support the goal of getting 27 million Americans more physically active.
Florida’s Operation Strong and Ready
In April 2022, the Army replaced the Army Physical Fitness Test (APFT) with the Army Combat Fitness Test (ACFT). The ACFT is a significant change from the APFT, and training is ideally completed at a gym with specific equipment. In Florida, soldiers in Army Reserve and Army National Guard and their recruits have less access to resources, such as gyms, than their active-duty counterparts. Low ACFT scores can impact career advancement and occupational placement. The First Coast YMCA (Y) and the University of Florida Cooperative Extension (Extension) partnered with the Army to design a program, Operation Strong and Ready, to help recruits and current soldiers pass the ACFT. The Army trained a select number of Y fitness instructors to administer practice ACFTs and to lead exercises to improve performance. Soldiers and recruits needing assistance with the ACFT were granted free, time-limited memberships to the Y and trained with Y instructors on ACFT exercises. Extension designed online performance nutrition education classes to accompany the fitness training.Partnering Around Nutrition
Like physical activity, nutritional fitness is key to sustaining and optimizing physical and cognitive performance, as well as health, well-being, and readiness. Like civilians, Service members, veterans, and their families are affected by nutrition environments in communities. On installations, the quality and availability of healthy foods can vary. At the federal level, CDC is working with DoD on the Joint DoD Food and Nutrition and Dietary Supplement Subcommittees to determine how to make it easier for Service members to access and choose healthier foods. State Health Departments can mirror these collaborative efforts.
Food and nutrition security is a growing concern among the military-connected. A 2019 Military Family Advisory Network survey found that 1 in 8 military families reported some level of food insecurity, and in 2015, the Government Accountability Office reported that $21 million in SNAP benefits were used in active-duty commissaries. Finally, one-third of children at DoD-run schools are eligible for free or reduced lunches.
Breastfeeding for post-partum active-duty women can be a challenge. Compared to civilian mothers, active-duty mothers stopped breastfeeding their infants earlier (at four months), with enlisted mothers being the least likely group to breastfeed compared to officers. The Global Military Lactation Community (Global MilCom) provides lactation advocacy, information, and support for parents serving on active duty, in the National Guard, and in the Reserves. Their website outlines military resources and regulations for breastfeeding.
Partnership Ideas to Improve Nutrition
- Provide subject matter expertise to military installations to help them design breastfeeding friendly spaces on bases and posts.
- Offer to support use of the Military Nutrition Environment Assessment Tool (m-NEAT) in local installations and advise on best practices to improve the nutrition environment.
- Cobrand state nutrition recognition programs with DoD’s Go 4 Green food guidelines; Go 4 Green is a joint-service performance nutrition initiative that improves where military Service members live and work.
- Include military representatives on nutrition workgroups or food policy councils.
- Support local installations in the implementation of the directives given to the DoD and VA in the White House National Strategy on Hunger, Nutrition, and Health.
Minnesota’s VetCSA
In Minnesota, five organizations partnered to increase access to nutritious food for veterans in the rural counties of Cass, Crow Wing, Morrison, Todd, and Wadena. The Minnesota Department of Veterans Affairs awarded the Region 5 Development Commission a grant to launch the VetCSA program, which sources healthy foods from low-income farmers and delivers them semimonthly to 50 local veterans and their families. The food shares include chef cooking demonstrations, nutrition education, and referral services. Read the full story.New Mexico’s GoodFoodNM Texting Program
To support increased fruit and vegetable intake among Guard members, the New Mexico Department of Health partnered with the New Mexico Farmers’ Market Association to promote their GoodFoodNM texting program to Guard members in the state. Participants in the free program receive one to two texts per week with cooking tips, simple and healthy recipes, links to local farmers markets, information about food pantries and food access programs such as Double Up Food BucksTM, and other tailored messages based on their need. Read the full story.Partnering Around Commercial Tobacco Use
Commercial tobacco use impacts military readiness. It reduces Service members’ physical fitness and strength. It also makes them more likely to become sick, get injured, and have delayed healing if wounded.
The percentage of Service members who smoke cigarettes has historically been higher than that of the general adult population but has been dropping in recent years, along with declines in smoking in the general population. In 2018, more than 18% of active-duty personnel reported that they currently smoke.
The percentage of Service members who use smokeless tobacco (chewing tobacco, snuff, dip, or snus) is also higher than in the general population. In addition, e-cigarette use is increasing among Service members. Data from 2018 show e-cigarette use remains high, with several service branches reporting e-cigarettes as the most used product.
Partnership Ideas to Reduce Commercial Tobacco Use
- Work with active-duty and reserve component youth programs to engage military youth in tobacco prevention youth engagement activities.
- Work with military installation housing offices to require contracted property managers of off-post housing to adopt smoke-free housing policies similar to the U.S. Department of Housing and Urban Development rule.
- Refer active-duty Service members, veterans and their family members who want help quitting smoking to the cessation tools created specifically for them:
- Leverage DoD’s YouCanQuit2 campaign materials for messaging designed specifically for military audiences and to promote available cessation resources including those captured in the YouCanQuit2 Support Locator.
- Add your state’s quitline and other programming to YouCanQuit2’s Resource Locator through their Submit a Program or Resource portal.
- Leverage CDC’s Tips From Former Smokers® Military Service Members & Veterans Media Outreach Kit.
Oklahoma’s Tobacco Helpline
The Oklahoma Department of Health partnered with DoD’s Building Healthy Military Communities (BHMC) pilot to increase awareness of tobacco cessation services. They also added a question to the intake process for the Oklahoma Tobacco Helpline asking about military service. Read the full story.
Florida’s Tobacco-Free Recruiting Efforts
The Florida Department of Health also partnered with BHMC to engage military recruiters in helping new recruits quit using tobacco before they enter service and to stay quit once they enter. They organized a virtual, state-wide learning opportunity for Tobacco Free Florida service providers, recruiters, and military leadership to increase awareness of the problem and to lay the foundation for partnership efforts. The webinar reviewed the prevalence of tobacco use in the military, its impact on Service members’ readiness to deploy, and the cost to the DoD to treat tobacco-related medical care, including lost workdays. It also presented Tobacco Free Florida “Quit Your Way” services. Read the full story.
Other Resources to Support Collaborative Efforts
- Guide to Local Government and Military Partnerships in Public Health
The Center for State and Local Government Excellence offers a guide to help navigate partnerships with local military leaders. It reviews areas where communication, training, planning, and response can better serve the public health needs of community residents, active-duty military, dependents, and civilian employees, while building enduring relationships of trust and collaboration between the base leadership and city/county management. - Building Healthy Military Communities Thought Leader Round Table Recommendations
NACDD convened partners through a series of four Thought Leader Round Table Sessions to develop recommendations for state Chronic Disease Directors and other health department staff to help orient their agency’s contribution to the Building Healthy Military Communities effort and continue to adapt community-based solutions as progress is made toward military health and mental fitness. - Working With Local Governments: A Practical Guide for Installations
This National Association of Counties’ guide is designed to help installation officials better understand how they can work with local governments on urban, regional, and transportation planning. It addresses some of the common concerns that local military leaders may have in working with civilian governments on planning issues. - Healthy Base Initiative
The Healthy Base Initiative was a 2014 DoD pilot that implemented a variety of public health evidence-based programs at 14 installations. The goals of the pilot were to reduce overweight and obesity, decrease tobacco use, increase healthy eating and active living, and foster a healthy environment on the installation.