Mortality surveillance in the U.S. Army, 2005-2011.

Purpose: Mortality rates in the U. S. Army from 2005 to 2011 were examined over time and compared to the U. S. general population. Method: Cases were U. S. Army Soldiers (active duty or activated National Guard/Reserve) with dates of death between 2005 and 2011 and between 18 and 64 years of age in the Department of Defense Medical Mortality Registry. Age-and sex-adjusted annual mortality rates (AR) were calculated for each category of death and examined via linear regression. Proportions of underlying causes of death were also examined. Results: The trend in AR in the U. S. Army significantly decreased for combat deaths, the average annual percent change (AAPC) = 15.2% decrease in the log of the rate (LAR); p = 0.04 and accident deaths, AAPC = 5.4% decrease in the LAR; p = 0.002 and significantly increased for suicides, AAPC = 10.6% increase in the LAR; p = 0.001. The trend in AR for suicides for the Army was significantly different compared to the U. S. general population, AAPC = 11.0% increase in the LAR; p < 0.001. Conclusions: Trends in rates of combat deaths and accident deaths declined although rates of suicides increased. The Army suicide rate increased in comparison to the United States. 70% of accident deaths were transportation related. Almost 70% of suicides and homicides were firearm related.