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Department of DefenseOperation Live Well

National Conference of State Legislators: Hunger Partnership Meeting

May 19, 2017

DoD’s Approach to Service Member Well-Being

2

Understanding the Environment to Identify Challenges and Potential Solutions

Department of DefenseThe Need For Nutritional and Physical Fitness

3Image found at http://channel.nationalgeographic.com/no-man-left-behind/

Presenter

Presentation Notes

The image of an Active Service member is one of youth, strength, fitness…

http://channel.nationalgeographic.com/no-man-left-behind/

Nutritional FitnessDefining the Issue: Overnutrition

4

Like the rest of the nation, Service members and their families face well-being challenges that may compromise readiness, resiliency, and combat effectiveness.

1. This estimate includes medical and non-medical costs in 2014. Cost of Tobacco Use & Exposure, Overweight and Obesity, and High Alcohol Consumption within the TRICARE Prime and Standard Population. Technical Report, March 2016.

2. Healthy Base Initiative Executive Report. 2015. 3. Mission: Readiness. (2012). Still Too Fat to Fight4. D. N. Cowan, S. A. Bedno, N. Urban, B. Yi, D. W. Niebuhr; Musculoskeletal injuries among overweight army trainees: incidence and health care utilization. Occup Med (Lond) 2011; 61 (4): 247-252

More likely to experience a musculoskeletal injury if overweight or obese. More Service members are evacuated from war for serious sprains than combat injuries4

Readiness & Resiliency

47%

Annual cost in DoD to treat the effects of obesity-related illnesses1

Financial Impact

$3.4B

Of potential recruits will not qualify for service due to their weight by 20302

Recruitment

64%

First-term enlistees discharged before their contracts are up due to weight problems every year3

Retention

1,200

Presenter

Presentation Notes

The reality is that the Department of Defense, like the civilian community, faces challenges related to physical fitness and overall well-being in two major and seemingly incongruent ways – overnutrition and food insecurity. Reference the statistics in the above slide. OLW currently looks to advance the wellbeing of Service members and their families through comprehensive community resiliency and capacity building efforts across the entire military. OLW supports well-being policy development, revision and monitoring, engages stakeholders to monitor effects of programs, conducts research to define progress in wellbeing, and shares knowledge to inform issue identification Additional Statistics: Recruitment: In 2010, 27 percent of recruits did not qualify for the military due to height/weight standards. (Mission: Readiness. (2009). Ready, Willing, and Unable to Serve. Retrieved from: http://cdn.missionreadiness.org/MR-Ready-Willing-Unable.pdf) By 2030, 64 percent of potential recruits will not qualify due to their weight. ("F as in Fat: How Obesity Threatens America's Future 2012“. Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation.) Retention: Failure to meet weight standards is a leading cause of involuntary separation from the military, and obesity in the civilian community is limiting DoD’s ability to recruit qualified personnel. (Mission: Readiness. (2012). Still Too Fat to Fight. Retrieved from: http://missionreadiness.s3.amazonaws.com/wp-content/uploads/Still-Too-Fat-To-Fight.png) Readiness and Resiliency: More service members were evacuated from Iraq and Afghanistan for serious sprains and fractures than for combat injuries; “overweight or less-fit young men and women are at a higher risk for these injuries.” (Mission: Readiness. (2012). Still Too Fat to Fight. Retrieved from: http://missionreadiness.s3.amazonaws.com/wp-content/uploads/Still-Too-Fat-To-Fight.png)

Nutritional FitnessFraming the Issue

5

The traditional medical model treats health behavior issues after the onset of disease, but proactively addressing the social determinants of health behaviors has long-term disease prevention and cost

savings implications.1

Past Medical Model

To more effectively address social determinants of health, improve the readiness of the Total Force, and reduce the cost of care, the DoD will need to improve coordination of efforts across the enterprise.

Future Need

1. Taylor, LA, et. al. Leveraging the Social Determinants of Health: What Works?. PLoS One. 2016; 11(8).2. This estimate includes medical and non-medical costs in 2014. Cost of Tobacco Use & Exposure, Overweight and Obesity, and High Alcohol Consumption within the TRICARE

Prime and Standard Population. Technical Report, March 2016.

Presenter

Presentation Notes

These nutritional fitness challenges come with a price. Alcohol consumption, tobacco use, and excess weight amounted to $6.6B in 2014. Past Medical Model: The traditional medical model treats health behavior issues after the onset of disease and limits the scope of treatment to the clinical setting. However, research indicates that proactively addressing the social determinants of health behaviors has long-term cost saving implications and potential of preventing disease. The FY2014 military budget accounted for a $6.6 billion increase in medical costs and nonmedical costs for TRICARE beneficiaries as a result of tobacco use, excess weight-related medical problems, and alcohol abuse. The numbers presented on this slide represent cost for all TRICARE beneficiaries, not isolated to Active Duty and Reserve Service members. Future Need: Moving forward, the DoD will need to improve coordination efforts across the enterprise so we can ensure 1) that the social determinants of health are effectively addressed, 2) that the Total force experiences optimal readiness, and 3) that the cost of care is reduced.

Nutritional FitnessDefining the Issue: Food Insecurity

6

1. GAO-16-561. Military Personnel: DOD Needs More Complete Data on Active Duty Service members’ Use of Food Assistance Programs. July 2016. http://www.gao.gov/assets/680/678474.pdf.2. DeCA Coupon Redemption.Exchange and Commissary News. November 2015. http://www.ebmpubs.com/ECN_pdfs/ecn1115_News.pdf. 3. DoDEA schools within the US serve dependent children of DOD military members on Active Duty and civilian federal employees assigned permanent living quarters on a military installation, as well as other eligible

dependents if space is available. 4. This reflects civilian and military families surveyed in Hunger in America Study 2014. Feeding America. http://help.feedingamerica.org/HungerInAmerica/hunger-in-america-2014-full-

report.pdf?s_src=W175DIRCT&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2F&_ga=1.257412939.1168868384.1469148423

Serving in the military does not guarantee that a family will have food security throughout the year.

Sum that Active Duty Service members spent in SNAP benefits at commissaries in FY20151

Supplemental Nutrition Assistance Program (SNAP)

$21M

Of children in the 52 DoDEA schools are eligible for free or reduced-price meals1,3

National School Lunch and School Breakfast Program at DoD Education Activity (DoDEA) Schools

51%

Sum that Service members or their spouses spent in WIC benefits at commissaries in FY20152

Special Supplemental Program for Women, Infants & Children (WIC)

$24M

Of families reported buying cheaper food even if it was less nutritious in order provide enough food4

Coping with food insecurity

79%

Presenter

Presentation Notes

The DoD and USDA has a long standing historical relationship seeking to address food insecurity in the civilian community since WWII. In the 1946 when men were too undernourished to meet height and weight standards for entrance into the military, Truman initiated what would become the National School Lunch program to address this national security issue. Of the 18 USDA-run food assistance programs SNAP, WIC, National School Lunch & Breakfast, CACFP, and the Summer Meal Program are the programs for which Active Duty or Reserve Service members are most eligible. However, USDA estimates between 2,000 and 22,000 Active Duty Service members utilized SNAP. Exact numbers are not known because there is not a requirement for states to collect data on military service status during eligibility applications. Active Duty Service members spent over $21 million in SNAP benefits at commissaries from September 2014 through August 2015. The Status of the Force Survey in 2013 reports that 9% of Active Duty Service members or their spouses had received income from either WIC and/or Temporary Assistance for Needy Families (TANF) in 2013. However, the WIC and TANF data are of limited usefulness in determining the extent to which Service members use food assistance, because it combines a food assistance program (WIC) with a non-food assistance program (TANF). In 2014-2015 school year, on average, of the 19,001 children enrolled in DoDEA schools in the CONUS, 26% (5,010) were eligible for free meals and 25% (4,675) were eligible for reduced-price meals. Data is not available regarding the use of the Summer Meal program for children. However, that is also a food assistance program utilized in the military. Other than the stress that occurs with food insecurity, we know that healthy food choices are more likely to be compromised when families are struggling to make ends meet. Malnourishment includes overconsumption of calories but also underconsumption of nutrients, such as vitamins and minerals. As seen from the prior slide, under consumption of vital nutrients can lead to other medical issues.

http://www.gao.gov/assets/680/678474.pdf

http://www.ebmpubs.com/ECN_pdfs/ecn1115_News.pdf

http://help.feedingamerica.org/HungerInAmerica/hunger-in-america-2014-full-report.pdf?s_src=W175DIRCT&s_subsrc=http://www.feedingamerica.org/&_ga=1.257412939.1168868384.1469148423

7

Overview of Military RankingsMilitary ranks are organized into four main groups: 1) Enlisted Officers 2) Warrant Officers 3)

Commissioned Officers, and 4) Cadets-Midshipmen (includes officer trainees).

1. Data from February 2017 found at https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp2. Data found at http://download.militaryonesource.mil/12038/MOS/Reports/2015-Demographics-Report.pdf

12,895

1,053,531

18,347

207,044

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

Active Duty Military Personnel by Ranking Groups1

Number of Service Members

0

1000

2000

3000

4000

5000

6000

7000

8000

EnlistedMembers

WarrantOfficers

CommissionedOfficers

2016 Basic Monthly Pay2

$5,805

$1,567

$7,283

$2,906

$6,881

$2,972

Nutritional FitnessConsidering Military Occupations & Pay Grade

Enlisted Members, who have the lowest pay grade on average, make up the majority of the Total Force.

Presenter

Presentation Notes

It’s important to note that Enlisted Members, who have the lowest pay grade on average, make up the majority of the Total Force. In order to properly prepare Service Members for any and all jobs they might undertake – civilian or military – we must take into consideration their financial ability to access the healthiest food options. Military ranks are organized into four main groups: Enlisted Officers (includes E1 paygrades to E9 pay grades) Warrant Officers (includes Warrant Officers from pay grades W1-W5) Commissioned Officers (includes lieutenants, generals, and admirals) Cadets-Midshipmen (includes officer trainees).

https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp

http://download.militaryonesource.mil/12038/MOS/Reports/2015-Demographics-Report.pdf

Nutritional FitnessFood Assistance Programs

8

• 18% of the Selected Reserve members with children are E1-E4 with an average household size of 3.8• 15% of Active Duty members with children are E1-E4 with an average household size of 3.9

Discontinued in 2016

This figure represents the household size that an E4 would need in order to qualify for commonly used food assistance programs.

Presenter

Presentation Notes

Discuss eligibility of Service Members for food assistance programs 18% (63,678)of the Selected Reserve members with children are E1-E4 with an average household size of 3.8 15% (87,056) of Active Duty members with children are E1-E4 with an average household size of 3.9 - Percentage are those with children, married or single - Average household size is number of dependents + SM for AD who have children This figure represents the household size that an E4 would need to have in order to qualify for the food assistance programs. The E4 paygrade plus the location (cost of living) was taken into account. The locations are a sampling of each of the Services. Family Subsistence Supplemental Allowance (FSSA) DoD program that provided supplemental income, up to $1100 per month, to Active Duty families in order to raise their income above the threshold for SNAP benefits. Benefit for CONUS Service members was eliminated in National Defense Authorization Act of 2016 (effective Sept 30 2016) to reduce redundancies with SNAP benefits. Less than 300 people qualified for FSSA worldwide. Notes: Family Subsistence Supplemental Allowance Ending in September. 13 Jul 2016. http://www.military.com/benefits/2016/07/13/fssa-benefit-ending.html. Accessed 1 May 2017.

Building Healthy Military Communities (BHMC) Pilot

A Model for Understanding the Reserve Component and Geographically Dispersed Service Members

9

< 5,0005,00010,00015,00020,00025,00030,00035,000>40,000

Components of the Total ForceGeographic Dispersion of Reserve Members

17Data from May 31, 2016 found at http://www.governing.com/gov-data/military-civilian-active-duty-employee-workforce-numbers-by-state.html

Presenter

Presentation Notes

Reserve members are primarily concentrated in Texas and California.

http://www.governing.com/gov-data/military-civilian-active-duty-employee-workforce-numbers-by-state.html

Food Access & Healthy EatingDual Communities

Sectors of the Food Environment On Installation Civilian Community

Food Acquisition • Commissary, convenience stores, Dining Facilities, Exchanges, Farmer’s markets

• Local grocery store chain, Farmers’ markets, restaurants

Food Preparation

• Dining facilities and Exchanges have food preparation staff

• Barracks do not have cooking facilities• Multi-unit installation housing kitchens

• In-home kitchen (if applicable)

Food Delivery & Access

• Defense Logistics Agency works with Prime Vendors to distribute food across the installation to all food venues

• Time of operation and number of food venues in operation on base affects access

• Dependent on community food venues

• Time of operation and number of food venues in operation in community affects access

Nutrition Education

• Service-dependent wellness campaigns• Dietitians when in-patient or mandated

weight-loss program

• Federal and local nutrition information campaigns and programs

• Civilian health professionals

Research & Assessment

• Status of the Force Survey• Health Related Behavior Survey or

Service dependent Periodic Health Assessment

• USDA and CDC health assessment surveys

• Utilization of federal and local entitlements 11

Approximately 70% of Active Duty Service members and almost all Reserve and National Guard Service members live in civilian communities. For these Service members, food acquisition and purchasing can be mainly dependent on availability in the civilian community.

Presenter

Presentation Notes

This figure depicts how we have segmented the food environment. The structure of the DoD food environment is a microcosm of the international food ecosystem. Individual community members have differing nutritional requirements and access points to the DoD food environment. If Service members live off the installation and not near an installation, then their access points more closely align with the civilian community rather than DoD. Thus, their health is outside of the DoD influence

Building Healthy Military Communities PilotProblem Statement and Background

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DoD increasingly relies on the Reserve Component (RC) due to factors such as personnel and funding reductions, and this population is increasingly living off of the installation.1,2 Therefore, the DoD must

prioritize the integration of community and military resources to achieve heightened Total Force Fitness.3

Problem

• Understand requirements for optimizing well-being and readiness for geographically dispersed RC Service members and current capabilities to meet these requirements.

• Design a strategic plan to coordinate and integrate DoD, federal, state, regional, and local efforts to better support the needs of geographically dispersed service members and their families through community capacity building.

Proposed Solution

1. RAND Corporation, 2008.2. U.S. Senate Committee on Armed Services3. TFF is a methodology for understanding, assessing, and maintaining Serves members’ well-being and sustaining their ability to carry out missions.

Process Measures:• Aligned initiatives and increased efficiencies.

Outcome Measures:• Increased Health Related Quality of Life (HRQoL), a multidimensional concept that “goes beyond the

direct measures of health and focuses on the quality-of-life consequences of health status”.• Increased readiness, measured by % ready to deploy.

Desired Impact

Presenter

Presentation Notes

Despite heavy investment in programs supporting Service members, data suggest the need for increased support across Total Force Fitness domains for the geographically dispersed Uniformed Services population.1 S.R. 114-63 calls for the execution of a pilot to “ensure enhancement of recruitment, retention, readiness and resilience.” DoD increasingly relies on the Reserve Component, consisting of the Guard and the Reserves, due to factors such as decreasing budgets and personnel and funding reductions.3,4

13

Military CommunitiesDoD and Civilian

DoD Community Members

Individual: Active Duty and Reserve Component Service member, family member, DoD civilian, retiree

Interpersonal and Professional Relationships: Family unit, partners, peers, colleagues

Units andOrganizations: Unit members, commanders, supervisors

Installations:Installation, base, forward deployment regions

Services: Army, Navy, MarineCorps, Air Force, Coast Guard, National Guard and Reserves

DoD: Office of the Secretary of Defense-level components and offices, departments and agencies

Each individual Service member, Veteran, and Retiree is connected to multiple formal and informal networks within DoD and within the civilian community. Research indicates a need for multi-component support programs

that integrate both civilian and military formal networks and the resources of the informal community.1

1. Huebner AJ, Macini JA, Bowen GL, Orthner DK. Shadowed by war: Building Community Capacity to Support Military Families. Family Relations, 58(2); 2009. 216-228.

Relationships

Installations

Services

DoD

Individual

Military Units

Presenter

Presentation Notes

There are two worlds of resources (military and civilian) to access food and other needs. Service members rely on both because they are apart of both communities. However, these resources between the two may not be integrated or readily available to SM. Importantly, approximately 70% of Active Duty Service members and almost all Reserve and National Guard Service members live in civilian communities.

Building Healthy Military Communities PilotPilot Site Selection

14

The selected states meet the pre-determined site selection criteria, including strong leadership commitment and representation of multiple Services from both the AC and the RC. The sites also vary in

terms of demographic data and geographic location.

MN

IN

FL

MS

OKNM

MD

Presenter

Presentation Notes

Though the pilot is only in these seven states, we will use food access and healthy eating as a use case to show how to bring the idea of community capacity building into all states. Involvement from State leadership and legislators is vital, in pilot, and non-pilot states.

15

Operation Live Well Key Contacts

Pilot Site Building Healthy Military Communities PilotState Coordinator Contact Information

Maryland Ms. Joy Ashcraft, [email protected], (410) 576-6019

New Mexico Ms. Susie Galea, [email protected], (575) 518-9308

Mississippi Mr. Hugh (Rick) Tyler, [email protected], 601-313-6312

Oklahoma Mr. Lonnie Bacon, [email protected], (405) 228-5571

Florida Ms. Lynn Brannon, [email protected], (904) 827-8564

Indiana Mr. Kyle Wood, [email protected], (317) 247-3300, X64337

Minnesota Ms. Danelle Bybee, [email protected], (218) 831-1705

OLW Role Contact information

Director, OLW CAPT Kimberly Elenberg, [email protected], (703) 571-3159

Food Environment Lead

Ms. Kari N Harris, [email protected], (703) 693-4206

BHMC Pilot Lead Ms. Maddie Soskin, [email protected], (703) 693-2214BHMC Pilot Inbox, [email protected]

mailto:[email protected]










Defense State Liaison Office (DSLO) Points of Contact

16

State DSLO Name

Maryland • Mr. Harold Cooney; Harold.e.cooney@[email protected]; 571-309-7468

Florida/Mississippi

• Mr. Eric Sherman; [email protected]; 571-309-7589

Indiana • Mr. Jim Rickel; [email protected]; 571-239-9895

Minnesota • Mr. Martin Dempsey; [email protected]; 703-380-6625

Oklahoma/New Mexico

• Mr. Dale Vande Hey; [email protected]; 571-236-7833

Chief• Mr. Marcus Beauregard

The mission of the DSLO is to alleviate barriers in state policy faced by Service members and harmonize the differences in state and federal laws impacting this population.

Relevant issues are reviewed and prioritized annually.

mailto:Harold.e.cooney@[email protected]





How to Get Involved

Help the Military Community in Your State Overcome Well-Being Challenges

17

Community Capacity Building

18

Improve the community’s capacity to simultaneously support military Service members and their families in achieving readiness and civilian community health outcomes.

Define community and target population and their needs Assess

community assets

Assess Community readiness

Plan implementationstrategies

Monitor & Evaluateprogress

Execute community

capacity improvement

Presenter

Presentation Notes

Define Community: When approaching community capacity building, begin by defining the community, their target population, and their potential needs, making sure to consider the varied nature of Service members experiences and resources. As this presentation has highlighted, we must consider where they are in the deployment lifecycle, the size of their family and the nature of their personal relationships (married, single, divorced), their geographical location (are they close to and/or able to access the necessary food resources?), their pay grade and its effect on their eligibility for food assistance programs, in order to effectively identify the most pressing needs. Assess Community Assets: We must also analyze the resources provided by the community – does the community have commissaries, convenience stores, dining facilities, local grocery stores, farmer’s markets, etc. and which are the Service members using most commonly? How is food being prepared, delivered, and accessed by these facilities? What kinds of nutrition education is being offered? We must consider all of these questions to understand fully the community’s food environment. Assess Community Readiness: Once the target population and environment are analyzed and understood, we must then assess community readiness. Is the community prepared to fill the gaps that currently exist? How prepared is the community to undergo change and what is the highest priority concern? Plan and Execute Implementation Strategies: At this stage, we understand the target population, the community resources, and the readiness of the community to undergo change. With these three components in mind, we can plan and then execute strategies that can reasonably and effectively be implemented by the community. Monitor and Evaluate Progress: Finally, we must monitor and evaluate progress over time to identify those strategies that found success and those that did not.

Opportunities for Community Capacity BuildingRecess Before Lunch

19

“A recent study conducted at Yokota [Air Base, Japan] showed…consumption of fruits and vegetables had increased and teachers reported that students were calmer and more focused in the classroom.”

Action Plan

Program Overview

Operation Live Well identified Recess Before Lunch1, a CDC-endorsed best practice for elementary schools that has demonstrated nutrition and behavior benefits, as a “promising practice” to implement more widely at DoD.

1. Recess before lunch at Elementary Schools Impacts Nutrition, Develops Healthy Eating Habits. Military Health System Communications office. May 1 2015. https://health.mil/News/Articles/2015/05/01/Recess-Before-Lunch-at-Elementary-Schools-Impacts-Nutrition. Retrieved April 19 2017.

Understand your state’s policies around recess and lunch

Assess whether your community requires changes in recess and lunch policies

Assess whether your school system is prepared to take on changes to recess and lunch policies

Work to implement recess before lunch policies

Identify and assist stakeholders in determining an implementation plan for the recess before lunch policy

https://health.mil/News/Articles/2015/05/01/Recess-Before-Lunch-at-Elementary-Schools-Impacts-Nutrition

Opportunities for Community Capacity BuildingFood Assistance Programs

20

Understand your state’s policies around food assistance programs – and assess whether or not the military community is benefitting from these resources

Assess whether your community requires changes in food assistance program policies – how could they be improved?

Work to improve or implement food assistance program policies to benefit the intended users

Action Plan

Program OverviewFood Assistance Programs assist families in affording nutritious food. The Supplemental Nutrition Assistance Program (SNAP) provides families with electronic benefit transfer cards that work like debit cards and can be used nationwide. The Special Supplemental Program for Women, Infants, and children (WIC) provides Federal grants to States for supplemental foods, health care referrals, and nutrition education. SNAP includes military housing and other allowances from the income computations, which poses challenges for military families seeking food assistance.

Data from https://www.fns.usda.gov/wic/women-infants-and-children-wic and https://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap..

https://www.fns.usda.gov/wic/women-infants-and-children-wic

https://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap

Next Steps

21

Recommended Actions and Next Steps

Facilitate state-level data collection of Service members and their families who utilize USDA food assistance programs and share to the federal level

Identify DoD and civilian leaders who understand the community’s food access and healthy eating issues

Enable those leaders to define the target population and their needs and assess community assets and readiness

Define resources needed for an implementation strategy

Reach out to the OLW Team for more information about the BHMC Pilot*

Military communities face a wide-range of food access and healthy eating issues. State legislators can take steps within their community to build capacity and improve the food

environment for Service members and their families.

* See prior slides for contact information

Appendix

22

Operation Live WellPosition in the DoD

23

Under Secretary of Defense for

Personnel and Readiness

DoD Human Resources

Activity

Assistant Secretary of Defense for Readiness

Personnel Risk and Resiliency

Assistant Secretary of

Defense for Health Affairs

Assistant Secretary of Defense for

Manpower and Reserve Affairs

Operation Live Well

Secretary of Defense

In 2016, the OLW moved from the Defense Health Agency to an Office of the Secretary of Defense-level policy office to allow for a broader, cross-Department

focus on the well-being of the Total Force.

Presenter

Presentation Notes

Talking Points: The DoD views this as a readiness problem. If Service members and their families are struggling with excess-weight related medical problems or they are experiencing issues with food insecurity, it compromises the Readiness of the Force. Therefore, our team – Operation Live Well – is situated under the Under Secretary of Defense for Personnel and Readiness. In 2016, the OLW moved from the Defense Health Agency to an Office of the Secretary of Defense-level policy office to allow for a broader, cross-Department focus on the well-being of the Total Force – no longer focused just in the healthcare setting but rather on the overall readiness of its Service members, As a coordinating office, Operation Live Well is not positioned to design and implement individual efforts or initiatives that focus on individual-level Service members. This socio-ecological model represents/demonstrates that the sphere of influence for OLW is too far removed from the individual level to directly affect Service members. Rather OLW strives to coordinate change management at a systems level through policy, business processes, and initiatives across the Military Services and DoD Components that ultimately affect health behaviors and decision-making at installation- and military unit-levels and well as through interpersonal relationships and individuals downstream.

Operation Live WellMission and Efforts

1. TFF was created by the Joint Chiefs of Staff in 2011 (CJCSI3405.01), and expresses that optimal performance requires fitness of the mind and body. 2. The NPS was established in 2011 under Executive Order 13544 and the Patient Protection and Affordable Care Act (Public Law 111-148). U.S. Surgeon General. "National Prevention

Strategy.“ SurgeonGeneral.gov. U.S. Department of Health and Human Services (HHS), available at: www.surgeongeneral.gov/priorities/prevention/strategy/

Optimize Individual Well-BeingTotal Force Fitness1 (TFF)

TFF Domains

Social

Environmental

Spiritual

Psyc

holo

gica

l

Healthy and safe community

environments

Empowered people

Clinical and community preventive services

Elimination of health

disparities

Enhance Community Well-BeingNational Prevention Strategy2 (NPS)

11

OLW aligns, integrates, and coordinates policies, initiatives, and business processes among the Military Services, the Joint Chiefs of Staff, and the Office of the Secretary of Defense to enhance the well-

being of Service members and their families, advancing individual readiness and community resiliency.

Mission

Efforts• TFF Capabilities-Based Assessment• TFF Joint Capabilities Integration Development

System (JCIDS) Analysis• Building Healthy Military Communities Pilot

• Tobacco Cessation and Use Prevention• Food Environment Integration• Alcohol Abuse Prevention

Presenter

Presentation Notes

Talking Points: Here’s how we approach improving readiness…OLW uses two frameworks to guide our work: Total Force Fitness focuses on the individual well-being and the National Prevention Strategy from the Office of the Surgeon General guides the way forward in community well-being and emphasizes the need for a comprehensive approach. Total Force Fitness (TFF) is a methodology for understanding, assessing, and maintaining Service members' well-being and sustaining their ability to carry out missions. National Prevention Strategy (NPS) works to “…improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on prevention and wellness.” Food Environment is one area of effort within OLW. Several others efforts going on simultaneously. For example, in 2016 the Tobacco Cessation and Use Prevention effort saw a lot of progress with the first DoD-wide tobacco policy signed by SecDef in April 2016. Another effort large effort is the Building Healthy Military Communities Pilot, which is focusing on assessing the needs and available community resources of geographically dispersed Service members, primarily the NG and Reserve.

Total Force Well-BeingApproach

25

Total Force Fitness (TFF)

TFF Domains

Social

EnvironmentalPs

ycho

logi

cal

Nutritional

Supporting the Total Force requires a comprehensive approach to their well-being throughout their career.

Pre-Deployment

Deployment or Mission Employment

Sustainment

Redeployment or Mission Change

Post-Deployment/Reintegration 1 Recruitment

2 Readiness3 Resiliency4 Retention

The DoD Deployment Lifecycle can span

decades and requires differing support and

resources at every stage.

TFF is used to assess the Service member’s well-being in its entirety, at

each stage of the deployment lifecycle.

Proper assessment allows the DoD to identify and remediate issues and

enhance the Four Rs.

Presenter

Presentation Notes

Talking Points: Not only does OLW consider the individual domains when assessing overall well-being, it also considers where they are in their deployment lifecycle. Current War on Terrorism marks the first time in our Nation’s history of volunteer military service that the US has attempted to sustain such a large fighting force for such a long period of time.

Overview of the U.S. Military

26

Data from February 28, 2017 found at https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp

Active

Reserve

National Guard

46%

20%

34%

Army

Active: 466,524Reserve: 199,065National Guard: 341,467

85%

15%

Navy

Active: 322,799Reserve: 58,118

65%14%

21%

Air Force

Active: 318,571Reserve: 68,271National Guard: 105,021

Components of the Total ForceActive and Reserve Component Breakdown

83%

17%

Marine Corps


86%

14%

Coast Guard


14

Presenter

Presentation Notes

Talking Points: To fully understand the nutritional challenges faced by the DoD, it’s important to understand the demographic. Component Descriptions: The Army is built to execute large-scale and long-term ground operations. The Navy provides naval security, ensures sea transport, and allows for U.S. Force projection. The Air Force controls air and space operations and is in charge of two-thirds of our nuclear triad (ballistic Missiles and bombers). The Marine Corps are a rapid deployment amphibious force. The Coast Guard is also a uniformed service and is considered a part of our nation’s military. Provides Maritime Safety, Security and Stewardship.

https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp

Components of the Total ForceDemographics

28Data found at http://download.militaryonesource.mil/12038/MOS/Reports/2015-Demographics-Report.pdf.

Active Duty Reserve

1.3 Million Total Active Duty Members with 1.7 Million Family Members

826,000 Reserve and Guard Members with 1 Million Family Members

Gender 19% Women16% Women

Education 23% have a bachelor’s degree or higher

21% have a bachelor’s degree or higher

Marriage 45% are married 54% are married

Children 42% of members have children;31% of children are ages 0-5

41% of members have children; 42% of children are ages 0-5

50% live in CA, TX, FL, PA, NY, OH, GA, VA, NC, AL, LA, and MS.Location 87.5% live in the United States and

its territories, with a majority living in California, Virginia, and Texas.

26% Minorities31% MinoritiesRace/Ethnicity

34% are 25 years old or younger44% are 25 years old or youngerAge

Presenter

Presentation Notes

Notes: FY DMRR Final – http://www.people.mil/Portals/56/Documents/tfprq/FY17%20DMRR%20Final.pdf

http://download.militaryonesource.mil/12038/MOS/Reports/2015-Demographics-Report.pdf

Components of the Total ForceVariety of Military Occupation Specialties (MOS)

29

The below chart groups the total number of Active Duty enlisted personnel by broad occupation and demonstrates the wide range of civilian career opportunities for Service members.

Data found at https://stats.bls.gov/ooh/military/military-careers.htm.

Non-occupation or unspecified coded personnel

1%

Media and Public Affairs2%

Machine Operator and Production

2%Support Service

2%

Human Resource Development

3%Construction

3%

Administrative5%

Healthcare6%

Protective Service7%

Electronic and Electrical Equipment Repair

12%

Transportation and Material Handling

13%

Combat Specialty14%

Engineering, Science, and Technical

15%

Vehicle and Machinery Mechanic

15%

Presenter

Presentation Notes

Talking Points: Service members are employed not only in combat but also in civilian careers, which means their needs are varied and far-reaching. The population needs to be prepared for a variety of careers – some are combat specialty who are the DoD’s most elite athletes, others run offices and drive desk jobs. This needs to be taken into consideration when thinking about the overall well-being of the DoD.

https://stats.bls.gov/ooh/military/military-careers.htm