Amy Hagopian & Kathy Barker -
Abstract
Recruiters for the various US armed forces have free access to our nation’s public high schools, as mandated by the No Child Left Behind Act (NCLB). Military recruiting behavior in the nation’s high schools has become increasingly aggressive and predatory. Although adults in the active military service are reported to experience increased mental health risks, including stress, substance abuse, and suicide, there is evidence that military service for the youngest soldiers is consistently associated with health effects far worse than for those who are older. This suggests that military service is associated with disproportionately poor health for those in late adolescence. These negative outcomes for teen soldiers, coupled with significant evidence that the adolescent brain is not equipped to make accurate risk calculations, leads APHA to conclude entry into the military should be delayed until full adulthood. For these reasons, the American Public Health Association opposes military recruiting in public elementary and secondary schools. APHA should encourage the United States to cease the practice of recruiting military enlistees in public high schools, specifically by (1) removing the No Child Left Behind Act requirement that high schools both be open to military recruiters and turn over contact information on all students to recruiters and (2) eliminating practices that encourage military recruiters to approach adolescents in US public high schools to enlist in the military services.
Problem Statement
Across the United States, recruiters from all branches of the military regularly enter every public high school to approach adolescents aged 14 through 18 years to persuade them to enlist in military service branches. Underage students are recruited into what is called the “Future Soldier Program,” which encourages them to attend boot camp during the summer between their junior and senior years. (The laws governing military recruiters in high schools are Section 544 of the National Defense Authorization Act [Public Law No. 107-107] and Section 9528 of the No Child Left Behind Act of 2001 [Public Law No. 107-110].)
Public health issues for young recruits: There are public health reasons to be concerned about military recruitment in public elementary and secondary schools. Adolescent recruitment targets are at a vulnerable stage of brain development and may experience adverse health consequences from stress. Given their limitations in judging risk at this stage in life, they are also unable to fully evaluate the consequences of making a choice to enter the military.[1]
The bulk of newly enlisted military personnel are developmentally in late adolescence, a time of relatively robust physical health but not necessarily complete brain development or a wise time to introduce high levels of stress.[2] According to one pediatric researcher, “Joining the military service entails absolute obedience, uniform appearance, disengagement from the family, and a potential threat for physical injury and mental stress, as well as requirement for responsibility beyond the personal needs of the individual.”[3]
Much has been written about adolescent brain development to explain why adolescents make decisions differently than do adults. One recent review in the journal Nature explains: “Even before you add raging hormones and peer-group-driven rebelliousness-without-a-cause to the mixture, adolescents may simply be unable consistently to make decisions the same way adults do. This could well be one of the reasons that, although most people are healthier during their adolescence than at any other time in their lives, adolescents are three or four times more likely to die than children past infancy: they take risks, have accidents and pay the prices.”[4]
A plethora of studies demonstrate that adolescent development is insufficient to support wise choices that have lifelong implications.[5–13] Young people‘s underdeveloped brains and compromised decision-making abilities underlie many laws and public policy decisions.[14] As a result of drunken teens dying in crashes and killing innocent motorists, in 1984 Congress raised the minimum age for the purchase and possession of alcoholic beverages to 21 years.[14,15] Auto insurance companies certainly understand this concept and age-adjust their rates accordingly.
Although adults in the active military service are reported to experience increased mental health risks, including stress, substance abuse, and suicide,[16,17] the youngest soldiers consistently show the worst health effects, suggesting that military service is associated with disproportionately poor health for this population.[18] A study of mental disorders in the US military showed the highest rates of all disorders, including alcohol abuse, anxiety syndromes, depression, and posttraumatic stress disorder, among the youngest cohort, those aged 17 through 24 years.[19] Another study revealed that younger soldiers had 30%–60% more substance abuse disorders, and younger women in particular had the highest incidence of attempted suicide or self-inflicted injuries.[20] It was also recently reported that the youngest group of veterans experienced a 26% increase in suicides from 2005 to 2007.[21] A review of hospitalizations among military personnel in the 1990s showed the highest rates among the youngest recruits.[22] We also know that the youngest active-duty military engage in the riskiest sexual behaviors and that women younger than 21 years account for almost one third of first births among female active-duty personnel.[18]
There is a well-established relationship among employment, income, and health. US Bureau of Labor Statistics employment data indicate that while the job market is slowly improving for most Americans, it is worsening for Gulf War II veterans (those on active duty since 2001). The youngest of veterans, those aged 18 to 24 years, had a 30.4% jobless rate in October 2011, up from 18.4% a year earlier. By contrast, the rate among nonveterans of the same age improved, to 15.3% from 16.9%. Among Black veterans aged 18–24 years, the unemployment rate is a striking 48%.[23]
There is a growing literature on “military sexual trauma” (MST). MST is described by the Veterans Administration (VA) as “psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the [veteran] was serving on active duty or [in] training.” The VA reports that 1 in 5 women and 1 in 100 men seen in Veterans Health Administration facilities screen positive for MST.[24] A national study of women veterans who reported being raped while on active duty showed that they were more likely to enter the military at a younger age than those who reported no similar assault,[25,26] which provides additional evidence for the value of postponing entry into the military until individuals are better able to resist this type of assault. There was also an investigation, conducted by the Associated Press, into the sexual abuse of more than 100 potential enlistees on the part of military recruiters.[27] The pattern that emerged was that victims were typically between 16 and 18 years old, and they usually met the recruiters at their high schools.
Military recruiters engage in aggressive behaviors to gain the trust of youth that are inappropriate, according to psychologists. For example, recruiting behaviors observed in schools can be characterized as “the process by which a child is befriended…in an attempt to gain the child’s confidence and trust, enabling [the recruiter] to get the child to acquiesce.”[28] Another definition notes the importance of being “exceptionally charming and/or helpful” while “failing to honor clear boundaries.”[29] Some examples follow.
The US Army’s school recruiting program (SRP) handbook offers wide-ranging advice to its personnel seeking to enlist high school students. It declares that “[r]ecruiters—like infantrymen—must move, shoot, and communicate” (US Army Recruiting Command [USAREC] Pamphlet 3-01). Another recruiting handbook states the goal more clearly: “The objective of the SRP is to assist recruiters with programs and services so they can effectively penetrate the school market” (USAREC Pamphlet 350-13). Advice includes various ways for recruiters to insinuate themselves into the school community to gain access to adolescents:
• Be so helpful and so much a part of the school scene that you are in constant demand.
• Attend athletic events at the high school.
• Deliver donuts and coffee for the faculty once a month.
• Offer to be a timekeeper at football games.
• Martin Luther King Jr.’s birthday is in January. Wear your dress blues and participate in school events commemorating this holiday.
Recruiters are reported to chaperone dances, tutor kids, coach football teams, and ride buses to and from school, all in an effort to get near kids. They also “volunteer” to teach gym classes, sponsor climbing walls, bring large armored vehicles to campuses to create a sensation, and infuse counseling offices with the ASVAB—the Armed Services Vocational Aptitude Battery test—to assist young people in making career choices (with scores forwarded to recruiters).[30] Nothing in the manual advises recruiters to reveal the risks their prospects face, neither the physical hazards on the battlefield nor the psychological trauma and its aftereffects. Even when recruiters target adolescents 17 years or older for recruiting activities, the mere presence of recruiters in the schools exposes younger children to aggressive recruiting practices.
These soliciting behaviors (called “prospecting” in the recruiting handbook) are varyingly successful. During the height of the Iraq War, recruitment goals were modestly low; even so, the goals were not met for many months. The recent collapse of the US economy, however, has made the military a more attractive option for lower-income prospects.[17]
Military targeting of low-income youth and students of color: The American Civil Liberties Union has reported that military recruiters disproportionately target low-income youth and students of color.[31] Voluntary military enlistment during wartime is also associated with lower college aspirations, lower socioeconomic status, and living in an area with a high military presence.[32] The greatest likelihood of military service versus college or the labor force occurs when young men of modest ability come from disadvantaged circumstances, experience minimal connectedness to others, and report a history of adolescent fighting.[33] Nearly three quarters of those killed in Iraq came from towns where the per capita income was below the national average.[34]
Military recruiting budgets are estimated at between $1 billion and $20 billion per year, depending on the source.[35–37] This level of expenditure purchases a great deal of market penetration, with a strong ability to target specific audiences. The US military commissioned a report by the Rand Corporation on how to target recruits by race, ethnicity, and income.[38] The report clearly lays out the incentives that will appeal most to each ethnic group.[38] The army is reportedly purchasing a sophisticated market segmentation system that targets youngsters by income status.[39] The army contracts with 4 different advertising firms to create recruiting ads that target different ethnic groups, using cultural indicators to customize the ads.[40] Army recruitment ads exploit the fact that young people of color do not have the same opportunities as children from middle-class and wealthy families.[41]
Military recruiters acknowledge that “if joining the military is not considered by age 17, it likely will not be in later years” either.[42] Therefore, as is the case with tobacco marketing, military marketing is quite aggressively targeted at younger prospects. The Junior Reserve Officer Training Corps (ROTC) enrolls 286,000 youngsters in 1,645 schools, mostly in the southeastern US states, at ages as low as 13 years.[43]
The Blue Angels is described as another recruiting tool specifically aimed at the very young and vulnerable prospective recruit.[44] The Blue Angels will not perform in a city unless its recruiters gain access to high school students and their “influencers.”[45]
Student privacy protections: The No Child Left Behind Act, Section 9528, requires public schools to give military recruiters access to students at school and access to students’ contact information. It does, however, allow students and their families to opt out of this wholesale release of private information to the military. The privacy of underage students is also ensured under the Family Education Rights and Privacy Act (see full language at http://www2.ed.gov/policy/elsec/leg/esea02/pg112.html). However, many school districts do not inform families of their NCLB privacy rights, subjecting some students to aggressive military recruiting at home as well as at school.[30]
Despite these legal privacy protections, the army’s manual instructs high school recruiters to intentionally circumvent the law: “Lead generation is what makes prospecting possible. Asking a school official for a student directory is one example of lead generation. Be creative if the school doesn’t release a list. Consider, for example, contacting the company that produces senior photos. If necessary, have your Future Soldiers review your school’s yearbook(s). Have them identify their friends and acquaintances with a phone number, an e-mail address, or any other information they can provide. Use the phone book to identify phone numbers. Think! This kind of information gathering can establish contact with an otherwise hard to find lead. Establishing strong relationships with COIs [centers of influence]—such as yearbook photographers, school officials, and Future Soldiers—ensures you have a constant, reliable source of leads” (USAREC Pamphlet 3-01).
There are other ways in which schools help military recruiters violate student and family privacy rights. Approximately 12,000 high schools offer the 3-hour ASVAB as an aptitude test and recruiting tool.[46] Test results allow the military to obtain sensitive, personal information on more than 660,000 high school students annually, the vast majority of whom are younger than 18 years.[47] In some schools, taking the ASVAB is mandatory, however, and few parents or students are informed that the ASVAB is the Department of Defense placement test used for enlistees in the military[48] and that students’ home contact information will be sent with the results to military recruiters unless the school chooses “Option 8.”
Student home contact information is also collected through the Joint Advertising Market Research & Studies (JAMRS) database, a joint recruiting project of the Department of Defense and several marketing firms.[49] The database contains information on 30 million Americans between the ages of 16 and 25 years and is bought from agencies such as the College Board (which administers SAT tests), the Department of Motor Vehicles, the Selective Service System, and ASVAB. While students and families cannot opt out of the JAMRS database, many do not know they can suppress the use of their information with a written request.
Marketing campaigns emphasize practical skills, patriotism, and tales of adventure that appeal to teenagers and fail to discuss the actual risks of war. These appeals are based on the extensive research into the psychological and behavioral factors that influence teenagers to enlist in the military.[50]
Convention on the Rights of the Child: Since its adoption in 1989, the United Nations Convention on the Rights of the Child has been ratified more quickly and by more governments than any other human rights instrument.[51] Only 2 UN members have yet to ratify: Somalia and the United States of America. Opponents of ratification object to giving away US sovereignty to the UN and also claim that the treaty undermines parental rights.[51]
An “optional protocol” to the convention, which the United States has in fact signed, promises that “[p]ersons who have not attained the age of 18 years are not compulsorily recruited into [the] armed forces” and ensures safeguards for adolescents subjected to voluntary recruitment. Nonetheless, high school–based recruiting necessarily targets children as young as 13 years. According to the American Civil Liberties Union:
“The Optional Protocol on the Involvement of Children in Armed Conflict (Optional Protocol) is meant to safeguard the rights of children under 18 from military recruitment and deployment to war, and to guarantee basic protections to former child soldiers, whether they are seeking refugee protection in the United States or are in U.S. custody for alleged crimes. The U.S. Senate ratified the Optional Protocol in December 2002. By signing and ratifying the Optional Protocol to the Convention on the Rights of the Child, the U.S. bound itself to comply with the obligations contained in the Optional Protocol. The Optional Protocol provides that the absolute minimum age for voluntary recruitment is 16 years old. It also instructs countries to set their own minimum age by submitting a binding declaration, and the United States entered a binding declaration raising this minimum age to 17. Therefore, recruitment of youth ages 16 and under is categorically disallowed in the United States.”[31]
Analogies to sports recruiting: The military evades the type of safeguards that the National Collegiate Athletic Association (NCAA) has established to control the presence of sports recruiters in schools. The NCAA limits the number of phone calls that can be made by sports recruiters, the time of year they can be made, times of off-campus contact, and high school campus and game visits. Despite the number of violations of its policies that are regularly reported, the NCAA does attempt to protect student athletes and penalizes college recruiters for violations of policy. By contrast, there is no analogous organization that even attempts to protect the rights of young prospective recruits into the military; indeed, the mandating of access to adolescents by military recruiters sidelines the roles of schools as protectors of adolescents in their transactions with these recruiters.
While football coaches are prohibited from influencing students with elaborate theatrics, military recruiters often appear at schools in Blackhawk helicopters.[52] Also in contrast to military recruiting, the NCAA requires honesty in portraying the actual likelihood of prospects for young athletes. The NCAA keeps students informed of the estimated probability of competing in athletics beyond high school, for example.[53] In another divergence from sports recruiting, the military is not required to abide by any written or verbal commitments it makes to enlistees, while at the same time young recruits have no way out of the contracts they sign.[54] In sports recruiting, the National Letter of Intent and financial aid agreement are binding on both parties.[55]
Conclusion: Military service is associated with hazards to mental and physical health for the very youngest recruits. Despite this, current US law mandates that public schools open their doors to military recruiters. Public health programs worldwide rely on the UN Convention on the Rights of the Child to ensure the protection of children. Public health advocates who focus on children in the United States should monitor and, where necessary, rein in the behaviors of military recruiters in our schools as a matter of protecting child health and welfare and as a step toward bringing the United States into the family of nations that have ratified the treaty. Congress should remove the NCLB mandate that public high schools admit military recruiters. Military recruiters have sufficient access to adult recruits through community recruiting stations without accessing adolescents in the public schools.
The “precautionary principle” specifies that if a policy is suspected of causing harm, in the absence of a scientific consensus the burden of proof falls on those making the policy.[56] Given the growing evidence that school-based military recruitment of adolescents is harmful, the principle would require limiting the practice until or unless evidence to the contrary is established.
Proposed Recommendations Statement
To reduce the exposure of adolescents in public schools to military recruitment, we must eliminate the laws that protect and promote the behavior. In cases where military service provides side benefits, such as access to higher education and discipline, these positive effects can be more directly and efficiently provided without the hazards of service.
Opposing Arguments
The military strives to offer many opportunities for young people, especially those from low-income backgrounds who might not otherwise find opportunities to pay for college or find discipline in their lives. Many believe the benefits of military service outweigh the higher risks of death, disability, addiction, homelessness, and unemployment that plague America’s military veterans.[57–61] Since there has been no randomized controlled trial (or really any scientific assessment at all) of the effects of military service as compared with alternative service for young people, we have no control group by which to make definitive judgments. Indeed, in a recent New York Times article, Col. Jeffrey A. Bailey, the surgeon who directs the Joint Trauma System at the Institute of Surgical Research at Fort Sam Houston, was quoted: “There as yet is no standardized medical database that enables researchers to look back comprehensively on the experiences of Afghanistan and Iraq.”[62] Dr. Edmond Lounsbury, retired colonel and author of the textbook War Surgery in Afghanistan and Iraq, suggested the reason these data are restricted is a misguided “desire to present an airbrushed picture of war for public consumption.”[62]
The evidence available, however, demonstrates that military service is associated with worse health outcomes for the youngest recruits and therefore supports the removal of military recruiting from our nation’s high schools, where the youngest and most vulnerable recruits are found. Although there are certainly public health benefits to gaining access to college (one of the benefits the military purports to offer to recruits), there are more direct avenues to a college education, and at a lower overall cost to society and the individual.
The military argues that access to youngsters in their high schools provides necessary efficiencies in the recruitment process, as the target population is assembled and readily accessed. However, the presence of recruiters in schools implies the sanction of this career choice on the part of the school and the community, regardless of the health consequences. Recruiters are quite adept at finding other more neutral locations where potential recruits, preferably older ones, can be accessed.
Furthermore, opponents might assert that the rights of the federal government take precedence over the rights of schools, families, communities, or individuals. Section 8 of the Constitution of the United States gives the federal government the right to raise and support armies, and to do so in an era without a fair draft of all eligible members of the population requires access to young people in the places where they congregate. We argue, however, that since attendance in school is compulsory, parents have no way to protect children in those settings from recruiters.
Alternative Strategies
• The national Parent Teacher Association (PTA) adopted a position in 2007 to support HR 551, the Student Privacy Protection Act, which would require an active “opt-in” requirement for parents and students before contact information is sent to military recruiters.
• California’s Humboldt County voted to prohibit the military recruitment of children younger than 18 years in the cities of Eureka and Arcata on November 4, 2004, with the support of 56% and 73%, respectively, of the voters for a youth protection act.[63] A federal judge subsequently struck down the measure,[64] a decision both cities unsuccessfully appealed.[65]
• In Seattle, the school board adopted strict restrictions on military recruiting in public schools,[30] and the Oakland Unified School District similarly took strong action to rein in military recruiting on its campuses.[66] Other districts are regulating some facets of recruiter access in schools or student privacy protections as well.[67]
• Maryland passed legislation in 2010 barring high schools from automatically forwarding students’ test scores on the ASVAB (the test developed and used by the US military to identify potential recruits that is given—and required—in many schools) to military recruiters. Many schools had been sending test results and detailed information about students directly to recruiters without student or parental permission.[68]
• Hawaii’s Department of Education decided in 2009 that public schools could not release student ASVAB test scores and contact information to the military; students must go to a recruiting station off campus and request that their information be sent to the military.[69]
• The Oakland Unified School District requires schools (as of 2010) to offer students the chance to suppress their information from use by the Department of Defense’s JAMRS database.[70]
• The New Hampshire commissioner of education voted in May 2012 to advise all state public high schools to restrict the release to military recruiters of student information obtained as a result of administering the ASVAB test.[71]
Action Steps
The US Government Accountability Office (GAO) should:
• Conduct a follow-up to its 2006 investigation into the behaviors, practices, and policies associated with US Armed Forces recruiting in our nation’s public elementary and secondary schools.[72] At that time, GAO found “that between fiscal years 2004 and 2005, allegations and service-identified incidents of recruiter wrongdoing increased, collectively, from 4,400 cases to 6,600 cases; substantiated cases increased from just over 400 to almost 630 cases; and criminal violations more than doubled from just over 30 to almost 70 cases.”
• Conduct an analysis of the military’s college education benefit packages and the frequency of utilization as promised to recruits. These costs should be compared with other strategies for expanding access to college among low-income youth, to provide full disclosure to all young people considering entering the military for purposes of gaining access to this benefit.
The US Department of Education should:
• Advise parents how to “opt out” of having contact information referred to recruiters and create guidelines for recruiting in schools.
• Advise parents and the schools that offer the ASVAB career test that they can withhold student names from being turned over to military recruiters.
• Advise parents they can suppress their names on the Department of Defense JAMRS database, through which military recruiters are sent student names acquired through SAT applications and other sources.
• Provide guidance to school districts on how to protect adolescents from unwarranted attention by aggressive recruiters, along with informing school districts of US Armed Forces recruiting practices in public elementary and secondary schools.
• Develop resources for adolescents to critically assess marketing messages directed at them.
• Encourage school districts to present a range of alternatives to military enlistment for post–high school life, including Vista, AmeriCorps, and other paths that engage young people in public service and provide access to higher education.
The U.S. Department of Defense should:
• Restrict its recruiters from entering public schools to recruit students and from obtaining names and addresses of students from public elementary and secondary schools.
• Revise recruiting manuals to refrain from predatory recruiting practices and to require that recruiters fully disclose the provisions of enlistment contracts and the full risks of military enlistment, including the likelihood of being sent to war.
The US Congress should:
• Repeal the provisions of the No Child Left Behind Act that mandate that public schools collaborate with military recruiters by providing full access to school buildings and student contact information.
• Reiterate its commitment to abide by the optional protocol of the UN Convention on the Rights of the Child by restricting recruiter access to adolescents in their schools and ensuring safeguards for adolescents subjected to voluntary recruitment.
Source: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1445
References
1. Steinberg L. A social neuroscience perspective on adolescent risk-taking. Dev Rev. 2008;28(1):78–106.
2. Kelley AE, Schochet T, Landry CF. Risk taking and novelty seeking in adolescence: introduction to part I. Ann N Y Acad Sci. 2004;1021:27–32.
3. Hardoff D, Halevy A. Health perspectives regarding adolescents in military service. Curr Opin Pediatr. 2006;18(4):371–375.
4. Powell K. Neurodevelopment: how does the teenage brain work? Nature. 2006;442(7105):865–867.
5. Spano S. Adolescent brain development. Youth Stud Aust. 2003;22(1):36–38.
6. Reed SC, Bell JF, Edwards TC. Adolescent well-being in Washington state military families. Am J Public Health. 2011;101(9):1676–1682.
7. Irwin CE Jr, Burg SJ, Uhler Cart C. America’s adolescents: where have we been, where are we going? J Adolesc Health. 2002;31(suppl 6):91–121.
8. Sawyer SM, Afifi RA, Bearinger LH, et al. Adolescence: a foundation for future health. Lancet. 2012;379(9826):1630–1640.
9. Sawyer MG, Borojevic N, Ettridge KA, Spence SH, Sheffield J, Lynch J. Do help-seeking intentions during early adolescence vary for adolescents experiencing different levels of depressive symptoms? J Adolesc Health. 2012;50(3):236–242.
10. Dashiff C, DiMicco W, Myers B, Sheppard K. Poverty and adolescent mental health. J Child Adolesc Psychiatr Nurs. 2009;22(1):23–32.
11. Patrick V, Critchfield E, Vaccaro T, Campbell J. The relationship of childhood abuse and early separation from the military among Army advanced individual trainees. Mil Med. 2011;176(2):182–185.
12. Spenrath MA, Clarke ME, Kutcher S. The science of brain and biological development: implications for mental health research, practice and policy. J Can Acad Child Adolesc Psychiatry. 2011;20(4):298–304.
13. Viner RM, Ozer EM, Denny S, et al. Adolescence and the social determinants of health. Lancet. 2012;379(9826):1641–1652.
14. Steinberg L, Cauffman E. The elephant in the courtroom: a developmental perspective of the adjudication of youthful offenders. Va J Soc Policy Law. 1999;6:389–417.
15. National Minimum Drinking Age Act, 23 USC §1581984.
16. Bray RM, Hourani LL, Rae Olmsted KL, et al. Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel: A Component of the Defense Lifestyle Assessment Program (DLAP). Research Triangle Park, NC: RTI International; 2006.
17. Alvarez L. More Americans joining military as jobs dwindle. Available at: http://www.nytimes.com/2009/01/19/us/19recruits.html?pagewanted=all. Accessed February 13, 2012.
18. Klein DA, Adelman WP. Adolescent pregnancy in the U.S. military: what we know and what we need to know. Mil Med. 2008;173(7):658–665.
19. Riddle JR, Smith TC, Smith B, et al. Millennium cohort: the 2001–2003 baseline prevalence of mental disorders in the U.S. military. J Clin Epidemiol. 2007;60(2):192–201.
20. Wojcik BE, Akhtar FZ, Hassell LH. Hospital admissions related to mental disorders in U.S. Army soldiers in Iraq and Afghanistan. Mil Med. 2009;174(10):1010–1018.
21. Defense Centers of Excellence. Military suicide prevention: keynote address by Eric Shinseki. Available at: http://www.c-spanarchives.org/program/291177-1. Accessed January 21, 2010.
22. Hoge CW, Lesikar SE, Guevara R, et al. Mental disorders among U.S. military personnel in the 1990s: association with high levels of health care utilization and early military attrition. Am J Psychiatry. 2002;159(9):1576–1583.
23. US Department of Labor, Department of Labor Statistics. Unemployment for young vets: 30% and rising. Available at: http://www.businessweek.com/finance/occupy-wall-street/archives/2011/11/the_vets_job_crisis_is_worse_than_you_think.html. Accessed February 13, 2012.
24. . Women Veterans of Operations Iraqi Freedom and Enduring Freedom: Analysis of VA Health Care Utilization. Washington, DC: Veterans Administration Office of Public Health and Environmental Hazards; 2004.
25. Suris A, Lind L. Military sexual trauma: a review of prevalence and associated health consequences in veterans. Trauma Violence Abuse. 2008;9(4):250–269.
26. Sadler AG, Booth BM, Nielson D, Doebbeling BN. Health-related consequences of physical and sexual violence: women in the military. Obstet Gynecol. 2000;96(3):473–480.
27. Clark A. Sexual abuse by military recruiters: more than 100 women raped or assaulted by recruiters in past year. Available at: www.cbsnews.com/stories/2006/08/19/national/main1913849_page2.shtml. Accessed February 13, 2012.
28. Craven S, Brown S, Gilchrist E. Sexual grooming of children: review of literature and theoretical considerations. J Sex Aggress.2006;12(3):287–299.
29. Van Dam C. Identifying Child Molesters : Preventing Child Sexual Abuse by Recognizing the Patterns of the Offenders. New York, NY: Haworth Maltreatment and Trauma Press; 2001.
30. Hagopian A, Barker K. Should we end military recruiting in high schools as a matter of child protection and public health? Am J Public Health. 2011;101(1):19–23.
31. American Civil Liberties Union. Soldiers of misfortune: abusive U.S. military recruitment and failure to protect child soldiers. Available at: http://www.aclu.org/human-rights/soldiers-misfortune-abusive-us-military-recruitment-and-failure-protect-child-soldiers. Accessed February 13, 2011.
32. Kleykamp M. College, jobs, or the military? Enlistment during a time of war. Soc Sci Q. 2006;87(2):272–290.
33. Elder GH Jr, Wang L, Spence NJ, Adkins DE, Brown TH. Pathways to the all-volunteer military. Soc Sci Q. 2010;91(2):455–475.
34. National Public Radio. Small towns absorb the toll of war. Available at: http://www.npr.org/templates/story/story.php?storyId=74922312007. Accessed May 24, 2012.
35. Center for Strategic and Budgetary Assessments. Analysis of the FY 2012 defense budget. Available at: http://www.csbaonline.org/. Accessed May 24, 2012.
36. Fox News. Pentagon spending billions on PR to sway world opinion. Available at: http://www.foxnews.com/politics/2009/02/05/pentagon-spending-billions-pr-sway-world-opinion/. Accessed May 24, 2012.
37. McDuffee A. Dollar-driven recruiting. Available at: http://www.thenation.com/article/dollar-driven-recruiting. Accessed May 24, 2012.
38. Steinberg P. Explaining recent army and navy minority recruiting trends. Available at: http://www.rand.org/pubs/research_briefs/RB9463/index1.html: Accessed February 13, 2011.
39. Tetrad. PRIZM segments: overall affluence measures of youth. Available at: http://www.tetrad.com/pub/documents/pnesegments.pdf. Accessed May 24, 2012.
40. McMains A. U.S. Army puts marketing in play: the RFP projects a budget in excess of $150 million in the next fiscal year. Available at: http://www.adweek.com/aw/content_display/news/account- activity/e3i2c5aa2b5f24b2a9b530026d4d5d3161f. Accessed May 24, 2012.
41. Venetis P, Dearborn J, Johnson N, et al. Should you enlist? What everyone should know about military recruiting, military life, and veteran affairs before enlisting. Available at: http://www.law.newark.rutgers.edu/files/Military%20Recruitment%20Report.pdf. Accessed May 24, 2012.
42. Joint Advertising Marketing Research & Studies. State of the recruiting market. Available at: http://www.navy.mil/navco/CFA/JAMRS.pdf. Accessed May 24, 2012.
43. Army Junior Reserve Officer Training Corps. JROTC white paper. Available at: http://www.usarmyjrotc.com. Accessed May 24, 2012.
44. US Navy. Blue Angels. Available at: http://www.blueangels.navy.mil/show/faq.aspx. Accessed May 24, 2012.
45. US Navy. Blue Angels letter stating air show recruiting requirement. Available at: http://www.blueangels.navy.mil/media/support/support_manual_2012.pdf. Accessed May 24, 2012.
46. ASVAB. Career Exploration Program. Available at: http://www.asvabprogram.com/. Accessed May 31, 2011.
47. Elder P. Forced military testing in America’s schools. Available at: http://www.commondreams.org/view/2012/01/04-0. Accessed May 24, 2012.
48. Military.com. Ace the ASVAB. Available at: http://www.military.com/ASVAB. Accessed May 31, 2011.
49. Joint Advertising Marketing Research & Studies home page. Available at: http://www.jamrs.org/. Accessed May 31, 2011.
50. Eighmey J. Why do youth enlist? Identification of underlying themes. Armed Forces Soc. 2006;32(2):307–308.
51. Child Rights Information Network. Convention on the Rights of the Child. Available at: http://www.crin.org/resources/treaties/CRC.asp. Accessed May 31, 2011.
52. National Collegiate Athletic Association. Recruiting. Available at: http://www.ncaa.org/wps/wcm/connect/public/Test/Issues/Recruiting/. Accessed May 29, 2011>.
53. National Collegiate Athletic Association. Probability of competing in athletics beyond high school. Available at: http://www.ncaa.org/wps/wcm/connect/public/Test/Issues/Recruiting/Probability+of+Going+Pro. Accessed May 24, 2011.
54. Enlistment/Reenlistment Document of the Armed Forces of the United States. Available at: http://usmilitary.about.com/library/pdf/enlistment.pdf. Accessed May 29, 2011.
55. National Collegiate Athletic Association. NCAA Connect. Available at: http://www.ncaa.org/wps/portal/ncaahome?WCM_GLOBAL_CONTEXT=/ncaa/NCAA/Legislation+and+Governance/Eligibility+and+Recruiting/Faqs/recruiting. Accessed May 29, 2011.
56. Chaudry RV. The precautionary principle, public health, and public health nursing. Public Health Nurs. 2008;25(3):261–268.
57. Edens EL, Kasprow W, Tsai J, Rosenheck RA. Association of substance use and VA service-connected disability benefits with risk of homelessness among veterans. Am J Addict. 2011;20(5):412–419.
58. Seal KH, Bertenthal D, Miner CR, Sen S, Marmar C. Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Arch Intern Med. 2007;167(5):476–482.
59. Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023–1032.
60. Mora AG, Ritenour AE, Wade CE, Holcomb JB, Blackbourne LH, Gaylord KM. Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries. J Trauma. 2009;66(suppl 4):S178–S185.
61. Gaylord KM. The psychosocial effects of combat: the frequently unseen injury. Crit Care Nurs Clin North Am. 2006;18(3):349–357.
62. Chivers C. Cataloging wounds of war to help heal them. Available at: http://www.nytimes.com/2012/05/18/world/asia/catalog-of-wounded-in-afghan-war-could-be-model.html?pagewanted=all. Accessed May 31, 2012.
63. League of Women Voters. Local measures in Humboldt County, California. Available at: http://www.smartvoter.org/2008/11/04/ca/hm/meas/. Accessed January 21, 2010.
64. Ballotpedia. Eureka Military Recruiting Measure J. Available at: http://ballotpedia.org/wiki/index.php/Eureka_Military_Recruiting_Measure_J,_2008. Accessed January 22, 2010.
65. Johnson C. Court upholds ruling on military recruitment bans in Eureka and Arcata. Available at: http://www.news10.net/news/local/story.aspx?storyid=112600&catid=2&provider=email17. Accessed January 22, 2010.
66. Oakland Unified School District. Student privacy and equal access policy. Available at: http://afsc.org/sites/afsc.civicactions.net/files/documents/Student%20Privacy%20and%20Equal%20Access%20Resolution.pdf.Accessed May 31, 2011.
67. Network Opposing the Militarization of Youth. Current policies and campaigns. Available at: http://www.nnomy.org/index.php?option=com_flexicontent&view=items&cid=306%3Aschool-policies&id=341%3acurrent-policies-and-campaigns&itemid=207&lang=en. Accessed February 13, 2011.
68. Birnbaum M. Maryland law limits military recruitment of high school students. Available at: http://www.washingtonpost.com/wp-dyn/content/article/2010/04/14/AR2010041404601.html. Accessed Februry 13, 2011.
69. Hamamoto P. State of Hawaii Department of Education memo to area superintendents. Available at: http://www.dmzhawaii.org/?tag=opt-out. Accessed February 13, 2011.
70. Oakland Unified School District. Student privacy and equal access resolution. Available at: http://www.ousd.k12.ca.us/ousd/site/default.asp. Accessed May 31, 2011.
71. Barry VM. New Hampshire schools to recommend schools select Option 8 under the Armed Services Vocational Aptitude Battery (ASVAB) test (“access to student test information is not provided to recruiting services”). Personal communication, May 16, 2012.
72. US Government Accountability Office. Military recruiting: DOD and services need better data to enhance visibility over recruiter irregularities. Available at: http://www.gao.gov/new.items/d06846.pdf. Accessed May 31, 2012.
Policy Date: 10/30/2012
Policy Number: 20123
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APHA Policy Statement 20019 – Protection of Child and Adolescent Workers
APHA Policy Statement 200118 – Support for Curricula in Firearm Related Violence Prevention
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APHA Policy Statement 201013 – American Public Health Association Child Health Policy for the United States
APHA Policy Statement 2002-11 – Opposing War in Central Asia and the Persian Gulf
APHA Policy Statement 200324 – Opposition to United States Plans for New Nuclear Weapons Development and Pre-emptive War
APHA Policy Statement 2005-1 – Condemning the Cooperation of Health Professional Personnel in Physical and Mental Abuse and Torture of Military Prisoners and Detainees
APHA Policy Statement 200617 – Opposition to the
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APHA Policy Statement 200718 – Opposition to US Attack on Iran
APHA Policy Statement 20075 – Agent Orange
APHA Policy Statement 20094 – Ensuring the Achievement of the Millennium Development Goals: Strengthening US Efforts to Reduce Global Poverty and Promote Public Health
APHA Policy Statement 20095 – The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War
APHA Policy Statement 6901 – Chemical and Biological Methods of Warfare
APHA Policy Statement 7319 – Lives and Safety of Public Health Colleagues in Chile
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APHA Policy Statement 7913 – World Peace and the Military Budget
APHA Policy Statement 8531 – The Health Effects of Militarism
APHA Policy Statement 9205 – Reducing and Monitoring the Use of Toxic Materials in Production by the Departments of Defense
APHA Policy Statement 9804 – Cessation of Continued Development of Nuclear Weapons
APHA Policy Statement 9923 – Opposing War in the Middle East
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