The Health and Well-Being of Service Members and Veterans Before and During the COVID-19 Pandemic: Findings From the US Millennium Cohort Study.

Publication date: Jun 07, 2026

Service members and veterans may have been particularly vulnerable to the stressors of the COVID-19 pandemic because of the unique challenges tied to military service. Understanding the pandemic’s impact on the health and well-being of these populations is critical for maintaining military readiness and preparing for future crises. The study sample included 80,974 US military personnel and veterans from the Millennium Cohort Study who completed the 2019-2021 survey. Participants who responded between October 23, 2019, and March 10, 2020, were classified as pre-pandemic responders (63%), while those who responded between March 11, 2020, and August 31, 2021, were classified as peri-pandemic responders (37%). Associations between pre- or peri-pandemic response group and mental, behavioral, and physical health, and stress and resilience factors were estimated using modified Poisson regression with inverse probability of treatment weighting to account for differences in sociodemographic, military, behavioral, and prior health factors. This study was approved by the Naval Health Research Center Institutional Review Board. Compared with pre-pandemic responders, peri-pandemic responders had higher adjusted prevalences of mental health conditions, including problematic anger (adjusted prevalence ratio [aPR = 1. 05, 95% confidence interval, [95% CI, 1. 01, 1. 09]), anxiety (aPR = 1. 13, 95% CI, 1. 09, 1. 17), depression (aPR = 1. 07, 95% CI, 1. 02, 1. 11), and post-traumatic stress disorder (aPR = 1. 10, 95% CI, 1. 06, 1. 14). Peri-pandemic responders were also more likely to report poor health (aPR = 1. 05, 95% CI, 1. 02, 1. 08) and express concern about stable housing (aPR = 1. 19, 95% CI, 1. 11, 1. 27). Associations between pandemic response group and physical and behavioral health outcomes (insomnia, somatic symptoms, and tobacco use) varied by military service status. Findings suggest a higher burden of adverse health outcomes among service members and veterans during the COVID-19 pandemic. Tailored support strategies may be needed to address the specific needs of military and veteran populations during times of crisis. However, differences were modest in magnitude, which may reflect the underlying resilience of military communities.

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