Wellness in the Military

Bending the cost curve, and improving care.

The Problem

1. We are as unhealthy as the general US population

Which means that we have an increasing burden of illness due to chronic disease. Add to that,  the  long-term impact of war and the ongoing need for care (particularly mental healthcare) and we end up with an escalating, unsustainable cost.

Why 75% of Americans 17-24 are unable to serve

Startling statistics released by the Pentagon show that 75 percent of young people ages 17 to 24 are currently unable to enlist in the United States military. Three of the most common barriers for potential recruits are failure to graduate high school, a criminal record, and physical fitness issues, including obesity.

Physically unfit: 27 percent of young Americans are too overweight to join the military. Many are turned away by recruiters and others never try to join. Of those who attempt to join, however, roughly 15,000 young potential recruits fail their entrance physicals every year because they are too heavy.

The United States military requires rigorous eligibility standards because it needs competent, healthy and educated individuals to staff the world’s most professional and technologically-advanced military. The best aircraft, ships and satellite-guided weaponry alone will not be enough to keep our country strong. To ensure a strong, capable fighting force for the future, America’s youth must succeed academically, graduate from high school, be fit, and obey the law.

Source: Ready Willing and Unable

2. The cost of military health care has almost tripled since 2001

It has gone from $19 billion in 2001 to $53 billion in 2012, and stands at 10 percent of the entire defense budget. Health care spending now accounts for about half the military spending on personnel costs. Whether this is a proxy for increased illness, or improved healthcare, it is unsustainable. We have to figure out ways to keep these costs down.

We need to keep healthcare costs down

Chronic diseases are the most common and costly of all health problems, taking 75% of every healthcare dollar – but they are also the most preventable. Four common, health-damaging, but modifiable behaviors—tobacco use, insufficient physical activity, poor eating habits, and excessive alcohol use—are responsible for much of the illness, disability, and premature death related to chronic diseases.

Clinical staff with additional training as Wellness Practitioners can begin the conversation about critical lifestyle changes in the clinical setting before the patient is discharged and provide brief, but powerful ongoing support after. That’s continuity of care!
  • Adults who smoke 20%
  • Adults who do not have sufficient aerobic activity 33%
  • Young Americans unable to serve in military 75%
Source: CDC

The Challenge

How do we:

  • Improve the HEALTH of our service members?

  • Improve care for existing service members and their families?

  • Reduce our long term chronic disease burden and healthcare costs?

  • Address the psychosocial cost of 12 years of war, including rampant PTSD?

  • While increasing our Readiness and Resilience…

Our solution follows…

The Solution – Make health and wellness the social norm

Step 1: Move from a culture of treatment to one of prevention of sickness

There are some disease that we cannot prevent. But the good news is much chronic disease can be prevented and costs can be lowered! This is low hanging fruit! And it’s going to take more than just telling people to eat more vegetables and take a few more steps, although those things are important.

Learn more about:  Stress, Diabetes, Obesity, Substance Abuse

Step 2: Extend the culture of prevention, to one of wellness.

But why stop at just prevention? Its pretty much self evident that if the Military is Well – healthy and mentally prepared, its going to be the best trained and prepared military in the world. Surely our troops deserve that!

Learn more about Transforming Culture
Learn more about Careers as a Wellness Practitioner


Step 3: Prepare the ground

Manpower and Logistics

Build in internal capability for wellness management: Train a large, diverse network of wellness practitioners to advocate, act and accelerate Advocates go through a 6-week, part-time program. They’re the people who will encourage service members on their wellness journey. Staying healthy and well is hard work, and people hate change even if they know it’s good for them. Some will respond, but others will fight hard to stay put. Advocates can play a powerful role, because they’ve been through the self-change process and can speak from experience. They know exactly where the leverage points are and have the skills to help other service members find the way that works for them. Coaches go through a 12- to 18-month part-time program. They provide the ongoing support at an intensity that’s right for each person to help them define, achieve, and maintain their goals.

Certified Wellness Coaches (Level 1) - Advocates

Certified Wellness Coaches (Level 1) become Advocates and model the fundamental philosophy that all change is self-change and that change is a process and a journey, not a single event. Behavior change is unique for each person, so Wellness Advocates help people explore their own readiness; strengths, skills, and resources; and process of change. The purpose of the Certified Wellness Coach Training Program is to develop a cohort of trained community members who can influence and inspire those around them. They do this by modeling positive lifestyle choices, sharing accounts of their own wellness journey, and using evidence-based tools to help others reflect on their current state of health and wellness and consider changes they may want to undertake.

Certified Wellness Coaches (Levels 2-5)

Certified Wellness Coaches (Levels 2-5) are senior coaches who have additional coaching training to help guide, support, and empower meaningful, enduring change among individuals and organizations. They provide a comprehensive ongoing program of support that reinforces client competence, motivation, and sense of purpose. Senior Wellness Coaches work most intensively and on an ongoing basis with people or groups wanting support to achieve short and long-term goals. There should be roughly one senior coach to around 500 servicemen, or operational unit if this is smaller.

IWE's Flexible Online Training Schedules

The Wellness Practitioner training programs are online, so they can be done anytime, anywhere and at your own pace – without disrupting your operational or training schedules. IWE’s learning environment also provides plenty of opportunities for real-time interaction with faculty and collaboration with others. “Learn by doing” is fundamental, so students apply new skills and knowledge in real life from day one. Learn more about Training contact hours and Types of Training

Command and Control

Facilitator Changing a culture requires endorsement from the top. Base commanders or commanding officers need buy in, or the project will fail. They in turn, will appoint facilitators, whose job it will be to organize the Wellness movement in their respective areas of responsibility. Facilitators also will work with base hospitals and clinics as part of a coordinated plan for our bases.

Certified Wellness Facilitators

Wellness Facilitators are Certified Wellness Coaches who have been trained to drive the wellness agenda throughout their organizations by taking a leadership role to transform organizational culture. They communicate the belief that wellness is an imperative for the organization, community, and nation. They facilitate and support the work of the Certified Wellness Coaches (of all levels) as well as tie these activities back to the Base Medical Centers and Command structures.

Step 4 – Base Hospitals and Clinics

Improving care to our servicemen and their families Some patients need a little help while others need much more. IWE’s model of support matches patients’ needs. Clinical Wellness Advocates help patients explore their own resources for self-management and their path on the change process. Clinical Wellness Coaches provide more intensive ongoing support, and help with self-management skill building and problem-solving. All Practitioners are empowered to work with patients in ways that work and fit for the patient, whether in person or by phone, email, or texting. The patient drives the agenda and the method. See “Solutions for Healthcare Providers

Step 5: Engage the whole ecosystem

Why settle for less? Let’s get everyone involved! In fact, it’s imperative. We win this battle not just one person at a time, but by transforming our culture. Wellness isn’t just a slogan. It’s our life and our future. We need everyone on board, fighting fit!

  • Service members
  • FRGs, spouses and families
  • Medical centers,
  • Allied health groups
  • Local gyms and health clubs
  • Alternative and complementary medicine
  • Towns servicing bases

We need to get away from the mentality of needing to do something only after a problem occurs (like dieting only after you have put on too much weight). Lets work on maintaining the health and wellness of our service members and their families so that they can stay fighting fit!

Learn more about the 10 Dimensions of Wellness

Step 6: Make Wellness a group activity

Doing something that you know is good for you, like losing weight, getting a ‘flu shot or giving up smoking is hard to do by yourself, but it’s a lot easier if your buddies are all doing it at the same time. And if you make it a social activity, then everyone can support each other. Suddenly, it’s not so hard after all… Learn more about: 6 Steps to Workforce Wellness


Behavior is the greatest determinant of health and cause of illness and death, so the key challenge is to engage people in making healthier decisions and taking action to promote and sustain health. It’s a National Imperative.

Do your part. Get ready…

Talk to us if you want to

get your base/unit ahead of the curve

Photo Credits: Main screen image: A Marine air Control Squadron 1 child holds her father tight at Marine Corps Air Station Yuma, Aug. 22, after her father returned home from a six-month Afghanistan Deployment. Marine Corps Air Station Yuma Photo by Cpl. Laura Cardos. Corpman examining patient at Kenner Army Pulmonology Clinic.
Army nurses 2nd Lt. Rosa Cervantes (right) and 2nd Lt. Tracy Swan work together to give an IV to a intensive care unit patient at Carl R. Darnall Army Medical Center. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
F16 taken at Duluth Air Show by zman z28. U.S. Army Sgt. Michael Smith is greeted May 14, 2010, at Hector International Airport in Fargo, N.D., upon returning from a peacekeeping deployment to Kosovo. (DoD photo by Senior Master Sgt. David H. Lipp, U.S. Air Force/Released) ANNAPOLIS, Md. (May 15, 2012) U.S. Naval Academy plebes carry a log as part of teamwork training during Sea Trials.  (U.S. Navy photo by Mass Communication Specialist 2nd Class Alexia Riveracorrea/Released)