Ethical Responsibilities of a Military to the Social Determinants of Health of its Service Members.

Abstract

A military exists in a unique position. It is an organization in which active duty members knowingly join or are conscripted into service with the understanding that there is an increased risk of mental and/or bodily harm as compared to many other occupations. However, while the nature of the profession can inherently be dangerous, it does not follow that its members be placed at undue excess risk if that risk can be reasonably avoided or reduced. Social determinants of health are one example of influences under a military's purview that impact health outcomes and well-being. Although the U.S. Military performs well across many health equity measures, disparities persist and require attention and redress. Military policies and practices deeply impact members' lives during and after service, and the durability and profundity of these effects establish the ethical grounds upon which any military policy should be structured. The ethical obligation is fortified by the extent of control a military exercises over its personnel. Taken together, these factors necessitate a concerted effort by militaries to remain cognizant of the ethical impacts of their policies and practices and to ensure focus remains on the well-being and readiness of its personnel. As such, militaries have ethical responsibilities to promote healthy social determinants of health among their service members via policies and public health measures.