Why Pediatric Health is a National Security Imperative

Utilizing longitudinal data and a network of physicians, USU researchers identify links between pediatric health and force readiness.

A healthcare provider wearing a yellow protective gown, pink mask, and goggles tends to a young girl in a hospital bed. The girl wears a green patterned gown and looks down at the provider's hands.

For researchers in the Department of Pediatrics, the Center for Health Services Research (CHSR), and the Center for Deployment Psychology (CDP) at the Uniformed Services University (USU), the child at home often serves as a leading indicator of deployment readiness. (U.S. Army photo by Jason W. Edwards)

April 29, 2026 by Hadiyah Brendel

In the high-stakes world of military medicine, leaders often measure readiness by the fitness of the service member. For researchers in the Department of Pediatrics (PED), the Center for Health Services Research (CHSR), and the Center for Deployment Psychology (CDP) at the Uniformed Services University (USU), the child at home often serves as a leading indicator of deployment readiness. In recognition of the Month of the Military Child, USU highlights the interlinked efforts to protect this future force.

The Navigator: Tracking Systems and Slumps

The mission begins with the data. Dr. Tracey Koehlmoos, director of CHSR, monitors the health trends of 1.6 million military-connected children in the U.S. Her team utilizes the Military Health System Data Repository (MDR), a massive longitudinal database that tracks how system disruptions–such as a global pandemic or a change in TRICARE policy–affect the pediatric population.

Kohelmoos focuses on children aged 2 to 17, a critical window spanning early habit formation to pre-accession years. Her latest analysis observed a profound post-pandemic side effect: a significant spike in Body Mass Index (BMI).

Koehlmoos attributes this slump to the abrupt loss of structured activity–organized sports, physical education, playground time–replaced by sedentary behavior imposed by school closures and sport cancellations.

However, the study also reveals a rebound. Beginning in late 2022 through 2023, military children began to return to pre-pandemic norms in BMI. “We’re actually starting–we’re working on the analysis now– a bit of a post-COVID-19 rebound in wellness. It’s a very big deal to see that turnaround,” she says.

"We are seeing indicators that military children are recovering their wellness milestones faster than many of their civilian peers," Koehlmoos explains.

Tracking this recovery involves more than statistics, it involves the long-term vitality of the military. Military children are four times more likely to join military service over their peers. “A healthy child today is a deployable parent today and a potential recruit tomorrow," Koehlmoos adds.

A U.S. Navy Sailor in a camouflage uniform uses an otoscope to examine the ear of a young girl. The girl is wearing a purple cloth face mask with a "Nightmare Before Christmas" pattern.

"By providing on-demand training and support to primary care doctors in rural settings, we’re working to take the 'worry off the plate' for the service member," says Dr. Elizabeth Hisle-Gorman, director of the division of Military Child and Family Research and professor of Pediatrics at USU. (U.S. Navy photo by Deidre Smith)

The Advocate: Uncovering the Residual Risk

Dr. Elizabeth Hisle-Gorman, director of the division of Military Child and Family Research and professor of Pediatrics at USU, likens the university’s work to the parable of the blind men and the elephant. While various centers may touch on different areas of pediatric wellness, combining these perspectives shows more of the "whole picture."

Hisle-Gorman’s research, which also utilizes the MDR, focuses on how a child’s health is linked to the parent’s military experience. Notably, her work has identified what she calls the impact of “parental invisible injury,” showing that Post-traumatic Stress Disorder, traumatic brain injuries, or reintegration after a deployment don’t just affect the service member–they manifest physically in the child through sleep disorders or gastrointestinal distress.

The research further tracks the clinical footprint of parental injuries, revealing an associated link to increased pediatric mental health diagnoses and psychotropic medication prescriptions. These stressors also correlate to an increased risk of child maltreatment and decreased preventive health care for the child.

“Stress in a military child may present as a somatic symptom,” she explains. Think stomach aches that won’t go away and can’t be diagnosed via tests, and sleep disturbances that keep both the child and parent awake. “If we don't look at the family’s deployment and injury history, we can miss the stress that is behind the diagnosis,” she adds.

Crucially, Hisle-Gorman’s work Hisle-Gorman’s work underscores an important factor in family stability: access to specialized care at rural military treatment facilities (MTFs) across the continental United States. Outside of major metropolitan areas, families may navigate referral processes and a more limited pool of specialty providers, which can often extend the timeline for critical care related to neurodevelopmental or behavioral needs.

Through her work with the CDP, she aims to mitigate this by empowering general pediatricians in these remote areas. "By providing on-demand training and support to primary care doctors in rural settings, we’re working to take the 'worry off the plate' for the service member," she says.

Hisle-Gorman notes, "If the service member is worried about their child’s hospitalization or their welfare, their focus is diverted from the mission. When the family is stable, the unit is ready.”

The Architect: Operationalizing the "Whole Picture"

Bringing these systemic and behavioral insights into the forefront of the Military Health System is the mission of Dr. Patrick Hickey, chair of the Department of Pediatrics. Through the RAMP (Research Accelerating Military Pediatrics) initiative, Hickey worked to move away from merely admiring the problem, to active intervention at both the clinical and community level.

"At USU, we aren't just training doctors; we are training military-unique physicians," says Hickey. "Our students learn that a well-child visit for a military family is a different conversation. It’s about understanding the 'dual-threat' of a parent’s absence on deployment and a child’s developmental needs."

A key legacy of the RAMP initiative was the ability to capture the ground truth of the issues surrounding pediatric care. By leveraging a worldwide network of faculty, including those at remote installations, the initiatives uncovered the administrative and geographic barriers that can stall care in these settings.

Additionally, engaging directly with primary care clinicians and families allowed the USU Department of Pediatrics to identify key obstacles to stability–such as the Reintegration Spike. Data showed pediatric mental health visits and family stress levels often peak in the months after a service member returns home, not during.

Training at USU now includes specific protocols for identifying tip-of-the-iceberg stressors that are often the first signs of family instability. "We are caring for the future fighting force," Hickey notes. "If we don’t get pediatric wellness right, we are failing on two fronts, both for the families entrusted to our care and for the long-term readiness of future service members."

Answering the Call

The trajectory of the military child serves as the quiet foundation for the future of the force. By leveraging the university's collective expertise to address the scope of care from rural access barriers to post-pandemic wellness, USU is utilizing specialized training and evidence-based intervention to enable the next generation to one day answer their own call to serve.