Back to Top Skip to main content Skip to sub-navigation

Joint Chiefs say mind, body, spirit all part of Total Force Fitness

Image of a Marine climbing a rope ladder A Marine competes in the High Intensity Tactical Training Championship at Marine Corps Base Quantico, Virginia. Total Force Fitness offers a framework for improving wellness and resilience of military members and their families. The eight TFF domains are medical and dental preventive care, environmental, nutritional, psychological, social, physical, financial, and ideological and spiritual. (U.S. Marine Corps photo by James Frank)

Recommended Content:

Health Readiness | Total Force Fitness | Total Force Fitness

Fitness of mind, body, and spirit is inherently connected with military service. But the understanding of this relationship is constantly evolving as our operational and family commitments change. For 2020, the Military Health System is focusing on Total Force Fitness, a comprehensive framework for improving readiness and resilience of the nation’s military, families, and the communities that support them.

The concept of Total Force Fitness is not new. As early as 2006, the Uniformed Services University of the Health Sciences (USUHS) was investigating the aspects that led to human optimal performance or HPO, allowing service members to excel in an operational environment. In 2009, then-Chairman of the Joint Chiefs of Staff, Adm. Michael Mullen, commissioned USUHS to develop the Total Force Fitness concept into a CJCS Directive that would address the intersection of health, fitness, and performance optimization.

"[Adm.] Mullen recognized that it required Total Force Fitness to defend our nation,” said USPHS Capt. (Dr.) Kimberly Elenberg, chief, Total Force Fitness branch, Public Health Division, Defense Health Agency.

Mullen realized that “Total force fitness is more than a physical fitness,” he wrote in the August 2010 supplement to Military Medicine, Volume 175, No. 8. “It is the sum total of the many facets of individuals, their families, and the organizations to which they serve. It is not something that someone achieves twice a year for a test.  It is a state of being.”

USUHS staff discovered that much of the research on human performance centered on “prevention of disease through physical examinations, vaccinations, health risk screening, enhanced exercise, and the reduction of unhealthy habits, such as smoking and alcohol use.” But with the constant demands placed on service members and their families, more emphasis needed to focus on what factors contributed to resiliency.”

Mullen, with the help of experts at USUHS and the services, developed Total Force Fitness into a concept, adaptable by the services, that included more than the physical aspects of health. They wanted a program that would lead to a military force that could adapt to changing requirements and be resilient to stress. Later this year, a new CJCS Directive will update the Total Force Fitness concept, outlining eight dimensions that help the services achieve total force fitness.

The dimensions were derived from a variety of sources, including current practices on medical fitness, psychological resilience, physical fitness and injury screening, and integrated health approaches. The Total Force Fitness concept integrates health, resilience, and human performance into the following domains:

  • Physical Fitness: the ability to physically accomplish all aspects of human performance while remaining mission capable and avoiding injury.
  • Environmental Fitness: the ability to optimally perform in any environment, including worldwide, garrison, training, and operational environments.
  • Medical and Dental Fitness: the ability to sustain health and wellness and facilitate restoration to meet established medical and dental standards for fitness for duty, return to duty, and medical readiness.
  • Nutritional Fitness: the ability to sustain an optimal level of performance through consuming foods, supplements, and beverages in adequate quantities, quality (nutrient content), and proportions.
  • Spiritual Fitness: the ability to operationalize one’s spirituality to optimize performance. Spirituality is composed of beliefs and practices that strengthen connectedness with sources of hope, meaning, and purpose.
  • Psychological Fitness: the ability to integrate and improve cognitive, emotional, and behavioral capacities to optimize performance and ensure mission readiness.
  • Social Fitness: the ability to engage in productive personal and professional relationships, positively interact with unit and command networks, and leverage resources that promote overall well-being and optimal performance.
  • Financial Fitness: the combination of attitude, knowledge, skills, and self-efficacy needed to make and exercise money management decisions that best support the circumstances of the service member’s life.

DHA’s Total Force Fitness branch, working with USUHS and the Consortium for Health and Military Performance (CHAMP), will help educate service members and their families to Total Force Fitness concepts. "We'll focus on optimizing the [military] communities’ ability to better understand, assess, and maintain mind, body, and spirit, to include psychological and cognitive wellness," Elenberg said.

The CHAMP website and Health.mil will provide updates and resources throughout the year that military health practitioners, service members, and their families can use to learn more about how they can achieve and support Total Force Fitness.

You also may be interested in...

Incidence rates of cold weather injuries: Non-Hispanic black service members, five cold weather seasons, July 2012 – June 2017

Infographic
1/18/2018
Did you know for all of the services, overall rates of cold weather injuries were higher among non-Hispanic black service members than among those of other race/ethnicity groups? •	Rates of cold weather injuries among non-Hispanic black service members were two-times as high as those among non-Hispanic white or other race/ethnicity groups.  •	The rates of frostbite among non-Hispanic black service members were three-times those of the other race/ethnicity groups. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to www.Health.mil/MSMR  #ColdReadiness Image of non-Hispanic black service member in the snow displays.

This infographic documents incidence rates of cold weather injuries among non-Hispanic black service members during the July 2012 – June 2017 cold weather seasons.

Recommended Content:

Winter Safety | Health Readiness

2016 – 2017 Cold Season, Cold Weather Injuries, Active and Reserve Components, U.S. Armed Forces

Infographic
1/18/2018
or the 2016 – 2017 cold season, the number of active component service members with cold weather injuries was the lowest of the last 18 cold seasons since the Medical Surveillance Monthly Report (MSMR) began reporting such data in the 1999-2000 cold season. Findings •	The overall incidence rate for cold weather injuries for all active component service members in 2016 – 2017 was 15% lower than the rate for the 2015 – 2016 cold season. •	The 2016 – 2017 rate was the lowest of the entire five year surveillance period. •	In the 2016 – 2017 cold season, the Army’s incidence rate of 41.0 per 100,000 person-years for active component soldiers was 18% lower than the Army’s lowest previous rate in 2012 – 2013. •	In the Navy, Air Force, and Marine Corps, the active component rate for 2016 – 2017 was only slightly higher than their lowest rates during the 2012—2017 surveillance period. Pie chart 1 (left side of infographic): Cold Weather Injuries, By Service, Active Component, 2016 – 2017 data •	Army 57.6% (n=189) •	Marine Corps 21.0% (n=69) •	Air Force - 13.1% (n=43) •	Navy – 8.2% (n=27) •	The sharp decline in the Army rate during the 2016 – 2017 cold season drove the overall decline for all services combined. Pie chart 2 (right side of infographic): Percentage distribution by service of cold weather injuries among reserve component service members during cold season 2016 – 2017  •	Army 72.9% (n=43) •	Marine Corps 13.5% (n=8) •	Air Force 13.5% (n=8) •	Navy (n= 0) •	For the 2016 – 2017 cold season, the overall rate of cold weather injuries for the reserve component and the rates for each of the services except the Air Force were lower than in any of the previous four seasons. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR

This infographic documents cold weather injuries among the active and reserve components of the U.S. Armed Forces for the 2016 – 2017 cold season.

Recommended Content:

Winter Safety | Health Readiness

Cold weather injuries during deployments, July 2012 – June 2017

Infographic
1/18/2018
During the 5-year surveillance period, 105 cold weather injuries were diagnosed and treated in service members deployed outside the U.S. of these, 39 (37%) were immersion injuries; 33 (31%) were frostbite; 16 (15%) were hypothermia; and 17 (16%) were “unspecified” cold weather injuries. Pie chart for cold weather injuries during deployments displays depicting the information above. Number of cold weather injuries bar chart: Of all 105 cold weather injuries during the surveillance period, 68% occurred during the first two cold seasons. Bar chart shows the number of cold weather injuries by year: •	2012-2013 cold season had 35 cold weather injuries •	2013-2014 cold season had 100 cold weather injuries •	2014 -2015 cold season had 13 cold weather injuries •	2015-2016 cold season had 11 cold weather injuries •	2016 – 2017 had 10 cold weather injuries Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR  #ColdReadiness

This infographic documents cold weather injuries during deployments for the July 2012 – June 2017 cold seasons.

Recommended Content:

Women's Health | Armed Forces Health Surveillance Branch | Health Readiness

Percentages of each Service’s cold weather injuries, 2016 – 2017 cold season

Infographic
1/18/2018
Did you know when all cold weather injuries were considered, not just the numbers of individuals affected, frostbite was the most common type of cold weather injury, comprising 53% (n=177) of all cold weather injuries among active component service members in 2016 – 2017? •	In the Air Force and Army respectively, 60.9% and 58.9% of all cold weather injuries were frostbite, whereas the proportions in the Marine Corps (42.9%) and Navy (25.0%) were much lower. •	For the Navy, the 2016-2017 number and rate of frostbite injuries in active component service members were the lowest of the past 5 years. •	The number of immersion injury cases in 2016 – 2017 in the Marine Corps was the lowest of the 5-year surveillance period. Bar graph: Percentages of each Service’s cold weather injuries that were frostbite, 2016 – 2017 cold season •	Air Force (60.9%) •	Army (58.9%) •	Marine Corps (42.9%) •	Navy (25.0%) For all active component service members during the 2016 – 2017, the proportions of non-frostbite cold weather injuries were as follows: •	19.5% hypothermia •	17.7% immersion injuries •	9.9% Other & unspecified cold weather injuries Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR  #ColdReadiness

This infographic documents the percentages of each service’s cold weather injuries, U.S. Armed Forces for the 2016 – 2017 cold season.

Recommended Content:

Winter Safety | Health Readiness

Obstructive Sleep Apnea Diagnosis Treatment Guide Active Duty U.S. Military

Infographic
3/13/2017
This infographic provides information on Obstructive sleep apnea (OSA) diagnosis and treatment of active duty U.S. Armed Forces to help primary care providers screen high-risk individuals and encourage patients to explore OSA treatment options for managing this burden of disease. The data comes from an analysis of sleep apnea conducted from 2004 through 2016.  With appropriate diagnosis and treatment of OSA, this growing health concern for military populations can be effectively managed. OSA symptoms include snoring, gasping for breath during sleep, headaches, insomnia and daytime fatigue. During the surveillance period, OSA were highest in those aged 40 years or older, male non-Hispanic  black, obese, army service members, married, had more than one prior deployment or had completed 18 years or more of service.  The incidence rate among individuals aged 40 years or older was more than 3-fold higher in 2015 compared to 2004. Individuals serving 18 or more years had a 3-fold higher incidence rate of OSA in 2015, compared to 2004. The 12-year incidence rate in service members serving 18 years or more was more than 2-fold higher than those with 11-17 years of service.  Improved screening, referral, and treatment have been recommended for individuals who may suffer from post-traumatic stress disorder (PTSD) and depression, in which OSA-associated fatigue and poor sleep quality can exacerbate symptoms.  Additionally, the STOP-BANG questionnaire for sleep apnea may help primary care providers to screen high-risk individuals and identify those whose symptoms warrant further evaluation. Individuals who suffer from OSA have increased rates of cardiovascular disease, chronic fatigue, motor vehicle accidents, cognitive impairment, and post-traumatic stress disorder.  Learn more about OSA and treatment options for managing this burden of disease by visiting Health.Mil/AFHSB

This infographic provides information on Obstructive sleep apnea (OSA) diagnosis and treatment of active duty U.S. Armed Forces to help primary care providers screen high-risk individuals and encourage patients to explore OSA treatment options for managing this burden of disease.

Recommended Content:

Total Force Fitness

Obstructive Sleep Apnea Rates by Service, U.S. Armed Forces

Infographic
3/13/2017
This infographic documents an increase in the incidence of Obstructive sleep apnea (OSA) diagnoses and associated attrition among U.S. service members over a 12-year surveillance period from 2004-2015. It also examines time to separation from military service after an incident of OSA diagnosis. Here are key facts about the OSA incidence rates by service: •	Rates of OSA were lowest in young service members, white non-Hispanics, Marines, air crew, and in those with less than five-years of service or no prior deployments. •	The category of pilots/ air crew consistently had the lowest OSA incidence rates, compared to all other occupations •	The annual incidence rates for the Army rose steadily from 2008 to 2015 and were higher during this period than the rates of the other services  The high percentage of cases diagnosed prior to separation from service is a concern because OSA as a large health and economic burden for the armed services is a treatable and partially preventable disease. For more information on OSA, appropriate screening and prevention strategies to improve both individual health and mission performance, visit Health.mil/AFHSB

This infographic documents an increase in the incidence of Obstructive sleep apnea (OSA) diagnoses and associated attrition among U.S. service members over a 12-year surveillance period from 2004-2015. It also examines time to separation from military service after an incident of OSA diagnosis.

Recommended Content:

Total Force Fitness

Schedule Your Power Nap

Infographic
3/13/2017
Need to recharge? Don't lean on caffeine -- a power nap will boost your memory, cognitive skills, creativity and energy level.

Need to recharge? Don't lean on caffeine -- a power nap will boost your memory, cognitive skills, creativity and energy level.

Recommended Content:

Total Force Fitness

Eating Smart on the Run

Infographic
1/25/2016
infographic for eating smart when eating out

Tips for making healthy choices when eating out.

Recommended Content:

Total Force Fitness | Nutritional Fitness

Practice Healthy Living Habits

Infographic
1/19/2016
Infographic listing 5 key healthy habits for the new year

A list of healthy living habits you can take on in 2016.

Recommended Content:

Total Force Fitness | Nutritional Fitness | Physical Fitness | Tobacco-Free Living | Medical and Dental Preventive Care Fitness

Global Health Engagement Month #3

Infographic
12/29/2015
infographic for global health engagement

A healthy partner is a stable partner! Supporting partner nations' health system capacities is a critical element of global health engagement.

Recommended Content:

Health Readiness | Global Health Engagement

6 Easy Tips for Reducing Holiday Stress

Infographic
11/30/2015
holiday graphic listing 6 tips to reduce stress

Infographic listing 6 tips for reducing holiday stress.

Recommended Content:

Total Force Fitness | Psychological Fitness
<< < ... 6 > >> 
Showing results 76 - 86 Page 6 of 6

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.