The children of U.S. service members grow up under unique circumstances, experiencing numerous moves, frequent changes in schools and friends, and long separations from deployed parents. These challenges caused sisters Cassidy Watson and Kelsey Schertz — self-described “military brats” — to wonder about the health outcomes of military children.

Now in their mid-20s, Watson and Schertz were both drawn to the field of public health. Watson (18MPH) recently graduated from the University of Iowa and Schertz is an MPH candidate at the University of Minnesota. Their father, a pilot, served consecutive stints in the U.S. Air Force, Air Force Reserve, and Air National Guard over a period of 22 years that included more than 20 overseas deployments.

Based on their own experiences, Watson and Schertz co-authored an article that appeared in the July 2018 issue of the American Journal of Public Health titled, “What Becomes of America’s Military Brats?”

“Growing up in the military is both physically and mentally disruptive,” they write, listing many of the stressors military children face. “Over time and after multiple deployments, resilience can wear thin. Emerging evidence suggests that military children struggle with more mental health and behavioral problems than their civilian counterparts, particularly at times of deployment.”

Watson and Schertz go on to pose a number of questions about military children as they age out of dependent status and transition into civilian life.

“What are the late-stage effects of growing up as a military child? Do these experiences shape — negatively or positively — health and behavior outcomes or health care utilization in adulthood? And if so, are targeted interventions needed?” Watson and Schertz ask.

Currently the answers are unknown because there are no data. Once they are of age, children of service members aren’t tracked in medical records or registries, making it difficult to identify them. Military kids could number in the tens of millions, the authors estimate.

“In the sphere of public health, a robust evidence base is critical to identify knowledge gaps, propose interventions, and inform policy decisions,” Watson and Schertz write. “We hope to encourage dialogue that considers whether we might be missing an important part of the health disparity puzzle by not evaluating the long-term effects of growing up a military kid.”