Military service requires not only physical but mental as well as moral fitness. To qualify for service, recruits must meet standards in each area, demonstrating their abilities to meet the demands of military service.¹ Maintaining physical and mental fitness is necessary, as continued military career success is contingent on sustained health and fitness. Inability to physically or mentally meet the standards of the U.S. Armed Forces can result in no longer qualifying for service.^2-4

The Career History Archival Medical and Personnel System (CHAMPS) is a comprehensive archival database that collects and maintains career and medical related records for millions of U.S. service members of all branches of service: Army, Navy, Marine Corps, Air Force, Space Force, and Coast Guard. CHAMPS comprises over 1 billion career records from 1980 through 2022, with medical records from 2001 through 2023, for millions of active duty and activated reserve U.S. service members. On average, 212,493 new service members join the military each year (Table). This robust source of data creates a timeline of career and medical events as service members enter, progress through, and separate from service.

The CHAMPS database was created to be a comprehensive, longitudinal database of all career and health events throughout a service member’s military career. CHAMPS can be used to trace the complete trajectory of an individual service member’s career, from accession and occupational specialty to career progression and promotion, deployment history, and eventual separation. Medical history data in CHAMPS include diagnosis and procedure codes, vital and immunization history, and laboratory and radiology records for all inpatient and outpatient encounters within military hospitals and clinics in addition to civilian health care providers.

CHAMPS was designed to provide insight into the correlation between health characteristics and military careers. Thorough analysis of the timing and trajectory of career and health events creates a more robust understanding of the experiences of service members and the complex interplay between career and health in a service member’s life. This editorial presents an overview of the CHAMPS database, including available data fields, sources used, and example questions being answered with CHAMPS data. This editorial is intended to provide a comprehensive understanding of the utility and opportunities for research that CHAMPS presents, its existing and potential collaborations, as well as its significant analytical products to date, in an effort to help answer the most pressing questions about military health, readiness, and career outcomes. This study was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable federal regulations governing the protection of human subjects (NHRC.2021.002).

Data sources

CHAMPS includes demographic, career, and deployment military data from the Defense Manpower Data Center (DMDC) and health data from the Military Health System (MHS) Data Repository (MDR). Career events comprise 47% of the data in CHAMPS, with the remainder (53%) comprised of medical events (Table). All career and medical events are chronologically concatenated in CHAMPS.

CHAMPS incorporates monthly personnel-and career-related data including demographics, military occupational specialty, accession and separation, deployment start and stop dates, and deployment countries or duty locations from DMDC. Data from a total of 11,748,005 unique service members are housed in the CHAMPS database (Table). Records are uniquely identified using Social Security Numbers (SSNs). Demographic characteristics for each service member include full name, date of birth, SSN, Electronic Data Interchange Personal Identifier (EDI-PI), age, sex, race and ethnicity, education, marital status, and most recent home location prior to military service. Total records in CHAMPS are predominantly Army (42%), followed by Air Force (24%), Navy (21%), Marine Corps (11%), and Coast Guard (2%); Space Force data are still too limited to constitute a significant percentage. On average, from 1980 through 2022, over 80% of accessions are consistently new Army, Air Force, and Navy service members (Figure 1). CHAMPS contains historical medical data from 2001 through 2023, with medical-related information obtained from the MDR on an annual basis. MDR data include medical reimbursement information including dates, locations, and types of encounters; medical codes (e.g., International Classification of Diseases, Current Procedural Terminology, diagnosis-related group); prescriptions for all outpatient care at military hospitals and clinics (i.e., Click to closeDirect CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care) as well as civilian (i.e., Click to closePurchased CareThe TRICARE Health Program is often referred to as purchased care. It is the services we “purchase” through the managed care support contracts.purchased care) facilities; in addition to death date, when applicable, and status. In addition, detailed clinical and administrative data from military hospitals and clinics are available: appointments, referrals, laboratory and radiology orders and results, immunizations, vital records, and both inpatient and outpatient pharmacy records. Civilian care data are limited to health care administrative data billed to TRICARE.

Career-related information in CHAMPS reflects core aspects of a military service career, including promotions, duration of service, and events of significance both individually and historically, as the database spans decades and multiple major conflicts. CHAMPS data include each service member’s initial accession date to the military, rank (e.g., enlisted, E01-E09; officer, O01-O10; warrant officer, W01-W05), branch of service (Army, Navy, Marine Corps, Air Force, Space Force, Coast Guard), status (active duty, activated reserve or Guard), and occupation designator (duty, primary or secondary).

Information on career progression (e.g., promotions, demotions) can be found using rank and branch of service variables. Condition of discharge or reason for separation from the military is categorized and defined as: “dropped from strength or correction” (e.g., desertion, imprisonment, missing in action or prisoner of war, change in status); “entry into officer program” (e.g., officer commissioning, warrant officer program, military service academy); death (e.g., battle casualty, non-battle casualty such as disease, cause of death not specified); administrative separation (e.g., failure to meet behavioral and performance criteria such as character or behavior disorder, drug or alcohol misuse, ineptitude); medical separation (e.g., medical disqualification due to disability, condition existing prior to service, failure to meet weight or body fat standards); early release (e.g., school attendance, insufficient retainability, police duty, seasonal employment, national interest); end of active service (e.g., expiration of term of service due to end of contract without re-enlistment); re-enlistment (if immediate re-enlistment required); and retirement (e.g., service of 20+ years, medical retirement). Military discharge based on conduct and performance are divided into 2 categories: administrative discharge—e.g., honorable, general (under honorable conditions), or other than honorable—and punitive discharge (e.g., bad conduct or dishonorable).

Capabilities, collaborations, and future directions

The CHAMPS database offers numerous research possibilities, given the types, volume, and depth of information it contains. CHAMPS represents a prime opportunity for collaboration and data-driven exploration of the factors that affect not only the career and health outcomes of service members but the complex relationships among those factors. CHAMPS data reveal that some of the principal reasons service members separate from the military are required re-enlistment (37%), end of active service or expiration of term of service (23%), administrative separation or failure to meet behavioral and performance criteria (13%), and retirement (9%) (Table). If including only desired type of discharges—e.g., early release, end of active service, failure to meet behavioral or performance criteria, medical disqualification, retirement—the majority of service members separated because they reached the end of their contracts or chose not to re-enlist (Figure 2). Since early 2000s there has been a notable increase in medical discharges, comparable to a study published by the RAND Corporation.⁵

Career history information in CHAMPS can be compared with available medical information to estimate the relative influence of career- or medical-related factors on service member retention, and other related topics. Numerous medical conditions could be examined in relation to successful military service, to determine their prevalences and corresponding impacts on service member performance. Because CHAMPS passive data collection spans decades, it allows a longitudinal understanding of the relationship between career and health outcomes during time in service.⁶

The inclusion of individual identifiers such as SSNs allows for links with other data sources. Extant military datasets have been augmented with the CHAMPS database to answer pressing questions, resulting in published findings on studies of the impact of injuries on military career outcomes⁷; mortality rates and severe extremity injuries⁸; impacts of traumatic brain injury (TBI) and severe limb injury on suicide⁹; musculoskeletal and blast-induced injuries¹⁰; TBI and low-level blast exposure on adverse career outcomes¹¹; associations between concussion, severe TBIs, and early-onset of dementia¹²; brain injury and military alcohol misuse¹³; the relationship between mental health issues and attrition¹⁴; predictors of psychiatric disorders among combat veterans^15-18; tele-behavioral health, in-person, and hybrid treatment of U.S. service members¹⁹; Marine recruit health and the Recruit Assessment Program^16,20,21; and the limited duty Sailor and Marine Readiness Tracker System.²²

CHAMPS does not track service members (e.g., death records) after separation, as it is limited to data captured during activated reserve or active duty status, but CHAMPS can be linked to data sources that follow health characteristics after service (e.g., Department of Defense and Veterans Affairs Infrastructure for Clinical Intelligence, or DaVINCI).

CHAMPS has been used extensively as a resource at the Naval Health Research Center, both as a named compendium of data and as a program for specific data elements (e.g., DMDC, MDR) that provides expertise and support for data agreement development, links, management, and analysis. All projects utilizing CHAMPS through data sharing agreements are tracked and enumerated. CHAMPS has been utilized for an assessment of the functional outcomes of lumbar microdiscectomy using a standardized physical readiness test (PRT) in a military population; identification of factors associated with PRT failure among U.S. Navy active duty and reserve service members; identification of characteristics of service members assigned to shipboard duty associated with admittance to U.S. Navy Medicine’s temporary limited duty (LIMDU); utilization of event transaction data to investigate post-LIMDU career outcomes for sailors designated for return to duty, in collaboration with Naval Medical Center San Diego; retrospective review of pulmonary medicine patients diagnosed with bronchiectasis and creation of a bronchiectasis registry, generating hypotheses for future research; identification of patients diagnosed with basal cell carcinoma matched with prescription medication history, deployment history, and career history; linking the data of personnel with musculoskeletal injuries sustained during combat; and collaboration with the Department of Defense and Uniformed Services University Brain Tissue Repository to improve warfighter brain health.

CHAMPS is an invaluable resource utilized in a multitude of military health research topics, through the detection of precursor metrics of risk as well as protective factors associated with outcomes such as readiness, individual trajectories, specific health conditions, substance abuse, sexual assault, domestic violence, and suicide. Prior and ongoing projects that have utilized the wealth of longitudinal and individual information housed in the CHAMPS database demonstrate not only its current but continuously expanding capabilities, with significant potential for additional exploration and further collaborations.

References

1. Office of the Under Secretary of Defense for Personnel and Readiness. DoD Instruction 6130.03, Volume 1: Medical Standards for Military Service: Appointment, Enlistment, or Induction. U.S. Dept. of War. Updated May 28, 2024. Accessed Feb. 1, 2026. https://www.esd.whs.mil/portals/54/documents/dd/issuances/dodi/613003_vol01.pdf  
2. Office of the Under Secretary of Defense for Personnel and Readiness. DoD Instruction 1332.18: Disability Evaluation System. U.S. Dept. of War. Nov. 10, 2022. Accessed Feb. 1, 2026. https://www.esd.whs.mil/portals/54/documents/dd/issuances/dodi/133218e.pdf  
3. Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023-1032. doi:10.1001/jama.295.9.1023  
4. Mullinax M, Sorensen I, Dintaman J, Hisle-Gorman E. Effect of serious mental health and physical injuries and their treatment on career trajectories for military service members. Mil Med. 2025;190(11-12):e2466-e2473. doi:10.1093/milmed/usaf191  
5. Simmons MM, Farmer CM, Cherney S, et al. Post 9/11 Trends in Medical Separation and Separation for Service Members with Posttraumatic Stress Disorder and Traumatic Brain Injury. RAND Corporation;2021. Accessed Feb. 1, 2026. https://www.rand.org/pubs/research_briefs/RBA1197-1.html  
6. Gunderson EK, Miller MR, Garland CF, Naval Health Research Center. Career History Archival Medical and Personnel System (CHAMPS): Data Resource for Cancer, Chronic Disease, and Other Epidemiological Research. Report 02-06. Dept. of the Navy, U.S. Dept. of Defense;2002. Accessed Feb. 2, 2026. https://apps.dtic.mil/sti/citations/ADA419547  
7. Trone DW, Villaseñor A, Macera CA. Negative first-term outcomes associated with lower extremity injury during recruit training among female Marine Corps graduates. Mil Med. 2007;172(1):83-89. doi:10.7205/milmed.172.1.83  
8. Schmied EA, Boltz J, Levine JA, et al. All-cause and cause-specific mortality rates after severe extremity injuries among previously deployed active duty service members. PM R. 2023;15(10):1300-1308. doi:10.1002/pmrj.12954  
9. Chung SY, Levine JA, Schmied EA, et al. Impacts of traumatic brain injury and severe limb injury on death by suicide: concurrent investigations using path analysis. J Head Trauma Rehabil. 2025;40(5):e420-e429. doi:10.1097/htr.0000000000001053  
10. Belding JN, Englert R, Bonkowski J, Thomsen CJ. Occupational risk of low-level blast exposure and TBI-related medical diagnoses: a population-based epidemiological investigation (2005-2015). Int J Environ Res Public Health. 2021;18(24):12925. doi:10.3390/ijerph182412925  
11. Belding JN, Bonkowski J, Englert R. Traumatic brain injury and occupational risk of low-level blast exposure on adverse career outcomes: an examination of administrative and medical separations from service (2005-2015). Front Neurol. 2024;15:1389757. doi:10.3389/fneur.2024.1389757  
12. Belding JN, Bonkowski J, Englert R, Grimes Stanfill A, Tsao JW. Associations between concussion and more severe TBIs, mild cognitive impairment, and early-onset dementia among military retirees over 40 years. Front Neurol. 2024;15:1442715. doi:10.3389/fneur.2024.1442715  
13. Woodruff SI, Hurtado SL, Simon-Arndt CM, Lawrenz J. An exploratory case study of environmental factors related to military alcohol misuse. BMC Public Health. 2018;18(1):902. doi:10.1186/s12889-018-5843-5  
14. Schmied EA, Highfill-McRoy RM, Crain JA, Larson GE. Implications of psychiatric comorbidity among combat veterans. Mil Med. 2013;178(10):1051-1058. doi:10.7205/milmed-d-13-00135  
15. Booth-Kewley S, Schmied EA, Highfill-McRoy RM, et al. Predictors of psychiatric disorders in combat veterans. BMC Psychiatry. 2013;13:130. doi:10.1186/1471-244x-13-130  
16. Booth-Kewley S, Highfill-McRoy RM, Larson GE, Garland CF. Psychosocial predictors of military misconduct. J Nerv Ment Dis. 2010;198(2):91-98. doi:10.1097/nmd.0b013e3181cc45e9  
17. Crain JA, Larson GE, Highfill-McRoy RM, Schmied EA. Postcombat outcomes among marines with preexisting mental diagnoses. J Trauma Stress. 2011;24(6):671-679. doi:10.1002/jts.20700  
18. Baker DG, Nash WP, Litz BT, et al. Predictors of risk and resilience for posttraumatic stress disorder among ground combat marines: methods of the Marine Resiliency Study. Prev Chronic Dis. 2012;9:e97. doi:10.5888/pcd9.110134  
19. Walter K, Glassman L, Levine J, et al. Telebehavioral health, in-person, and hybrid modalities of treatment delivery among US service members: a longitudinal observational study. JMIR Ment Health. 2026;13:e83809. doi:10.2196/83809  
20. Larson GE, Booth-Kewley S, Highfill-McRoy RM, Young SY. Prospective analysis of psychiatric risk factors in marines sent to war. Mil Med. 2009;174(7):737-744. doi:10.7205/milmed-d-02-0308  
21. Williams D, Yea JC, Zhu Y, Naval Health Research Center. Summary of Recruit Assessment Program Survey Prediction of Military Personnel Outcomes. Report 21-75. Dept. of the Navy, U.S. Dept. of Defense;2021. Accessed Feb. 1, 2026. https://apps.dtic.mil/sti/citations/AD1158054  
22. McWhorter S, Simon-Arndt C, Carlson L. Overview of Navy Medicine’s limited duty patient population. Mil Med. 2024;189(3-4):820-827. doi:10.1093/milmed/usac348 

Author Affiliations

Deployment Health Research Department, Naval Health Research Center, San Diego, CA: Mr. Haile, Mr. Bonkowski, Dr. Khodr, Dr. McAnany, LT Lausted, LT Carnes; Leidos, Inc., San Diego, CA: Mr. Haile, Mr. Bonkowski, Dr. Khodr, Dr. McAnany; Department of Health Professions Education, Uniformed Services University, Bethesda, MD: LCDR Biggs

Acknowledgments

We greatly acknowledge the support of an additional data management team member of the Career History Archival Medical and Personnel System (CHAMPS): Khider Allos, MCS, BSc. We also thank all current and previous members of the CHAMPS data management team for maintaining this important archival database since its inception.

Disclaimer

The views expressed in this article are those of the authors and do not necessarily reflect official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.

LCDR Biggs, LT Lausted and LT Carnes are military service members. This work was prepared as part of their official duties. Title 17, U.S. Code Section 105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S. Code Section 101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

The authors declare that they have no competing interests.

Report 25-70 was supported by the Office of Naval Research under work unit NMR11355-29. The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable federal regulations governing the protection of human subjects. Research data were derived from approved Naval Health Research Center Institutional Review Board protocol NHRC.2021.002.

The datasets generated and analyzed during the current study are not publicly available due to personally identifiable information regulations, but they may be made available by the corresponding author on reasonable request and approval by the Naval Health Research Center Institutional Review Board/Privacy Office.