FALLS CHURCH, Va. — 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 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,” USUHS Capt. (Dr.) Kimberly Elenberg, chief, Total Force Fitness Branch, Public Health Division, Defense Health Agency, said.

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 fental 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, 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.