depend on the availability of smaller expeditionary forces that maintain a high level of military readiness. This greater reliance on readily deployable forces includes increased participation by guard and reserve members. Both active-duty, guard, and reserve forces experience profound life disruptions connected to all phases of deployment that, despite the relatively rapid and short-term experience, may have long-standing health consequences. Additionally, there is a component of deployed civilian workers who are similarly impacted by military deployment. The committee found that:
Extensive research exists on the health of veterans of military conflict.
The definition of deployment-related health issues selected for research has been too narrowly focused and has excluded some health consequences related to deployment.
There are gaps in the emerging data relevant to the study of war-related illnesses and postdeployment health issues.
Many investigations of health issues and effects of deployment have been mounted in response to health problems after they occurred, rather than being undertaken proactively.
Many veterans and some congressional staff are skeptical of the objectivity of both the Department of Defense (DoD) and the VA in the conduct of research into deployment-related health issues.
None of the locations of existing or proposed centers provides an adequate model for a national center that not only must be responsible for the conduct of a broad range of research but also must provide for synthesis and coordination of research efforts and for proposing policy changes based on research findings.
Examples exist of centers that cut across agencies and groups to carry out effective research agendas.
One component of the committee's charge was to review the VA's proposal to establish Centers for the Study of War-Related Illnesses and Postdeployment Health Issues by using the model of the Geriatric Research, Education, and Clinical Centers (GRECCs). The GRECC program has been successful in training health professionals, conducting cutting-edge research, and implementing effective treatment programs. Creating centers based on this model for the study of deployment-related health should contribute greatly to the advancement of knowledge in this area. Therefore, the committee recommends that the Department of Veterans Affairs proceed with its proposal to establish centers for the study of war-related illnesses, and that these centers be similar in structure to the Geriatric Research, Education, and Clinical Centers.