traditional considerations of such things as acute illnesses and injuries resulting from combat, training, infectious diseases, and environmental exposures. Issues that fall within the construct of deployment health research Should include: diagnosable conditions; medically unexplained symptoms (both physical and mental); effects on health-related quality of life (e.g., death and duration of life, impairment, physical and mental functional status, health perceptions, and opportunity [the capacity for health, the ability to withstand stress, and physiologic reserves]); family impacts; and sequelae of combat injuries. Such issues may arise prior to, during, or following deployment. The focus of research efforts, then, should encompass this broadened definition of deployment health.
There are gaps in the emerging data relevant to the study of war-related illnesses and postdeployment health issues.
Data generated by the DoD primarily relate to active-duty soldiers. Information regarding their health tends to focus on acute effects of war-related illnesses. Many deployed personnel in today's military, however, may be activated from reserve units that are deployed, then separated soon after return from conflict. The VA, on the other hand, concentrates on the health of those individuals no longer on active-duty, and this frequently includes older veterans. There are significant gaps in knowledge, both in the focus of research by the DoD and VA as well as in the delivery of services from postdeployment to later in life.
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.
A review of previous research led the committee to conclude that research has been aimed at attempting to solve identified problems, such as the health effects of mustard gas in WWII testing, and of Agent Orange in Vietnam, as well as the medically unexplained health problems of individuals deployed to the Gulf War. Such research efforts increased as complaints from the veterans' community, the Congress, and the general public increased, yet research still lagged far behind efforts to provide care. Research efforts only recently have begun to focus on a broader, more proactive research agenda.
The committee was impressed with the newly broadened focus of research into war-related illnesses and postdeployment health issues. As with all research, the quality of the studies varies. Many excellent efforts have been fielded and the findings reported in prestigious biomedical journals. These research efforts have in large part, however, not been undertaken in response to a well-developed and coordinated research agenda. Further, coordination of research efforts and strategies, as well as communication of findings, has been limited.