sources and efforts; encourage interdepartmental coordination at the federal level; encompass the deployment-related health concerns of all interested parties, including veterans, active-duty personnel, guard and reserve forces, deployed civilians, and their families; and foster relevant interdisciplinary research in the biomedical, epidemiological, and social sciences. To the extent possible, committee recommendations incorporate existing efforts, structures, and plans, while striving to provide a model that will enhance trust in the scientific integrity of research results.

ASSESSMENT OF THE VA PROPOSAL

The committee analyzed the VA's proposal to establish Centers for the Study of War-Related Illnesses and Postdeployment. Health Issues. As described in Chapter 2, this proposal calls for establishing centers that have four distinct program components (research, treatment, education, and risk communication) and that are similar in structure to the VA's Geriatric Research, Education, and Clinical Centers. Such an approach has proven quite successful in the areas of geriatrics and gerontology, and the committee believes that comparable centers focused on deployment-related health also will contribute greatly to the nation's knowledge and ability to care for military veterans.

The committee, therefore, strongly supports the emulation of the GRECC program as it has been successful in training health professionals, conducting cutting-edge research in the field, and implementing effective treatment programs. Strengths of the GRECC program include close collaboration with medical schools and universities, as well as the establishment of multiple centers (each drawing on the research expertise of the host VA medical center and integrating a variety of scientific disciplines).

Further, the GRECC program has an active advisory committee, the Geriatrics and Gerontology Advisory Committee, which is composed of experts from outside the VA and is charged with evaluating the centers and providing scientific expertise on all aspects of caring for aging veterans (Goodwin and Cohen, 1994). The committee encourages the implementation of each of these features to help ensure the success and effectiveness of the VA's work on deployment-related health concerns. Further, the committee urges the VA to incorporate university-based research in its centers in order to expand the research base and foster new approaches and initiatives. VA centers structured in such a manner would play a major role in the broader National Center effort described in the following section. 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.



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