Informing the Future Critical Issues in Health, Fifth Edition (2009) / Chapter Skim
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Taking Care of Those Who Take Care of Us: Military and Veterans
Taking Care of Those Who Take Care of Us: Military and Veterans
Pages 85-102
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From page 85... ...
troops, including many members of the reserve and National Guard, took part in the Persian Gulf War. On returning home, a substantial number of military personnel reported health problems that
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From page 86... ...
The fourth volume, published in 2006, examines the state of veterans' health in the years since the conflict, rather than specific potential causes of health problems. The fifth volume, published in 2007, examines the long-term health effects associated with various infectious diseases that Gulf War veterans -- as well as veterans of the Afghanistan and Iraq wars -- may have faced.
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From page 87... ...
This knowledge gap is taking on increased importance as the United States continues its military operations in Iraq and expands them in Afghanistan. To help bridge the gap, the DoD should conduct comprehensive, standardized evaluations of service members' medical conditions, psychiatric symptoms and diagnoses, and psychosocial status and trauma history before and after they deploy to war zones.
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From page 88... ...
That is, a consistent positive association has been observed between deployment to a war zone and a specific health outcome in human studies in which chance and bias, includ ing confounding, could be ruled out with reasonable confidence. For example, several high-quality studies report consistent positive associations, and the studies are sufficiently free of bias and include adequate control for confounding.
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From page 89... ...
• Incarceration. Inadequate/Insufficient eidence to Determine Whether an Association exists Evidence from available studies is of insufficient quantity, quality, or consistency to permit a conclusion regarding the existence of an association between deployment to a war zone and a specific health outcome in humans.
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From page 90... ...
Traumatic brain injury may cause other adverse consequences as well, such as vision problems and seizures, a particular type of diabetes, psychosis, and suicide, though there is not sufficient evidence to make definitive conclusions. The report emphasizes the need to develop a fuller picture of the effects of traumatic brain injuries and other blast injuries.
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From page 91... ...
It also should conduct predeployment neurocognitive tests of all military personnel to establish a baseline for identifying postinjury consequences, and it should conduct postdeployment neurocognitive testing of representative samples of military personnel, including those who have and have not suffered traumatic brain injury. In addition, the VA should include uninjured service members and other comparison groups in the Traumatic Brain Injury Veterans Health Registry that the agency is developing.
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From page 92... ...
Participants, including both engineering and health experts, considered ways to better design care practices for service members treated at multiple institutions within the military, the VA, and the civilian sector. ealuating the health effects of depleted uranium The Gulf War marked the first time that the U.S.
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From page 93... ...
finds that the evidence is still inadequate or insufficient to determine whether an association exists between exposure to depleted uranium and all of the health outcomes examined. This list includes lung cancer, leukemia, lymphoma, bone cancer, renal cancer, bladder cancer, brain cancer, During the gulf War, an stomach cancer, prostate cancer, testicular estimated 4 to 4 people cancer, reproductive or developmental dys- experienced high leels function, nonmalignant respiratory disease, of exposure to depleted gastrointestinal disease, and immune-medi- uranium, and hundreds or ated disease, among others.
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From page 94... ...
military sprayed herbicides, including a compound called Agent Orange, over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of U.S. base camps and outlying fire-support bases.
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From page 95... ...
Even as the IOM carried out its series of studies, one key factor that helps determine health risk remained poorly understood -- that is, comprehensive information was lacking about the levels of Agent Orange and other herbicides to which military personnel serving in Vietnam were exposed. To fill this need, a group of academic researchers developed a computer model that characterizes soldiers' exposure based on their proximity to herbicide spraying.
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From page 96... ...
recomserice members or their mends that the military adopt a systematic commanders on how to use approach that encompasses three primary dietary supplements safely. strategies: developing a system for monitor ing the use of dietary supplements by mili tary personnel, charting a framework for determining which dietary sup plements pose the greatest potential problems, and devising a system that soldiers and others and can use to report adverse events associated with dietary supplements.
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From page 97... ...
The services also should increase their educational and outreach efforts to provide soldiers and their families, unit commanders, and health care personnel with accurate, up-to-date information about the effects of dietary supplements and the importance of reporting any adverse effects that result from their use. reducing tobacco use Fewer than 20 percent of Americans use tobacco, but more than 30 percent of active-duty military personnel do.
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From page 98... ...
Identifying the best ways to treat posttraumatic stress disorder Posttraumatic stress disorder (PTSD) is the most commonly diagnosed ser vice-related mental disorder among military personnel returning from Iraq
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From page 99... ...
Surveys indicate that an estimated 12.6 percent of those who fought in Iraq and 6.2 percent of those who fought in Afghanistan have experienced PTSD. Significant numbers of Vietnam veterans and veterans of earlier conflicts also report suffering from PTSD.
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From page 100... ...
ealuating military medical ethics Military health professionals play a key role in ensuring the welfare of the service members -- and, in some cases, the nonmilitary detainees -- they treat. But these professionals sometimes may face ethical conflicts that arise from their responsibilities to their patients and their duties as mili tary officers integrally involved in military operations.
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From page 101... ...
They also discussed a need for improvements in training in medical ethics and outlined steps that public and private organizations might take in supporting better ethical awareness and expanded use of ethical standards.
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