212921 Health impacts of war from a public health perspective using an

Tuesday, November 10, 2009: 3:30 PM

Stephen C. Hunt, MD MPH , Department of Medicine, VA Puget Sound/University of Washington, Seattle, WA
Since 2001, over 1.7 million US military personnel have been deployed to the combat theaters in Iraq and Afghanistan; more than 900, 000 of these individuals have separated from the military and are eligible for VA health care and other services and benefits. Approximately 42% of these combat veterans are using VA resources; the remainder, if they are receiving medical care and support at all, are utilizing non-VA health care systems and providers.

Post-war concerns among these veterans include medical conditions (particularly physical injuries with chronic pain), mental health issues (both diagnosable conditions and sub-syndromal symptoms) and psychosocial impairments affecting marriages, families, social functioning and occupational endeavors. There are elevated rates of divorce, employment problems, suicide, substance abuse and trauma related deaths among these veterans.

The care of returning combat veterans and the support of their families is a public health issue of considerable proportions; integration of VA and non-VA resources and efforts is essential if we are to succeed in our mission of insuring full recovery and reintegration of these veterans and optimally health futures for them and their families.

This presentation will include information and data on the post-combat health concerns of veterans returning from war throughout history, including those of veterans currently returning from Iraq/Afghanistan. The impact of these post-war health concerns on the veterans, their families and their communities will be described. A VA initiative currently in progress to implement "integrated post-combat care" for all returning combat veterans will be outlined. A model for providing post-war support based upon the principles of connection and integration, both relative to the specifics of health care delivery as well as relative to our more general community and national response to these veterans and their families will be presented and promoted. The importance of recognizing and addressing the life-long impacts of war on combat veterans and their families, and the need for ongoing support from the VA and the wider community, will be stressed.

Learning Objectives:
Identify suicide risk factors among the Iraq and Afghanistan veterans’ population. Discuss public health implications of the suicide risk factors.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: ABSTRACTS: Richardson, R.D. & Hunt., Engel, C., McKnight, K., & McFall, M. (1999) Psychological distress, physical symptoms and functional status of Gulf War Veterans seeking Primary care. Proceedings of the 15th Annual Meeting of the International Society of Traumatic Stress Studies, 188. Richardson, R.D. & Hunt, S. (1999) Psychosocial management of Gulf War Veterans with multi-symptom illnesses. Conference on Federally Sponsored Gulf War Veterans Illnesses Research, Washington, D.C. INVITED 2008 Briefing, Advisory Committee on Gulf War Veterans Health 2008 Speaker, 19th Annual Pacific Northwest Ambulatory Care Nursing Conference 2007 Presentation on Deployment Health Clinic as a Best Practices Model: to Deputy Under-Secretary for Health for Operations and Management Will Feeley and the VISN Directors monthly conference call 2007 National VA Conference on Treatment of Returning Combat veterans: “Use of PDHA/PDHRA in a VA Post-Combat Care Clinic” (delivered by Miles McFall); “Risk Assessment and Risk Communication in a VA Post-Combat Care Clinic” (delivered by Matthew Jakupcak); “Health Concerns of Female Combat Veterans” (delivered by Michele Klevens) 2007 5th Annual Western Regional International Health Conference: Health Consequences of War: A Focus on Iraq 2006 International Society of Traumatic Stress Studies: “An integrated model of care for returning combat veterans” and “A comparison of Gulf War veterans to Iraq/Afghanistan veterans” Los Angeles, CA. 2005 US Senate Committee on Veterans Affairs Field Hearing: testimony on issues facing veterans returning from Iraq and Afghanistan 2005 International Society of Traumatic Stress Studies: Toronto, presenter 2005 16th Annual Pacific Northwest Ambulatory Care Nursing Conference. Presenter: “Meeting the Health Care Needs of Returning Combat Veterans” 2005 Washington Society of Clinical Social Workers Conference. Presenter: “Post Combat and Re-integration” 2005 Northwest Association of Occupational and Environmental Medicine Winter Scientific Meeting. Presenter: “Health Concerns of Military Personnel Returning from Iraq and Afghanistan” 2005 Madigan Army Medical Center. Presenter: “The Health Care Needs and Integrated Health Care of OIF/OEF Veterans.” 2005 Caring for Veterans Returning from Recent Conflicts” Presenter, War Related Illness and Injury Study Center, Washington DC 2005 Washington Tribal Veterans Representatives. Presenter: “American Indian Combat Veterans Health Concerns” 2003 National NPR radio broadcast: Science Friday. Guest expert, live Call-in national radio broadcast on “Gulf War Illness”. 2002 National Compensation and Pension Exam Project (CPEP) Collaborative, Nashville (April 8-11). Faculty 2001 National C&P Breakthrough Collaborative Conference, Philadelphia (June 28-29) and Orlando (January 17-18, 2002). Faculty 2000 PRESENTATIONS: Panelist—National Video Broadcast to introduce Clinical Practice Guideline for Medically Unexplained Symptoms. Washington DC 2000 DoD Office of the Special Assistant for Gulf War Veterans Illnesses, Town Meeting, Madigan Army Medical Center, 8-17-00. Panel Member. 2000 The Gulf War: Environment and Veterans' Health , Invited Lecture, University of Washington, Department of Environmental Health 2000 At One VA: Meeting the needs of Former Prisoners of War, "An Extended Format for the Former Prisoner of War Protocol Examination and Its Use in a Group of Underserved Former Prisoners of War in Washington State". 2000 DoD's Office of the Special Assistance for Gulf War Veterans Illnesses, Town Hall Meeting, Madigan Army Medical Center, Panel Member 1999 Findings from the VA Puget Sound Gulf War Clinic, Committee on Health Effects Associated with Exposures Experienced During the Persian Gulf War, National Academy of Sciences, Institute of Medicine, Washington, D.C. 1999 Treatment of Gulf War Veterans in Primary Care, Grands Rounds, MIRECC, VA Puget Sound Health Care System, Seattle Division. 1999 Management of Health Concerns of Gulf War Veterans, Specialized Outpatient Conference Call, NEPEC. Puget Sound Health Care System, Seattle Division. 1999 Health Issues in Gulf War Veterans, Case Conference, General Internal Medicine Clinic, Puget Sound Health Care System, Seattle Division. 1999 Exposures and Health Effects from the Persian Gulf War, Occupational & Environmental Medicine, Grand Rounds, University of Washington. Seattle, WA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.