1

Deployment Health Report – April 2008Emphasis on OIF, OEF

Organization• Casualty Summary - Deaths and Injuries• Severely Injured

– Traumatic Brain Injuries– Amputees

• Disease and Non-battle Injuries (DNBI)• Medical Air Transports from CENTCOM• Post-deployment Health Assessment and Re-Assessment• Medical Holding• Conditions Found in Medical Evaluation Boards• Surveys of Ill / Injured Service Members Post Deployment

2

• Of those wounded in action, approximately 70% (OIF) and 43% (OEF) remain in theater, i.e., do not require Medical Air Transport.

• Of those wounded in action, approximately 55% (OIF) and 39% (OEF) return to duty within 72 hours.

Source: Defense Manpower Data Center, Statistical Information Analysis Division

Total Deaths – 4,511

Total WIA – 31,707

(as of April 12, 2008)

3Source: Defense Veterans Brain Injury Center as of February 29, 2008

TRAUMATIC BRAIN INJURIES

Agent of Injury Severity of Injury

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Percent of Amputees, by Service Circumstances of Injury

AMPUTEES – OEF AND OIF(N = 1,056)

Source: US Army OTSG, as of 1 March 2008

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Disease & Non-Battle Injuries (D & I) in TheaterCENTCOM (OEF/OIF) Combined

Percent of all Encounters

Data Source: JMeWS 01JAN05 to 07APR08

           

Army NavyMarine Corps

Air Force

Total

Combat Stress 1% 1% 1% 1% 1%

Dermatologic 10% 11% 11% 13% 11%

GI 4% 3% 3% 5% 4%

Injuries, all causes 30% 24% 30% 19% 29%

Other 39% 45% 42% 41% 40%

Psych Mental 6% 5% 5% 6% 6%

Respiratory 9% 11% 7% 15% 10%

Total Encounters 785,237 44,551 18,247 112,671 960,706

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Injury Distribution in TheaterCENTCOM (OEF/OIF) CombinedPercent of all Injury Encounters

Data Source: JMeWS 01JAN05 to 07APR08

           

Army NavyMarine Corps

Air Force

Total

Injuries, all causes 30% 24% 30% 19% 29%

Injury Heat/Cold 1% 1% 1% 1% 1%

Injury MVA 1% 1% 2% 1% 1%

Injury Other 18% 21% 19% 31% 19%

Injury Sports 28% 33% 24% 28% 28%

Injury Work 51% 44% 54% 40% 50%

Total Encounters 239,357 10,867 5,502 21,170 276,896

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Medical Air Transports from CENTCOM for OEF/OIF

Total # of Service Members Transported: 48,904

Distribution by Underlying Condition:• Disease 58%• Non-Battle Injury 21%• Battle Injury 21%

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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0%

10%

20%

30%

40%

50%

60%

70%

80%

2001 2002 2003 2004 2005 2006 2007 2008

% A

mo

ng

SM

s M

edic

ally

Air

Tra

nsp

ort

ed

1Battle Inj 2NonBI 3Disease

% Distribution, by Year, of Disease, Non-Battle Injuries, and Combat Injuries Among Service Members Medically Air Transported from

CENTCOM

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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GWOT Medical Air Transports (MAT)

Individual Service MembersTransported from CENTCOM to Elsewhereas of 15 April 2008, source: TRAC2ES

OIF - MATs (since 19March2003) TOTAL USA USN USMC USAF USCGBI - Battle Injury MATs 9,068 6,818 163 1,997 88 2 NBI - Non Battle Injury MATs 8,470 6,714 296 1,102 352 6 Dz - Disease MATs 23,597 20,159 754 1,583 1,091 10 TOTAL - OIF Medical Air Transports 41,135 33,691 1,213 4,682 1,531 18

OEF - MATs since 07October2001) TOTAL USA USN USMC USAF USCGBI - Battle Injury MATs 1,083 942 13 90 38 0 NBI - Non Battle Injury MATs 1,748 1,263 98 138 249 0 Dz - Disease MATs 4,938 3,787 207 213 729 2 TOTAL - OEF Medical Air Transports 7,769 5,992 318 441 1,016 2

GLOBAL WAR ON TERRORISM - TRAC2ES - Medical Air Transports (MATs)

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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MATs from OEF / OIF for DiseaseMilitary Personnel

Most Frequent Major Diagnostic Categories

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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MATs from OEF / OIF for DiseaseCivilians and Contractors

Most Frequent Major Diagnostic Categories

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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Musculoskeletal System / Connective Tissue

Disorders of the vertebral column 2,664

Miscellaneous soft tissue disorders 1,327

Non-arthritic joint disorders 894

Arthritis of the joints of the arms and legs 54

All other conditions 403

TOTAL 5,342

MAT from OEF and OIF for DiseaseMilitary Personnel Only

Details about Major Diagnostic Categories (selected)

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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MAT from OEF and OIF for DiseaseMilitary Personnel Only

Details about Major Diagnostic Categories (selected)

Symptoms, Signs, and Other Ill-Defined Conditions

Symptoms related to the respiratory system and chest 1,176(Chest pain, Dyspnea, Cough, Hemoptysis, Stridor)

Alterations of consciousness 847 (Convulsions, Syncope and collapse, Alteration of consciousness,

Dizziness and giddiness, Hallucinations)

Abdominal pain 413

Sleep disturbances 210

Headache 188

All other conditions 1,551(e.g., Swelling or mass or lump in head and neck, Palpitations, Enlargement

of lymph nodes, Dysphagia, Abdominal or pelvic swelling, mass or lump)

TOTAL 4,389

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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Mental Disorders

Depression and depressive disorders 1,044

Adjustment disorders (incl. PTSD) 677

Neurotic disorders 419

Manic and bipolar disorders 292

Organic mental disorders 246

Personality disorders 217

Acute stress reactions 141

Schizophrenia 66

All other conditions 396

TOTAL 3,498

MAT from OEF and OIF for DiseaseMilitary Personnel Only

Details about Major Diagnostic Categories (selected)

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

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12 Most Common Types of “Disease” Resulting in MAT

Military Personnel Only No. of MAT % of all for This Disease Category MATs

Disorders of the vertebral column 2,664 9.2%Misc. soft tissue disorders of the musculoskeletal system 1,327 4.6%Ill-defined symptoms related to resp. system and chest 1,176 4.0%Inguinal & abdominal hernias 1,054 3.6%Depression and depressive disorders 1,044 3.6%Non-arthritic disorders of joints 894 3.1%Ill-defined alterations of consciousness 847 2.9%Skin disorders 739 2.5%Adjustment disorders, including PTSD 677 2.3%Urinary stones (calculi) 543 1.9%Breast Disorders 435 1.5%Appendicitis 432 1.5%Coronary artery disease 423 1.5%TOTAL OF THESE 13 CATEGORIES 12,255 42.9%

TOTAL OF ALL DISEASE MATS 28,535

Data Source: USTRANSCOM TRAC2ES

As of 15 April 2008

16*2% of individuals do not respond to this question, so the total is less than 100%♦ Any positive response to Questions 11-13 on DD Form 2796 or Questions 8, 9, or 11 on DD Form 2900

Pre-DHA

(DD 2795)

Post-DHA

(DD 2796)

Post-DHRA

(DD 2900)

# Completed (# of Individuals) 105,317 78,136 102,278

Self-reported HealthExcellent, Very Good, Good

Fair, Poor

97%

3%

94%

6% 84%*

15%*

Physical Concerns 10% 24% 40%

Mental Health Concerns n/a 33% ♦ 43% ♦

Exposure Concerns n/a 17% 27%

Referred for Further Evaluation 5% 23% 27%

When Assessment is Completed Within 60 days of expected deployment

Within 30 days of return home

3 – 6 months after return

Pre- and Post-Deployment Health Assessments and Post-Deployment Health Re-assessments (PDHRA)

1 January 2008 – 17 April 2008

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Recovering Service Member OverviewTotal force, not just GWOT related

Source: Services

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Recovering Service Member Overview Total Force, not just GWOT-related

Source: Services SGs: As of April 1, 2008

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Medical Evaluation Boards (MEB)Most Common Major Categories of Primary Diagnoses Among

3,825 Army Personnel Completing MEBs (1 Sep 07 – 20 Mar 08) No. of Soldiers % of Total Musculoskeletal System 2,100 55% Lower back pain 453 Degenerative disc dis 310

Knee pain 294 Foot, ankle pain 140 Shoulder pain 116

Mental Disorders 584 15% PTSD 302 Bipolar disorder 64

Anxiety disorder 61 Depression 53

Injury and Poisoning 280 7% Traumatic brain injury 44

Nervous System and Sense Organs 193 5% Respiratory System 125 3% Asthma 110 Endocrine, Metabolic Conditions 124 3%

Diabetes mellitus 117 Symptoms, Signs, Ill-Defined Conditions 116 3% Sleep apnea 43 All 13 Other Major Categories 303 8%

(Includes all Soldiers, not just OEF/OIF veterans)

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Telephone Survey of Ill and Injured Service Members

Post-Operational DeploymentAfter Ten Months

March 27, 2008

Rich Bannick, Ph.D.OASD(HA)/TMA,

Health Program Analysis & Evaluation Division

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MEB

PEB*Manage duties

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

May 07(n=154

234)

Jun 07(n=10-241)

Jul 07(n=2-104)

Aug 07(n=4-78)

Sep 07(n=5-104)

Oct 07(n=4-87)

Nov 07(n=15-173)

Dec 07(n=6-156)

Jan 08(n=56-123)

Feb 08(n=1-104)

% R

ati

ng

1

or

2

Health care Lodging

Basic needs Medical attendees

Medical Evaluation Board (MEB) Physical Evaluation Board (PEB)*

Manage duties

Surveyed Service Members’ Ratings in Areas Related to Their Medical Hold / Holdover Experience

(Points on Graph Reflect the Percentage of Participants in the Month Shown Who Responded with a Rating of “1” or “2” on the 5-point scale)

1 2 3 4 5Poor Outstanding

PreferredDirection

* Small PEB numbers

PEB: n=1

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Getting urgent care as soon as needed

Getting an appointment as soon as needed

Getting treatment or counseling

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

May 07(n=53-245)

Jun 07(n=58-263)

Jul 07(n=29-141)

Aug 07(n=12-129)

Sep 07(n=18-136)

Oct 07(n=14-133)

Nov 07(n=37-185)

Dec 07(n=24-131)

Jan 08(n=17-100)

Feb 08(n=15-136)

% R

ate

"1

" o

r "2

"

Transportation to medical care Support for visiting family & friends

Pay issues Medical claims

Personnel orders Patient and family's needs

Getting urgent care as soon as needed Getting an appointment as soon as needed

All health care Personal doctor

Specialists Getting treatment or counseling

Outpatient Health Care-Ratings over Time (Points on Graph Reflect the Percentage of Participants in the Month Shown

Who Responded with a Rating of “1” or “2” on the 5-point scale)

PreferredDirection

Noteworthy:Very few problems with doctors, or health care relative to concerns with access

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Self-Reported Health Status Ratings over Time(Percentage of survey participants rating their Overall Health or Mental Health as “1” or “2” on 5-point scale; % indicating health is worse than before deployment)

PreferredDirection

Overall health

Health compared to before

Mental health

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

May 07(n=415-

416)

Jun 07(n=439-

443)

Jul 07(n=215-

216)

Aug 07(n=204-

205)

Sep 07(n=234-

234)

Oct 07(n=217-

218)

Nov 07(n=331-

337)

Dec 07(n=242-

242)

Jan 08(n=186-

187)

Feb 08(n=194-

194)

% R

atin

gs

1 o

r 2

or

Mu

ch w

ors

e/w

ors

e

Overall health Health compared to before Mental health

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Backup Slides

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Post-deployment Health Assessment Key Results - Cumulative1 January 2003 – 17 April 2008

Medical/ Dental

Problems

Health

(Excellent, Very Good,

Good)

Currently on Profile

Mental Health

Concerns*

Referral Indicated for any reason

93% 23% 7% 31% 20%

90% 42% 12% 29% 25%

Summary of responses for all Service members

with a DD Form 2796 submitted since 01 Jan 03,

all operations/deployments

Data Source: Defense Medical Surveillance System,

As of 17 April 2008

Active Duty

(N = 830,207)

Reserve Components(N = 440,832)

* Service member reported mental health concerns: any positive response to Questions 11-13