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  1. Why should we care about combat stress and related disorders?

  2. How do you define cultural competence regarding military service members, veterans, and their families?

  3. What are the medical problems associated with military service and deployment stress?

  4. How would you describe point-of-care strategies to improve the care of military service members, veterans, and their families?

  5. What resources are available to provide information, support, and access needed by military service members, veterans, and those who care for them and about them?

An estimated 2.2 million American military members have served in Operation Enduring Freedom (OEF) in Afghanistan and/or Operation Iraqi Freedom (OIF) since the first of these wars began in 2001. As of November 2006, these two conflicts have exceeded the duration of World War II. The attention rightfully paid to OEF in Afghanistan and/or OIF war fighters should also alert the public that there are 23.4 million living American veterans, three-quarters of whom served during an official period of conflict. Approximately one in every four Americans is eligible for benefits from the United States Department of Veterans Affairs (VA) because they are either veterans or the dependents of veterans. Yet only one in four veterans is enrolled for VA health services. The remaining 75% of veterans and all their dependents receive health care outside of VA.

The composition of those currently serving is described:

  • 12% of those serving in a combat area of operations are women.
  • 58% of the military forces are 29 years of age or younger.
  • 63% are active duty (AD) component members, and 37% are the Reserve component (RC) including Reservists and National Guard Members.

AD component members have the support of a strong military community due to their serving a continuous “hitch” on a military base. The RC “Citizen Soldiers,” however, move back and forth between military and veteran status. They may live hundreds of miles from the nearest military community and thousands of miles from the troops with whom they are deployed. Spouses may be the only person in their workplace who has had a wife or husband deployed in the military. Their children may be the only ones in their school to have a parent serving overseas.

The nature of our volunteer military requires multiple deployments per member. Each time a military member deploys, the individual's risk of developing a postdeployment mental health problem increases. When a service member deploys, a family serves too. As yet, there has been little research on how the health of military family members may be affected in the course of the deployment cycle.

At the time of this writing, there are still two dependents of American Civil War Veterans receiving VA benefits. Going to war is a very long-term investment. Yet, despite the large number of veterans and their dependents and an enduring obligation to serve those who have served our country, few health care providers routinely enquire about ...

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