The effect on Vietnam War veterans are so well known they have been the subject of films such as Born on the Fourth of July. There is much parallel between the Vietnam War (1961-1975) and the more recent Iraq and Afghanistan conflicts. Public opinion polls showed that the majority of Americans felt it was a mistake to send troops into these wars. (Joyner, 2005) Aside from the casualties of war, those veterans repatriated after their tour of duty have had difficulty in going back to civilian life.
Most apparent had been the adverse effects on health and possibly employment. It has been confirmed that these armed conflicts brought about a substantial economic drain in the US, and this has resulted in some strain on the social services that should have been earmarked for veterans in general, particularly on health services. This is significant because it has been recognized that posttraumatic stress disorder (PTSD) has had a profound impact on veterans in the prevention of their resumption of civilian life, including that of employment.
Such an impact was observed in veterans of the Vietnam War era and led to legislation designed to provide equal opportunities for employment for this sector of the population. This paper intends to briefly illustrate the parallels between Vietnam War and what is termed the Gulf War-era (Iraq and Afghanistan) and then discuss the effects of health, emphasizing PTSD, with special emphasis on employment status of veterans. 2. LITERATURE REVIEW The paper focused primarily on surveys undertaken by the Bureau of Labor Statistics in conjunction with the Current Population Survey for statistics on employment.
It took particular advantage of the first-ever comprehensive survey focusing on the employment of veterans of the various wars in the US beginning with World War II up to the most recent Gulf War. The figures focused on available data as of August 2005. To support the findings of the survey regarding young Gulf War veterans, a longitudinal study conducted by the National Organization of Research based in the University of Chicago was cited. Other sources for health issues for veterans include The New England Journal of Medicine, articles from the American Psychological Association, Medicine Net.
com, National Center for Posttraumatic Stress Disorder and the Disability Rights Advocates. 3. METHODOLOGY The Current Population Survey is often used to provide objective and nationwide information for the specific needs of a particular research. In this case, the U. S. Census Bureau with the help of the CPS monthly surveys provided the initial information for focusing on the employment of veterans of the Gulf War era in order to determine the status of this population sector once they had returned to civilian life.
The 1997 National Longitudinal Survey of Youth (NLSY97) dataset also provided some important insight into the need for longitudinal studies to resolve some issues regarding the apparent age-related aspects of unemployment, specifically for the 18-24 year old age bracket. With regard to health issues, studies by the American Psychological Association provided some summaries regarding the risk, incidence and effects of posttraumatic stress disorder (PTSD) and related conditions on veteran employment, as well contributing factors to mental health problems of returning veterans.
A Gallup poll article provided longitudinal data regarding the progress of opinion of the American public about the Iraq war with particular reference to the Vietnam War. 4. DEFINITION OF TERMS Some terms need to be defined in the interest of clarity. a. Gulf War era is a term used in the August 2005 CPS/BLS survey on veteran employment, denoting wars including the Gulf War of 1980, the Iraq War and the Afghanistan War. b. Veterans refer to those who have undergone active military service of at least 6 months in the US Armed Forces regardless of gender, age, race, military position, or branch of the Armed Forces.
c. Non-veterans refer to civilians who have not been in active service at the US Armed Forces at any time for 6 months or more. d. Related conditions refer to mental health problems that are related but not equal to posttraumatic stress disorder (PTSD) and may include but not limited to depression, anxiety disorders and problems resulting from prolonged substance abuse. 5. HEALTH EFFECTS The costs of long-term medical care for chronic PTSD is high, because PTSD is often associated with poor mental health, increased medical morbidity and more veterans are availing of medical care as well as disability compensation.
Veterans Affairs medical institutions have reported doubts about being able to meet the demand for PTSD treatment as of February 2005, and reports indicate the demand is projected to increase. At present, each available behavioral health provider has to service 900 soldiers, accounting for the fact that only 27% of all soldiers diagnosed with PTSD and related conditions are treated. (American Psychological Association, 2007) The September 11, 2001 terrorist attack on the US has brought into prominence the effects of PTSD on humans.
It has been acknowledged, however without much fanfare or conviction in general, that PTSD is a condition that veterans have lived with since war has been in existence. The proximity of the attack had jolted American society into taking a closer, more personal look into what PTSD is, its scope and how it is really affecting American soldiers. (Panzarino, 2005) a. Definition of PTSD PTSD is not a new concept, although it had been referred to under different names.
French physician and psychologist Pierre Janet was the first to coin the phrase dissociation and traumatic stress and to provide comprehensive description of the syndrome of PTSD. It has been called shell shock in World War I and combat fatigue in World War II, later referred to as Post Vietnam Syndrome, inaccurate because PTSD is not only associated with military-related trauma, but implicitly acknowledging the widespread incidence of PTSD and other mental health problems experienced by Vietnam war veterans.
However, treatment for PTSD was first proposed in the 1940s by Harvard Medical School psychiatrist Dr. Eric Lindemann. A systematic management of PTSD was proposed at Massachusetts General Hospital in Boston. Trauma in this context is defined as the first-hand experience of a person of terrible events, usually as a result of violent acts, or actual recipient of physical or psychological violence, injury or death resulting in feelings of intense horror and fear.
PTSD is the abnormal and prolonged retention of negative response of a person to such trauma that may carry over many years after the event. (Panzarino, 2005) b. Causes of PTSD Dying in combat is an accepted risk of soldiers going into war. However, the risk to soldiers does not stop once they leave the combat zone. Long-term emotional and psychological effects of trauma, stress and adversity found in war-zones had been an issue of concern among veteran soldier psychologists and care providers.
The armed conflict in Afghanistan and Iraq is comparable only to the Vietnam War in terms of length of time in which combat of operations have been sustained. Aside from the economic costs, the projected risk of mental health problems has been much discussed among concerned policy makers. The frequency and intensity of the combat experience has been shown to have adverse effects on combatants, most probably leading to military service-related PTSD and related conditions. During the Vietnam War, PTSD was not so clearly understood, nor was the treatment and care available for those who were most affected.
In the latest wars fought on foreign soil, a study by Hoge and associates compared the incidence of PTSD in active-duty soldiers in the Afghanistan and Iraq and found that more of those who served in Iraq were more likely to have PTSD, strengthening the theory that increased combat exposure is associated with development of PTSD and the fact each war carries its own unique stressors that may also contribute to PTSD aside from combat exposure. (Litz, 2007) Violence in all forms and degrees was plentiful in Iraq.
The war in Iraq resulted in the highest wounded to killed-in-action ration in the history of the US, more than 86% of soldiers reporting being witness to a killing or serious injury of another person, and 68% the killing or serious injury of another American. More than half have handled or discovered human remains, and almost that many reported being the involved in the killing of a combatant with 28% reporting responsibility for the death of a noncombatant. There was a constant bombardment of threat even away from combat zones i. e. terrorist acts in civilian areas, and required combatants to be on alert over an extended period of time.
Because much guerilla warfare was carried out in areas populated by civilians, the danger of causing collateral damage in a spate of armed fighting is very real. Even civilians who may appear to be non-combative are suspect, and this constant vigilance causes great anxiety and strain. It is also suggested that the negative public opinion of the role of the military in Iraq and Afghanistan may also have a role in deflating morale and the conviction that they are on a laudable mission, and soldiers may feel their physical and emotional sacrifice may have been unnecessary and meaningless.
c. Effects of PTSD on civilian life Veterans who suffer from PTSD and other chronic mental health problems are not a rarity. Vietnam was fought in similar conditions albeit the danger was in the unseen enemy and an unknown terrain. The fear of the civilian combatant and children wielding weapons is a familiar theme in many documentaries and films. The effect of psychosocial dysfunction is to present society with a persistent and serious public health problem in terms of medical treatment and social service costs.
As of 2006, the healthcare service for US veterans is operating under a $2. 6 billion shortfall, and a backlog of claims to medical service stands at 600,000. The doctor to patient ration is 1 to 531. (Facts about veterans: needs and solutions, 2007; Nationwide class action against VA, 2007) Aside from this, this dysfunction renders the afflicted veteran unfit for employment and other income-generating activities. They are subject to mood swings and aggression.
Even if treatment for acute trauma is available, many veterans reuse to avail of it because of the stigma attached to being openly treated for mental problems. It was only in 1980 that PTSD became a recognized disorder. In the meantime, the veterans of the Vietnam War had to struggle against its effects on their own. The lack of social support, considered as much a factor in PTSD as actual combat trauma, increased the risk of developing the psychosocial disorders. This social support includes family cohesion, friends and community relations.