1 Deployment Health Report – April 2008 Emphasis 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)

3 Source: Defense Veterans Brain Injury Center as of February 29, 2008 TRAUMATIC BRAIN INJURIES Agent of InjurySeverity of Injury

4 Percent of Amputees, by ServiceCircumstances of Injury AMPUTEES – OEF AND OIF (N = 1,056) Source: US Army OTSG, as of 1 March 2008

5 Disease & Non-Battle Injuries (D & I) in Theater CENTCOM (OEF/OIF) Combined Percent of all Encounters Data Source: JMeWS 01JAN05 to 07APR08 ArmyNavy Marine Corps Air Force Total Combat Stress 1% Dermatologic 10%11% 13%11% GI 4%3% 5%4% Injuries, all causes 30%24%30%19%29% Other 39%45%42%41%40% Psych Mental 6%5% 6% Respiratory 9%11%7%15%10% Total Encounters 785,23744,55118,247112,671960,706

6 Injury Distribution in Theater CENTCOM (OEF/OIF) Combined Percent of all Injury Encounters Data Source: JMeWS 01JAN05 to 07APR08 ArmyNavy Marine Corps Air Force Total Injuries, all causes30%24%30%19%29% Injury Heat/Cold1% Injury MVA1% 2%1% Injury Other18%21%19%31%19% Injury Sports28%33%24%28% Injury Work51%44%54%40%50% Total Encounters239,35710,8675,50221,170276,896

7 Medical Air Transports from CENTCOM for OEF/OIF Total # of Service Members Transported: 48,904 Distribution by Underlying Condition: Disease58% Non-Battle Injury21% Battle Injury21% Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

8 % Distribution, by Year, of Disease, Non-Battle Injuries, and Combat Injuries Among Service Members Medically Air Transported from CENTCOM Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

9 GWOT Medical Air Transports (MAT) Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

10 MATs from OEF / OIF for Disease Military Personnel Most Frequent Major Diagnostic Categories Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

11 MATs from OEF / OIF for Disease Civilians and Contractors Most Frequent Major Diagnostic Categories Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

12 Musculoskeletal System / Connective Tissue Disorders of the vertebral column2,664 Miscellaneous soft tissue disorders1,327 Non-arthritic joint disorders 894 Arthritis of the joints of the arms and legs 54 All other conditions 403 TOTAL5,342 MAT from OEF and OIF for Disease Military Personnel Only Details about Major Diagnostic Categories (selected) Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

13 MAT from OEF and OIF for Disease Military 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 consciousness847 (Convulsions, Syncope and collapse, Alteration of consciousness, Dizziness and giddiness, Hallucinations) Abdominal pain413 Sleep disturbances210 Headache188 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 TRAC 2 ES As of 15 April 2008

14 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 Disease Military Personnel Only Details about Major Diagnostic Categories (selected) Data Source: USTRANSCOM TRAC 2 ES As of 15 April 2008

15 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 column2, % Misc. soft tissue disorders of the musculoskeletal system1,3274.6% Ill-defined symptoms related to resp. system and chest1,1764.0% Inguinal & abdominal hernias1,0543.6% Depression and depressive disorders1,0443.6% Non-arthritic disorders of joints % Ill-defined alterations of consciousness % Skin disorders % Adjustment disorders, including PTSD % Urinary stones (calculi) % Breast Disorders % Appendicitis % Coronary artery disease % TOTAL OF THESE 13 CATEGORIES 12, % TOTAL OF ALL DISEASE MATS 28,535 Data Source: USTRANSCOM TRAC 2 ES 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 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) 105,31778,136102,278 Self-reported Health Excellent, Very Good, Good Fair, Poor 97% 3% 94% 6% 84% * 15% * Physical Concerns 10% 24% 40% Mental Health Concernsn/a 33% ♦ 43% ♦ Exposure Concernsn/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

17 Recovering Service Member Overview Total force, not just GWOT related Source: Services

18 Recovering Service Member Overview Total Force, not just GWOT-related Source: Services SGs: As of April 1, 2008

19 Medical Evaluation Boards (MEB) Most Common Major Categories of Primary Diagnoses Among 3,825 Army Personnel Completing MEBs (1 Sep 07 – 20 Mar 08) (Includes all Soldiers, not just OEF/OIF veterans)

20 Telephone Survey of Ill and Injured Service Members Post-Operational Deployment After Ten Months March 27, 2008 Rich Bannick, Ph.D. OASD(HA)/TMA, Health Program Analysis & Evaluation Division

21 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) Poor Outstanding Preferred Direction * Small PEB numbers PEB: n=1

22 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) Preferred Direction Noteworthy: Very few problems with doctors, or health care relative to concerns with access

23 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) Preferred Direction

24 Backup Slides

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26 Post-deployment Health Assessment Key Results - Cumulative 1 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