Many individuals, groups, and federal agencies have a strong interest in finding answers to the numerous and complex questions regarding the health of Gulf War veterans. Various types of research and health measurement are needed to address these diverse issues. The Institute of Medicine (IOM) was asked by the Department of Veterans Affairs (VA) and the Department of Defense (DoD) to undertake a study to identify important questions concerning the health of Gulf War veterans and then to design a study to answer those questions. The committee determined that it is of fundamental importance to ask how healthy are Gulf War veterans? Are they as healthy as others? What characteristics are associated with differences between the health of Gulf War veterans and the health of others?

To address these questions, it will be necessary to measure not only the health status of those who served in the Gulf War, but also to compare Gulf War veterans with other groups. Further, one must continue to follow these groups through time to determine whether the groups differ in the way their health status is changing. As the committee began to develop a design that would address the fundamental questions identified, it realized that such a study could have important implications for understanding not only the health of Gulf War veterans, but also the health of veterans of other conflicts.

Contents

• Committee on Measuring the Health of Persian Gulf Veterans
• Preface
• Acknowledgments
• Executive Summary
• 1. Introduction
  • VA and DoD Programs for Gulf War Veterans
  • Gulf War Reports and Evaluations: A Brief Summary
  • Measuring the Health of Gulf War Veterans
  • Defining Gulf War Veterans
  • Structure of the Report
• 2. Studies of the Health of Gulf War Veterans
  • Introduction
  • Specific Studies of Gulf War Veterans
  • Limitations of Previous Studies
  • Remainder of this Report
• 3. Measuring Health
  • The Evolving Definition of Health
  • Core Concepts of Health
  • Correlates of Health
  • Measuring Health-Related Quality of Life
  • Summary
• 4. The Gulf War Veterans Health Research Portfolio
  • Research Portfolio to Guide Studies of the Health of Gulf War Veterans
  • Summary
• 5. Gulf War Veterans Health Study
  • Study Questions and Design
  • Sampling
  • Scheduling
  • Mode of Survey
  • Improving Response Rates
  • Pilot Study
  • Data Collection Instruments
  • Cost
  • Ethical Considerations
  • Independent Advisory Board
  • Summary
• 6. Conclusion
• References
• Appendix A Coalition Forces and Force Strength
• Appendix B Design Issues in the Gulf War Veterans Health Study

Support for this study was provided by the Departments of Defense (Contract No. DASW01-98-K-0002) and Veterans Affairs (Contract No. V101[93]P-1580). The views presented are those of the Institute of Medicine Committee on Measuring the Health of Persian Gulf Veterans and are not necessarily those of the funding organization.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.