Changes in the distribution of navy and marine corps casualties from World War I through the Vietnam conflict

This paper, utilizing data from the annual reports of the Surgeon General of the Navy and from the health statistics of the United States, has reviewed the temporal changes in disease and mortality trends in the civilian community, and compared them with changes which have been seen among active duty Navy and Marine Corps personnel. In general, the trends have been similar, with decreasing overall mortality, a declining admission rate, and a lessening impact of infectious diseases and their complications. Likewise, changes have been noted during successive periods of war. There has been a gradual shift from World War I (when the rank ordered causes of admission were respiratory illness; infectious and parasitic disease; digestive disease; accidents, poisoning and violence; battle casualties; genitourinary disease; and ill-defined conditions) to the pattern seen during the Vietnam Conflict (where accidents, poisonings, and violence; respiratory illness; infective, and parasitic diseases; digestive diseases; battle casualties; ill-defined conditions; and genitourinary illness) were relatively more important. Although one is tempted to project medical resource requirements in future conflicts based uponthese figures, an examination of the estimated man-days lost by ICDA category, for calandar year 1975, indicates that much of the major impact of musculoskeletal disease; accidents, poisoning, and violence; mental disorders; respiratory illness; and dermatologic illness, is not reflected in hospital admissions alone. It is obvious that outpatient morbidity must be added to hospitalizations and mortality, if accurate planning is to result. Further, the impact of secular trends must be accounted for as these changes take place. Military medical planners need to constantly reexamine the data available to them, in order to adequately assess the needs of their respective Services and commands for medical resource support.