Executive Summary:
In 2018, Headquarters Marine Corps Force Preservation Directorate (MCDAPO), in collaboration with the Navy Marine Corps Public Health Center (NMCPHC), initiated a longitudinal health record review of the medical encounter data of 56 service members (SM) from Fox Battery 2/10 (F 2/10), which fired an unusually high number of artillery rounds while deployed from April-September 2017. Initial analysis revealed that these SMs suffered a higher rate of traumatic brain injuries (TBIs) than the rest of the artillery community. When scaled to larger artillery units and future combat against peer/near peer adversaries, this operational tempo could result in the artillery community suffering injuries faster than combat replacements can be trained to replace them. Such human costs should be incorporated into the evaluation of future programs and systems. Subsequent analysis exploring correlations between combat and several categories of medical conditions and procedures that might be caused by exposure to combat revealed that artillery Marines, regardless of whether they have deployed or not, suffer a higher rate of TBIs and Sensory injuries in comparison to Marines in other MOSs. This difference is exacerbated the more an artillery Marine deploys. Furthermore, in the five months prior to a combat deployment, TBIs suffered by artillery Marines increase by a factor of 4, and once artillery Marines suffer a TBI, they will suffer, on average, 1.2 additional TBIs per year of service after their initial TBI and become more susceptible to spending extended periods of time on Limited Duty. Artillery Marines and those in other combat arms MOSs require, on average, a similar amount of medical care costs (~$600) for procedures related to BOP injuries each year. This average cost accounts for 13% of total budgeted costs for medical care for the average Marine ($4,471). The characteristics of the blast wave that cause TBIs are not fully understood at this time. As such, the Marine Corps should consolidate and fund blast surveillance programs that monitor, record, and maintain data on blast pressure exposure for individual Marines to inform ongoing research and the evaluation of potential mitigation techniques and protective equipment. A 01 February 2019 memo signed by the Deputy Assistant Secretary of Defense for Health Readiness Policy and Oversight outlines six lines of effort that should similarly guide the Marine Corps’ efforts to improve the health and readiness of the artillery community.
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