October 24, 2011: The U.S. Army has been ordered to reduce its strength over seven percent. This is bad news for a lot of good soldiers who have been diagnosed with physical or mental stress problems. That's because there's a growing shortage of troops fit for combat zone duty. Currently, 15 percent of the troops cannot be sent overseas because they have medical problems that render them incapable of handling the stress of a combat zone. Until last year, this was much less of a problem, because the army could keep people in service up to twelve more months. This "stop loss" rule enabled units to go overseas with all the troops it needed to get the job done. But now, with stop loss gone and a growing number of combat troops unfit for deployment, the army is having a hard time manning combat units fit for overseas duty. One solution will probably be to medically retire many of those unfit to deploy, and recruit new troops who are more fit. The reduction in strength makes this easier to do.

New recruits present another problem. Bad diet and lack of exercise has become a major problem with American children over the last two decades. Thus the army is getting recruits who are chubbier and less fit (low bone density and iron levels) than ever before. This results in more injuries during training, and while in combat. These troops are more prone to suffer physical injuries that will make them unfit for overseas service.

There's more to all this, because of many new technologies and tactics. Some of the new tech has resulted in the discovery of injuries that eluded earlier generations of medical personnel. And there has also been a new pattern of combat losses. These days, most of the serious casualties (about half) are for physical (31 percent) or mental (19 percent) stress. Only 14 percent of the casualties have been from the direct effects of combat. This decade of fighting has killed 6,000 American troops, and wounded 45,000. But over 100,000 have been badly hurt by accidents, mental stress and disease. While most of the sick and wounded have been treated, and often discharged, there are now a growing number of active duty troops who cannot be sent to a combat zone because of injuries, illness or PTSD (post-traumatic stress disorder).

Even in peacetime, there are some troops who have a “profile” that makes them ineligible for certain types of duty. But because of the large number of casualties in the combat zone (including injury and disease), and the need to keep experienced NCOs and troops with technical skills, the number of those with a profile is much higher than it normally is in peacetime.

For the U.S. Army, this is not unexpected. Over a million American military personnel have gone to Afghanistan and Iraq since 2001, most of them army, and as more of them came back wounded, sick or injured, the number of people with a profile increased. This was particularly true with PTSD, which has become the most common reason for a profile that keeps troops out of combat.

While the risk of getting killed in combat is now a third of what it was in Vietnam and World War II, the incidence of physical and mental strain appears to have more than doubled. This is largely because troops are in combat for so much longer than in past wars. This makes it much more likely for troops to eventually develop PTSD, and the kinds of stress injuries (often accompanied by chronic pain) amateur and professional athletes suffer from as they get older. The lower death rate came about partly because of much more effective, and heavier body armor. Then there was all the weight of additional equipment (medical, combat and so on) that made combat safer. But at a cost. And the cost will be paid for by the troops for decades to come.