A Public Death: Five Tips from American-Statesman's Investigation of Veteran Deaths
The Austin American Statesman wrote an investigation into the post-war deaths of veterans from Iraq and Afghanistan that will make you cry.
But the reporters on "Uncounted Casualties," which launched Sunday, didn't set out to make that happen. They attempted to write a very thorough and measured account without relying too heavily on the emotional response that often comes with stories about people who have served their country and died.
Here are five tips from the series for health writers looking to cover the factors driving the deaths of veterans in their own communities.
1. Go wide with the document search. The sheer volume of public records reviewed by the Statesman is a big reason for the investigation's success. The paper says it obtained documents from more than 50 agencies in Texas. The records included autopsy results, toxicology reports, and accident reports. It also relied on obituaries and, of course, interviews with the veterans' families.
By doing this, the team made sure that it wasn't missing cases or missing details about cases. As it explained, the information about the deaths that it received from the military agencies themselves was often "fragmentary." The Statesman wrote a detailed explanation of how the investigation was conducted, too.
2. Go narrow with the focus of the investigation. The paper could have focused on all veterans, but it decided to narrow that universe. It examined only "veterans who served in operations Enduring Freedom and Iraqi Freedom." And then it added another restriction. Probably because the information was more readily available, it decided to look only at those veterans "who were receiving Department of Veterans Affairs disability benefits when they died."
By setting boundaries like this at the outset of an investigation – or even partway through – you make the reporting more manageable and the end result more understandable for readers. The team wrote:
The 345 Texas veterans identified by the VA as having died since coming home is equal to nearly two-thirds of the state's casualties in Iraq and Afghanistan. But that only includes veterans who have sought VA benefits, meaning the total number of deaths is likely much larger.
3. If something's wrong, say so. Writing about veterans can be difficult. There is an understandable tendency to treat veterans differently from other sources or subjects of stories, in part because of the military culture of strict rules and decorum and in part because the subject matter has a tendency to become political. The Statesman was respectful throughout, but it didn't shy away from calling out significant problems with how we "respect" our veterans. The team wrote:
Of those with a primary diagnosis of post-traumatic stress disorder, the numbers are even more disturbing: 80 percent died of overdose, suicide or a single-vehicle crash. Only two of the 46 Texas veterans of the Iraq and Afghanistan operations who had a PTSD diagnosis died of disease or illness, according to the newspaper's analysis.
4. If something's new, say so. A reader might assume that the military has a comprehensive view of what happens to veterans when they return home but that the information is kept secret. Instead, it seems the military could learn a lesson from the Statesman.
The team wrote:
Researchers said the analysis gives what might be an unprecedented look at veterans' mortality. "The VA really doesn't know' the full picture of how veterans are dying," said B. Christopher Frueh, a PTSD expert at the Menninger Clinic in Houston who previously worked as a researcher at the VA for 14 years. "I don't know anyone who has really (tracked individual causes of death) for a large cohort of veterans."
VA officials say they are hopeful that better cooperation with the Department of Defense and individual states will help them better study the fates of the nation's veterans. The VA is pushing all 50 states to improve reporting of veterans' deaths, although death certificate limitations will continue to bedevil researchers.
5. Simplify. With as many records as the Statesman gathered and as much work as went into this piece, it could have become a mess of factoids and numbers. Instead, the team used the numbers to underscore the main points of the story.
Perhaps the most powerful use of the data is in a simple bar chart comparing the deaths of veterans to the deaths of all Texans ages 20 to 34. Drug overdoses accounted for more than a quarter of the Iraq and Afghanistan veteran deaths, but only 11 percent of the deaths in the rest of the young adult population.
The Statesman wrote about the role of the now shuttered American Pain Foundation in providing guidance on painkiller prescriptions. "In 2007, the American Pain Foundation authored the 'chronic pain' chapter of "The American Veterans and Service Members Survival Guide," widely distributed to veterans. … the guide assured that 'when used for medical purposes and under the guidance of a skilled health-care provider, the risk of addiction from opioid pain medication is very low.'"
I salute reporters Brenda Bell, Eric Dexheimer, Dave Harmon, Tony Plohetski and Jeremy Schwartz; database editor Christian McDonald; and visual reporters Jay Janner and Kelly West.
Most of us don't serve in the military. More of us come from a military family – as I do. But you don't have to know someone who has served to care about what happens to veterans when they come home. This is a series that everyone should read, and it is journalistic work worth replicating throughout the country.
Photo credit: Terry Eiler via Flickr