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January 29, 2013

At Last: "The Truth"!

From Elspeth Reeves, no less: (the comments are particularly amusing):

Conservative pundit George Will made this case on ABC's This Week Sunday, claiming:
"You're 6'4", 240-pound Marine, and you're injured, and you need a Marine next to you to carry you back to safety, and the Marine next to you is a 5'4" woman who weighs 115 pounds. It's relevant."

Host Martha Raddatz interrupted him, saying she'd seen female combat medics rescue 6'4" Marines. "That's fine," Will responded, noting 152 women had died in the post-9/11 wars. "But there are certain anatomical facts about upper body strength and stamina." Panelist Steve Inskeep said, "there are surely individual women who could pick you or I up wounded and carry us off a battlefield." Raddatz concluded, "It probably would not be me, but there are lots of them." Raddatz is selling herself short. Using the standard military technique for carrying people off the battlefield, she could have carried Will off the set quite easily.

American troops are trained use the fireman's carry, which is a way of sort of slinging a dude over your shoulder, as seen in the GIF at right. It's shockingly easy. It's so easy that in instructional YouTubes, the carried sometimes laugh with surprise. Earlier this month, on vacation, I ran in circles while fireman-carrying my (admittedly indie-rock thin) 6'2" male friend on a Miami beach, because it was funny. There are tons of YouTubes of women carrying men this way.

A YouTube video! Well, that certainly settles it!

Alert readers will remember Ms. Reeve's involvement in a previous truth-to-powering exercise.

Whether or not military women are easily able to lift and carry their male comrades ought to be easy enough to establish. If, as Ms. Reeve claims, it is "surprisingly easy", then certainly the technique ought to be widely practiced during recruit training (and women ought to be carrying men with some regularity). After all, it's surprisingly easy!

Unlike Ms. Reeve, I have no opinion on the ease with which military women can perform such feats. But that's probably because my opinion is utterly irrelevant to the debate when we could be discussing whether women can and do, in fact, perform such tasks in the field with any regularity(as opposed to on YouTube, or in the gym with a guy who helpfully cooperates).

How helpful is it to frame a debate over what will happen in the real world in less than ideal conditions around isolated examples of what some women can do under ideal conditions? Again, where are the facts on the real performance of women under real world combat conditions?

I've been reading military injury and illness studies, and I'm seeing the same themes over and over again. Despite being held to far lower standards of physical fitness and being excluded from the most physically demanding specialties, injury and illness rates for military women far exceed those for men.

Study 1 (2006, Ft. Irwin):

Soldiers from a brigade of the 1st Cavalry Division were involved in a 5-week training exercise at the National Training Center. Health care visits were systematically recorded by the unit medics. Of 4,101 men and 413 women who participated in the exercise, 504 soldiers (409 men and 95 women) sought medical care at the main support medical clinic or Weed Army Community Hospital. The rates of injury and illness visits were 1.2% and 0.6% per week for men and 2.3% and 2.2% per week for women, respectively. Women had twice the risk of an injury and 3.5 times the risk of an illness, compared with men. Compared with other branches, combat service support soldiers had higher rates of injuries and illnesses.

Study 2: (2007)

Included in this analysis were 792 women for an injury hospitalization rate of 11.0 per 1000 individuals (95% confidence interval [CI]=8.5-13.5) and 4879 men for a rate of 15.5 per 1000 individuals (95% CI=14.0-16.9). While women had significantly more injuries during scheduled training, schemes, and exercises than men (p<0.0001), there were few differences in the cause of those injuries. Women had longer average hospital stays compared to men due to these injuries (9.3 days vs 7.4 days, p=0.002), although these injuries were not more severe (average Injury Severity Score=3.5 for men vs average ISS for women=3.5, p=0.79). There was no difference between the genders in the percent of injuries that occurred off duty; however, men were more likely to get injured due to sports and athletics (p=0.001) and due to fighting (p=0.017) while off duty compared to women.

Note here that we're not comparing soldiers in equal jobs. Women are actually excluded from many of the more physical specialties. So if we are to extrapolate from this to illess/injuries if women are admitted to the combat arms, that must be taken into account.

Study 3: (2010, includes all armed services)

Hospitalization rates by gender:

In 2010, the hospitalization rate (all causes) was more than three times higher among females than males (hospitalization rate, overall: females: 147.9 per 1,000 p-yrs; males: 45.7 per 1,000 p-yrs); however, pregnancy and childbirth accounted for 58.6 percent of all hospitalizations of females.

[Editor's note: if we exclude pregnancy-related hospitalizations, women are hospitalized at a rate of 61 per 1000 p-yrs vs. men at 45.7]

The rate of hospitalizations for conditions not related to pregnancy and childbirth was one-third (33.9%) higher among females (61.2 per 1,000 per year) than males

Ambulatory visits:

In 2010, males accounted for three-fourths (75.3%) of all illness and injury-related visits; however, the annual crude rate was approximately twice as high among females (12.7 visits/ p-yr) than males (6.4 visits/p-yr). Excluding pregnancy related visits (which accounted for 13.1% of all non-V coded ambulatory visits among females), the ambulatory visit rate among females was 11.0 visits/p-yr. As in the past, rates were higher among females than males for every illness and injury related category.

...For each of the most frequently reported illness or injury-specifi c diagnoses, the crude rate was approximately 50 percent higher among females than males: other/unspecifi ed disorders of joints (rates [per 1,000 p-yrs], female: 728.6; male: 465.8;
female:male rate ratio [RR]: 1.56); adjustment reaction (rates,
female: 537.8; male: 362.8; RR: 1.48); and other/unspecifi ed
disorders of the back (rates, female: 534.3; male: 350.2; RR:
1.53).

Without much effort, I found several other studies that had the same broad results: despite being excluded from the most difficult/dangerous specialties, womens' illness and injury rates far exceed those of their male counterparts.

But by all means, let's focus on YouTube videos.

Posted by Cassandra at January 29, 2013 07:21 AM

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Comments

But look at it this way: if a female soldier is injured, it will be that much easier for her comrade to drag her to safety. Maybe we should consider a maximum size for anyone who's going to have to climb down through a turret?

I'm not serious, of course. It's true that the average soldier size in WWI was tiny compared to today, but the real trick is to have all the combatants as close to the same size as possible. If a bunch of WWI vets traveled through time, they might cause problems in the modern army, too. And it will never make sense to screen out the biggest warriors, so we'll end up screening out the smallest ones. That means it would be a rare women indeed who qualified.

Not that that will matter, as I said below, because the last thing we'll do is adopt a gender-neutral approach that applies strictly equal standards. The whole thing will become an affirmative-action entitlement circus where the least relevant concern will be ability to do the job. The bureaucrats will be completely caught up in how much each soldier needs the paycheck, and whether it's a blow to his or her dignity not to keep the job.

Posted by: Texan99 at January 29, 2013 10:25 AM

Here's another argument I rarely if ever see made.

Women are more than 50% of the population, but only about 15% of the military (and for the Marines, I think it may be more like 7%). So what we're really talking about here is accommodating a very small percentage of an already small minority.

Canada, for instance, has allowed women in most (not all) of their combat arms since 1989, has only a tiny number of women in combat specialties:

But the country's efforts for combat-zone equality have hit other obstacles. For years, Canada has found it difficult to fill combat roles with women in the first place. Women account for about 14% of all military positions in the Canadian Forces but just 2.4% of combat jobs, according to government data.

Karen Davis, a defense expert at the Canadian Forces Leadership Institute in Kingston, Ontario, said women considering a combat role are more likely than men to cite concerns about the effect on their families.

Shocker - military women behave very much like civilian women. Who woulda thunk it?

Posted by: Cass at January 29, 2013 10:41 AM

Despite being held to far lower standards of physical fitness and being excluded from the most physically demanding specialties, injury and illness rates for military women far exceed those for meni>

Despite, or because of?

Had they been held to the higher standard, *and* those in the most physically demanding been excluded (mostly men who, by being more accustomed to physical exertion, would be less likely to become injured in training), would the rates still be different?

As you note, it doesn't appear that any of these studies controlled for MOS or physical capabilities.

*If* the same physical standards already in use for the non-combat specialties are then used for the combat specialties then your assertion that injury rates would be far higher than is reported in these studies would be a fair claim.

If the women had to pass the same standards the guys already do, this is less clear. You would have far fewer women that could make the cut and those that did would be at the extreme fringes of the bell curve for physical fitness. At the same time, the men's top end is still higher. So you would have to compare within those men and women just over the standard.

The question, for me on the physicality side, is that if only a very tiny portion of women could meet the higher standards (say 1%), is that reason enough that that 1% should be excluded anyway?

Do we exclude the 1% for the characteristics of the group?

The libertarianish side of me says, no. *If* they can do the job as well as the men, then have at it. If that means that only 0.5% of the combat forces are women, who cares? The military isn't about "fairness" and "diversity" it's about kicking someone's @$$ and hard. And if the women can do that, the more the merrier.

The conservative side of me says, yes. The time, effort, and expenses used to identify that 1% are too high a trade-off and could be better spent on more and better weapons, armor, combat training, etc. The military isn't about "fairness" and "diversity". It's about kicking someone's @$$ and hard. And if finding that tiny majority hinders that, then tough cookies.

That said, the pregnancy thing is a huge deal for me. It seems to me, that should over 10% of the male soldiers every year engage in an activity that made them undeployable for months at a time, that activity would be banned and stiff penalties imposed.

And planning it would be right out. "Hey sarge, I'm going to go skiing and break my leg and be out for the next few months. Is that OK?" Yeah, I see that conversation going well.

Posted by: Yu-Ain Gonnano at January 29, 2013 04:05 PM

Actually, a few of the studies I read found that when you controlled for physical fitness level and overweight (women are worse on average for both), the injury rates for men and women were a lot closer.

But as you note, having the same standard would not deliver the desired result (not that 15% women is anything close to their share of the general population, but even with the easier standards women are grossly underrepresented in the armed forces).

The question, for me on the physicality side, is that if only a very tiny portion of women could meet the higher standards (say 1%), is that reason enough that that 1% should be excluded anyway?

Well, I'm pretty sure at least 5% of physically fit young men with very mild asthma would have no problem - ever - making it through basic training or military service. My son hasn't used an inhaler in ages. I actually used one for the first time in decades last week when my bronchial tubes pretty much squeezed shut on me. It was that or go to the emergency room. But that was only because I was already pretty sick. I've never had a single asthma attack as an adult.

As a teen, though, I had asthma too - very mild. And I used to run 6 miles a day, so clearly it wasn't debilitating. Should the military have to make endless exceptions for every disqualifying trait?

...the pregnancy thing is a huge deal for me. It seems to me, that should over 10% of the male soldiers every year engage in an activity that made them undeployable for months at a time, that activity would be banned and stiff penalties imposed.

The argument I always see here is, "Well, it's not FAIR! Men can have children and that doesn't make them non-deployable". And it doesn't.

But the military still has to deal with pregnancies, and when large numbers of these unplanned pregnancies involve single women with no one to share child care responsibilities.... that's a problem, and not just for the woman.

Posted by: Cass at January 29, 2013 04:30 PM

Well, I'm pretty sure at least 5% of physically fit young men with very mild asthma would have no problem - ever - making it through basic training....Should the military have to make endless exceptions for every disqualifying trait?

Well, technically, you wouldn't need to make "exceptions". You simply put them through the paces and either they make it or they don't. That would sort out the correct 5%.

The flip side of that is whether the time, effort, and money spent on the 95% that *don't* make it would have been better spent on those without asthma than on finding that 5%.

Posted by: Yu-Ain Gonnano at January 29, 2013 04:46 PM

The flip side of that is whether the time, effort, and money spent on the 95% that *don't* make it would have been better spent on those without asthma than on finding that 5%.

That's how I see it :)

But once we entertain the frankly ludicrous argument that the individual desire to serve (and not just to serve, but to serve in a specified MOS of one's own choosing) is paramount, such mundane considerations as the good of the service fly right out the window.

Posted by: Cass at January 29, 2013 05:08 PM

I would dispute that the average soldier in WWI was "tiny" by comparison to today's soldiers. My grandfather served as an infantryman in WWI, and was only slight (~ 1 inch) shorter than I am, and was not considered large even at the time - maybe average.
A young mad who my son went to HS with went Army ROTC and completed basic last summer, and was 1st in his class (a very conditioned distance runner) and he is also just slightly taller than me, and pretty lean.

Size is not necessarily relevant, and there will always be outliers of very tall and strong guys and some guys smaller than normal. Not all men can hack it as an infantryman. It is dangerous to any soldier serving in a real combat unit to have substandard soldiers serving beside him, which was a large point in going to an all-volunteer force.

The bottom line is why does the Army and Marine Corps infantry exist? Is this the last bastion of some "boys club" , or do they have a real mission to complete, when called upon? If the combat unit cannot achieve it's mission, it's called "defeat". It is an illusion to think that across a wide range of women and their physical abilities that some women could not make it past physical standards, but yet it still begs the question whether they would be good infantrymen. Physical abilities and stamina are just part of it. The dirt, privation, psychological stress can crack guys who are battle-experienced soldiers at some point. If you have not read David Bellavia's "House to House" about the battle of Fallujah, then perhaps it will be an eye-opener as to what this sort of combat is like. This cracks a lot of good men who are soldiers. Having an infantryman collapse from the psychological stress of the horror of battle at a key moment is a hell of fix to put the rest of their combat team into.

This is not some EO slot to be filled. People end up dead or wounded when they venture out there.

Posted by: Don Brouhaha at January 29, 2013 06:34 PM

Cassandra - There are similar differences in injury rates between men and women in professional basketball, though it isn't something that gets discussed much.

And those women are almost certainly in the top 1 percent for fitness.

As I recall, one of the reasons for the different rates was simply the difference in sizes of bones, muscles and tendons. It takes less force to injure the smaller ones.

Posted by: Jim Miller at January 29, 2013 07:39 PM

I remember meeting Mr. Will for the first time. He is a quite diminuitive gentleman. Perhaps 5'7" and 135-140 lbs?
.

Posted by: TMI at January 29, 2013 07:41 PM

I'm not sure that the Fireman's Carry -- while still taught, I'm sure -- is entirely appropriate for the modern battlefield. /googles/ There seem to several alternatives (more than a dozen) being taught, as long as when to use (and not use) each of them, including the Fireman's Carry. So just because Mable Marine can't lift and carry me that way, she's got other options.

Posted by: htom at January 29, 2013 07:52 PM

The whole point of "can they carry one of their comrades off the battlefield" is a lot of silly misdirection.

The purpose of the infantryman with a rifle in the battlefield is to kill people, with your rifle. Be prepared to kill people at a moments notice.

Pump artillery shells down range and blow things up. Those 155 mm shells won't load themselves with every field piece, they're heavy! Blow them up with grenades. Blast them to pieces with the 120 mm maingun of an M1 tank. An M1 is fun to drive, but man, throw a tread link and that is some pretty heavy work. Let's see you crank that tread link back together.

This isn't some EO committee meeting. Train hard, live in the dirt, take a shit with all your team mates around. Eat lousy food and kill people when necessary. Frankly I'd look for a way out of all that, and I frankly think women are stupid for trying to get a piece of it. Going camping with the Boy Scouts for a few days is about enough. Being deployed out in the field for weeks on end, being shot at, eating crappy food, sounds like a real great time. Welcome equals!

It's another attempt at confusing appearance with reality.

Posted by: Don Brouhaha at January 29, 2013 09:45 PM

'..surely there are women who can...'

What a quaint belief! Even at the height of my physical fitness, I could barely drag my brother
off. We used to practice stuff like that just to see how strong we were. I know. Dork kids.

But, it was important, because even my height was against me, and I am 5'8". My brother is 6'1", and at that time, weighed 170 lbs.

Does she believe in skittle flatus from unicorns too?

Posted by: Puff'sMeds at January 29, 2013 09:52 PM

"Having an infantryman collapse from the psychological stress of the horror of battle at a key moment is a hell of fix to put the rest of their combat team into."

Agreed, but should we assume that women collapse more easily from psychological stress? I'd love to find a metric that lets us eliminate soldiers subject to this risk, but I don't think we have one.

Posted by: Texan99 at January 29, 2013 11:34 PM

Train hard, live in the dirt, take a shit with all your team mates around. Eat lousy food and kill people when necessary. Frankly I'd look for a way out of all that, and I frankly think women are stupid for trying to get a piece of it.

Agreed, again, but irrelevant. Is it for men to decide for women that they're better off avoiding an ugly experience? It's about battle-readiness, right, not about men wanting to make life pleasant for women. Men could be called stupid for trying to get a piece of it, too, but they must have their reasons.

Posted by: Texan99 at January 29, 2013 11:37 PM

Cassandra - There are similar differences in injury rates between men and women in professional basketball, though it isn't something that gets discussed much. And those women are almost certainly in the top 1 percent for fitness. As I recall, one of the reasons for the different rates was simply the difference in sizes of bones, muscles and tendons. It takes less force to injure the smaller ones.

That's a great point. I actually did see several references to bone diameter and the thickness of some bone component whose name I've already forgotten in a few of the studies I read (I read more than 10, but some were better than others).

One I saw yesterday actually had a diagram showing the average diameter of male vs. female leg bones. Smaller males with bone sizes similar to women were somewhat more susceptible to fractures than most men, but even their bones were thicker than most women's.

Another major factor is hormones. Female hormones loosen tendons and ligaments. This is helpful in childbirth as the hips often have to accommodate a very large (10+ pounds, in my case) infant.

A third factor in injuries was carrying extra weight and poor physical fitness. Women are more susceptible to heat-related ailments too.

If you don't think that's a big deal in Iraq and Afghanistan, think again.

Posted by: Cass at January 30, 2013 06:47 AM

Alas, what do pretty much irrefutable facts matter when diversity and fairness rule over all?

Posted by: CAPT Mongo at January 30, 2013 08:37 AM

That's how I see it :)

Personally, I don't know what the answer to that question is.

Maybe it is worth it. Having more funds to buy more guns doesn't matter if you don't have enough people to shoot them.

Maybe it isn't worth it. The days of mass forces storming a beach are waning and small highly trained firesquads make up an increasing portion of the fight.

Regardless, to me, *that* is the question that needs answering: Does it increase our military's ability to kick @$$ and take names or decrease it.

My suspician is that it decreases it. Especially since most of the arguments for it aren't about improving the military's lethality, but about improving women's career options.

Posted by: Yu-Ain Gonnano at January 30, 2013 08:38 AM

There are tons of YouTubes of women carrying men this way.

That a fireman's carry is theoretically easy I have no doubt.

My experience, as a somewhat spindly young Marine carrying the biggest, bulkiest, guy in the company, both of us wearing a flak, helmet, deuce gear ... not so much.

And this was on a level surface, for training.

Posted by: Brian Dunbar at January 30, 2013 09:54 PM

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