WHEN Diane Lake began visiting her late husband's resting place at Long Island National Cemetery in Farmingdale, she became alarmed by what she saw nearby: memorial markers that showed many of her husband's fellow Vietnam veterans had died even younger than he had.
The markers, spaced along a wall where the ashes of her husband, Spc. 4th Class Robert Lake, and others are interred, indicate which war a veteran served in, along with rank and branch of service.
"I would look up on the wall and see this one was only 62 and this one was only 61, and say to myself these men were pretty young to be dying already," said Lake, whose husband was 65 when he died of an aggressive skin cancer May 13.
Lake, of East Northport, is among an increasingly vocal number of Vietnam veterans or their loved ones who are questioning whether participation in the Vietnam War is hastening the deaths of soldiers who survived it.
John Rowan, of Queens, national president of Vietnam Veterans of America, said his organization had been frustrated that the Department of Veterans Affairs has not done current research on the death rates of Vietnam vets. But he said he sees change coming. In September, VA Secretary Eric Shinseki said his department has begun a study of the health impacts of the war, which he said would be complete in about three years.
"The insight we gain from this study will help give us an understanding of how to better serve America's veterans," Shinseki said in a news release.

Death rate concerns veterans
The VA study could go far in addressing concerns of Vietnam veterans groups who believe the war has had a devastating effect on their health and life expectancy. Their evidence is mostly anecdotal, though. Some experts familiar with limited data regarding veterans' deaths say they have seen nothing that supports the charge that Vietnam vets are dying at unusually high rates. Still, many Vietnam veterans believe it is true.
"The Vietnam guys are going faster than the World War II guys," said Joe Ingino, president of the Nassau County chapter of Vietnam Veterans of America. He said he has come to believe this from stories he has been told across the region.
Examples on Long Island include a Medal of Honor awardee, Army Spc. George C. Lang, who grew up in Hicksville. Lang, who was paralyzed during a 1969 firefight, was 57 when he died of cancer five years ago.
Sharing a section of the memorial wall, known as a columbarium, in Farmingdale are the names of Staff Sgt. Leslie Garcia, formerly of Central Islip, who was 58 when he died of a heart attack this year, and PV2 Angel Gonzalez, of Manhattan, who was 53 when he died in 2009. The marker for another soldier nearby - Pfc Lawrence Gilmore was 61 when he died of a heart attack last year - reads "No more pain beloved son and brother."
"He was a loner, and never married," said his mother, Eva Gilmore, of Port Richey, Fla., who said Gilmore battled diabetes before he died. "He was in a lot of pain."
Many veterans note with alarm that the VA this year again expanded the list of more than a dozen diseases - including a host of cancers, Type 2 diabetes, and ischemic heart disease - directly linked to exposure to Agent Orange and other herbicides sprayed in Vietnam between 1962 and 1971. A diagnosis on the list can entitle a veteran to compensation related to a service-connected disability.

Other factors at play
Advocates say factors other than service in Vietnam also likely undermined the health of veterans. Because returning troops were rejected by a war-weary public, many turned inward, battling anxiety, depression and Post Traumatic Stress Syndrome on their own, often made worse by alcohol or drugs, experts say. And for most of the war, troop rations included free cigarettes.
"I can't say if his heart attack had anything to do with him being in the war because he was a heavy smoker," said Jocelyn McIntee, of Greenlawn, whose husband, Eugene, served in Vietnam in the mid-1960s, and died in 1992 when he was 49. "He really didn't talk about it, but do I think he came back with a lot of stress, yes. He saw a lot of people killed, and that must have been disturbing."
As early as 1987, the Centers for Disease Control and Prevention reported that troops who had been in Vietnam were dying faster because of risky or violent behaviors after their return.
In its 1987 Vietnam Experience Study, the CDC reported that the death rate for U.S. troops who served in Vietnam was 1.5 times higher than for troops who served elsewhere in the first five years after their discharge.
Violent deaths accounted for much of the increase in that study, with Vietnam veterans twice as likely to die from car crashes, suicide and homicide as were troops who served elsewhere during that era.
A 1996 study by Australia's Department of Veterans Affairs showed that Australian troops who served in Vietnam died younger than Australian troops who served elsewhere in the same period. They were twice as likely to die of lung cancer and three times as likely to die of cirrhosis of the liver, the study showed.
More recent data on the rate of Vietnam veteran deaths is anything but clear, says Mary Paxton, of the national Institute of Medicine, a sister organization of the National Academy of Sciences that evaluates health data for the Department of Veterans Affairs.
Paxton said studies of U.S. veterans cannot be regarded as definitive because incomplete record-keeping by the U.S. military means researchers cannot reliably track the health outcomes of the 2.6 million Americans who served in Vietnam.

No 'massive die-off'
But her reading of research has convinced her that there is no epidemic of early deaths among Vietnam vets.
"I get calls from veterans who say they are dropping like flies, but that doesn't seem to be the case," Paxton said. "I think they are at somewhat higher risk, but there is not the massive die-off that is being claimed."
Paxton referenced a 2004 update of the 1987 CDC study, which followed 18,313 male Army veterans.
"Death rates from disease-related chronic conditions, including cancers and circulatory system diseases, did not differ between Vietnam veterans and their peers," the report said.
To families of many Vietnam veterans, the statistics only go so far, as many now wonder whether their service in Vietnam so long ago is threatening their lives a second time. That's a question that tugs at Diane Lake, who said it became clear her husband knew he would not live past 65.
"He said, 'Diane, I don't have much time,' " she said, recalling his words shortly before his death. "He was with us another 10 days, and he was gone."