Veteran health care in the United States today can be a complex subject, yet it is one of great importance. Jessica L. Adler has tackled this important and relevant topic in her recent monograph, Burdens of War: Creating the United States Veterans Health System. This book is a thought-provoking piece of scholarship that attests to how “the [US] federal government made an expansive commitment that shaped a century's worth of postwar experiences for veterans” (2). It was a commitment that, Adler argues, led veterans’ health care to venture past short-term care and into long-term health care following World War I, into the interwar years. This care, contends Adler, has become the groundwork for modern-day health care for veterans. Adler thoroughly takes readers through this system, one that over the course of several decades was shaped and reshaped by politicians, medical professionals and veterans themselves. The system started after World War I to provide more than just “financial support and shelter in domicile care facilities” (251) because of policy developments. Adler skillfully utilizes an array of sources, including individualized accounts of veterans, and explores both the negative and positive steps in the creation of this “legacy of Great War health policy” (253).

Burdens of War is partitioned into seven chapters, in addition to an introduction and conclusion. Each of the sections begins with a short account of a veteran experience demonstrating a need for a solid health care system, which was a system in “constant flux” (81) from push-back for the creation of improved care. Adler has seamlessly woven these accounts into her main argument and into each chapter. I believe, though, that these stories also serve a greater purpose for the book, as well as the veterans themselves. These interlaced stories within the book give a voice to the veterans, demonstrating their involvement in advocating not just to secure any level of health care, but to secure a level of health care that would provide effective treatment and resources for their needs and to allow veterans to be self-reliant.

While I believe that the veterans’ stories themselves are one of the strongest assets to Adler's book, the book's strengths do not end there. There is also the bureaucratic and political examination of the health care system for veterans that Adler has crafted well. The system, as Adler has established, was a concern early on in the war for the United States. There was hope and determination by policymakers “to quell some of the dire consequences of war through smart, efficient planning” (11). Adler traces this planning in extensive detail from the War Risk Insurance Act, which was passed prior to World War I but “set the tone for the legislative conceptualization of the treatment of Great War soldiers and veterans” (12). She continues to trace this through the Veterans Bureau, and all the way to the creation of the Veterans Health Administration of today. In between these health care entities, Adler illustrates well how policies were reflections of Progressive Era thought, and how events such as the Great Depression affected views on veterans’ health care. Adler includes many solid examples, including President Franklin D. Roosevelt, who, like others, expressed issues with the veterans health care system and pushed back on furthering the system; however, through her analysis Adler once again demonstrates the voice veterans had and how they furthered the health care system for themselves and for future veterans.

Adler concludes her monograph with not only a detailed overview of her argument, but a more generalized look at the progression of veterans’ health care from World War I to now, allowing readers to fully grasp what she has detailed throughout the book. The conclusion also looks at modern-day veteran health care to an extent, though I do believe the book could have benefited by including more analysis of it; however, in lieu of that, Adler has written a well-crafted monograph that not only adds to the historiography of World War I and health care, but also has impeccably chronicled a vital and relevant concern from a hundred years ago. Adler's book provides an intricate historical account, but also an awareness of veterans’ health care then and today.