Biggest ongoing risk factor to veterans’ health is smoking, study finds
A major study into the health of veterans in Scotland found smoking is the biggest major ongoing challenge impacting their overall wellbeing.
The Trends in the Scottish Veterans’ Health report, published on Tuesday, is a comparison between the health of those who have served and that of the wider community over almost 40 years.
The study compared the medical records of 78,000 veterans in Scotland who were up to 73 years old at the end of the collection of data in 2017, with more than 250,000 non-veterans.
It found that smoking-related diseases, including cardiovascular disease, remain a major issue for veterans – although this is improving as military smoking reduces.
Research in the 1950s and 1960s showed that people who were then young soldiers were smoking about 20% more than civilians; 50 years later, up to 10% of veterans have experienced at least one major smoking-related health outcome, reflecting the consequences of this earlier smoking pattern.
Key findings in the latest paper, led by Dr Beverly Bergman at the University of Glasgow, and funded by Forces in Mind Trust (FiMT), said veterans are more likely than non-veterans to develop cardiovascular disease, and possibly at an earlier age.
The risk of a heart attack is also 15% more likely, though, this is a decrease from 22% recorded in the first Scottish Veterans Health study released in 2012.
The slightly increased risk of diabetes is not changing, and the risk of prostate cancer and bowel cancer in veterans is no different from non-veterans.
Generally, veterans who have served for longest are enjoying better health, while those who leave service early have the poorest health outcomes, which is partly explained by living in deprived areas and taking on the health risks of the community where they settle, the report said.
Some of the study’s recommendations included providing targeted health promotion and smoking cessation services to all service users identified as veterans.
It said smoking during recruit training should be prohibited in order to break the link between “bonding” and tobacco.
The study also looked into changing mental health outcomes.
Researchers said they found that understanding the drivers for mental ill-health was challenging with the pattern of mental health in the wider community also changing.
Data showed there has been a marked deterioration in the mental health of middle-aged veterans born in the 1970s in comparison with non-veterans.
Researchers said this cannot cannot be completely explained by operational service, adding there is “an urgent need for research” into their risk of conditions such as post-traumatic stress disorder (PTSD), and that more support is provided to this age group.
The paper went on to highlight that middle age has been identified as a high-risk period for mental ill-health and suicide in veterans.
The researchers also found that the mental health profile of female veterans differs from men, and suggested that male-orientated veteran services may not be the best way of meeting their needs.
Reassuringly, more recent birth cohorts are showing some improvement, which may be related to initiatives in recent years to support transition that were not available to older veterans.
The report also found evidence that more recent generations of veterans had benefited from the Defence Health Strategy, implemented from the late 1970s, which introduced mandatory fitness training and health promotion in the Armed Forces, as well the ban on indoor smoking on premises in 2006.
Tom McBarnet, acting chief executive of FiMT, said: “We were pleased to be able to fund this important follow-up to the Scottish Veterans Health Study (2012-2015) which provided an unprecedented insight into the health of veterans.
“This study has provided useful insights into the impact changing attitudes towards smoking, alcohol and fitness has had in the Armed Forces, and dispels harmful myths about military service negatively impacting health.
“In fact, it shows that often it can have a positive effect.”
He added: “We hope that this report will help policymakers and practitioners to understand the health needs of veterans, and to recognise where efforts can be focused to make further improvements.”
Dr Bergman, the lead researcher, said: “This study provides information on the key areas where veterans’ health differs from the wider community, enabling service providers to target their activities to benefit those whose need is greatest and thereby optimise the allocation of scarce resources.
“It also indicates where improvement in health is slowest, and therefore where the greatest need lies for further health promotion targeted at the veteran community.
“The report highlights areas where more detailed research is needed, and recommends that veterans’ health should be routinely monitored by national statistical organisations.”
Kevin Stewart, Minister for Mental Wellbeing and Social Care, said: “We are committed to ensuring that all veterans living in Scotland are able to access the best possible care and support, including safe, effective and personalised healthcare.
“We aim to ensure that the long-term clinical needs of serving personnel and veterans are better understood and supported within the NHS.
“The publication of the Veteran Mental Health & Wellbeing Action Plan in December 2021, reinforces our commitment to further improve support for veterans and their families.
”It also recognises and prioritises the needs of female veterans, veterans from ethnic minorities and individuals from the LGBTQ+ community who have specific needs.
“We are working with a range of organisations, including Combat Stress and Veterans First Point, to ensure the delivery of services that meet the needs of veterans.
“We will provide over £2 million to veterans’ services this financial year to provide a range of specialist and community based services for veterans resident in Scotland.
“An initial priority has been the need to address stigma, “See Me “ will be launching a campaign later this year that highlights the impact stigma has on our veteran community and encourages those who need help to come forward.”