Veterans

The term ‘veteran’ traditionally described former ADF personnel who were deployed to serve in war or war-like environments. Veterans are now considered people who have any experience in the Australian Defence Force (ADF) including permanent, reserve, and former (ex-serving) personnel (Tehan 2017).

Australian Defence Force (ADF) members have unique experiences as a result of their service in the military, which can influence their health and wellbeing relative to the rest of the Australian population. In general, ADF members are trained to be physically and mentally fit, receive regular medical assessments, and have access to comprehensive medical and dental treatment. In contrast to the general Australian population, ADF members can be subject to workplace stressors from exposure to combat, periodical geographical relocations, and lengthy separation from family. Military service also increases the likelihood of exposure to life threatening situations, which may result in physical and mental trauma and moral injury (Jones et al. 2020).

Healthy soldier effect

The healthy soldier effect is the observed phenomenon that military populations are healthier than the general population. This builds upon the healthy worker effect (McLaughlin et al. 2008), whereby people who are currently employed are generally healthier than the general population, usually due to lower participation in employment among people with serious illness, injury, or disability.

The healthy soldier effect is generally thought to be the product of several factors. The first is the selection bias for enlistment. When people apply to enlist in the military, they are subject to extensive medical and psychological screening (Wilson et al. 2005a). People with life-limiting illnesses or behavioural disorders are excluded, which raises the average health status of the military compared with that for the general population. Further, if a person develops a medical condition while serving in the military and becomes medically unfit, they can be discharged involuntarily (Dunt 2009). Again, this can raise the average health of the serving military population, compared with both the general population and the ex-serving population.

Beyond this selection effect, ongoing military service itself can potentially act as a protective health factor. People serving in the military are required to maintain a high level of physical fitness and good physical and psychological health (Wilson et al. 2005b). They also have access to funded medical services through ADF member free healthcare (Department of Defence n.d.). The selection effect and these ongoing protective factors can result in military populations having a substantially raised health status compared with that of the general population.

The presence of the healthy soldier effect over time has been found to vary substantially between different causes of death and different cohorts of the veteran population (Waller & McGuire 2011).