Health of veterans

While good health is a requirement for joining the Australian Defence Force (ADF), the experience of military service means current and ex-serving ADF members may have different health challenges compared to other Australians. This is why monitoring of the health and wellbeing of the ADF veteran population is important.

Key findings

Australia’s veteran population

According to the 2021 Census of Population and Housing, more than half a million Australians (581,000) have ever served in the ADF, representing 2.8% of Australians aged 15 and over. Around 84,900 (15%) are currently serving ADF members (60,300 permanent and 24,600 reservists), and over 496,000 (85%) are ex-serving (ABS 2022b).

The age and sex profile of veterans is different to non-veterans (Figure 1):

• Veterans are mostly male – 86% (497,000) compared with 48% of non-veterans aged 15 and over. Fourteen per cent (84,100) of veterans are female.
• Ex-serving veterans are an older population – 53% (263,000) are aged 65 years and over, compared with 20% of non-veterans aged 15 and over (ABS 2022b).

This means that some health issues that are more common in males and older people will be more common in veterans compared with non-veterans.

Figure 1: Australian veteran and non-veteran populations, by sex and age group, 2021

Health status

Self-assessed health

In 2020–21, male veterans were less likely to rate their health as excellent or very good than males who had never served in the ADF (45% compared with 57%, respectively). This may be explained in part by the older age of Australia’s male veteran population (AIHW analysis of ABS 2023).

Long-term health conditions

In 2020–21, male veterans reported a higher prevalence of several long-term health conditions than male non-veterans (AIHW analysis of ABS 2023) (Figure 2). Similarly to self-assessed health, this may be explained by the older age of Australia’s male veteran population.

The prevalence of different long-term health conditions among male veterans was similar between veterans who were clients and/or beneficiaries of the Department of Veterans' Affairs (DVA), and non-DVA veterans (AIHW analysis of ABS 2023).

Mental health

Mental health conditions from the 2020–2022 National Study of Mental Health Wellbeing

In the 2020–2022 NSMHW, veterans were less likely to have reported a mental health disorder in the previous 12 months than non-veterans (17% compared with 22%, respectively). In particular, they were less likely to have reported an anxiety disorder in the previous 12 months (14% compared with 17%, respectively). Rates of affective disorders (7.7%) and substance use disorders (2.4%) among these veterans were similar to non-veterans (7.5% and 3.3%, respectively) (ABS 2022a).

Mental health conditions from the 2020–2021 National Health Survey

In the 2020–21 NHS, male veterans were more likely to report a current and long-term mental or behavioural condition than males in the non-veteran population (27% compared with 17%, respectively). In particular, they were nearly twice as likely (21%) to report having a long-term anxiety-related disorder compared with males in the non-veteran population (11%) (AIHW analysis of ABS 2023).

Mental health consultations

The 2020–2021 NSMHW showed that around 17% of all veterans had at least one mental health related consultation with a health professional in the previous 12 months. This was similar to people in the non-veteran population (17%) (AIHW analysis of ABS 2022a).

Self-harm and suicidal thoughts and behaviours

The 2020–2021 NSMHW found that around 6.4% of all veterans reported having self-harmed in their lifetime, compared with around 8.5% of non-veterans (AIHW analysis of ABS 2022a).

Rates of suicidal thoughts and behaviours over the lifetime were similar between veterans and non-veterans:

• 19% of all veterans and 16% of non-veterans had experienced suicidal thoughts.
• 8.6% of all veterans and 7.7% of non-veterans had made suicide plans.
• 7.8% of all veterans and 4.7% of non-veterans had attempted suicide (AIHW analysis of ABS 2022a).

However, this may not reflect the experiences of all sub-populations of Australia’s veterans.

Disability

According to self-reported data from the 2020–21 NHS, almost 2 in 5 (37%) male veterans had a disability with a limitation or restriction, while 1 in 5 (20%) had a disability but with no limitation or restriction. These proportions were around twice as high as non-veteran males (17% and 12%, respectively) (AIHW analysis of ABS 2022b).

Among the 496,000 ex-serving veterans aged 15 years and over captured within the 2021 Census of Population and Housing, 13% need assistance with core activities including self-care, body movement and communication, due to a long-term health condition or disability (ABS 2022b). Ex-serving veterans who served in the regular forces were more likely to need assistance with core activities than non-veterans, regardless of age (Figure 3).

Health risk factors

According to the 2020–21 NHS, male veterans had similar risk factors for ill health compared with non-veteran males, including:

• daily smoking (11% of male veterans compared with 13% of non-veteran males)
• excessive alcohol consumption (40% compared with 33%)
• insufficient fruit consumption (55% for both)
• insufficient vegetable consumption (94% compared with 96%)
• insufficient physical activity (70% for both).

Male veterans were more likely to be overweight or obese than male non-veterans (75% compared with 61%) (AIHW analysis of ABS 2023), although the fact that the body-mass index (BMI) methodology does not distinguish between the weight of fat or muscle in an individual should be noted (Health Direct 2024).

Deaths

Between 1997 and 2022, there were 17,217 deaths among people with at least one day of ADF service since 1 January 1985. Of these 17,217 deaths:

• around 15,508 (90%) occurred among ex-serving members
• almost 831 (4.8%) among permanent members and 
• 878 (5.1%) among reservists (AIHW 2024b).

Between 1997 and 2022, age-specific rates across all causes of death for permanent and reserve ADF members were lower than rates for ex-serving ADF members (Figure 4).

Age-specific rates across all causes of deaths for permanent, reserve, or ex-serving ADF males were lower than rates for all Australian males (Figure 4). The exception to this was for ex-serving males aged under 30, where the rate was higher, and for ex-serving males aged 30–39, where the rate was similar.

Age-specific rates across all causes of death for permanent and reserve females were lower than rates for all Australian females between 1997 and 2022 (Figure 4). Compared with all Australian females, ex-serving females:

• aged under 30 had a higher rate across all causes of death
• aged 30–39 had a similar rate
• aged 40–49 had a similar rate
• aged 50–70 had a lower rate.

Figure 4: Age-specific rates for all causes of death for veterans and all Australians, by age group and sex, 1997–2022

Leading causes of death

Leading causes of death is a useful measure of population health, especially when making comparisons between population groups. Figure 5 provides the leading causes of death in permanent, reserve, and ex-serving males and ex-serving females for 1997–2022 by age group, with the Australian comparison. Permanent and reserve females were not presented due to small numbers when disaggregated by age group.

Suicide was the leading cause of death for permanent, reserve, and ex-serving males, and all males in the Australian population aged under 50. For permanent males aged under 30 however, the leading cause was land transport accidents. For those aged 50–70, the leading cause of death for all groups was coronary heart disease.

The leading cause of death for ex-serving females, and all females in the Australian population was death by suicide for those aged under 40. For those aged 40–49, the leading cause of death was suicide for ex-serving females and breast cancer for females in the Australian population. For females aged 50–70, the leading cause of death for all groups was lung cancer (AIHW 2024b).

Figure 5: Leading causes of death among veterans and all Australians, by sex, age group and service status, 1997–2022

Deaths by suicide

Between 1997 and 2022:

• males currently serving in the permanent or reserve forces were around half as likely to die by suicide as all Australian males
• ex-serving males were 26% more likely to die by suicide than all Australian males
• ex-serving females were twice as likely to die by suicide than all Australian females, but had a lower rate of suicide than ex-serving males.

The suicide rate for ex-serving males who separated involuntarily for medical reasons was around three times the rate of those who separate voluntarily (62.7 compared with 22.0 per 100,000 population per year). However, the suicide rate for ex-serving females was similar between those who separated involuntarily for medical reasons and those who separated voluntarily (AIHW 2024b).

Health service use

Medicines

In 2017–18, more than 1 million medications were dispensed under the Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme (PBS/RPBS) to around 70,000 ex-serving veterans with service between 1 January 2001 and 1 July 2017. This was an average of 16 medications dispensed per ex-serving veteran in 2017–18.

After accounting for age and sex differences, similar proportions of the ex-serving population and all Australians were dispensed medications in 2017–18 (72% and 71%, respectively) (AIHW 2019).

Hospitalisations

In 2021–22, around 11,800 hospitalisations were funded by the Department of Defence, and 179,000 were funded by DVA. Combined, this represented 1.6% of all hospitalisations. DVA- and Defence-funded hospitalisations occurred most frequently in private hospitals (73% of DVA-funded hospitalisations and 89% of Department of Defence funded hospitalisations). For all other Australian hospitalisations, 40% were in private hospitals.

DVA-funded hospitalisations decreased by 6.6% on average each year between 2017–18 and 2021–22, while total hospitalisations in Australia increased by an average of 0.9% over the same time period.

Between 2017–18 and 2021–22, the number of DVA admitted patient days decreased by 8.5% on average each year (Figure 6). This may be due to the declining number of DVA-funded hospitalisations, potentially caused, in part, by the declining number of the older DVA Gold Card population and increasing number of younger DVA White Card population (DVA 2023). In comparison, patient days across all Australian funding sources has remained relatively stable over the same period, increasing by 1.3% on average each year (AIHW 2023a).  

Reasons for hospital admission

The most common reasons for admission to public hospitals were similar for both ex-serving members and the total Australian population. The three most common reasons that ex-serving ADF members were admitted to public hospitals were symptoms and signs, injury and poisoning and digestive diseases (AIHW 2024a).

Hospital admissions for mental health, self-harm and suicidal ideation

Of persons admitted to public hospital in 2019–20:

• a higher proportion of ex-serving ADF males were admitted for mental health-related care compared with all Australian males (8.1% and 6.6%, respectively).
• the proportion of ex-serving females who were admitted for mental health-related care was higher in comparison to admitted Australian females, but this was mainly driven by those aged 25–34 (7.4% and 4.9%, respectively).

Between 2013 and 2020, almost 4,400 ex-serving ADF members presented to an emergency department for intentional self-harm or suicidal ideation. This is equivalent to 3.7% of all ex-serving ADF presentations to emergency departments, higher than the proportion of 2.8% for all Australians (AIHW 2024a).

Health expenditure

Department of Veterans' Affairs health expenditure

In 2021–22, DVA spent $2.8 billion on health, mostly on hospital services ($1.0 billion), primary health care ($0.7 billion) and referred medical services ($0.6 billion) (AIHW 2023b). DVA spending on health declined in real terms over the decade to 2021–22 across several areas of spending:

• public hospitals (decreased an average of 8.8% per year)
• private hospitals (decreased an average of 6.4% per year)
• primary health care (decreased an average of 4.1% per year)
• referred medical services (decreased an average of 2.2% per year).

Based on the number of people in the DVA treatment population (which includes all DVA Orange, Gold and White cardholders), DVA spent $10,190 on health per member of the treatment population in 2021–22, which is 8.8% higher than the health spending per person in the total Australian population ($9,365). This average health spending per member of the DVA treatment population peaked in 2014–15 and decreased over the period 2015–16 to 2021–22. This recent downward trend in the health spending per member of the DVA treatment population is due to the decline in the number of Veteran Gold Card Holders and increase in those of Veteran White Card Holders. DVA will pay for the hospital treatment costs for Veteran White Card holders for accepted conditions or conditions under non-liability health care whereas all hospital services that meet the clinical needs of Veteran Gold Card holders are paid by DVA (AIHW 2023b).

Defence health expenditure

In 2021–22, the Department of Defence (Joint Health Command) spent $568 million on health. This was a decrease of 4.2% ($25.0 million) from 2020–21 in real terms. In descending order, the areas of spending were:

• other health practitioners ($164 million)
• referred medical services ($128 million)
• unreferred medical services ($88 million)
• private hospitals ($74 million)
• dental services ($52 million)
• administration ($37 million).

Where do I go for more information?

• General – Veterans
• Profile of veterans
  • Service with the Australian Defence Force: Census
  • Department of Defence annual reports
  • DVA annual reports
• Health status – National Heath Survey
• Social determinants of health
  • Wellbeing characteristics
  • Sources of income
  • Social connectedness
• Health risk factors – Smoking among Australia’s veterans 2020–21
• Mental health
  • National Study of Mental Health and Wellbeing
  • Characteristics of ex-serving Australian Defence Force members hospitalised for suicidality and intentional self-harm
• Suicide
  • Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 1997 to 2022
• Health service use
  • Characteristics of ex-serving Australian Defence Force members hospitalised for suicidality and intentional self-harm
  • Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18
  • Admitted patients
  • Specialist homelessness services annual report 2022–23
  • Health expenditure Australia 2021-22

For more on this topic, visit Veterans.