What health issues are you likely to encounter in your veterans?

Veterans present with the same types of conditions seen in all Australians, albeit often at an earlier age and with different types of exposures. Ensuring you are knowledgeable about these problems and the resources available to support veterans will help to significantly improve their health outcomes.

Key Data Sources on Veterans' Health

Two important data sources for information on veterans' health are:

• The Transition and Well Being Research program (TWRP) Physical Health Status Report (2018), which offers a comprehensive, high-level overview of the self- reported physical health and wellbeing of transitioned (2010–14) ADF personnel and current serving (2015) ADF personnel in connection with several key health outcomes previously found to be of importance among deployed and non-deployed military and veteran populations in Australia and internationally.
• The 2020-21 Australian Bureau of Statistics National Health Survey (Health of Veterans 2023), which is based on self-reported information provided by males aged 18 years and over who had ever served in the ADF.

Veterans’ Health Status

Based on self-reported data from the 2020–21 National Health Survey:

• The majority (76%) of people who have ever served in the ADF rated their health as good or better
• Male veterans generally had lower rates of age-specific all-cause mortality than Australian males
• Male veterans shared similar exposure to several health risk factors compared with males who had never served

Note: The relatively low numbers of women who have ever served in the ADF constrains reporting on the health of women who have served; therefore, most reports typically present only data for men aged 18 years and over.

Distinctive Health Conditions Among Veterans

Data in the Physical Health Status Report (2018) show that veterans, as a group, are more likely than the general Australian population to suffer from:

• musculoskeletal disorders including osteoarthritis
• deafness and tinnitus secondary to occupational noise exposure and solar skin damage
• psychological problems and/or mental health issues (for example, posttraumatic stress disorder, alcohol dependence, anxiety and depressive disorders)

These conditions may lead to a range of behaviours including anger, being uncooperative, displaying thoughts of self-harm, demonstrating risky behaviours through alcohol use or exhibiting unacceptable social behaviours.

Most common self-reported symptoms

According to the Physical Health Status Report 2018, the 10 most common symptoms reported by both current serving (2015) and transitioned (2010–2014) ADF personnel were:
●    fatigue
●    sleeping difficulties
●    headaches
●    feeling unrefreshed after sleep
●    muscle aches or pains
●    low back pain
●    irritable outburst
●    joint stiffness
●    difficulty finding the right word
●    ringing in the ears

Most common self-reported doctor-diagnosed conditions

The five most commonly reported doctor-diagnosed conditions among transitioned (2010-2014) ADF were:

• chronic low back pain (18.5%)
• hearing loss (15.7%)
• high cholesterol (12.8%)
• other musculoskeletal condition (12.2%)
• high blood pressure (12.0%)

The five most commonly reported doctor-diagnosed conditions among current serving (2015) ADF were:

• chronic low back pain (11.7%)
• other musculoskeletal condition (11.1%)
• high cholesterol (11.0%)
• hearing loss (9.1%)
• sinus problems (8.2%)

Most prevalent self-reported chronic conditions

Male veterans are more likely to self-report experiencing long-term health conditions than males who have never served. This includes higher rates of:

• arthritis (33% compared with 12%)
• back problems (31% compared with 19%)
• heart, stroke and vascular disease (15% compared with 5.9%)
• diabetes (14% compared with 6.9%)
• cancer (6.7% compared with 2.6%)
• chronic obstructive pulmonary disease (3.6% compared with 1.0%)

Conditions specific to veteran cohorts

According to a number of studies cited in AIHW’s 2018 report, A profile of Australia’s veterans, some veteran cohorts have higher rates of chronic conditions than the Australian population; for example:

Male Vietnam War veterans

• higher incidence of selected cancers, e.g., melanoma, prostate cancer (Wilson et al., 2009)
• self-reported higher rates of multiple sclerosis, motor neurone disease, mental health conditions, skin conditions, ischaemic heart disease, hypertension, asthma, diabetes (AIHW, 1999)

Male Korean veterans

• higher incidence of selected cancers (AIHW, 2003)
• higher prevalence of mental health disorders (Sim et al., 2005)
• higher prevalence of medical conditions (Sim et al., 2005)

Male Gulf War veterans

• increased likelihood of PTSD, alcohol disorder, chronic fatigue, irritable bowel syndrome, chronic multi-symptom illness (Sim et al., 2005)

DVA-Accepted Conditions

An accepted claim condition is an injury or disease that has been determined under the Veterans' Entitlements Act 1986, Military Rehabilitation and Compensation Act 2004 (MRCA)or the Safety Rehabilitation & Compensation (Defence Related Claims) Act 1988 (DRCA) to be war-caused or defence-caused, and for which Veterans are eligible for compensation. Veterans will frequently enlist the aid of their GP in submitting this claim paperwork.

Claim data does not represent the full range of conditions seen in veterans, only those related to service which attract compensation.

DVA-accepted conditions by recent conflicts

The DVA provides data on the number of veterans and number of accepted conditions relating to claims under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). More details: Accepted conditions for veterans of selected conflicts (Mar 2024)

As at March 2024, for veterans deployed to conflicts in East Timor, Solomon Islands, Afghanistan and Iraq, there were:

• a total of 28,275 veterans with an accepted condition
• a total of 127,745 accepted conditions
• an average number of 4.52 conditions per veteran

Top-10 accepted conditions

The top 10 accepted conditions for the selected conflicts across East Timor, Solomon Islands, Afghanistan and Iraq were:

• Tinnitus
• Sensori-neural hearing loss
• Post-traumatic stress disorder
• Thoracolumbar spondylosis
• Osteoarthritis
• Depressive disorders
• Alcohol dependence and abuse
• Rotator cuff syndrome
• Erectile dysfunction
• Acute sprain and acute strain

Disability

According to self-reported data from the 2020–21 NHS:

• almost 2 in 5 (37%) males who had ever served in the ADF had a disability with a limitation of restriction
• 1 in 5 (20%) males had a disability but with no limitation or restriction.

These proportions were around twice as high as those of males who had never served (17% and 12%, respectively).

As at June 2021, there were 189,500 veterans with an accepted disability, equating to 72% of the DVA treatment population.