New report on the health patterns of Scottish military veterans published

The Scottish Veterans Health Research Group, based at the University of Glasgow and supported by the Forces in Mind Trust, has published a new report which maps the health needs of the Scottish veteran community. Unique in both its scale and scope, this study – entitled Trends in Scottish Veterans’ Health and coordinated by Dr Beverly Bergman – builds on existing research to reveal how the wellbeing of Scottish veterans has evolved over time together with the ways in which it has come to vary across different demographic groups.

Written in an accessible style, this innovative piece of research stems from an appreciation that recent discussions about the needs of military veterans have focused overwhelmingly on the physical and mental effects of service life. As stressed in the report’s Foreword, such a tendency not only restricts our understanding of the veteran community as a whole, but also has the potential to mask the individual experiences of former service personnel. Notably, this restricted outlook has helped to foreground the unfounded notion that all veterans are somehow ‘damaged’ by their military career and additionally diverted attention away from other factors which influence veteran wellbeing. What is more, to consider exclusively the physical and mental health impacts of a military career is to overlook how the needs of the veteran community may reflect or differ from those of the wider public.

It is these potential stumbling blocks which Trends in Scottish Veterans’ Health looks to address. Informed by a research project conducted at the University of Glasgow in 2015 (which examined the long-term health needs of 57,000 Scottish military veterans compared to 173,000 non-veterans), the new study develops and refines the findings of this initial study in several respects. In particular, it uses a larger sample group of 78,000 veterans and 253,000 non-veterans while also supplementing the original dataset with information from up to the end of 2017. In so doing, Bergman and their colleagues show how the health needs of veterans have changed during the intervening period and highlight the emerging vulnerabilities of those who served in more recent military operations.

The key findings of Trends in Scottish Veterans’ Health include:

• Tobacco smoking continues to have a major impact on veterans’ health in Scotland. The study reveals that 5.4% of veterans were diagnosed with Chronic Pulmonary Disease over a 37-year follow-up period – a condition which includes smoking as a leading risk factor. Although changes to the UK Armed Forces’ smoking policy have been introduced in recent years, Trends in Scottish Veterans’ Health indicates that it is still too early to assess the possible benefits of such interventions.
• Early Service leavers have the poorest health outcomes in several respects. The report charts a general decline in mental health amongst specific groups of veterans between 2012 and 2017. Despite the temptation to attribute this trend to the intensity of recent overseas military operations, the poorest outcomes were observed amongst early service leavers and, crucially, those whose time in the Armed Forces was restricted to initial training.
• Mental health is a particular challenge for middle-aged veterans. While there is evidence to suggest that progress has been made in meeting the mental health needs of younger and more recent service leavers, the report notes that middle-aged veterans continue to face considerable challenges in this regard. This trend is attributed to a breakdown of social support structures and the limited availability of mental health initiatives designed to meet the needs of veterans born between 1970 and 1979.
• Longer Service generally results in better mental and physical health. Although a longer military career can increase exposure to in-service hazards, Trends in Scottish Veterans’ Health provides evidence to suggest that this outcome is often counterbalanced by greater access to workplace health benefits. The study also reveals the existence of ‘healthy worker’ and ‘less healthy leaver’ effects across the Scottish veteran community.
• Certain health outcomes amongst Scottish veterans can be attributed to deprivation. Appealing to wider public health data and other geographic factors, Trends in Scottish Veterans’ Health shows that health risks disappear entirely in certain veteran groups when the relative depravation of former service personnel is taken into account.

Drawing on the above findings, Trends in Scottish Veterans’ Health additionally outlines a series of research and policy recommendations, including:

• Smoke cessation is the most effective measure which can be adopted to improve veterans’ health. This initiative should include efforts to break the association between ‘bonding’ and tobacco which currently exists across the Armed Forces.
• Veteran support services must be tailored to the vulnerabilities of different demographic groups. The findings of Trends in Scottish Veterans’ Health suggest that support services which account for age- and gender-specific needs may have far greater impact than more generalised policies.
• Urgent research on the mental health needs of middle-aged veterans is needed. Recognising the higher risk of conditions such as PTSD amongst veterans born between 1970 and 1979, the study proposes that additional research is required to explore the factors contributing to the declining mental health of this age group.
• Routine and robust data-collection programmes on veterans’ health should be introduced.

The full text of Trends in Scottish Veterans’ Health is available here.