What lifestyle factors influence the health of veterans?

Based on self-reported data from the 2020–21 National Health Survey, male veterans shared similar exposure to several health risk factors compared with males who had never served. This included lifestyle factors, which are unpacked below with a veterans lens.

Smoking

Smoking rates for veterans were similar to people of the same age who had not served. Based on self-reported data from the 2020–21 NHS:

• 11% of those who ever served in the ADF smoked daily, which was similar to those who had never served (13%).

The higher prevalence of smoking among DVA clients compared with that for the general population has been identified as a key health concern for the DVA community. 

• the 2020–21 NHS data showed that 1 in 6 (16%) DVA clients and 1 in 12 (8.4%) non-DVA clients smoked daily.

Smoking prevalence differs across military populations:

• for example, compared with the Australian population, there have reportedly been more current or former smokers in the Korean and Vietnam War veteran cohorts =.

Changes in smoking behaviour during and after deployment have also been observed in some Australian and military populations:

• for example, in the Middle East Area of Operations (MEAO) Census Study, 38% of respondents reported smoking more than usual during deployment, and 17% reported beginning or re-starting smoking (Dobson et al., 2012 in AIHW 2018).

Alcohol consumption

Based on self-reported data from the 2020–21 NHS:

• risky alcohol consumption (i.e., consumption exceeding the Australian Adult Alcohol Guideline) was generally higher (40%) among men who had ever served in the ADF compared with men who had never served (33%)

• almost half (47%) of all DVA clients exceeded the Guideline compared with 36% of non-DVA clients.

The Middle East Area Operations (MEAO) Census Health Study found:

• a greater prevalence of alcohol misuse among Navy and Army personnel and lower-ranked ADF personnel

• ex-serving members were nearly 10 times more likely to report an alcohol problem than current serving members.

Alcohol use varies with service characteristics, for example:

• Exposure to combat has been associated with increased alcohol consumption and hazardous drinking.

• Ex-serving ADF peacemakers have exhibited significantly higher levels of alcohol abuse and dependence compared to a civilian sample.

• Korean War veterans have shown increased likelihood of binge drinking (6 or more drinks in a single sitting) and a 36% greater rate of death from alcoholic liver disease than Australian men of the same age.

Illicit drug use

Illicit drug use is strictly prohibited in the ADF.

The 2015 Mental Health and Wellbeing Transition Study estimated that:

• 39% of recently transitioned ADF members had used illicit drugs in their lifetime, with 16% reporting illicit drug use in the previous 12 months (van Hoof et al. 2018).

• among transitioned ADF members, the proportion of members who use illicit drugs and prescription drugs for non-medical purposes increased gradually over the first few years after discharge and was the greatest at 3 years after transition.

Illicit drug use varies across veteran cohorts, for example:

• drug dependence or abuse was almost 2 times as high among Gulf War veterans and among ADF veterans who were not deployed to the Gulf (Sim et al. 2003).

Overweight and obesity

The risk of weight gain after leaving the ADF has been identified as a health issue for Australian veterans. According to the 2020–21 NHS data:

• 75% of those who had ever served in the ADF were overweight or obese ( by the standard BMI classification), which was higher than those who had never served (61%).

The ADF acceptable BMI range for entry covers the normal weight, overweight and part of the obese classification based on the international standard. Thus, the higher rates of overweight/obesity in the ADF population may be in part due to physical characteristics rather than increased health risk generally associated with excess body weight.

Fruit and vegetable intake

According to the 2020–21 NHS data:

• men who served in the ADF had a similar fruit and/or vegetable intake as those who did not serve,

• of those who had ever served, 89% of DVA clients and 97% of non-DVA clients did not meet the recommended vegetable intake guidelines.

Physical activity

According to the 2020–21 NHS data:

• around 70% of males did not meet the 2014 Physical Activity guidelines (including workplace activity) regardless of ADF service status. 

This included 60% of DVA clients and 72% of non-DVA clients.