The unique nature of Australian Defence Force (ADF) service can enhance a person’s health and wellbeing. Military personnel are generally physically and mentally fit, receive regular medical assessments, and have access to comprehensive medical and dental treatment as a condition of service. However, ADF service increases the likelihood of exposure to trauma (either directly or indirectly) and affects support networks, for example, separation from family during deployment (Daraganova et al. 2018; Lawrence-Wood et al. 2019). Veterans can therefore experience health needs, outcomes and challenges that are different from the rest of the Australian population.

Who are 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 ADF including current, reserve and former (ex-serving) personnel (Tehan 2017).

Different sections of this page use different definitions of veterans depending on the available data. The following describes the possible options:

  • Clients of the Department of Veterans’ Affairs (DVA)—eligible veterans and their families who are supported by DVA. DVA clients may receive a range of entitlements depending on personal circumstances, such as compensation payments, means-tested pensions and subsidised health treatment.
  • ADF members—people who are currently serving or have previously served at least 1 day in a regular capacity or as a member of the active or inactive reserves (also referred to as people who ‘have ever served in the ADF’).
  • Contemporary ex-serving ADF members—ex-serving members who have had at least 1 day of full-time or reserve service on or after 1 January 2001, and have since been discharged from the ADF (‘current serving’ and ‘current reserve’ members mentioned on this page are also restricted to having service from 1 January 2001 onwards).

Data on veterans’ health and the use of health services by the entire veteran population are limited. Further, identifying veterans in health research is restricted by the available data.

Women currently make up 19% of the ADF workforce (Department of Defence 2019a). Participation has been increasing (Department of Defence 2019b), but the relatively low numbers constrain reporting on the health of women who have served. Consequently, most sections of this page present data for men only.

The AIHW is increasing the range of data available about veterans through data linkage initiatives. For example, information on medications dispensed to contemporary ex-serving ADF personnel under the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) was first published in 2019, while information on services used by contemporary ex-serving ADF personnel under the Medicare Benefits Schedule is forthcoming.

Profile of veterans

The exact number of Australian veterans is unknown.

  • At 30 June 2019, the ADF comprised about 58,000 permanent (47,000 men and 11,000 women) and 27,500 active reserve personnel across the Royal Australian Navy, the Australian Army and the Royal Australian Air Force. In 2018–19, more than 7,000 people enlisted to permanent or reserve roles, and more than 5,600 left the ADF (Department of Defence 2019a).
  • At June 2019, there were more than 290,000 DVA beneficiaries in receipt of pensions, allowances, and treatment or pharmaceuticals. This included approximately 184,000 veterans and 110,000 dependants (DVA 2019).
  • Many veterans in Australia are not in contact with DVA. In 2017, DVA estimated contact with 1 in 3 veterans who had served since Vietnam, and 1 in 5 veterans who had served since 1999 (DVA 2017).
  • DVA (2019) estimated there were about 631,800 living Australian veterans who have ever served in the ADF, either full-time or in the reserves, at 30 June 2019 (DVA 2019).

Health status

The Australian Bureau of Statistics’ (ABS) 2017–18 National Health Survey (NHS) estimated almost half (49%) of people who had ever served in the ADF considered themselves to be in excellent or very good health, while 21% considered their health to be fair or poor.

However, based on age-standardised findings, more than half (57%) of people who had ever served in the ADF were estimated to consider themselves to be in excellent or very good health, while 17% considered their health to be fair or poor. This perception was very similar to people who had never served: an estimated 56% reported excellent or very good health and 15% reported fair or poor health (ABS 2019a).

Health conditions

A range of conditions can affect an individual’s health. Common conditions experienced among the Australian population include cancer, cardiovascular disease, mental disorders and musculoskeletal conditions; those who have served in the ADF also experience these and other conditions to varying degrees.

Addressing the development and management of mental disorders such as depression, post-traumatic stress disorder, other anxiety disorders and alcohol dependence for the veteran community has been identified as a priority for the Australian Government (DVA 2015). There are limited data available about the current prevalence of mental disorders among the Australian population, but further information will be available from the Intergenerational Health and Mental Health Study 2020–21 (ABS 2019b).

Based on overall estimates from the 2017–18 NHS, more than 1 in 5 (22%) men who had ever served in the ADF reported a mental or behavioural condition (for example, anxiety and mood disorders, or problems with alcohol)). After accounting for differences in age structures, 21% of men who had ever served in the ADF reported a mental or behavioural condition in the previous year. This proportion was similar for men who had not served (18%). Rates of self-reported high or very high psychological distress were also similar across these 2 groups (about 12%) (ABS 2019a).

See Mental health for more information.

Men who had served in the ADF reported a similar prevalence of chronic conditions (such as arthritis, back pain and diabetes), to men who had not served. This was also seen once differences in age structures of the 2 groups were taken into account. The exception was cardiovascular disease which, after accounting for differences in age structures, was reported by a greater proportion of men who had served in the ADF (24%), than men who had not served (18%) (ABS 2019a).

Deaths

Current serving, reserve and contemporary ex-serving ADF men and women have lower all-cause mortality rates than the Australian population (AIHW 2018).

Table 1 shows all-cause mortality rates of men who served in the ADF since 2001 for the period 2002–2015. Age-specific all-cause mortality rates for current serving, reserve or contemporary ex-serving ADF men were lower than rates for Australian men (with the exception of contemporary ex-serving ADF men aged 16–29, which was similar to Australian men).

Table 1: Age-specific rates of all-cause mortality (per 100,000 population), men (a) in ADF service status groups and Australian men, 2002–2015

Age group (years)

Current serving (population)

Reserve
(population)

Contemporary Ex-serving
(population)

Australia
(population)

16–29

49.2

39.9

81.6(b)

69.0

30–49

58.1

64.5

106.1

152.6

50–70

155.7

229.5

385.1

741.1

  1. Due to small sample sizes, mortality rates for women are not available by age group.
  2. All differences in age-specific rates between ADF service groups and the Australian population were statistically significant. The exception was the contemporary ex-serving 16–29 year age group; the difference with the Australian population was not statistically significant.

Sources: AIHW analysis of linked PMKeyS-NDI data 2002–2015; AIHW NMD 2002–2015.

When comparing the causes of death for current serving, reserve or contemporary ex-serving ADF men with Australian men of the same age:

  • death rates due to chronic disease were lower for current serving, reserve and contemporary ex-serving ADF men with the exception of melanoma, which was similar
  • death rates due to injury were lower, or similar, for current serving, reserve and contemporary ex-serving ADF men (AIHW 2018).

Generally, the leading cause of death for each age group was similar for current serving, reserve and contemporary ex-serving ADF men, and men in the Australian population (with the exception of current serving men aged 16–29; Figure 1). Figure 1 provides the top 5 leading causes of death in current serving, reserve and contemporary ex-serving ADF men for 2002–2015 for age groups, with the Australian comparison.

See Causes of death.
 

This chart shows the leading cause of death among men by different serving status (serving, reserve and contemporary ex-serving) with an Australian comparison, split into different age groups (16-29, 30-49 and 50 and over). The most common cause of death across serving status and in the Australian population for 16-29 and 30-49 was suicide, except for serving men aged 16-29, which were land transport accidents. Coronary heart disease in 50 and over was the leading cause of death across serving status and in the Australian population.

There is continuing concern within the ADF and the wider Australian community about suicide in current serving and contemporary ex-serving ADF personnel. In particular, contemporary ex-serving ADF personnel may face increased risk of suicide.

Between 2001 and 2017, there were 419 suicides among current serving, reserve and contemporary ex-serving ADF personnel (AIHW 2019a).

After adjusting for age, the rate of suicide compared with Australian men for 2002–2017 was:

  • 48% lower for current serving men
  • 48% lower for men in the reserves
  • 18% higher for contemporary ex-serving men (AIHW 2019a).

The number of women in the ADF is increasing, but historically, numbers have been relatively low (Department of Defence 2019b). Suicide information for contemporary ex-serving women was reported for the first time in 2019, as the number of contemporary ex-serving women was sufficient to have confidence in the results (see AIHW 2019a).

Between 2001 and 2017, there were 21 suicides among contemporary ex-serving women: a rate of 15 per 100,000. This was lower than the rate for contemporary ex-serving men (27 per 100,000), but higher than for Australian women (see AIHW 2019a).

On 5 February, the Federal Government announced the appointment of a National Commissioner for Defence and Veteran Suicide Prevention. The AIHW will be playing a new role in some of the interim work preparing for the new commissioner. This work will align with existing work and will include further analysis of suicides among current, reserve and contemporary ex-serving personnel who have served since 2001.

Open Arms—Veterans and Families Counselling provides support and counselling to current ADF members, veterans and their families and can be contacted 24 hours a day on 1800 011 046.

See Suicide and intentional self-harm.

Disability

A disability or restrictive long-term health condition exists if a limitation, restriction, impairment, disease or disorder has lasted, or is expected to last, for 6 months or more, and restricts everyday activities (ABS 2019a).

According to the 2017–18 NHS, a disability or restrictive long-term condition is classified by whether or not a person has a specific limitation or restriction. The specific limitation or restriction is further classified by whether the limitation or restriction is a limitation in core activities, or a schooling/employment restriction only. There are 5 levels of activity limitation in the 2017–18 NHS:

  • profound
  • severe
  • moderate
  • mild
  • school/employment restriction only.

These are based on whether a person needs help, has difficulty, or uses aids or equipment with any core activities (mobility, self-care and communication). A person's overall level of core activity limitation is determined by their highest level of limitation in any of these activities.

According to estimates from the 2017–18 NHS, almost 2 in 5 (37%) men who had served in the ADF reported a disability. Age-standardised data found that men who had served in the ADF were more likely to report a disability (28%) than men who had not served (20%) (ABS 2019a).

Health risk factors

Veterans’ health is influenced by health behaviours that may relate to ADF service or individual lifestyle. Screening at recruitment and aspects of serving in the ADF—such as the requirement to maintain a high level of physical fitness and regular health assessments—may act as a protective factor for veterans’ health.

Based on estimates from the 2017–18 NHS, men who had ever served in the ADF had similar exposure to health risk factors to men who had not served (after accounting for differences in age structure between the 2 groups). This included smoking, alcohol consumption, overweight and obesity, fruit and vegetable consumption, sweetened drink consumption and physical activity.

Health care

The departments of Defence and Veterans’ Affairs provide services to support serving and contemporary ex-serving ADF members during and after ADF service. Veterans may use these services, or those available to all Australians through mainstream providers. DVA funds health-related services and programs where clinically required for eligible veterans and their families (those with a DVA-issued health card). DVA funding of health care for entitled veterans is ‘demand driven and uncapped’—this means that the Australian Government increases health care funding if needed (DVA 2018). In 2017–18, DVA spent $3.0 billion on health-related services (excluding aged care-related services): the majority was for treatment in hospitals (private and public $1.4 billion), and primary care ($1.4 billion) (AIHW 2019b).

The 2014–15 NHS, estimated that 90% of people who had served in the ADF consulted a general practitioner (GP) in the 12 months preceding the survey; the highest rate of GP visits was among those aged 75 and over (95%) (ABS 2017). Rates were similar between men of the same age who had or had not served except those aged 35–44, where 89% of men who had served consulted a GP in the 12 months preceding the survey compared with 74% of men who had not served (ABS 2017).

Medicines

The Australian Government subsidises many medications. All Australian residents who hold a current Medicare card can access medications listed under the PBS, subject to patient entitlement status. The RPBS funded by DVA subsidises medications listed under the PBS and additional medications and items for eligible veterans, war widows/widowers, and their dependents.

See Medicines in the health system for more information.

In 2017–18, more than 1 million medications were dispensed under the PBS/RPBS to around 70,000 contemporary ex-serving ADF personnel with service from 1 January 2001, an average of 16 dispensed per person (AIHW 2019c).

After accounting for age and sex differences, similar proportions of the contemporary ex-serving and Australian populations were dispensed medications in 2017–18 (72% and 71%, respectively) (AIHW 2019c). Among contemporary ex-serving personnel:

  • 37% were dispensed at least 1 nervous system medication (including antidepressants and anxiolytics)—compared with 31% for all Australians
  • 22% were dispensed a cardiovascular system medication (for example for hypertension or high cholesterol)—compared with 24% for all Australians.

Policies regarding mental health treatment for contemporary ex-serving personnel have undergone change in recent years to facilitate early access to mental health treatment. The full effect of these changes may not be reflected for the contemporary ex-serving personnel captured in this data. Due to these policies, contemporary ex-serving ADF members have different pricing structures for, and access to, medications from the Australian population. These factors may influence the levels of dispensing between contemporary ex-serving members and the Australian population.

Overall, 17% of the contemporary ex-serving ADF population were dispensed at least 1 antidepressant in 2017–18 (AIHW 2019c). Figure 2 shows that after accounting for differences in the age and sex structures of the populations, 20% of all contemporary ex-serving ADF members received at least 1 dispensing for antidepressants, compared with 15% in the Australian population. On average, contemporary ex-serving ADF members who received at least 1 dispensing for antidepressants, received 9 dispensings per person, similar to the Australian population. Antidepressants are most commonly prescribed for mood and anxiety disorders but are also prescribed for other medical conditions, for example, chronic pain and sleep disorders.
 

This chart shows the per cent of contemporary ex-serving members and the Australian population who received at least one prescription of antidepressants, beta-lactum antibacterials, drugs for peptic ulcer and gastro-oesophageal reflux disease and opioids. The results show levels of dispensing between contemporary ex-serving members and the Australian population are similar across medications. However, 20% of contemporary ex-serving members received at least one prescription of antidepressants compared with 15% in the Australian population. 

Hospitalisations

The Department of Defence funds all hospital care for current serving ADF members while DVA funds hospital care for eligible veterans and eligible dependents.

Data are available for public and private hospitalisations. In 2017–18, data from the National Hospital Morbidity Database show more than 235,000 hospitalisations were funded by DVA and 9,900 hospitalisations were funded by Defence. DVA and Defence hospitalisations occurred more commonly in private hospitals: 70% of DVA-funded hospitalisations and 84% of Defence-funded hospitalisations were in private hospitals. For all other Australian hospitalisations, 40% were in private hospitals.

DVA provides Non-Liability Health Care, which allows for easier access to treatment for certain health conditions, such as mental health, which is not available to the general population. As a result, veterans receiving DVA funding may be higher consumers of Non-Liability Health Care-specific health care services.

See Hospital care.

Where do I go for more information?

For more information on the health of veterans, see:

Visit Veterans for more on this topic.

 

What support is available?

Open Arms—Veterans & Families Counselling

Provides 24-hour free counselling and support to you and your family.

ADF Mental Health All-hours Support Line

A confidential 24-hour telephone service for ADF members and their families.

Lifeline Australia

Provides free support services if you are in crisis and need to talk to someone.

1800RESPECT

Provides 24-hour counselling services to help you cope with sexual assault or violence.

Ex-service organisations

Connect with an ex-service organisation in your local area. These organisations may be able to provide you with support and resources.

References

ABS (Australian Bureau of Statistics) 2017. Microdata: National Health Survey 2014–15. ABS cat. no. 4324.0.55.001. Canberra: ABS.

ABS 2019b. Forward work program, 2019–20. ABS cat. no. 1006.0. Canberra: ABS.

ABS 2019a. Microdata: National Health Survey, 2017–18, TableBuilder. Findings based on AIHW analysis of ABS TableBuilder data.

AIHW (Australian Institute of Health and Welfare) 2018. Causes of death among serving and ex-serving personnel: 2002–2015. Cat. no. PHE 228. Canberra: AIHW.

AIHW 2019b. Health expenditure Australia 2017–18. Health and welfare expenditure series no. 65. Cat. no. HWE 77. Canberra: AIHW.

AIHW 2019c. Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18. Cat. no PHE 264. Canberra: AIHW.

AIHW 2019a. National suicide monitoring of serving and ex-serving ADF personnel: 2019 update. Cat. No. PHE 222. Canberra: AIHW.

Daragnova G, Smart D & Romaniuk H 2018. Transition and Wellbeing Research Programme Family Wellbeing Study.  Part 1 Families of current and ex-serving ADF members: health and wellbeing Part 1 Canberra: Department of Defence and Department of Veterans’ Affairs.

Department of Defence 2019a. Annual reports 2018–19. Canberra: Department of Defence.

Department of Defence 2019b. Women in the ADF report 2016–17. Canberra: Department of Defence.

DVA (Department of Veterans’ Affairs) 2015. Social Heath Strategy 2015-2023 for the Veteran and Ex-Service Community. Canberra: DVA.

DVA 2017. Myth busters: who are Australia’s veterans? Vetaffairs Spring 2017. Vol. 33. No. 3. Canberra: DVA.

DVA 2018. No cap on funds for medical treatment. Vetaffairs Winter 2018. Vol 34. No. 2. Canberra: DVA.

DVA 2019. Department of Veterans’ Affairs annual report 2018–19. Canberra: DVA.

Lawrence-Wood E, McFarlane A, Lawrence A, Sadler N, Hodson S, Benassi H et al. 2019. Impact of combat report. Canberra: Department of Defence; DVA.

Tehan, the Hon. D, MP 2017. Joint communique—Veterans’ ministers’ meeting. Media release by Minister for Veterans’ Affairs. 8 November. Canberra.