Valuable information on the health of a population can be gained by looking at how many people die and what caused their death. Comparing causes of death between populations frames this information within the context of the wider community and can help to explain differences in the health of populations. Differences in patterns of death between populations can result from differences in behaviours, exposures to disease or injury, and social and environmental circumstances. This information can be used to guide and evaluate health policy and interventions.
This report examines leading causes of death among three Australian Defence Force (ADF) service status groups—personnel serving full time, personnel in the reserves, and ex-serving personnel. Comparisons are made with leading causes of death in the Australian population to determine if any groups of ADF personnel are at greater risk of death from particular causes. This analysis builds on findings from the 2018 AIHW study into the incidence of suicide among serving and ex-serving ADF personnel and is based on the same data as the comparative analysis undertaken for that study (AIHW 2018b).
Results are based on analysis of 1,939 deaths that occurred between 2002 and 2015 among serving and ex-serving personnel with at least 1 day of ADF service since 1 January 2001. As such, the maximum length of follow-up between discharge and death for ex-serving personnel in this study is 15 years, and less for those discharged after 2001.
Overseas deaths, including deaths that occur on operational deployments, are generally outside the scope of Australian death statistics, and are therefore largely not captured in these results. While the proportion of women in the ADF is increasing, the number of women serving in the ADF has historically been low. As such, analysis focuses on men as they made up the majority of both ADF personnel (around 85%) and deaths (92%) in the study. Some of the results in this study are based on small numbers, particularly those involving women. Rates produced using small numbers can be sensitive to small changes in counts of deaths over time. This should be taken into account when interpreting the findings from this study.
Rates of death from all causes are generally lower for serving, reserve and ex-serving men and women than for the Australian population
Between 2002 and 2015, there were 1,790 deaths of men and 149 deaths of women with at least 1 day of service since 2001. For men, 52% (929) were ex-serving at the time of their death, 26% (468) were in the reserves and 22% (393) were serving full time. The all-cause mortality rate was generally lower for men across all age groups examined for each of the three ADF service status groups than for men in the same age range in the Australian population.
In most cases, the all-cause mortality rate for women—for all ages combined and by age group—was lower than the rate for women in the same age range in the Australian population.
Leading causes of death by age are similar between serving, reserve and ex-serving men and Australian men
For all Australian men aged 16–29, suicide, land transport accidents and accidental poisonings were the top three leading causes of death. These causes of death also appeared in the top three leading causes for men in the same age range who were serving full time, in the reserves and ex-serving at the time of their death.
Suicide was the leading cause of death for men aged 30–49 in the Australian population, and for men in the same age range in each of the three ADF service status groups. Land transport accident deaths and deaths due to coronary heart disease featured prominently among other leading causes of death for these groups.
For men aged 50 and over, chronic diseases were the leading causes of death in the Australian population, and across each of the three ADF service status groups.
Death rates due to chronic diseases are lower, or similar, for serving, reserve and ex-serving men than for Australian men
Men in the three ADF service status groups generally had statistically significantly lower rates of death due to chronic diseases than men in the Australian population of the same age range. This is a key factor contributing to the lower all-cause mortality rates for men across the three ADF service status groups when compared with rates for Australian men in the same age range.
The exception was rates of death due to melanoma in each of the three ADF service status groups, which were similar to the rates for Australian men in the same age range.
Death rates due to injury are generally lower, or similar, for serving, reserve and ex-serving men than for Australian men
Men in the three ADF service status groups generally had statistically significantly lower, or similar, rates of death due to external causes (injury) than men in the Australian population of the same age range. Rates of death were compared for the top three external causes of death in these populations: suicide, land transport accidents and accidental poisoning.
Men who were serving full time and in the reserves had significantly lower age-adjusted rates of suicide than Australian men in the same age range.
Between 2002 and 2015, the rate among ex-serving men, after adjusting for age, was similar to that for Australian men in the same age range. However, the rate of death due to suicide was significantly higher for ex-serving men aged under 30 than for Australian men in the same age range. These findings were reported previously in Incidence of suicide in serving and ex-serving Australian Defence Force personnel: detailed analysis 2001–2015 (AIHW 2018b). It is important to note that high-level information on the rate of suicide in the three ADF service status groups will be updated annually as new cause of death information becomes available. This may result in changes to previously published results.
Land transport accidents
For men serving in the reserves, and ex-serving men, age-adjusted rates of land transport accident death were significantly lower than for all Australian men in the same age range.
The age-adjusted rate of land transport accident death among serving men was similar to the rate for men in the Australian population in the same age range.
The age-adjusted rates of death due to accidental poisoning for men in all three ADF service groups were significantly lower than the rates for all Australian men in the same age range.
Preliminary matter: Acknowledgments; Abbreviations; Symbols
2 The study populations
3 Identifying leading causes of death
4 Comparing rates of leading causes of death
5 Detailed analysis—land transport accidents
Appendix A: Data sources and classifications
Appendix B: Data linkage
Appendix C: Statistical tables
End matter: Glossary; References; List of tables; List of figures; List of boxes; Related publications