A study of causes of death among serving Canadian Forces personnel and veterans has some good news—military personnel have had lower death rates from cancer and cardiovascular disease than people of similar ages in the general population.
The Canadian Forces Cancer and Mortality Study: Causes of Death, undertaken to determine health effects of a military career, showed CF members studied had a 35 per cent lower chance of dying from all causes than people of the same age in the general population, and had a significantly lower risk of dying from cancer and heart disease. But it also alerted the CF and Veterans Affairs Canada to health concerns among particular age groups.
“We deploy our military members in many different countries and many different situations where they are exposed to fairly harsh conditions,” said Colonel Colin MacKay, former director of Force Health Protection and co-chair of the study’s advisory committee. “We wanted to know what health impacts there are as a result of service.” Data from the report will be used to create and tweak policy, programs and practices to promote a healthier workplace for serving personnel and post-release transition for veterans, and to guide future research.
The study considered mortality data on 188,161 CF personnel who enrolled in the regular force between 1972 and 2006, including 112,225 who released before Dec. 31, 2006. Over the 35-year period, there were 3,969 deaths, including 2,824 among released personnel. The report did not include the 44 combat deaths to the end of 2006. Nor did it include reservists, for whom data was incomplete for the study period. Age standardized mortality ratios were used to compare causes and rates of mortality for both sexes in five-year age groups in CF personnel and the general population.
Serving and former military personnel overall had significantly lower risk of death from a host of diseases and health conditions, including a 40 per cent lower risk of death from cancer compared to the general population. The difference in the risk for death from cardiovascular conditions is stunning—55 per cent lower for CF men and 60 per cent for CF women compared to the general population of the same age.
One possible explanation could be the “healthy worker” effect—CF personnel are chosen from the healthiest Canadians, says Statistics Canada analyst Jean-Michel Billette. A culture which focuses on health and physical fitness may be another factor, says MacKay, since the CF’s universality of service policy requires personnel to be physically fit and ready for deployment.
Over the 35 years studied, 824 CF personnel and veterans died from unintentional injury. There was a higher risk of death for males in air and space transport accidents, and for CF females aged 20 to 24 from unintentional injury, both attributed to the nature of military work. Released males aged 20 to 24 have a 42 per cent higher risk of death from unintentional injury than men of similar age in the general population. Future research is planned to determine causes for these differences and whether there are changes that could lower the risks of death and injury, said MacKay.
Although the overall risk of death from suicide was not higher for CF personnel than the general population, there were some statistically significant differences in certain groups; findings that prompted further study “to identify factors associated with the likelihood of committing suicide,” says the report.
Over the 35 years studied, 695 males and 12 females committed suicide. The risk of suicide is one and a half times greater for male personnel to age 44 and two and a half times greater for released females aged 40 to 44. Further analysis showed that among CF personnel, suicide risk was greater for males than females, for non-commissioned members than officers, for those with less than 10 years’ service, those involuntarily released and twice as high for those medically released.
However, the data for this report ends in 2006 and did not capture the effect of subsequent beefing-up of the CF mental health and suicide prevention programs, says MacKay. The CF suicide prevention program offers a wide range of services, from education and support to treatment. As well, a recent mental health awareness campaign, Be the Difference, features education and training for military personnel and their families. CF members and veterans now also have access to a network of 10 operational stress injury clinics, a couple of dozen peer support programs across the country and 30 Integrated Personnel Support Centres on bases and wings serving health needs of CF personnel, veterans and their families.
The CF hopes to repeat the study every decade, and the next study should show the effects of these newer programs, said MacKay.
The report also does not capture longer term health effects. “We don’t have anyone past the age of 69” among study participants, Billette said. “Things would probably be different if we considered people 90 years old.” That data will build up over time, says MacKay.
The second part of the study examining cancer mortality will be released in 2012.