Comparisons with other estimates of ex-serving members with chronic conditions
AIHW acknowledges that estimates of chronic conditions vary based on the number of conditions included in the analysis, as well as the data source (AIHW 2024a). Identifying conditions based on health service use requires persons to have accessed condition-specific medication that is included in the PBS/RPBS or been diagnosed/treated in a public hospital setting within the year (and therefore excludes people who were only diagnosed in other health settings who are not using the condition-specific medications).
However, some people with chronic conditions may not access medications, for example if the condition is in remission or it is being managed through lifestyle behaviour modifications. Some people may also only access over-the-counter medications to manage their condition (which are not captured in PBS/RPBS data). As a result, AIHW has also sought to understand if prevalence was similar to self-report results from the ABS Census.
The 2021 Census asked respondents if the person had been told by a doctor or nurse that they have any of the selected long-term health conditions (ABS 2021). This question therefore is expected to include people who had a chronic condition at any time and includes those who were in remission at the time the data were collected. It should be noted that self-reporting in the Census has limitations itself such as it being collected using a single question which could affect its accuracy (ABS 2022).
The list of chronic conditions that were included in the Census varied from those that were included in the AIHW analysis of the Veteran Health Dataset (VHD) based on measurement through health services use. The conditions included in the Census were arthritis, asthma, cancer, dementia, diabetes, heart disease, kidney disease, lung condition, mental health, stroke and any other long-term health condition.
More information on the different data sources and limitations is included in the Technical notes.
The 2021 Census showed that 57% of ex-serving members had at least one selected long-term health condition. In comparison, 35% of people who had never served in the ADF had at least one of the selected conditions. The higher prevalence in ex-serving members is influenced by their older age, as chronic conditions are more common in older people (AIHW 2024a). For example, 53% of ex-serving members in 2021 were 65 years and over, well above the 21% for persons who had never served in the ADF.
Therefore age-standardised rates are important to reliably compare with the Australian population. Around 2 in 5 (39%) ex-serving members had at least one selected long-term health condition compared with a third (32%) of those who had never served in the ADF. The difference when age-standardised was much smaller relative to the not age-standardised rates but the ex-serving age-standardised rate was still higher than the rate for persons who had never served in the ADF.
The Census age-standardised prevalence (39%) for ex-serving members closely aligns with AIHW analysis of VHD which found that 39% of ex-serving members were living with a chronic condition. However, this comparison should be interpreted with caution due to differences in the type of chronic conditions included in the two data sources. For example, ex-serving members in the Census are average on older than those in the VHD (see Comparing prevalence between the data sources).
Prevalence of chronic conditions based on the 2021 Census
Analysis based on the 2021 Census showed that the most common chronic condition for ex-serving members using age-standardised rates was mental health (17.4%), followed by arthritis (13.1%), then any other long-term health condition (12.0%). Table 2 shows the prevalence of each condition included in the Census.
Chronic condition group | Ex-serving males (%) | Ex-serving females (%) | All ex-serving members (%) |
|---|---|---|---|
Mental health condition (including depression or anxiety) | 16.3 | 22.1 | 17.4 |
Arthritis | 12.5 | 16.8 | 13.1 |
Any other long-term health condition(s) | 11.4 | 14.6 | 12.0 |
Asthma | 6.7 | 10.5 | 7.4 |
Heart disease (including heart attack or angina) | 6.9 | 4.2 | 6.6 |
Diabetes (excluding gestational diabetes) | 6.5 | 4.5 | 6.2 |
Cancer (including remission) | 4.4 | 4.6 | 4.5 |
Lung condition (including COPD or emphysema) | 2.9 | 2.8 | 2.8 |
Stroke | 1.5 | 1.2 | 1.4 |
Kidney disease | 1.3 | 1.3 | 1.3 |
Dementia (including Alzheimer's) | 0.7 | 1.1 | 0.8 |
Source: Australian Bureau of Statistics Census, 2021.
AIHW acknowledges that estimates of prevalence for mental health conditions from the Census differ from those using the National Study of Mental Health and Wellbeing (NSMHW) and National Health Survey (NHS). For more information see Health of veterans. However, these surveys do not provide information on ex-serving members specifically, instead grouping ex-serving together with current serving members.
Comparing prevalence between the data sources
AIHW has undertaken analysis of prevalence of chronic conditions based on health service use data and are seeking to assess whether this provides similar estimates to using self-reported information collected by the ABS. While each data source has different limitations and will identify different ex-serving members with each condition, if there is similar condition prevalence, this could suggest that either source could be used to monitor condition prevalence. Given the Census is only conducted every 5 years, using health service information could provide more timely data to monitor chronic conditions in the future.
When making comparisons it should also be noted that the Census defines certain chronic conditions differently to the VHD. For instance, the Census captures data on arthritis, while analysis from the VHD grouped arthritis with other types of musculoskeletal conditions such as back problems and osteoporosis.
As a result, AIHW has focussed on comparing conditions that are similarly defined between the data sources. These conditions were asthma, cancer, chronic kidney disease, dementia, diabetes and mental health conditions. While these conditions are more comparable, there are still some small differences in the definition of these conditions between the data sources. For example, chronic obstructive pulmonary disease (COPD) is combined with asthma in the VHD, but COPD would be captured separately under lung condition in the Census.
AIHW has compared the results in the 2021 Census with the most recent year of data in the VHD (2019–20) to minimise impacts of differences from timing. Table 3 shows conditions that were most comparable between the Census and VHD:
- Prevalence was were similar for diabetes
- Prevalence was higher based on Census data for cancer, chronic kidney disease and dementia
- Prevalence was lower based on Census data for mental health conditions.
The higher prevalence for conditions in the Census may be due to ex-serving members reporting these conditions and not receiving recent medical treatment for it or because the condition-specific medications included in this analysis are not a representative way to identify these conditions. Further, it could be because there are no effective treatments.
It could also be due to the limitation within the VHD where this cohort only includes ex-serving who separated from the ADF from 1 January 1985. This therefore excludes a cohort of older ex-serving ADF members who may be more likely to have conditions associated with older age such as cancer (AIHW 2024b) and chronic kidney disease (AIHW 2024c).
On the other hand, the higher prevalence for mental health conditions based on the VHD could be due to underdiagnosis in the Census or overtreatment in the VHD. As previously noted, the NSMHW and NHS provide more reliable estimates of mental health conditions.
Condition | Census - Male (%) | VHD - Male (%) | Census - Female (%) | VHD - Female (%) | Census - total (%) | VHD - total (%) |
|---|---|---|---|---|---|---|
Mental health | 16.3 | 20.6 | 22.1 | 25.0 | 17.4 | 20.0 |
Diabetes | 6.5 | 7.3 | 4.5 | 3.7 | 6.2 | 5.6 |
Cancer | 4.4 | 2.8 | 4.6 | 1.9 | 4.5 | 2.4 |
Chronic kidney disease | 1.3 | 0.5 | 1.3 | 0.4 | 1.3 | 0.5 |
Dementia | 0.7 | 0.2 | 1.1 | 0.1 | 0.8 | 0.2 |
Source: Census of Population and Housing, 2021 and Veteran Health Dataset 2019–20
Note: Census includes all jurisdictions while the VHD excludes Western Australia and Northern Territory. Figures are all age-standardised and based on people aged 17 years and older.
Comparison of ex-serving ADF population with Australian population
In addition to comparisons between ex-serving members from VHD and Australians from the National Health Data Hub (NHDH), AIHW has also compared the prevalence of chronic conditions between ex-serving ADF members and the Australian population based on age-standardised prevalence from the Census. This section discusses the comparison and is based on the Census.
Based on the 2021 Census, the most common chronic conditions for all Australians aged 17 and over were mental health conditions (10.5%) and arthritis (8.9%). The top two most common conditions were the same as for ex-serving members. However, the prevalence of these conditions were below the proportions for ex-serving ADF members for mental health and arthritis (17% and 13% respectively).
Table 4 shows selected long-term health conditions for ex-serving ADF members and all Australians from the Census. In comparison:
- Prevalence was similar for dementia
- Prevalence was higher among ex-serving ADF members for mental health, arthritis, any other condition, heart disease, diabetes, cancer, lung condition, kidney disease and stroke
- Prevalence was lower for ex-serving ADF members for asthma.
Condition | Male ex-serving | Male Australians | Female ex-serving | Female Australians | All ex-serving | All Australians |
|---|---|---|---|---|---|---|
Mental health | 15.8 | 8.2 | 21.5 | 12.8 | 16.9 | 10.5 |
Arthritis | 12.1 | 6.9 | 16.3 | 10.8 | 12.7 | 8.9 |
Any other condition | 11.1 | 7.3 | 14.2 | 9.7 | 11.6 | 8.6 |
Asthma | 6.5 | 7.2 | 10.2 | 9.8 | 7.2 | 8.5 |
Heart disease | 6.7 | 5.1 | 4.0 | 3.0 | 6.4 | 4.0 |
Diabetes | 6.3 | 5.8 | 4.4 | 4.4 | 6.1 | 5.1 |
Cancer | 4.3 | 3.0 | 4.4 | 3.1 | 4.4 | 3.0 |
Lung condition | 2.8 | 1.8 | 2.7 | 1.7 | 2.8 | 1.8 |
Stroke | 1.4 | 1.1 | 1.1 | 0.8 | 1.4 | 0.9 |
Kidney disease | 1.3 | 1.0 | 1.2 | 0.9 | 1.3 | 0.9 |
Dementia | 0.7 | 0.6 | 1.1 | 0.8 | 0.8 | 0.7 |
Source: Census of Population and Housing, 2021
Note: figures are age-standardised based on population aged 17 and over.
Australian Bureau of Statistics (2021) Sample 2021 Census Household Form, Australian Bureau of Statistics, Australian Government, accessed 08 July 2025.
Australian Bureau of Statistics (2022) Comparing ABS long-term health conditions data sources, Australian Bureau of Statistics, Australian Government, accessed 08 July 2025
AIHW (Australian Institute of Health and Welfare) (2024a) Chronic conditions, AIHW, Australian Government, accessed 08 July 2025.
AIHW (Australian Institute of Health and Welfare) (2024b) Cancer, AIHW, Australian Government, accessed 08 July 2025.
AIHW (Australian Institute of Health and Welfare) (2024c) Chronic kidney disease: Australian facts, AIHW, Australian Government, accessed 08 July 2025.