What chronic conditions do ex-serving ADF members have?
This report analyses eight types of chronic conditions (see Technical notes for full classifications and codes) using the VHD. Of these, the most common chronic condition among ex-serving ADF members was cardiovascular disease. Over 57,100 ex-serving members were living with cardiovascular disease in 2019–20, equivalent to an age-standardised prevalence of 21.1%.
The prevalence of cardiovascular disease has increased slightly from 20.7% in 2013–14. Similarly, the most common chronic condition in Australians in 2019–20 was cardiovascular diseases (21.8%), however this was a decrease from 2013–14 (22.6%). Table 3 shows the comparison of prevalence of each chronic condition among ex-serving members and Australians in 2019–20. For more information on prevalence by year, see Supplementary Table S2.1 and S5.1.
In 2019–20, cardiovascular disease prevalence was higher for males compared with female ex-serving members (21.5% and 17.3% respectively). This pattern was also observed in 2013–14 (21.1% for males and 16.9% for females) and in the adult Australian population. Cardiovascular disease prevalence for Australian males was 22.9% in 2019–20 and 20.8% in 2019–20 for Australian females.
Mental health conditions were the second most common chronic condition among ex-serving members, with a prevalence of 20.0% in 2019–20, above the 17.5% in 2013–14. Select musculoskeletal conditions was the third most prevalent chronic condition with a prevalence of 9.2% in 2019–20, similar to the 9.0% in 2013–14. Similarly, the second and third most common chronic condition in Australians in 2019–20 were mental health conditions (17.7%) followed by select musculoskeletal conditions (8.1%).
In 2019–20, the prevalence of mental health conditions was higher for females compared with male ex-serving members (25.0% and 18.9% respectively). This pattern was consistent for Australian females compared to males (20.7% and 14.5% respectively).
The prevalence of select musculoskeletal conditions was slightly higher in males compared with female ex-serving members (9.2% and 8.6% respectively). In comparison, select musculoskeletal condition prevalence was consistent between Australian males and females in 2019–20 (8.0% and 8.1% respectively).
| Condition | Ex-serving males (%) | Australian males (%) | Ex-serving females (%) | Australian females (%) | All ex-serving members (%) | All Australians (%) |
|---|---|---|---|---|---|---|
| Cardiovascular diseases | 21.5 | 22.9 | 17.3 | 20.8 | 21.1 | 21.8 |
| Mental health conditions | 18.9 | 14.5 | 25.0 | 20.7 | 20.0 | 17.7 |
| Select musculoskeletal conditions | 9.2 | 8.0 | 8.6 | 8.1 | 9.2 | 8.1 |
| Diabetes | 5.8 | 6.8 | 3.7 | 5.3 | 5.6 | 6.0 |
| Asthma/COPD | 4.8 | 6.1 | 6.2 | 8.0 | 5.0 | 7.1 |
| Cancer | 2.4 | 1.9 | 1.9 | 1.9 | 2.4 | 1.9 |
| Dementia | 0.5 | 0.7 | 0.4 | 0.7 | 0.5 | 0.7 |
| Chronic kidney disease | 0.2 | 0.4 | 0.1 | 0.4 | 0.2 | 0.4 |
Source: Veteran Health Dataset, National Health Data Hub 2019–20
Note: includes people aged 17 years and over. Figures are all age-standardised.
Male ex-serving members had a higher age-standardised prevalence of each condition in 2019–20 compared with 2013–14. This was the same pattern for ex-serving females, although cancer declined slightly from 2.1% to 1.9% over the period.
In comparison, prevalence of diabetes, asthma/COPD, cancer, chronic kidney disease and dementia was generally consistent from 2013–14 to 2019–20.
The least common conditions for ex-serving males and females were cancer, dementia and chronic kidney disease in both 2013–14 and 2019–20. The prevalence of cancer in ex-serving members was 2.4%, dementia was 0.2% and chronic kidney disease was 0.5% in 2019–20.
Similarly, the least common conditions for Australians were cancer, chronic kidney disease and dementia in 2019–20 (1.9%, 0.7% and 0.4% respectively), which was consistent with their prevalence in 2013–14. However, it should be noted that there are challenges with estimating these conditions using data available for this report and higher prevalence is reported using other data sources (see Cancer data in Australia, Cancer prevalence data, Chronic kidney disease: Australian facts and Dementia in Australia).
Service characteristics associated with chronic conditions
This report analyses the relationship between service characteristics and age-standardised prevalence of chronic conditions among ex-serving ADF members. The characteristics analysed included service, reason for separation, length of service, time since separation, rank and DVA client status.
AIHW analysis found that generally the pattern by each service characteristic was the same over the analysed period. Further, the patterns were also generally similar for both males and females. Figure 3 shows ex-serving members and age-standardised prevalence by each characteristic in 2019–20. See Supplementary table S3.1 for the findings for each year.
Figure 3: Service characteristics associated with prevalence of chronic conditions
Bar chart showing the number of ex-serving members with a chronic condition by year, type of chronic condition and service characteristic. It also shows the age-standardised prevalence.
Service
Ex-serving members of all branches had similar prevalences for most chronic conditions in 2019–20. However, ex-serving Army and Navy members had a higher prevalence of mental health conditions compared with RAAF members in 2019–20 (20.2% for Army, 20.4% for Navy, 18.9% for RAAF). This pattern was observed for ex-serving males but not for ex-serving females who had similar prevalence of mental health conditions across each service.
Reason for separation
The reasons that ex-serving members separated from the ADF can be categorised into five broad groups: voluntary separation, involuntary medical separation, involuntary other separation, involuntary separation not in service interest and contractual or administrative change. This is based on complete separation from the ADF, or in other words, no further permanent or reserve service being undertaken by the ex-serving member.
The prevalence of mental health conditions for ex-serving members who separated for involuntary medical reasons were much higher than for other separation reasons. In 2019–20, 41% of ex-serving members who separated for involuntary medical reasons were living with a mental health condition, compared with around 15% for those who separated voluntarily, due to contractual/administrative change. Ex-serving who separated involuntarily for retention not in service interests also had higher prevalence of mental health conditions (18%) compared to those who separated voluntarily.
Ex-serving members who separated for involuntary medical reasons had a higher prevalence than any other reason across all chronic conditions in 2019–20. The greatest differences when compared with voluntary separation, for those who separated involuntarily due to medical reasons (after mental health) were for select musculoskeletal conditions (18% compared with 8%), cardiovascular diseases (28% compared with 18%) and diabetes (8% compared with 4%).
Length of service
Ex-serving members with longer service length had a higher prevalence for cancer, cardiovascular and select musculoskeletal conditions in 2019–20, but a lower prevalence for asthma/COPD which may be partly due to medical criteria at ADF recruitment. For mental health conditions, ex-serving ADF members who served for at least 5 but less than 10 years had the highest prevalence (22.7%).
Time since separation
Ex-serving members who had been separated from the ADF for longer generally had a higher prevalence of asthma/COPD and diabetes in 2019–20. In contrast, mental health conditions had a higher prevalence specifically for those who separated at least 5 but less than 10 years ago. Select musculoskeletal conditions and cardiovascular diseases were less prevalent for those who had separated for less than a year.
Rank
Ex-serving members of officer rank had a lower prevalence than ex-serving members of other ranks for asthma/COPD, cardiovascular disease, diabetes, select musculoskeletal conditions and especially mental health conditions (14.8% for officers and 21.0% for other ranks) in 2019–20.
Male ex-serving members of officer rank had a higher prevalence of cardiovascular diseases and diabetes than females in 2019–20, but a lower prevalence of asthma/COPD. In 2019–20, female officers had a prevalence of mental health conditions of 20.2% compared to the 13.4% of male officers and female ex-serving members of other ranks had a prevalence of 26.0% compared to 19.9% of male ex-serving members of other ranks.
DVA client status
Ex-serving DVA clients are a sub-population of ex-serving ADF members and have different characteristics to the overall ex-serving ADF member cohort. ADF members who are eligible for DVA support – and who access services funded by DVA – are more likely to have physical and mental health needs that would have qualified them for subsidised services from DVA. People in this group may be more likely to seek health services and may have better access to health services than non-DVA clients.
For the purposes of this report, the definition of a DVA client is an ex-serving ADF member who has at least one of the following:
- been issued a White, Orange or Gold health card
- had at least one accepted claim for a health or disability condition accepted as being related to service
- has received or is receiving benefits or payment from DVA
- had at least one health service or support service through the DVA National Treatment Account.
The following subgroups of DVA/non-DVA clients were included in the analysis:
- DVA clients: White, Orange or Gold card holders
- Non-DVA clients: rejected claimants (ex-serving members whose only interaction with DVA was to make one or more claims that have not been accepted).
Ex-serving DVA client members had a higher prevalence for most conditions in comparison with ex-serving non-DVA client members in 2019–20. This difference was greatest for mental health conditions (27.6% for DVA clients and 14.2% for non-DVA clients) followed by select musculoskeletal conditions (13.1% for DVA clients and 6.5% for non-DVA clients), cancer and cardiovascular diseases.
Among the DVA client subgroups, gold cardholders had a higher prevalence of most conditions, while other DVA client subgroups had a lower prevalence. DVA gold cardholders had high prevalence for mental health conditions (61.8%) and select musculoskeletal conditions (27.1%) relative to white cardholders (22.9% and 11.0% respectively).