How Does Military Service Impact Long-Term Health and Well-Being?

What you need to know

• This is the fourth phase of a long-term study examining the health impacts of military service on UK personnel who served during the Iraq and Afghanistan conflicts
• The study will survey over 7,000 current and former military members about their physical and mental health, relationships, and life experiences
• Key topics include mental health conditions, alcohol use, gambling, and the impacts of major events like the Afghanistan withdrawal

Background and purpose

Military service can have significant impacts on a person’s health and well-being, both during their time in the armed forces and after transitioning to civilian life. To better understand these long-term effects, researchers have been following a large group of UK military personnel since 2003 in a study called the King’s Centre for Military Health Research (KCMHR) Health and Wellbeing Cohort Study.

This study has surveyed the same group of people multiple times over nearly 20 years, allowing researchers to track changes in health and other life outcomes over time. The current phase is the fourth major wave of data collection, taking place in 2022-2023.

The main goals are to:

1. Continue monitoring the mental and physical health of those who deployed to Iraq and/or Afghanistan compared to those who did not deploy
2. Compare health outcomes between those still serving in the military versus those who have left service
3. Examine a wide range of other outcomes relevant to military personnel and veterans

Who is being studied

The study will invite over 7,600 current and former UK military members to participate. This includes both regular forces and reservists. All were serving during the era of the Iraq and Afghanistan conflicts, though not all deployed to those specific operations.

Importantly, this group has been followed since the early 2000s, allowing for long-term tracking of health and life outcomes. About 40% had left military service by the previous survey in 2014-2016.

Key topics and measures

The survey covers a wide range of health and well-being topics, including:

• Common mental health conditions like anxiety and depression
• Post-traumatic stress disorder (PTSD)
• Alcohol use and misuse
• Physical health symptoms
• Mild traumatic brain injury
• Anger and aggressive behavior
• Drug use
• Gambling
• Relationship quality
• Loneliness and social support
• Cognitive function

New areas being examined in this phase include:

• Complex PTSD - a more severe form of PTSD
• Impact of the withdrawal from Afghanistan in 2021
• Effects of the COVID-19 pandemic

The researchers use standardized questionnaires that have been scientifically validated to measure these different areas. Many of the same measures have been used across all phases of the study, allowing for comparisons over time.

How the study is being conducted

Participants will be invited to complete an online or paper questionnaire that takes about 40-45 minutes. They will be contacted by email, mail, and potentially text message or phone.

To encourage participation, there will be multiple reminders sent out and efforts to update contact information for those who have moved. Participants can also enter a prize draw as an incentive.

The researchers expect about 50-60% of those invited will complete the survey, which would result in over 4,500 responses. Data collection is occurring from January 2022 to September 2023.

Importance of the research

This study provides critical information to help support the health and well-being of military personnel and veterans. Key reasons it is valuable include:

• Tracking health over nearly 20 years allows researchers to identify long-term trends and impacts of military service
• Comparing those who deployed to Iraq/Afghanistan to those who did not helps isolate the effects of combat exposure
• Examining both current and former military members shows how health may change after leaving service
• The large sample size provides the statistical power to detect even small but meaningful differences between groups
• Using consistent measures over time allows for direct comparisons across different phases of military careers and life stages

The findings will be used to inform policies and support services for UK military members, veterans, and their families. This can help ensure resources are directed where they are most needed.

Conclusions

• This long-running study provides unique insight into the health trajectories of UK military personnel over nearly two decades
• The current phase will give updated information on mental health, alcohol use, and other key outcomes as participants progress through different career and life stages
• New measures on topics like gambling and complex PTSD will shed light on emerging areas of concern
• The results will help shape evidence-based policies and services to support the wellbeing of military members and veterans