UK ex-servicewomen at higher risk of COPD
New report highlights unique health challenges facing female veterans
UK ex-servicewomen are significantly more likely to experience health conditions such as COPD, osteoarthritis and obesity than civilian women, according to a comprehensive new research report published today.
Led by Anglia Ruskin University (ARU) and funded by the Office of Veteran Affairs (OVA), the report, entitled The Physical Health and Healthcare Experiences of UK Ex-servicewomen, delivers an analysis of the physical health needs and healthcare experiences of UK ex-servicewomen, using a range of sources including UK biobank data and interviews.
Analysis of UK Biobank data by collaborators at King’s Centre for Military Health Research (KCMHR) suggests that osteoarthritis appears to be a prevalent health problem among ex-servicewomen. Among the 546 ex-servicewomen and 2,722 ex-servicemen studied, ex-servicewomen were more likely to have the condition compared to ex-servicemen (21.1% vs 17.5%) and civilian women (21.1% vs 17.4%).
The data also found that ex-servicewomen had more than double the prevalence of COPD (2.6% vs 1.2%) than civilian women and that, when adjusting for demographics, body mass index and smoking status, ex-servicewomen showed 79% higher odds of developing the condition.
The prevalence of obesity is notably higher among ex-servicewomen than in civilian women (29.7% vs 19.3%). In addition, ex-servicewomen are also more likely to smoke or be former smokers than civilian women (45.6% vs 37.3%).
“Chronic conditions are life changing and can have a dramatic impact on a person’s wellbeing. While we found a relatively similar prevalence of conditions between ex-servicewomen and civilian women; ex-servicewomen bear a greater burden of musculoskeletal and respiratory conditions than both male veterans and female civilians.”
Alexandria Smith, a research associate at KCMHRInterviews carried out by the researchers highlight how military service influences ex-servicewomen’s lifelong approach to their health. Military cultural attitudes were found to create pressure for servicewomen to prove themselves, often leading to physical overexertion. This approach to health continued post-service, with women continuing to push physical boundaries and delaying access to support.
The research found ongoing challenges with gynaecological health, fertility and menopause, including delays in diagnosis and treatment, both during and after service. Some participants described misdiagnosed or untreated conditions that lead to long-term consequences, such as infertility.
Ex-servicewomen are historically underrepresented in veteran health research, despite making up 13.6% of the former serviceperson population in England and Wales, and 12% in Scotland. A 2019 literature review revealed that just 2% of international veteran research mentions women.
The report makes 23 recommendations for policymakers, charities and health service providers, including raising awareness of the unique needs of ex-servicewomen, developing campaigns ensuring ex-service personnel are aware of statutory health support available to them, and focused training for NHS staff.
“We can see from these results that UK ex-servicewomen have distinct physical health needs, including increased prevalence of musculoskeletal conditions compared to ex-servicemen, and increased prevalence of COPD, smoking and obesity in comparison to civilian women.
“Obesity in ex-service personnel may be related to lower levels of physical activity, health problems and lifestyle changes following discharge from the military. Analysis of the UK Biobank data found that differences in general health and the prevalence of osteoarthritis in ex-servicewomen compared to civilian women were no longer significant when adjusted for smoking and body mass index. This suggests that the higher prevalence of smoking and obesity may contribute to long-term physical health conditions in ex-servicewomen compared to civilian women.
“After leaving service, ex-servicewomen face similar challenges to civilian women regarding healthcare access. However, a lingering military mindset centred on toughness, self-reliance, and reluctance to seek help, can still shape their behaviour, creating extra barriers to accessing care.
“We would like to see more understanding amongst healthcare professionals of the military cultural factors that can influence ex-servicewomen’s health behaviours.”
Lead author Dr Lauren Godier-McBard, Director of the Centre for Military Women’s Research at Anglia Ruskin University (ARU)The study is a collaboration between five organisations: The Centre for Military Women’s Research at ARU, King’s College London, Defence Medical Welfare Service, Op RESTORE and the Royal British Legion. To read the report, visit https://www.centreformilitarywomensresearch.com/projects/female-veterans-physical-healthcare-needs-and-support-preferences/