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Cited by 153Occupational Health and PerformanceEducation and Military IntegrationMilitary and Defense Studies

An Evaluation of the Effect of Military Service on Mortality: Quantifying the Healthy Soldier Effect

McLaughlin, Ruth, Nielsen, Lisa, Waller, Michael·2008·Annals of Epidemiology
DOI 10.1016/j.annepidem.2008.09.002
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Abstract

Purpose The healthy soldier effect denotes the proposition that military populations are likely to be healthier than other populations. A systematic review was conducted which aimed to quantify the magnitude of the healthy soldier effect.Methods Studies containing mortality rates of military personnel were identified from multiple electronic databases. Studies were included in the meta-analyses if they reported all-cause, cancer, or external-cause mortality in a military population and compared the rates to the general population. Fifty-nine studies were initially identified and 12 were included in the meta-analyses.Results The overall meta-standardized mortality ratios (SMRs) for all-cause mortality for deployed veterans was 0.76 (95% confidence interval [CI]: 0.65-0.89) and 0.73 (95% CI: 0.56-1.97) for non-deployed veterans based on a mean follow-up of 7.0 and 2.4 years, respectively; for cancer mortality, the SMRs were 0.78 (95% CI: 0.63-0.98) for deployed veterans and 0.75 (95% CI: 0.50-1.14) for non-deployed veterans based on 6.7 and 3.1 years follow-up, respectively; for external-cause mortality, the SMRs were 0.90 (95% CI: 0.72-1.13) for deployed veterans and 0.80 (95% CI: 0.63-1.01) for non-deployed veterans based on 4.8 and 2.0 years follow-up, respectively.Conclusion Military personnel do display a healthy soldier effect that decreases their risk of mortality compared to the general population. The overall healthy soldier effect estimated ranges from 10% to 25%, depending on the cause of death studied and the period of follow-up.

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Crossref · 10.1016/j.annepidem.2008.09.002

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  • The healthy soldier effect is well known, with service having a positive effect on well-being.

    “The healthy soldier effect is well known, service having a positive effect on well-being, with serving NZ Veterans having good access to primary healthcare through the military system, but the public healthcare system is the primary pathway to care for all Veterans, who are also covered by the ‘no fault’ accident compensation scheme for accidental injuries and occupational diseases.29”

    From Factors associated with self-reported health among New Zealand military veterans: A cross-sectional study (2022) · cites this paper as [1]

  • Age had a negative association and length of service a positive association with EQ-VAS, most likely due to the healthy soldier effect.

    “Age had a negative association, length of service being positive, most likely due to the ‘healthy soldier’ effect.1”

    From Factors associated with self-reported health among New Zealand military veterans: A cross-sectional study (2022) · cites this paper as [1]

  • On entry, selection ensures good physical and mental health, giving rise to the healthy soldier effect, with service personnel being on average healthier than the general population.

    “On entry, soldiers, sailors and air personnel are subject to a selection process to ensure, as far as possible, good physical and mental health, giving rise to the ‘healthy soldier effect,’ with service personnel being, on average, healthier than the general population.1”

    From Factors associated with self-reported health among New Zealand military veterans: A cross-sectional study (2022) · cites this paper as [1]

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Authors
McLaughlin, R., Nielsen, L., & Waller, M.
Affiliations
The University of Queensland (AU)
Corresponding author
McLaughlin, Ruth
ORCID
Venue
Annals of Epidemiology
Publisher
Elsevier BV
Published
2008-12
Volume
18
Issue
12
Pages
928-936
ISSN
1047-2797 (ISSN-L)
DOI
10.1016/j.annepidem.2008.09.002
OpenAlex
W1999317474
Cited by
153
References
39
Citations by year
2026: 7 · 2025: 15 · 2024: 14 · 2023: 14 · 2022: 15 · 2021: 8 · 2020: 9 · 2019: 10 · 2018: 9 · 2017: 11 · 2016: 9 · 2015: 10 · 2014: 4 · 2013: 1 · 2012: 7
FWCI
11.09
Type
journal article
Language
en
Update notices
erratum (2015-02-01)
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Annals of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
  • Social Sciences › Education › Education and Military Integration
  • Social Sciences › Political Science and International Relations › Military and Defense Studies
Keywords
military personnel, mortality, cancer mortality, external causes of death, all-cause mortality, standardized mortality ratio, military health
MeSH terms
Australia, Female, United Kingdom, Humans, Male, Military Personnel, Mortality, Neoplasms, Regression Analysis, United States, Veterans, Models, Statistical, Cohort Studies, Epidemiologic Studies

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