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BACKGROUND: Self-rated health is an useful indicator of the general health in specific populations and used to propose interventions after service in the military context. However, there is scarce literature about self- rated health (SRH) in the Canadian Veterans of the Reserve Force and its relationship with demographic, health and occupational characteristics of this specific group. The aims of this research were to determine the SRH in Canadian Reserve Force Veterans and to explore the relationship between demographic, military service and health factors by reserve class. METHODS: Data from the individuals was collected from the Life After Service (LASS) 2013 survey, including Veterans with Reserve Class C (n = 922) and Class A/B (n = 476). Bivariate and multivariate analysis using logistic regression models, were used to assess the association between the demographic characteristics, physical health, mental health, and military service characteristics and the self-rate health by both reserve classes. RESULTS: The overall prevalence of poor SRH in Reserve Class C Veterans was 13.1% (CI:11.08–15.4) and for Reserve Class A/B was 6.9% (CI:5.0–9.1). Different degrees of associations were observed during the bivariate analysis and two different models were produced for each reserve class. Veterans of Reserve Class C showed that being single was (OR = 2.76, CI: 1.47–5.16), being 50–59 years old (OR = 4.6, CI: 1.28–17.11), reporting arthritis (OR = 2.49, CI: 1.33–4.67), back problems (OR = 3.02, CI:1.76–5.16), being obese (OR = 1.96, CI: 1.13–3.38), depression (OR = 2.34, CI: 1.28–4.20), anxiety (OR = 4.11, CI: 2.00–8.42), PTSD (OR = 2.1 CI: 0.98–4.47), PTSD (OR = 20.9, CI:0.98–4.47) and being medically released (OR = 4.48, CI: 2.43–8.24) were all associated with higher odds of poor SRH. The Reserve Class A/B model showed that completing high school (OR = 4.30, CI: 1.37–13.81), reporting arthritis (6.60, CI: 2.15–20.23), diabetes (OR = 11.19, CI: 2.72–46.0), being obese (OR = 3.37, CI: 1.37–8.27), daily smoking (OR ...

Introduction: Employment is important to health, well-being, and adjustment from military to civilian life. Given the importance of employment, we examine Veteran labour force outcomes in Canada. Methods: We examined labour market indicators from the 2010 and 2013 Life After Service Studies cross-sectional Survey on Transition to Civilian Life, along with the 2013 Income Study for Canadian Regular Force Veterans (released since 1998). Results: In Canada, most Regular Force Veterans surveyed were employed after release and satisfied with their work – both employment and satisfaction rates grew over time. The unemployment rate did not differ from that of the general Canadian population. However, Veterans were more likely than the general Canadian population to experience activity limitations at work. Variations in outcomes were found across diverse groups of the population. For example, unemployed Veterans were younger at release, had the fewest years of service, and were more likely to have served in the Army than employed Veterans. Veterans who were not in the labour force were older and had more years of service, and many were experiencing barriers to work. Employment rates were lower among female Veterans and among medically released Veterans. Discussion: Labour market outcomes vary across sub-groups of the Veteran population, suggesting targeted approaches to improve labour market outcomes. Findings suggest that the prevention of work disability is important for improving outcomes. Best practices in preventing work disability include restructuring compensation to recognize varying degrees of earnings capacity and to encourage labour market engagement and supported employment programs.

Introduction: Work satisfaction contributes to the health and well-being of Veterans transitioning to civilian life after service. Therefore, the purpose of this study is to examine the factors contributing to work satisfaction among Canadian Veterans. Methods: We examine multiple factors thought to be associated with work satisfaction using the cross-sectional 2010 survey of the Life After Service Studies (LASS) program of research, which includes a national sample of 3,154 Canadian Veterans released from the regular forces between 1998 and 2007. We performed both unadjusted and adjusted logistic regression models for three rank groupings: privates and cadets, Non-Commissioned Members (NCMs), junior and senior, and officers (junior and senior). Results: In the year after release, 73% of Veterans were satisfied with their work. Officers (89%) were the most satisfied, followed by NCMs (77%), and privates and cadets (52%). Using unadjusted models, factors associated with higher satisfaction rates were: release due to reaching retirement age; being older than 50; reporting no work stress; reporting knowledge, skills, and ability transferability; and similar job tasks between military and civilian occupations; reporting easy adjustment to civilian life; and being satisfied with finances. Using adjusted models, only satisfaction with finances was associated with work satisfaction for NCMs, privates, and cadets. Only involuntary release and years of service were associated with work satisfaction for officers. Discussion: Work satisfaction rates varied considerably according to military rank, and were highest among officers and lowest among privates and cadets. This suggests a need to account for rank when developing strategies to improve work satisfaction rates and reintegration into civilian life among Veterans.

LAY SUMMARY The objective of this research was to explore the association between demographic and service characteristics and mental health in Canadian Veterans of the Reserve Force. The Reserve Force Class C model showed that marital status, age, chronic pain, depression, anxiety, posttraumatic stress disorder (PTSD), and type of release were associated with mental health. The Reserve Force Class A/B model showed that age, depression, anxiety, PTSD, and type of release were associated with mental health. These results showed that similar factors were associated with the mental health score, with different degrees of association by reserve class. These results will help to better describe Reserve Force Veterans that may require mental health assistance.

LAY SUMMARYThis research explored the demographic, military service, and health characteristics associated with cannabis for medical purposes (CMP) reimbursements among Veterans Affairs Canada (VAC) clients and respondents of the Life After Service Survey 2016 (LASS). Of the initial number of indicators selected contained in the LASS 2016, some specific variables were significantly associated with CMP reimbursement, from which physical/mental health and well-being indicators, such as anxiety, posttraumatic stress disorder (PTSD), depression, bowel ulcer, traumatic brain injury, chronic pain, needing help with tasks, psychological distress, and having three or more conditions of the PTSD diagnosis, were positively associated with CMP. Moreover, unemployment, having low income (< $5,000), a difficult adjustment, being very dissatisfied with life, having low social support, a weak community belonging, and reporting high stress also increased the odds of being reimbursed. These results will help to identify a preliminary profile of VAC clients with higher need for CMP reimbursement.

Introduction: The goal of this study was to identify factors associated with the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) measures of health-related quality of life (HRQOL) in former Canadian Armed Forces (CAF) Veterans after transition to civilian life. Methods: Data were taken from the 2010 Survey on Transition to Civilian Life, a national computer-assisted telephone survey of CAF Regular Force personnel who released during 1998–2007. Multivariate linear regression models were developed using a variety of socio-economic, military, health, and disability characteristics. Results: Mean age was 46 years (range 20–67 y), and 12% of the participants were women. Higher age was associated with lower PCS but higher MCS scores. High ratings of mastery and high satisfaction with life were strongly associated with higher scores on both the PCS and the MCS. Most chronic physical health conditions were associated with poorer PCS scores, in particular chronic pain, musculoskeletal conditions, cancer, gastrointestinal conditions, hearing problems and, to a lesser degree, chronic mental health conditions. The only chronic condition associated with poorer MCS scores was presence of one or more mental health conditions. Both activity limitation in major life domains and needing assistance with activities of daily living were negatively associated with PCS scores, whereas only the latter was negatively associated with MCS scores. Discussion: The models suggested protective factors and identified characteristics of subgroups vulnerable to poor HRQOL after accounting for confounding. Findings can be used to identify those at high risk who may benefit from targeted interventions and to develop health promotion and prevention strategies for Canadian Armed Forces personnel in transition to civilian life.

Introduction: Although hearing impairment is a known hazard of military service, there is limited prevalence data for Canadian Armed Forces (CAF) Veterans. Using two self-report methods in the 2010 and 2013 Life After Service Studies (LASS), this study compared hearing problem prevalence in Veterans and in the general Canadian population. Methods: Self-reported hearing problems were measured in Regular Force Veterans using a question adapted from the Participation and Activity Limitation Survey (PALS) in LASS 2010 and the Health Utilities Index Mark 3 (HUI3) in LASS 2013. Prevalence was compared to the general population using the 2013 Canadian Community Health Survey (CCHS) and to Veterans Affairs Canada audiometry-based disability benefits assessment for service-related hearing loss and tinnitus. Results: Hearing problem prevalence was 27.8% (26.3–29.4%) using the adapted PALS question in 2010 and 8.5% (7.4%–9.8%) using the HUI3 module in 2013. The prevalence of hearing problems in the general population using HUI3 after adjusting CCHS data for age and sex to match the Veterans was 2.0% (1.8–2.2%). Hearing problem prevalence in those aged 20–49 was higher in Veterans using PALS (21.1%, 19.4–23.0%) and HUI3 (4.7%, 3.6–6.3%) than in the general Canadian population (1.0%, 0.7–1.3%). Discussion: Self-reported hearing problems are more prevalent in CAF Veterans than the general population, prevalence varies considerably with the measurement instrument used. Veterans who did not have disability benefits for ear diagnoses reported hearing problems. Implications are discussed for services and research aimed at the prevention, mitigation, and measurement of hearing loss in this at-risk population.