Overall mortality of Canadian Armed Forces personnel enrolled 1976–2012

Rolland-Harris, Elizabeth; Weeks, Murray; Simkus, Kristen; VanTil, Linda

doi:10.1093/occmed/kqx182

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…8 In an effort to maximize the quality and completeness of the data used to create the CF CAMS I cohort, CF CAMS II was initiated in 2016, using compensation data as the cohort file backbone. 27 The results from this study are only beginning to emerge, 28 but planned deliverables include using these data to conduct survival models to identify risk and protective factors associated with suicide both during and post-military release. The very large sample size in the CF CAMS II cohort (>240,000 discrete individuals) contributing a total of nearly 5 million person years of observation support multivariable analyses that can respond to the need for evidence and evidence-based prevention that CAF's traditional suicide surveillance system simply could not address.…”

Section: Cf Cancer and Mortality Study I/iimentioning

confidence: 99%

More Than Just Counting Deaths: The Evolution of Suicide Surveillance in the Canadian Armed Forces

Rolland-Harris

2019

Military Medicine

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Suicide prevention and surveillance are of primary concern to the Canadian Armed Forces (CAF) and to the CAF Health Services (CFHS). Suicide surveillance has been conducted on behalf of the CFHS by the Directorate of Force Health Protection for nearly 30 years. Over time, multiple changes have occurred within CAF: changes in its military role (from a primarily peacekeeping role to one also involving active combat), changes in operational tempo, temporal changes in at-risk subpopulations, as well as increased awareness and concern with suicide and suicide prevention. This has resulted in the annual reporting of CAF suicide rates and the evolution of the report’s content to respond to the needs of its end users. More recently, Regular Force Army and Combat Arms males have been identified as being at significantly higher risk of suicide, relative to their counterparts, as well as to the Canadian general population. However, this trend has been fairly stable. To optimize the use of limited epidemiologic resources and to shift the focus from the rates themselves towards a better understanding of what they represent and how they can be modified, the suicide surveillance portfolio is evolving to include complementary data sources and elements. This paper describes the different data sources that constitute the CAF’s enhanced suicide surveillance portfolio, the value-added evidence generated by the use of complementary data collection methods and sources, and how this evidence is used by CAF leadership in their efforts to prevent suicide amongst those who serve.

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Section: Cf Cancer and Mortality Study I/iimentioning

confidence: 99%

More Than Just Counting Deaths: The Evolution of Suicide Surveillance in the Canadian Armed Forces

Rolland-Harris

2019

Military Medicine

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Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years

et al. 2020

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ObjectivesTo investigate temporal trends in the ‘healthy soldier effect’ (HSE) among 28 300 Royal Norwegian Navy servicemen who served during 1950–2004.MethodsStandardised mortality ratios (SMRs) for all causes, diseases and external causes were calculated from national rates for the entire study period (1951–2017), and for seven successive follow-up periods after the first recorded day of Naval service, for the overall cohort and for two subgroups: land-based personnel and vessel crews. Poisson regression, expressed as rate ratios, was used to compare all-cause mortality between the subgroups.ResultsIn the overall cohort, SMRs for all-cause mortality increased steadily during the first six 10-year follow-up periods, from 0.52 to 0.94, which was still lower than national rates. After 60 years, the lower mortality compared with national rates was no longer statistically significant (SMR=0.93). Low non-neoplastic disease mortality contributed most to the longevity of the HSE. For neoplastic diseases, there was a mortality deficit only for the first and third 10-year follow-up periods. External-cause mortality rose to national rates after 40 years. An HSE was present among vessel crews, but their total mortality rate was 24% higher than that among land-based personnel, who also showed a longer-lasting HSE.ConclusionsThe HSE eroded gradually over time but was still present at 60 years of follow-up for all-cause mortality. The effect was strongest and most long-lived for non-neoplastic disease, lasted up to 40 years for external causes, and was relatively short for cancers. Land-based personnel showed stronger and longer-lasting HSE than vessel crews.

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Studying military and Veteran health using a life-course approach: Lessons learned from a Canadian record linkage study

Rolland-Harris,

Bryan,

VanTil

2024

Journal of Military, Veteran and Family Health

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LAY SUMMARY The Canadian Forces Cancer and Mortality Study (CFCAMS) is an example of a study that uses the life-course approach to research. This article provides an overview of CFCAMS challenges and solutions. Institutional challenges arise from the different mandates of the Department of National Defence and Veterans Affairs Canada. These challenges were addressed by collaboration with Statistics Canada. Data-driven challenges were addressed by data linkage in a secure environment at Statistics Canada. Budget-based challenges could be addressed only for topics that aligned with funded priorities. Human-resource-related challenges include recruitment and retention of experienced personnel, and addressing these challenges is an ongoing issue. These interconnected challenges can leave gaps that result in unrealized stakeholder expectations. Policy-relevant research must incorporate these expectations. Understanding the roles and structures required to generate life-course research can lead to increased influence on policy and practice.

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Overall mortality of Canadian Armed Forces personnel enrolled 1976–2012

Abstract: Military service may have a protective effect that may be partly explained by the healthy soldier effect and the stringent selection process at enrolment.

Cited by 4 publications

References 18 publications

More Than Just Counting Deaths: The Evolution of Suicide Surveillance in the Canadian Armed Forces

More Than Just Counting Deaths: The Evolution of Suicide Surveillance in the Canadian Armed Forces

Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years

Studying military and Veteran health using a life-course approach: Lessons learned from a Canadian record linkage study

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