Thank you, ladies and gentlemen of Parliament. Thank you for the invitation today.
My name is Dr. David Pedlar. I'm the research director at Veterans Affairs Canada. I work in Charlottetown. My colleague Charlotte Bastien joins me today.
The work of your committee on the health and well-being of veterans is very important, and various colleagues at Veterans Affairs have been here to talk to you about it. In fact, last December my colleague Janice Burke introduced you to the life-after-service studies. These are studies that are providing critical information to the department as we continue to integrate our research findings into our programs and services.
I welcome this opportunity to give you more detail about these studies. As you might recall, the life-after-service studies research program was a partnership of Veterans Affairs Canada, the Canadian Forces, the Department of National Defence, and Statistics Canada. It was for understanding the transition from military service to civilian life and the short-term and long-term health effects of military service on the later life courses of veterans.
We're excited about what we're learning from these studies, partly because in the past our evidence on this subject was related only to VAC clients—that's about 11% of the post-Korean War CF veteran population in Canada. Up until now, we've had very little empirical data on the veterans who weren't receiving benefits from Veterans Affairs. That's the majority of veterans in Canada. These studies have changed that. The studies include both veterans receiving benefits from the department and those who are not, and we can make comparisons with the Canadian population.
We use a population health approach. This allows us to understand what may cause disease and what keeps a population healthy. It also allows us to answer critical questions about life after military service and about whether transition needs are being met.
I'm proud to say that this work puts VAC at the forefront of research on transition. It's a unique piece of work, which is generating real interest in the academic community but also among our international veterans affairs partners.
We're seeing more interest in this area, and we are taking all work, nationally and internationally, into consideration, including the work of people such as my colleague Dr. Alice Aitken. As you know, the department has already put in place improvements, through the Enhanced New Veterans Charter Act, to enhance the financial supports in place for our most seriously disabled veterans. Within VAC we make sure that the work has a practical application in the benefits and services we provide veterans and their families.
Now let's talk about what we've learned. There were three studies released in 2011. The first one looked at income before and after service, because we know that income is critically important to health and to security. The second was a population health survey of living Canadian Forces regular personnel who were released over a ten-year period, from 1998 to 2007. We looked at health, disability, and a range of determinants of health, such as income, employment, and social support, among others. The third was a mortality study; it looked at causes of death among current CF members and former personnel.
Let me share with you some of the findings from the study. First, let me tell you about some of the positive findings. First of all, 65% of that group who transitioned felt that they had an easy adjustment to civilian life. Second, as a whole, released Canadian Forces members were less likely to experience low income compared to other Canadians. In fact, they were about 50% less likely than other Canadians to have fallen below the Statistics Canada low-income measure. Less than 2% experienced persistent low income, which is low income that has continued.
Almost 90% worked after release, and the majority were satisfied with their work. Veterans were no more likely to experience unemployment. The unemployment rate was about 8% at the time of the survey, which was comparable to the general population.
On the question of death, male veterans had a 23% lower overall risk of death from all causes combined compared to the general Canadian population.
Finally, veterans were more likely than other Canadians to have a regular medical doctor and health care coverage.
I'll now go on to some of the findings that point to a challenges in this population and to some of the actions we're taking. While the findings I just mentioned report an overall lower risk of premature death, there was an important exception to this finding. That pattern was for suicide. Male veterans had a 46% higher rate of death from suicide. That is in the release population. With respect to these findings, we have been taking concrete research actions but also program actions in the area of suicide prevention.
Of course, there are issues of disability that do not result in death. For example, the rates of musculoskeletal disorders, which would be things like arthritis and back problems, pain, chronic pain, anxiety disorders, and disability are higher in the survey population than the Canadian population. Arthritis is reported at almost twice the rate of the general population, as are back problems.
Many of these conditions were concentrated in an important group of veterans who had what I would describe as very complex states of health. I have come to call this pattern the triple threat. That is veterans who suffer from musculoskeletal disorders--arthritis and back problems--mental health conditions, and chronic pain. That accounted for 16% of veterans in the survey. So we are focusing on these health issues in the analyses that we're doing so we can support the development of health care programs to support this group even better.
We also learned there are veterans out there who may need our help but may not be coming to us. For example, 17% of veterans who are not VAC clients reported they had a difficult or very difficult adjustment to civilian life, and 13% who are not our clients reported they have a mental health condition. This speaks to issues with program reach and communications to veterans. To address this we are working closely with our colleagues in communications outreach and engagement and national defence to try to reach these at-risk groups and to improve our communication with veterans.
As we spend more time looking at the data and focusing on smaller groups we're finding some groups have a disproportionate share of challenges. For example, low income was more prevalent among those released at young ages, those who were released involuntarily, and those who were released at lower ranks.
Another dimension of income is how much the income declines after they leave. We found that female veterans at release experienced one of the greatest declines in income.
While the majority did report a good transition experience, a sizeable minority, about one in four, had a difficult or a very difficult transition experience. Those who were more likely to have had a difficult experience included those who were medically released; those who were separated, widowed, or divorced; and those who had 10 to 19 years of military experience. They were in the middle.
There are subsets of veterans with very complex health needs, and we need to ensure our programs provide the support they need. Our case management function will play a critical role in addressing these concerns.
So there is a spectrum of health in this population of released members. Many are doing well. However, there are also some who have challenges, and a significant minority have complex states of health. According to our estimate, about 16% have this triple risk, if you will.
We are very active on the research side. In addition to some of the actions I mentioned earlier, such as the work on suicide prevention, we are continuing to be very engaged with knowledge exchange and making sure that these findings get out to end-users in the Department of Veterans Affairs, the Department of National Defence, and the Canadian Forces.
We are conducting further analyses on many fronts, including mental health, physical health, the income data, and a better understanding of those veterans who are not receiving services from Veterans Affairs. In addition, we are using the findings to improve aspects of VAC's policies, programs, and services, including disability benefits, programs, health care, case management, and informing health professionals.
A note: in these studies we were not able to look at those veterans who are members of the primary reserves. This is an area of interest to Veterans Affairs, the Canadian Forces, and the Department of National Defence. There are suggestions that reservists may have a more difficult time transitioning, but I do not have enough information to share on that today. This is a challenge that we and our international partners are facing as well, as reserve members become more and more active in armed forces operations and activities.
Thank you very much for the opportunity to share some information on the life-after-service studies with you this afternoon.
