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Introduction: This article examines the history of Veteran financial benefits provided by Veterans Affairs Canada (VAC) since the First World War. Methods: The history of financial benefits is described using policy documents held at VAC. Data from the Life After Service Studies (LASS), covering Veterans released since 1998, were used to describe income and employment among Veterans today. Results: For wartime-era Veterans, benefits supported those with service-related disability and their employment, along with those experiencing poverty. Post–Korean War Veteran benefits were limited to service-related disability benefits. Studies during 1997–2003 suggested that the needs of Veterans and their families were inadequately addressed by existing VAC programs. Consequently, the Government of Canada announced plans to modernize its programs, and the New Veterans Charter (NVC) was launched in 2006. Subsequently, NVC financial benefits have been expanded numerous times. The incomes of Regular Force Veterans declined after release but recovered, surpassing pre-release income, and low-income rates were half that of Canadians. Most Regular Force Veterans were employed after release and satisfied with their work. Lower rates of difficult adjustment were found among employed Veterans, who were satisfied with their finances and jobs. Higher rates of difficult adjustment were found among Veterans who were not employed; who were not satisfied with their job, main activity, or finances; or who were experiencing low income. Discussion: Wartime-era Veterans' financial benefits and employment supports were guided by the idea of opportunity with security. After 2006, policy returned to a focus on employment supports to enhance Veteran well-being while continuing to provide financial benefits for Veterans experiencing service-related disability.

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.

Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Veterans are disproportionately prevalent in sub-populations of males, persons with chronic physical conditions, chronic pain, mental health conditions, and those with disabling activity limitations. Veterans are a population of interest to Canadian researchers, but there is no publicly available comprehensive list of Veterans in Canada. This creates a need for a standard set of screening questions suitable for self-report surveys. This article proposes a series of screening questions to identify Canadian Veterans. Methods: The content of the questions were developed considering self-identity, past Canadian surveys, legislation, and relevant characteristics of Canadian military service. Results: The recommended Canadian Veteran identifier questions are: "Have you ever had any Canadian military service? Was this service with the Regular Force? Reserve Force? Navy? Army? Air Force? Are you currently in the Canadian Armed Forces? What year were you released from the Canadian Armed Forces? What year did you join the Canadian Armed Forces?" Discussion: The consistent use of these screening questions allows for comparisons with other studies and will contribute to a better understanding of Veterans in Canada and of the transition from military to civilian life.

Introduction: The Survey on Transition to Civilian Life (STCL) was created to measure the adjustment outcomes of recently released Canadian Armed Forces (CAF) members. The survey was administered to a sample of CAF regular force members released from 1998 to 2007. The aim of the current study was to examine resources that promote the successful adjustment to civilian life. Specifically, the goal was to conduct a secondary analysis of the STCL that examined the roles of mastery and social environment (that is, community belonging and satisfaction with support) in the transition to civilian life, as well as how these variables correlate with health and life stress. Methods: The sample data were used to conduct Kendall's tau correlations. Prevalence estimates, 95 per cent confidence intervals, and ordinal logistic regressions were conducted using weighted data that accounted for the complex survey design to ensure findings were representative of the sampled veteran population. Results: Ordinal logistic regression results revealed that mastery, satisfaction with types of social support (friends and family), and a sense of community belonging acted as potential protective factors that were associated with easier adjustment to civilian life for Veterans with physical health conditions, mental health conditions, and higher levels of life stress. The first model showed that the odds of an easier adjustment were lower for those who were more stressed (adjusted odds ratio [AOR]=0.13), self-reported a physical health condition (AOR=0.53), and self-reported a mental health condition (AOR=0.23). The second model revealed that the odds of an easier adjustment were lower for those Veterans dissatisfied with their family relationships (AOR=0.42) and their relationships with friends (AOR=0.47) and those with a very weak sense of community belonging (AOR=0.39), and they were higher among those with high levels of mastery (AOR=3.93). Discussion: The results of this study point to the importance of personal characteristics and aspects of the social environment in the adjustment to civilian life among military veterans. As well, ensuring a successful adjustment to civilian life may lead to better outcomes, such as enhanced mastery, following transition.

Exposure assessment is an important factor in all epidemiological research seeking to identify, evaluate, and control health risks. In the military and veteran context, population health research to explore exposure-response links is complicated by the wide variety of environments and hazards encountered during active service, long latency periods, and a lack of information on exposures in potentially vulnerable subgroups. This paper summarizes some key considerations for exposure assessment in long-term health studies of military populations, including the identification of hazards related to military service, characterization of potentially exposed groups, exposure data collection, and assignment of exposures to estimate health risks. Opportunities and future directions for exposure assessment in this field are also discussed.

Presumptive condition lists formally accept connections between military factors and veteran health conditions. An environmental scan of such lists and their evidentiary basis was conducted across four veterans' administrations to inform other administrations considering the development of such lists. Information on included conditions, qualifying military factors, and scientific processes was obtained through targeted internet searches and correspondence with veterans' administrations. The content of presumptive condition lists across jurisdictions varied by conditions included, as well as military eligibility requirements (e.g., service in particular conflict, context, or time period). Scientific review processes to develop lists also varied across jurisdictions. Findings indicate that evidence and experience may be leveraged across compensation systems (veteran and civilian). Ongoing research to understand links between military exposures and veteran health is recommended.

In the past 15 years in Canada, as in other nations, the mental health of veterans has emerged as a key concern for both government and the public. As mental health service enhancement unfolded, the need for wider population studies became apparent. This paper describes the renewal of services and key findings from national surveys of serving personnel and veterans.

OBJECTIVE: Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. METHOD: The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2—Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 (N = 5,155) were reinterviewed in 2018 (n = 2,941). The World Mental Health Survey–Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. RESULTS: The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. CONCLUSIONS: The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.

OBJECTIVE: The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period. METHOD: The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression. RESULTS: In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002–2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up. CONCLUSIONS: This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention ...