Alcohol misuse in the military:Should veterans' healthcare services focus on the longer-term physical, rather than mental, consequences of deployment?

与普通民众相比，英国军队有许多因素可能会使他们面临更大的身体健康问题和死亡风险。有非常高的酒精使用率，饮酒是军事文化中被接受的一部分。此外，军事人员比一般民众更有可能经历紧张事件，特别是在部署期间。此前已经发现，这些压力事件中的许多都与心理健康问题有关。国王军事健康研究中心(KCMHR)的队列研究是为了研究具有代表性的英国军事人员样本，并收集有关心理健康、酒精使用和部署经历的数据。研究发现，13%的军人滥用酒精的程度对他们的健康有害，总体来说，酒精使用水平远远高于所有年龄段的普通人群。来自普通人群的研究结果表明，饮酒和精神健康问题都与较差的身体健康结果有关。因此，据预测，目前和未来英国军人对身体状况的医疗保健使用量将很高。确定军事人员和退伍军人未来的医疗需求是英国政府当前的优先事项。然而，目前可用于查看医疗服务使用情况(及其原因)的数据集并未确定个人是否在军队中。这项拟议的研究将能够通过链接到KCMHR队列数据，在英格兰、威尔士和苏格兰现有的NHS数据集中识别包括二级医疗记录的军事人员。在NHS医院，每次有人作为住院患者入院、门诊或急诊科就诊时，数据都会被记录下来。就诊的原因是使用现有的国际疾病和健康相关问题分类(ICD-10)编码的。这些数据来自所有医院，在英国被称为医院流行病学统计(HES)。在这项研究中，英格兰、苏格兰和威尔士的数据将与KCMHR队列研究联系起来，提供约10,000名军事人员的信息。这将为研究英国军人的健康状况提供一个独特的机会，并将提供他们最常寻求帮助的健康问题的数据。我们将能够确定最常见的是身体健康状况还是事故和伤害。这项研究的另一个目的是看看我们是否可以通过使用KCMHR队列中关于饮酒量和是否有精神健康问题的信息来预测一个人是否可能因身体健康状况、事故或伤害而入院或就诊。我们还将能够研究NHS因军队中高水平饮酒和精神健康问题而产生的成本。确定英国军队(现役和退役)未来的医疗需求是高度社会、健康和政治优先事项，以便NHS委派委员会拥有他们需要的数据，以便计划专门的医疗服务委托。了解更多关于军人饮酒、心理健康问题和身体健康不良之间的联系也是非常重要的。这是为了确定哪些军事人员将来身体健康状况最差，也是为了有证据表明，关于在军事环境中使用酒精的现行政策可能需要改变。

There are a number of factors about the UK military which could put them at a greater risk of physical health problems and mortality than the general population. There are very high levels of alcohol use and drinking is an accepted part of military culture. In addition, military personnel are more likely to experience stressful events than the general population, particularly during deployment. Many of these stressful events have previously been found to be associated with mental health problems. The King's Centre for Military Health Research (KCMHR) cohort study was set up to look at a representative sample of UK military personnel, and collected data on mental health, alcohol use and deployment experiences. The study found that 13% of the military are abusing alcohol at a level which is hazardous to their health and overall, levels of alcohol use are much higher than the general population at all ages. Research findings from the general population have shown that both alcohol use and mental health problems are associated with poorer physical health outcomes. Therefore, it is predicted that current and future healthcare use for physical conditions will be high in the UK military population.Identifying the future healthcare needs of military personnel and veterans is a current priority for the UK government. However, the current datasets that are available to look at use of healthcare services (and the reasons why) do not identify whether or not an individual is in the military. The proposed study will be able to identify military personnel in existing NHS datasets for England, Wales and Scotland that include secondary healthcare records, by linking to the KCMHR cohort data. In NHS hospitals, data is recorded each time someone is admitted to hospital as an inpatient, or has an outpatient visit or visits an accident and emergency department. The reason for the hospital visit is coded using an existing international classification of disease and health related problems (ICD-10). This data is collated from all hospitals and is called Hospital Episode Statistics (HES) in England. In this study, English, Scottish and Welsh data will be linked with the KCMHR cohort study, providing information on approximately 10,000 military personnel. This will offer a unique opportunity to study the health of UK military personnel and will provide data on the health problems for which they most commonly seek help. We will be able to identify whether physical health conditions or accidents and injuries are most common. A further aim for the study will be to look at whether we can predict if an individual is likely to be admitted to, or visit hospital, for a physical health condition or an accident or injury, by using the information from the KCMHR cohort about how much alcohol they drink and whether they have a mental health problem. We will also be able to look at the costs to the NHS resulting from high levels of alcohol use and mental health problems within the military.It is a high social, health and political priority to identify the future health care needs of the UK military (serving and ex serving), so that the NHS commissioning board have the data they need in order to plan specialised commissioning of health care services. It is also very important to find out more information about the links between alcohol use, mental health problems and physical ill-health in military personnel. This is so we can identify which military personnel are most at risk of having poorer physical health in the future and also so that there is evidence that existing policies regarding the use of alcohol within military settings may need to be changed.