Prejudging the problems of Canada’s military families

I was delighted to read in “Caring for Canadian military families“ in the January issue of Canadian Family Physician that research is under way to identify medical concerns specific to Canada’s military families.¹ My interest is personal. I am the son of a career officer and World War II veteran, I was raised on military bases around Canada, and later I served as a Canadian Armed Forces (CAF) General Duty Medical Officer and raised my children on and near military bases.

I am concerned that the authors are pre-empting the research.¹ Their article begins with the usual vignette, in this case a military family in crisis. The infant son is not progressing, the daughter is regressing, the infantryman-father’s behaviour has changed, the mother is struggling. The vignette is a list of red flags, a picture of incipient failure.

The authors state that “this is not an uncommon situation for military families.”¹ Later they say that currently “there are no Canadian data comparing commonly experienced health problems by CAF spouses or children.”¹

You cannot say the problem is common and then say that you have no epidemiologic data.

The data in the article are essentially United States (US) data. Extrapolating these data would be unwise. United States military personnel start from different socioeconomic backgrounds; they are deployed abroad more frequently and for longer periods than Canadian personnel are; their families are uprooted more often; and the US military is embedded in American society and culture in a way that is foreign to this country.

Contrary to the article’s suggestion, the triad of mobility, separation, and risk is not unique to military life. I suggest that families of Canadian workers involved in resource extraction industries would be as close a comparator as US military personnel. Many miners spend more time away from their families than military personnel do. Thousands of oil field workers have moved their families to other provinces, often more than once. When mines close or logging is no longer profitable, miners and loggers pack up and move, with attendant discontinuity of care. Unlike military families their spouses and kids do not have a military family resource centre to turn to.

As for the risks of military service, this is a myth. Miners, loggers, fishermen, and oil field workers have a substantially higher risk of morbidity and mortality than soldiers, sailors, or air force personnel. In 2018 the CAF Directorate of Force Health Protection published an analysis of overall mortality in CAF personnel enrolled between 1976 and 2012.² They concluded that all-cause mortality was statistically significantly lower than in the general population, for both sexes. Rather than increasing risk of death, military service might have a protective effect.

Finally, I think it is worth mentioning that Calian is a for-profit company, with strong ties to the Department of National Defence.

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