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      Violent crime among Swedish military veterans after deployment to Afghanistan: a population-based matched cohort study

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          Abstract

          Objective

          To investigate the incidence of violent crime conviction among Swedish military veterans after deployment to Afghanistan versus non-deployed comparators. The main outcome was first conviction of a violent crime, retrieved from the Swedish National Council for Crime Prevention Register until December 31, 2013.

          Methods

          This was a cohort study of military veterans identified through personnel registers regarding deployment to Afghanistan between 2002 and 2013 ( n = 5894). To each military veteran, up to five non-deployed comparators identified via the Military Service Conscription Register were matched by age, sex, conscription year, cognitive ability, psychological assessment, self-reported mental health, body mass index, antidepressants/anxiolytics prescriptions and self-harm (fully matched comparators; n = 28 895). Multivariable adjustment was made for substance abuse and previous health care visits with psychiatric diagnoses. An additional comparator group matched only for age, sex and conscription year was also used (age-sex-matched comparators; n = 29 410).

          Results

          During 21 898 person-years of follow-up (median = 3.6 years) there were 26 events among deployed military veterans compared with 98 in non-deployed fully matched comparators [12 vs 9 per 10 000 person-years, adjusted hazard ratio (aHR) 1.36; 95% confidence interval (CI) 0.88–2.10]. Among non-deployed age-sex-matched comparators there were 170 violent crime convictions (16 per 10 000 person-years; aHR 0.85; 95% CI 0.56–1.29). Factors associated with greater risk of violent crime convictions were younger age, lower scores on cognitive ability tests and psychological assessment, and convictions preceding deployment.

          Conclusion

          The violent crime conviction rate after returning from military deployment to Afghanistan was not different compared with non-deployed comparators in individuals without history of violent crime convictions.

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          Most cited references15

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          Low intelligence test scores in 18 year old men and risk of suicide: cohort study.

          To examine the association between intelligence test scores in men, measured at age 18, and subsequent suicide. Record linkage study of the Swedish military service conscription register (1968-94) with the multi-generation register, cause of death register and census data. Four tests were performed at conscription covering logic, language, spatial, and technical skills. Sweden. 987 308 Swedish men followed up for 5-26 years. Suicide. 2811 suicides occurred during follow up. The risk of suicide was two to three times higher in those with lowest compared with the highest test scores. The strongest associations were seen with the logic test: for each unit increase in test score the risk of suicide decreased by 12% (95% confidence interval 10% to 14%). Associations were only slightly attenuated when we controlled for parents' socioeconomic position. Greatest risks were seen among poorly performing offspring of well educated parents. Performance in intelligence tests is strongly related to subsequent risk of suicide in men. This may be due to the importance of cognitive ability in either the aetiology of serious mental disorder or an individual's capacity to solve problems while going through an acute life crisis or suffering from mental illness.
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            Violent offending by UK military personnel deployed to Iraq and Afghanistan: a data linkage cohort study

            The Lancet, 381(9870), 907-917
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              An evaluation of the effect of military service on mortality: quantifying the healthy soldier effect.

              The healthy soldier effect denotes the proposition that military populations are likely to be healthier than other populations. A systematic review was conducted which aimed to quantify the magnitude of the healthy soldier effect. Studies containing mortality rates of military personnel were identified from multiple electronic databases. Studies were included in the meta-analyses if they reported all-cause, cancer, or external-cause mortality in a military population and compared the rates to the general population. Fifty-nine studies were initially identified and 12 were included in the meta-analyses. The overall meta-standardized mortality ratios (SMRs) for all-cause mortality for deployed veterans was 0.76 (95% confidence interval [CI]: 0.65-0.89) and 0.73 (95% CI: 0.56-1.97) for non-deployed veterans based on a mean follow-up of 7.0 and 2.4 years, respectively; for cancer mortality, the SMRs were 0.78 (95% CI: 0.63-0.98) for deployed veterans and 0.75 (95% CI: 0.50-1.14) for non-deployed veterans based on 6.7 and 3.1 years follow-up, respectively; for external-cause mortality, the SMRs were 0.90 (95% CI: 0.72-1.13) for deployed veterans and 0.80 (95% CI: 0.63-1.01) for non-deployed veterans based on 4.8 and 2.0 years follow-up, respectively. Military personnel do display a healthy soldier effect that decreases their risk of mortality compared to the general population. The overall healthy soldier effect estimated ranges from 10% to 25%, depending on the cause of death studied and the period of follow-up.
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                Author and article information

                Journal
                Int J Epidemiol
                Int J Epidemiol
                ije
                International Journal of Epidemiology
                Oxford University Press
                0300-5771
                1464-3685
                October 2019
                05 May 2019
                05 May 2019
                : 48
                : 5
                : 1604-1613
                Affiliations
                [1 ] Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet , Stockholm, Sweden
                [2 ] Cyclo AB , Stockholm, Sweden
                Author notes
                Corresponding author. Clinical Epidemiology Unit (T2), Department of Medicine (Solna), Karolinska Institutet, SE-171 76 Stockholm, Sweden. E-mail: carl-martin.pethrus@ 123456ki.se
                Author information
                http://orcid.org/0000-0001-8762-8973
                http://orcid.org/0000-0003-2300-3055
                Article
                dyz084
                10.1093/ije/dyz084
                6857751
                31056695
                91c86197-684d-4eeb-9af9-3288d43e1db0
                © The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 08 April 2019
                Page count
                Pages: 10
                Funding
                Funded by: Kungafonden
                Funded by: Swedish Armed Forces 10.13039/501100009238
                Categories
                Impact of Violence

                Public health
                deployment,military,violent crime
                Public health
                deployment, military, violent crime

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