Physical and mental health of ethnic minority service personnel in the UK Armed Forces: a retrospective pooled cross-sectional analysis.

OBJECTIVES: To assess physical and mental symptoms by ethnicity of a UK Armed Forces cohort. DESIGN: A retrospective, pooled cross-sectional analysis. SETTING: Self-report questionnaire collected between 2004-2023. PARTICIPANTS: Three samples of UK Armed Forces, including a Gurkha (n=254), Fijian (n=112) and a heterogeneous sample of British ethnic minority personnel (n=178) were compared with a sample of white British participants (n=254). MAIN EXPOSURE MEASURE: Physical and mental health symptoms were measured using individual items from the Patient Health Questionnaire, Post-traumatic Stress Checklist (Post-Traumatic Stress Disorder Checklist-Civilian Version) and General Health Questionnaire (GHQ-12) drawn from four phases of cohort data. Ethnic samples were matched by military role and veteran or active service status. RESULTS: Based on their first assessment, 60 white British participants (24.2%) met GHQ criteria for common mental disorder, significantly higher than found for the other three groups (χ2 (3, n=782)=25.03, p<0.001). Across all measures, Gurkha participants were the least symptomatic, though Gurkha and Fijian participants reported more symptoms of post-traumatic stress. British samples reported more somatic reports. Different patterns of post-traumatic and somatic symptoms may be explained by differential levels of traumatic exposures, recruitment profiles and culturally nuanced expressions of distress. CONCLUSIONS: Patterns of mental and physical symptoms warrant further investigation to inform prevention, more precise diagnosis and tailored care and treatment for specific ethnic groups.