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 (χ 2 (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.