Table 1

Child health in armed conflict

MechanismEffect
MortalityThe fatality rate of frontline combat infantry in Afghanistan was seven times higher than that in the rest of the armed forces9
IllnessConditions for maintenance of child health deteriorate in war—nutrition, water, safety, sanitation, housing and access to health services. Sustained deficiencies in these areas have been shown to have significant impacts on growth in children and adolescence10
Mental healthYounger military personnel are at a greater risk of mental health disorders than their civilian counterparts:
  • Exposure to combat is a risk factor for PTSD and other mental disorders, particularly among younger personnel and individuals with pre-existing psychosocial vulnerabilities and mental health conditions11

  • Self-harm and suicides in the UK armed forces are more common among younger personnel and exceed rates for young civilians12 13

  • Rates of alcohol misuse are considerably higher in the UK armed forces than in the general population. Young age is particularly associated with alcohol misuse in the UK armed forces14

These problems are related to the isolation and enculturation into military life, the trauma of combat, but also to the higher prevalence of preservice vulnerabilities among young recruits to the armed forces
Educational outcomesIn the armed forces, educational underachievement is a marked risk factor for PTSD as well as other common mental disorders, alcohol misuse, aggressive behaviour and violence.15 For instance, one study found a PTSD rate of 8.4% among Iraq War veterans who had joined the armed forces with no GCSE qualifications, compared with 3.3% among those with A levels16
  • PTSD, post-traumatic stress disorder.