The Role of Public Health in the Prevention of War: Rationale and Competencies (original) (raw)
Related papers
War & Public Health in the Twenty-First Century
2003
War has profound adverse effects on public health. War leads to death for military personnel and especially for civilians, long-term physical and psycho- logical consequences to survivors, destruction of sociocultural and ambient environments, and diversion of needed resources. In addition, war legalizes and promotes violence as a mode of solving problems. These and related issues relating to war in the twenty-first century are analyzed in this paper. The authors discuss several approaches to preventing war and minimizing its consequences on health — including addressing the underlying problems that often lead to war, promoting a culture of peace, and controlling weapons.
Health Effects of Combat: A Life-Course Perspective
Annual Review of Public Health, 2009
Armed combat (also termed war or armed conflict) has profound direct and indirect impacts on the long-term physical and mental health of both military personnel and noncombatant civilians. Although most research has focused on immediate and short-term health consequences of war, an increasing number of studies have focused on the long-term health consequences for both veterans of military service and noncombatant civilians. However, these long-term studies focus almost entirely on posttraumatic stress disorder and other mental health problems; relatively few long-term studies have focused on physical injuries due to war and the impact of those injuries on relationships, work, and other aspects of life. This article reviews illustrative examples of the existing literature on these long-term health consequences of war, focusing not only on military veterans of several different armed conflicts but also on noncombatant civilian populations, including spouses and children of military ve...
A Review of Military Health Research Using a Social-Ecological Framework
American journal of health promotion : AJHP, 2018
We aim to contextualize the growing body of research on the sequelae of military service in the wars in Afghanistan and Iraq. We employ a social-ecological (SE) framework for the taxonomy of military health research and classify risk as arising from the individual, family, community, and the institutional levels. We intend for this review to inform enhanced health promotion efforts in military communities. Articles reviewed were extracted from Web of Science, PubMed, and Scopus. Research focused on somatic and psychological sequelae of combat deployment published from 2001-the year the war in Afghanistan began-through the end of 2014. We excluded studies of non-US military personnel, other systematic reviews, meta-analyses, book chapters, and theoretical papers. We examined and summarized the aims, participants, methods, study design, SE framework tier, risk factors, and health outcomes. Studies were categorized according to SE tier, whether they focused on somatic, behavioral, or p...
Annals of Internal Medicine, 1997
War and public health Public health specialists and activists frequently struggle to maintain a broad perspective in achieving their mission, to think globally even if they act locally, as the saying goes. Yet, the fields of international policy often appear to be beyond the remit of public health action, especially when it means involvement in establishing international human rights, or challenging international trade, or even wars. Critical Public Health has addressed such changing global processes as the HIV/AIDS pandemic, the increasing rates of refugees and migrants, and the issue of access to medicines in the developing world but rarely the public health topics of war directly. War has been a relative latecomer to an expanding public health horizon, although we can no longer ignore its relevance to public health. The roots of its neglect as a public health issue arise from the fact that at the beginning of the twentieth century only 14% of the victims of violent conflicts were civilians (Garfield & Neugut, 1997). International attempts to address the health consequences of war thus focused on the military. Military medicine was commonly equated with treating the wounded and often ignored the far greater contribution of disease to the mortality and morbidity of soldiers. The 1864 Geneva Convention in its establishment of neutrality on the battlefield and ocean thus merely enabled the easier evacuation of the wounded and sick and other international organizational judicial developments did not aim to protect or consider the general population. It was not until the Nuremberg and Tokyo tribunals addressed the atrocities of the Second World War that the fourth Geneva Convention of 1949 recognized and defined protection of civilians, following the principles of the Universal Declaration of Human Rights, which appeared a year earlier. Significantly, around the same time, the newly established World Health Organization reproduced a 'war-blindness' by excluding war damage from medical and public health responsibility. The nuclear threat initiated some of the first concerns about war as a public health issue with the establishment of International Physicians for the Prevention of Nuclear War (IPPNW). Actual conflicts and their effects on civilians in Africa and Asia led also to the establishment of Médicins sans Frontières and Médecins du Monde, which developed as global movements. In this issue, Mike Rowson from Medact in the UK comments on the health crisis in Iraq. Medact was formed by a merger of two older organizations in 1992.
The long-term impact of war on health
The toll of warfare is often assessed in the short run and in terms of mortality. Other aspects of health have received limited attention, especially after warfare ends. This paper estimates the impact of exposure to US Air Force bombing during 1965-1975 on the disability status of individuals in Vietnam in 2009. Using national census data and an instrumental variable approach, the paper finds a positive and statistically significant impact of war time bombing exposure on district level disability rates about forty years after the end of the war. A ten percent increase in bombing intensity approximately leads to a one percent increase in the prevalence of severe disability at the district level. Impacts are highest for severe disability and among persons born before 1976. Smaller yet significant positive impacts are observed among persons born after the war. Results suggest that the toll of warfare on health persists decades later.
A Conceptual Framework for Public Health Analysis of War and Defence Policy
International Journal of …, 2008
Concepts of national security and human security can be tenuously balanced in any assessment of the risks and benefits of defence development. In order to ensure an effective balance is maintained in the interests of both human and national security, new paradigms and research agendas for pre-event public health analysis of war and defence policy should be applied. This paper discusses traditional approaches to war and public health, and considers the benefits of a shift in public health focus from post-event emergency relief to pre-event analysis of war and defence policy. Three concepts of public health are applied to the analysis of defence policy-injury epidemiology, public health surveillance and social epidemiology. We conclude that a refocus on pre-event analysis will strengthen the role of public health in contributing to prevention of war and in the reorientation of defence planning towards the protection of human security and not only the state.
Protecting the health of U.S. military forces: a national obligation
Aviation, space, and environmental medicine, 2000
THE GULF WAR in 1991 was the last critical test of military medicine during full scale ground and air combat operations. By nearly all measures, this war was a victory not only for United States combat troops and its allies, but also for the military health care system (26). The Department of Defense (DoD) was able to deploy an extensive clinical care and preventive medicine infrastructure rapidly to a distant, desert environment (2). As a result of these efforts and prevention programs established before the war, the disease and non-battle injury rate among deployed U.S. forces was lower in this war than in previous major conflicts (10,11). Even more importantly, the number of combat deaths was much less than anyone had predicted, mainly because of the quick and decisive defeat of the Iraqi military by superior U.S. and allied forces (39). Despite the success of military medicine in the Arabian Gulf, the general perception 9 yr later is considerably different because of unresolved questions about the health of Gulf War veterans (31). In particular, veterans have experienced fatigue, joint pain, sleep problems, and other diverse symptoms that have not been definitively explained (15,28,37). Gulf War health questions have resulted in substantial controversy over potentially hazardous exposures during the deployment, the possibility of adverse affects from preventive health measures, and the role of stress in causing chronic illness (23,31). Although further research is in progress, an optimistic perspective on veterans' health already has been provided by an extensive research effort based on clinical evaluations and medical records (29). Systematic clinical examinations have not identified a unique syndrome or a characteristic organic abnormality among over 100,000 U.S., British, and Canadian Gulf War veterans (7,22,27). Additionally, the mortality rate of Gulf War veterans has been less than half that of the civilian population (adjusted standardized mortality ratio of 0.44), and deaths due to medical causes have not increased (24,25). Only deaths due to accidents have been higher, as similarly observed after previous wars (5). Moreover, there has been no overall increase in hospitalizations among Gulf War veterans or birth defects among their children (8,18). In response to health questions following the Gulf War and the increasing demands of a series of hazardous deployments, the military health system has undergone a fundamental