War has enormous and tragic impacts, both direct and indirect, on public health, with long-lasting economic, social, and health consequences. War accounts for significant death and disability with estimates ranging from 100 to 200 million deaths in the last century depending on source and factoring in direct and indirect deaths. It destroys families, communities, and sometimes entire cultures. It directs resources away from health and other human services, often destroying the infrastructure for these services. In damaging the biophysical environment, it puts an even greater burden on health needs and impacts other determinants of health. War violates various forms of human rights in multiple ways, destroying the social fabric for populations, sometimes for generations. War leads many people to think that violence is the only way to resolve conflicts. This mind-set that contributes to domestic violence, street crime, and many other kinds of violence in the world. In summary, war threatens public health and its determinants in fundamental ways. This article encompasses major works in the field of war and health, examining war’s consequences on morbidity and mortality, as well as on economics and the environment. Other related topics covered here include weapons systems ranging from conventional weapons to weapons of mass destruction, war’s impacts on special populations such as health-care workers and children, its impact on mental health, and the role of terrorism. The article also reviews how health workers themselves can have an impact on war. We must express profound appreciation to Thomas Piggott and Joanna Santa Barbara who generously provided critical editing and proofreading while Simon Rushton and Ruwan Ratnayake reviewed suggested addendum to content and references.
The references presented in this section provide a general overview of the ways war has an impact on public health. Levy and Sidel 2008 is the landmark piece in this regard, providing a comprehensive examination of the relationship between war and public health, exploring the effects of war on health, human rights, and the environment and describing what health professionals can do to minimize these consequences and help prevent war. In addition, the health and environmental impacts of both conventional weapons and weapons of mass destruction are described in chapters that cover the consequences of their production, testing, use, and disposal. Additional chapters cover vulnerable populations, including women, children, and refugees. Taipale, et al. 2002 has sections on war and medicine, arms systems, health and social effects of warfare, war and the environment, prevention and the role of civilians and civil society. Rummel 1994 presents primary data on democide, while Krug 2002 (published by the World Health Organization) offers a broad examination of all forms of violence and how they impact health. Van Bergen 2009 provides a rich description of the physical and mental consequences of combat, reminiscent of Remarque’s All’s Quiet on the Western Front, a novel about the experience of soldiers in the First World War.
Krug, E. G., L. L. Dahlberg, J. A. Mercy, et al., ed. 2002. World report on violence and health. Geneva, Switzerland: World Health Organization.
This report serves as a reference document for WHO efforts to combat various forms of violence. These efforts are coordinated by the Program on Violence and Injury Prevention and Disability. Though the report has not been updated, it is accessible online and has much data on the impact of violence on health.
Levy, B. S., and V. W. Sidel, eds. 2008. War and public health. 2d ed. New York: Oxford Univ. Press.
This second edition adds new chapters on such topics as the mental health consequences of war, the human rights of prisoners of war, the health consequences of the Iraq war and the civil war in the Democratic Republic of Congo, the roles of health professionals in postconflict situations, and a culture of peace. In-depth descriptions of specific military conflicts provide striking illustrations of the human consequences of war. A section explores the roles of health professionals and their organizations during war, and in preventing war and its consequences. Explores the roles of health professionals and their organizations during war, and in preventing war and its consequences.
Rummel, R. J. 1994. Death by government. New Brunswick, NJ: Transaction.
Rummel defines democide as genocide and governmental mass murder and provides a historical sketch of the major cases of democide: those conflicts in which a million or more people were killed by a particular regime.
Taipale, I., P. H. Makela, and K. Juva, ed. 2002. War or health: A reader. New York: Zed Books.
This reader is more of a survey, covering a wide breadth of material and is written more for an engaged general readership rather than for an academic audience.
van Bergen, L. 2009. Before my helpless sight: Suffering, dying and military medicine on the Western Front, 1914–1918. Farnham, UK: Ashgate.
Van Bergen’s history documents the medical response to warfare (a field known as medical polemology) and includes an extensive bibliography.
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