The post-war public health effects of civil conflict

Social Science & Medicine
Volume 59, Issue 4, August 2004, Pages 869-884



H.A.Hazem Adam Ghobarah<sup>a</sup>, Paul Huth<sup>b</sup> and Bruce Russett<sup></sup><sup>, </sup><sup></sup><sup>, </sup><sup>c</sup>
<!-- authorsNoEnt --> <sup>a</sup> CBRSS, 34 Kirkland St., Harvard University, Cambridge, MA 02138, USA
<sup>b</sup> University of Michigan, 426 Thompson St., rm. 4203, Ann Arbor, MI 48106, USA
<sup>c</sup> Department of Political Science, Yale University, 124 Prospect St., New Haven, CT 06520-8301, USA

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Available online 23 January 2004.
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<!-- articleText --> Abstract

Civilian suffering from civil war extends well beyond the period of active warfare. We examine longer-term effects in a cross-national analysis of World Health Organization data on death and disability broken down by age, gender, and type of disease or condition.

We find substantial long-term effects, even after controlling for several other factors.


We estimate that the additional burden of death and disability incurred in 1999 alone, from the indirect and lingering effects of civil wars in the years 1991?1997, was nearly double the number incurred directly and immediately from all wars in 1999.


This impact works its way through specific diseases and conditions, and disproportionately affects women and children.



<!-- articleText --> Author Keywords: Age; Civil conflict; Death; Disability; Disease; Gender; War; WHO

<!-- articleText --> Article Outline

<dl><dt>? Introduction</dt><dt>? New measures of public health</dt><dt>? Theoretical framework</dt><dt>? Hypotheses on civil war and public health</dt><dt>? Controlling for other causes of public health</dt><dt>? A multivariate analysis of all deaths and disabilities</dt><dt>? The who and how of civil war effects</dt><dt>? Contiguous civil wars</dt><dt>? Conclusion</dt><dt>? Acknowledgements</dt><dt>? References</dt></dl>
<!-- articleText --> Table 1. Direct deaths from civil wars per 100 population, 1991?1997
Plus 27 countries below 0.100 each

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Table 2. DALYs lost to all disease categories
N=165; bolded cells are significant at <0.05 one-tailed level.

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Table 3. The long-term impact of civil wars: DALYs lost by disease categories

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Table 4. The long-term impact of contiguous civil wars: DALYs lost by disease categories

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