Devakumar Delan, Birch Marion, Osrin David, Sondorp Egbert, Wells Jonathan C K
Institute for Global Health, University College London, London, UK.
BMC Med. 2014 Apr 2;12:57. doi: 10.1186/1741-7015-12-57.
The short- and medium-term effects of conflict on population health are reasonably well documented. Less considered are its consequences across generations and potential harms to the health of children yet to be born.
Looking first at the nature and effects of exposures during conflict, and then at the potential routes through which harm may propagate within families, we consider the intergenerational effects of four features of conflict: violence, challenges to mental health, infection and malnutrition. Conflict-driven harms are transmitted through a complex permissive environment that includes biological, cultural and economic factors, and feedback loops between sources of harm and weaknesses in individual and societal resilience to them. We discuss the multiplicative effects of ongoing conflict when hostilities are prolonged.
We summarize many instances in which the effects of war can propagate across generations. We hope that the evidence laid out in the article will stimulate research and--more importantly--contribute to the discussion of the costs of war; particularly in the longer-term in post-conflict situations in which interventions need to be sustained and adapted over many years.
冲突对人口健康的短期和中期影响已有较为充分的记录。但冲突对几代人的影响以及对尚未出生儿童健康的潜在危害较少受到关注。
首先审视冲突期间接触因素的性质和影响,然后探讨危害可能在家庭内部传播的潜在途径,我们考虑冲突的四个特征——暴力、心理健康挑战、感染和营养不良——的代际影响。冲突引发的危害通过一个复杂的促成环境传播,这个环境包括生物、文化和经济因素,以及危害源与个人和社会对其抵御能力弱点之间的反馈循环。我们讨论敌对行动长期持续时持续冲突的倍增效应。
我们总结了战争影响能够代代相传的诸多实例。我们希望本文阐述的证据将激发研究,更重要的是,有助于对战争代价的讨论;特别是在冲突后局势的长期阶段,在这些局势中,干预措施需要持续多年并不断调整。