Garry S, Checchi F
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Chatham House, London SW1Y 4LE, UK.
J Public Health (Oxf). 2020 Aug 18;42(3):e287-e298. doi: 10.1093/pubmed/fdz095.
Many people worldwide are affected by conflict, and countries affected are less likely to meet the UN Sustainable Development Goals. This review outlines the effects of conflict on health and focuses on areas requiring more attention.
We completed a search of the literature using Medline, Embase and Global Health.
Health effects of conflict include trauma; mental health; non-communicable diseases (NCDs); child health; sexual, reproductive and maternal health; and infectious diseases. Conflict damages health directly through fighting, and indirectly through wider socioeconomic effects. Health outcomes are influenced by pre-existing population health and demographics, and access to appropriate healthcare. Vulnerable populations (the elderly, children, neonates and women) are especially at risk.
Several areas pose key challenges including: tactics of war as a public health problem; a lack of focus on neonatal care and NCDs; the long-term consequences of conflict across a life-course and into future generations; and the need to focus on wellbeing beyond standard health parameters. Clear decisions about prioritisation need to be made. The effects on civilians must be documented and recorded. Further research is required to understand chronic health needs and effects on future generations, to support fair and equitable resource prioritisation to best meet the needs of conflict-affected populations.
全球许多人受到冲突影响,受冲突影响的国家不太可能实现联合国可持续发展目标。本综述概述了冲突对健康的影响,并重点关注需要更多关注的领域。
我们使用Medline、Embase和全球健康数据库对文献进行了检索。
冲突对健康的影响包括创伤、心理健康、非传染性疾病、儿童健康、性健康、生殖健康和孕产妇健康以及传染病。冲突通过战斗直接损害健康,并通过更广泛的社会经济影响间接损害健康。健康结果受到既有人口健康和人口统计学因素以及获得适当医疗保健的机会的影响。弱势群体(老年人、儿童、新生儿和妇女)尤其面临风险。
几个领域构成了关键挑战,包括:战争策略作为一个公共卫生问题;对新生儿护理和非传染性疾病缺乏关注;冲突在整个生命历程及对后代的长期后果;以及需要超越标准健康参数关注福祉。需要做出关于优先事项的明确决策。必须记录和记载对平民的影响。需要进一步开展研究,以了解长期健康需求以及对后代的影响,支持公平合理地分配资源,以最好地满足受冲突影响人群的需求。