War

WAR

War is perhaps the most serious of all public health problems. Public health has been defined by the Institute of Medicine as "what we, as a society, do collectively to assure the conditions in which people can be healthy." Using this definition, war is clearly antithetical to public health. It not only causes death and disability among military personnel and civilians, but it also destroys the social, economic, and political infrastructure necessary for well-being and health. War violates basic human rights. As a violent method of settling conflicts, it promotes other forms of violence in the community and the home. War causes immediate and long-term damage to the environment. And war and preparation for war sap human and economic resources that might be used for social good.

DIRECT IMPACT ON HUMANS AND THE ENVIRONMENT

Worldwide, there were over 45 million deaths among military personnel during the twentieth century—a mean annual military death rate of 183 deaths per 1 million population. This rate was more than sixteen times greater than the reported rate for the nineteenth century, despite enormous progress in surgical treatment of war injuries and in the prevention and treatment of infectious diseases. In addition, since an increasing percentage of wars are civil wars or are indiscriminate in the use of weapons, civilians are increasingly caught in the crossfire. Civilian deaths as a percentage of all war-related deaths rose from 14 percent during World War I to 90 percent during some wars of the 1990s. Moreover, during civil wars civilians may find it difficult to receive medical care and may be unable to obtain adequate and safe food and water, shelter, medicinal care, and public health services. The physical, mental, and social impacts of war on civilians are especially severe for vulnerable populations, including women, children, the elderly, the ill, and the disabled. Further, war is responsible for many million refugees and internally displaced persons.


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