(originally published 11 October; updated 20 Oct because of new comments): 

Today’s (i.e., 11 October) big public health news report is the article by a Johns Hopkins University research team published in The Lancet on-line edition on the number of war-related casualties in Iraq. “We estimate”, the authors conclude, “that as of July, 2006, there have been 654 965 (392 979–942 636) excess Iraqi deaths as a consequence of the war, which corresponds to 2,5% of the population in the study area”.

As Lancet’s editor, Richard Horton, points out in a comment, “this study adds substantially to the new field of conflict epidemiology, which has been evolving rapidly in recent years”. Unsurprisingly, US President George W. Bush questions the findings: “I don’t consider it a credible report”, he told a White House press conference (according to today’s Guardian ).

The Lancet’s report underscores the importance of the complex relations between war and (lack of) health throughout history.

True, the war-medicine topic has been investigated by a numer of historians of medicine in recent years, e.g., in Roger Cooter, Mark Harrison and Steve Sturdy‘s collection War, Medicine and Modernity (1999), but nevertheless surprisingly few historians of 20th century medicine and public health have paid attention to the topic, despite the fact that it is probably among the most important global public health problems throughout the 20th century.

Today’s Lancet report emphasizes the importance of understanding the intertwining of global inequality, warfare and security with public health issues. Maybe this would be something for students at the School of Public Health and especially the Masters Program in International Health here in Copenhagen to pursue? There is much to do. For example, it would be quite interesting to know whether the changing global conflict pattern — from traditional regular inter-national warfare, to more diffuse, unorganised and distributed terrorist-ish war forms — also involves changes in the pattern of deteriorating health? Epidemiologists use to talk about the “epidemiological transition” — from (broadly speaking) infectious diseases to noncommunicable diseases, e.g. life-style diseases. Could one speak of another kind of epidemiological transition, from the effects of direct-contact warfare (wounds, shell-shock etc.) to the effects of large-scale destruction of the environment resulting in hunger, refugee problems, deteriorating sanitation, etc.?

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