Refugees and Health

A recent book, “War and the Health of Nations“,  by Zaryab Iqbal (Political Science, Penn State) takes a look at the associations between national health statistics and the presence and duration of war.

Chapter 8 explores the topic of forced migration and population health, though with a novel approach. Instead of exploring the ways that forced displacement by war is associated with health in refugees themselves, Iqbal looked at whether an influx of refugees affected overall health statistics in the host country. Utilizing aggregate health data from the World Bank and the number of refugees entering a state in a given year, she tested for associations between the two while accounting for multiple covariates (presence and duration of conflict, GDP, population size, openness to trade, and how democratic/autocratic a country is).

In multivariate models, she found that the number of refugees to enter a country had a negative impact on the host country in terms of its life expectancy and infant mortality rate (lagged 2 years from the time the refugees entered), while fertility rates increased. On page 145, she writes:

“the health effects of forced migration occur… in the state that they enter and, therefore, cause a dispersion of the negative consequences of war at the regional level.”

As Iqbal delineates throughout the rest of the book, it’s obviously also true that war impacts the health situation in the country of origin (I think this is particularly true for children). However, her contribution here – that the negative health effects of wars can spill across borders – is a welcome one, because it adds to the growing list of the deleterious impacts of armed conflict. Her take on the matter is the correct one: health is a global issue and it is in each nation’s interests to see that populations in neighboring states are healthy and stable. Here, she quotes Gro Harlem Bruntland, former Prime Minister of Norway and Director of the WHO, that “there are no impregnable walls between the world that is healthy, well-fed, and well-off, and another world that is sick, malnourished, and impoverished.”

It is somewhat worrisome that data such as these could further add to the mistreatment or rejection of refugees, who are often viewed as burdens by host nations. This has been the case recently among Tibetans entering Nepal , Burmese refugees in Bangladesh and Malaysia, and Laotian Hmong living in Thailand. But Iqbal is hopeful that nations will take full stock of the ways that war affects non-combatants before wars are initiated and refugees are displaced in the first place (p. 50-1):

“Assessing the health consequences of war deepens our comprehension of the costs of war… High costs of war in terms of human suffering would reduce the incentives for involvement in conflict and induce policy makers to pursue nonviolent means of conflict resolution.”

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