One of the strengths of a biocultural perspective in anthropology is its broad approach to understanding human biology and health (Wiley and Allen 2008). Such a framework seems particularly appropriate when looking at the fascinating phenomenon of SUDS (Sudden Unexplained Death During Sleep). Though SUDS first appeared in the medical literature 1917 in the Philippines, where it is referred to as ‘bangungut’ (Guazon 1917), it was largely forgotten until the late 1970s when it regained notoriety as an important cause of mortality among Southeast Asian refugees in the United States, particularly among young men (Baron et al 1983).
On the surface, it may not be so clear where war, health, and evolution intersect. From the perspective of biological anthropology, many have called for a holistic, transdisciplinary approach to human biology and health which considers the environment as the totality of its evolutionary, ecological, and social components, including social inequality (Little and Haas 1989; Thomas et al. 1989; Wiley 2004).
More than a decade ago, Leatherman and Goodman (1998) suggested that biological anthropologists put more effort toward better understanding what they termed the ‘biology of poverty.’ In this sense, poverty is an ‘environment’ that may induce consistent, but obviously varying, biological responses depending upon local circumstances. Similarly, war can be conceived as a biological environment. At least in the short term from an evolutionary point of view, wartime conditions may be as biologically challenging as some of the classic ecologically extreme environments faced by humans (circumpolar, tropical, high-altitude, desert, etc.) (Clarkin 2010).
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).
At the population level, childhood growth is often seen as a marker of health and the quality of the environment. When populations get taller in a few generations, this is likely due to some improvement in local conditions (better nutrition, less infection, cleaner water supply, etc.). Conversely, when linear growth declines, it is usually because local conditions (ecological, economic, political) have deteriorated. Two recent working papers illustrate how this pattern applies to war conditions.
I’ll be in Seattle April 22-25 at a conference on War and Global Health at the University of Washington.
My session is Saturday, April 24 at 11AM (War and Children). I’m really looking forward to it.
A recent study on child obesity by researchers at Harvard has received a good deal of media attention lately. In the NY Times, a synopsis of the study was one of the most emailed articles in the country (“Baby Fat May Not Be So Cute After All,” March 22). The key sentence from that article:
“More and more evidence points to pivotal events very early in life — during the toddler years, infancy and even before birth, in the womb — that can set young children on an obesity trajectory that is hard to alter by the time they’re in kindergarten.”
The Lao National Regulatory Authority (LNRA) recently released an impressive, 106-page report on the victims of unexploded ordnance (UXO) over the last few decades. The authors, Mike Boddington and Bountao Chanthavongsa, and all of the associated researchers should be commended for this invaluable contribution, which documents in a systematic fashion the damage done by the war. Researchers covered more than 9,000 villages in Laos (95%), collecting retrospective data from interviews with residents about injuries or deaths caused by mines, large bombs, mortars, bombies, etc. from 1964 to 2008. In all, the report found that more than 50,000 people were injured or killed by UXO in Laos, though the authors acknowledge that this is likely an underestimate, perhaps by as much as 20%. Results revealed that Savannakhet and Xieng Khouang provinces were the two most affected in terms of the number of casualties, which makes sense, given their strategic and geographic importance in the southern and northern parts of the country, respectively.