An official website of the United States government
The Russian invasion of Ukraine on February 24, 2022, has displaced more than a quarter of the population. Assessing disease burdens among displaced people is instrumental in informing global public health and humanitarian aid efforts. We estimated the disease burden in Ukrainians displaced both within Ukraine and to other countries by combining a spatiotemporal model of forcible displacement with age- and gender-specific estimates of cardiovascular disease (CVD), diabetes, cancer, HIV, and tuberculosis (TB) in each of Ukraine’s 629 raions (i.e., districts). Among displaced Ukrainians as of May 13, we estimated that more than 2.63 million have CVDs, at least 615,000 have diabetes, and over 98,500 have cancer. In addition, more than 86,000 forcibly displaced individuals are living with HIV, and approximately 13,500 have TB. We estimated that the disease prevalence among refugees was lower than the national disease prevalence before the invasion. Accounting for internal displacement and healthcare facilities impacted by the conflict, we estimated that the number of people per hospital has increased by more than two-fold in some areas. As regional healthcare systems come under increasing strain, these estimates can inform the allocation of critical resources under shifting disease burdens.
more »
« less
Mobile phone data reveal the effects of violence on internal displacement in Afghanistan
Abstract Nearly 50 million people globally have been internally displaced due to conflict, persecution and human rights violations. However, the study of internally displaced persons—and the design of policies to assist them—is complicated by the fact that these people are often underrepresented in surveys and official statistics. We develop an approach to measure the impact of violence on internal displacement using anonymized high-frequency mobile phone data. We use this approach to quantify the short- and long-term impacts of violence on internal displacement in Afghanistan, a country that has experienced decades of conflict. Our results highlight how displacement depends on the nature of violence. High-casualty events, and violence involving the Islamic State, cause the most displacement. Provincial capitals act as magnets for people fleeing violence in outlying areas. Our work illustrates the potential for non-traditional data sources to facilitate research and policymaking in conflict settings.
more »
« less
- Award ID(s):
- 1942702
- PAR ID:
- 10367799
- Publisher / Repository:
- Nature Publishing Group
- Date Published:
- Journal Name:
- Nature Human Behaviour
- Volume:
- 6
- Issue:
- 5
- ISSN:
- 2397-3374
- Page Range / eLocation ID:
- p. 624-634
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
The Russian invasion of Ukraine on February 24, 2022, has displaced more than a quarter of the population. Assessing disease burdens among displaced people is instrumental in informing global public health and humanitarian aid efforts. We estimated the disease burden in Ukrainians displaced both within Ukraine and to other countries by combining a spatiotemporal model of forcible displacement with age- and gender-specific estimates of cardiovascular disease (CVD), diabetes, cancer, HIV, and tuberculosis (TB) in each of Ukraine's 629 raions (i.e., districts). Among displaced Ukrainians as of May 13, we estimated that more than 2.63 million have CVDs, at least 615,000 have diabetes, and over 98,500 have cancer. In addition, more than 86,000 forcibly displaced individuals are living with HIV, and approximately 13,500 have TB. We estimated that the disease prevalence among refugees was lower than the national disease prevalence before the invasion. Accounting for internal displacement and healthcare facilities impacted by the conflict, we estimated that the number of people per hospital has increased by more than two-fold in some areas. As regional healthcare systems come under increasing strain, these estimates can inform the allocation of critical resources under shifting disease burdens.more » « less
-
Abstract Spatial interdependencies commonly drive the spread of violence in civil conflict. To address such interdependence, scholars often use spatial lags to model the diffusion of violence, but this requires an explicit operationalization of the connectivity matrices that represent the spread of conflict. Unfortunately, in many cases, there are multiple competing processes that facilitate the spread of violence making it difficult to identify the true data-generating process. We show how a network-driven methodology can allow us to account for the spread of violence, even in the cases where we cannot directly measure the factors that drive diffusion. To do so, we estimate a latent connectivity matrix that captures a variety of possible diffusion patterns. We use this procedure to study intrastate conflict in eight conflict-prone countries and show how our framework enables substantially better predictive performance than canonical spatial-lag measures. We also investigate the circumstances under which canonical spatial lags suffice and those under which a latent network approach is beneficial.more » « less
-
Satoskar, Abhay R (Ed.)BackgroundCutaneous and mucocutaneous leishmaniasis (CL/ML) cause significant morbidity globally and are vulnerable to changes from environmental events and conflict. In this ecological study, we aim to measure the associations between annual CL/ML cases, conflict intensity, and environmental factors between 2005 and 2022 globally. MethodsWe pulled annual case data from the WHO for 52 nations that had conflict intensity scores (ranging from 1–10) from the Bertelsmann Transformation Index. Using Earth observation tools, we gathered temperature, precipitation, vegetation, and humidity data, in addition to data on annual estimates of population, internal displacement, and GDP. We fit a negative binomial generalized additive model with a random nation-level intercept. ResultsConflict was positively associated with increased CL/ML across the studied nations (IRR: 1.09, 95% CI: 1.01–1.16, p = 0.02). Given this, intense conflict (a score of ten) was associated with over double the risk of CL/ML compared to the lowest conflict levels (score of one). We also identified a curvilinear relationship between mean temperature and cases, as well as between vegetation level and cases. Each had small pockets of significant increased and decreased risk, respectively. Larger mean humidity ranges were negatively associated with cases. Importantly, the relationship between conflict intensity and cases was mediated by displacement. DiscussionConflict is significantly associated with increased CL/ML cases. This is especially true at higher conflict levels, marking when conflict turns violent. The destruction of critical infrastructure (e.g., that related to healthcare, water, and sanitation) often seen during conflict could drive this association. Such environments can be hospitable to sandflies and can heighten individuals’ vulnerability through increased malnutrition, poverty, and displacement. Understanding this relationship is crucial for public health preparedness and response, especially as conflicts become increasingly violent and protracted.more » « less
-
Abstract Schools are often encouraged to foster a positive climate to reduce adolescent violence, but evidence on the effectiveness of this approach varies significantly. This study investigates the roots of this variation by testing alternative hypotheses about how positive school-level climate and school-level student friendship network density interact to shape adolescent violence perpetration. Research on informal social control and network closure suggests that the violence-reducing association of positive school climate will be enhanced among schools where students are more densely tied through their friendships. Research on youth conflict and subversion of control suggests the opposite. These hypotheses are tested with data from Waves I-II of the National Longitudinal Study of Adolescent to Adult Health (n = 11,771; 49% Female; Age mean = 15.04, SD = 1.60). Consistent with the conflict/subversion hypothesis, analyses indicate that the inverse association between positive school climate and adolescent violence is only evident among schools with a very low density of friendship ties. Strikingly, however, there is evidence that a more positive school climate is associated with increases in violence among youth attending schools with a high density of friendship ties. These findings suggest that efforts to reduce violence by fostering cohesion among youth in their schools and other social contexts can be undermined by youth network processes.more » « less
