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War and Public Health

By Barry S. Levy, MD and Victor W. Sidel, MD

Reviewed by Conn Hallinan

Back in the 60s peace activists sported a bumper sticker that read: “War is not good for children and other living creatures.” In a way, that sums up Barry S. Levy and Victor W. Sidel’s “War and Public Health,” where 46 experts on everything from epidemiology to international law weigh in on the authors’ central premise: “War and militarism have catastrophic effects on human health and well being.”

Levy and Sidel, both former presidents of the American Public Health Association, as well as distinguished researchers and practitioners in their fields, make the point that, in the end, wars always come home. The most obvious casualties are the young men and women shattered in body and mind by the cauldron of battle itself, but the devastation includes the terrible things that organized violence inflicts on the population and infrastructure where those wars are fought.

But the authors see the shock and awe of battle as only the beginning of the damage war inflicts. War means that nations divert their resources from things like education and health to smart bombs and high tech drones. It means choosing mayhem over economic development, exposing the most vulnerable in our society to disease and privation, and the systematic destruction of the environment. “War threatens much of the fabric of our civilization,” write Levy and Sidel.

Thinking of war as a public health issue allows the authors to break the subject into digestible pieces: consequences, types of weapons, vulnerable populations, specific wars, and prevention. Each major section is divided into chapters, spanning everything from “The Epidemiology of War” to “The Role of Health Professionals in Postconflict Situations.”

According to a recent estimate by sociologist Chalmers Johnson, if all U.S. military-related spending were added together it would come to about $1 trillion a year. Nobel Laureate economist Joseph Stiglitz concludes that the lifetime costs of treating veterans of Afghanistan and Iraq will top $3 trillion. At the same time, according to the U.S. Census, 50.7 million people in the U.S. are currently without health care.

These are the kinds of tradeoffs the authors and contributors to “War and Public Health” find unacceptable.

The book is more than an expose, however. Levy and Sidel argue that public health officials should be involved in preventing war, just as they would throw themselves into stopping an epidemic.

And in case the reader is not sure how to go about doing this, the book includes an appendix with the names, addresses, phone numbers and emails of virtually every international organization concerned with war and peace.

“War is hell,” said Union General William Tecumseh Sherman, and so it is. But the authors of this well-written and accessible book argue that wars are not inevitable, and that time and again human beings have demonstrated a capacity to avoid them. On one hand, “War and Public Health” is an important and valuable effort to expose the consequences of war. On the other, a practical guide to creating a world where health is a human right and war is an anachronism.

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