{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:18:00Z","timestamp":1787019480162,"version":"build-2736575974"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Social Determinants of Health and Health Services"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Wars have multiple complex effects on population health. Countries suffer extensively from disruptions to their societies, economies, and environment. Understanding the pathways of disruption helps to adapt and mitigate the catastrophic effects of war. We used a previously published 12-dimensional framework on the health impacts of war to derive pathways of influence under three phases. The first phase, before overt aggression, includes economic sanctions, trade wars, and embargoes, often combined with covert military action and disrupted supply chains, infrastructure, and health services. The second phase of overt aggression has multiple direct and indirect effects on health: (\n                    <jats:italic toggle=\"yes\">a<\/jats:italic>\n                    ) morbidity and mortality; (\n                    <jats:italic toggle=\"yes\">b<\/jats:italic>\n                    ) population displacements with psychosocial implications; (\n                    <jats:italic toggle=\"yes\">c<\/jats:italic>\n                    ) opportunity costs from military expenditures often reversing economic growth and widening inequalities; (\n                    <jats:italic toggle=\"yes\">d<\/jats:italic>\n                    ) environmental degradation; (\n                    <jats:italic toggle=\"yes\">e<\/jats:italic>\n                    ) air and soil pollution from explosives; (\n                    <jats:italic toggle=\"yes\">f<\/jats:italic>\n                    ) destroyed infrastructure include housing, basic amenities, and health infrastructure; (\n                    <jats:italic toggle=\"yes\">g<\/jats:italic>\n                    ) destroyed arable land, deforestation, and loss of biodiversity; (\n                    <jats:italic toggle=\"yes\">h<\/jats:italic>\n                    ) and contamination of water sources. The third phase occurs during peace negotiations and when peace appears and consists of long-term effects. The latter includes transgenerational impacts on human well-being. Considering the wide health, social, and environmental implications of wars lasting for generations, we reiterate the call for an \u201cend to all wars.\u201d\n                  <\/jats:p>","DOI":"10.1177\/27551938261417282","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:00:07Z","timestamp":1770141607000},"page":"298-305","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["War as A Determinant of Population Health: A Systems Approach to Understand Pathways"],"prefix":"10.1177","volume":"56","author":[{"given":"Santhushya","family":"Fernando","sequence":"first","affiliation":[{"name":"Department of Medical Humanities, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeeka","family":"Chandraratne","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1460-6073","authenticated-orcid":false,"given":"Saroj","family":"Jayasinghe","sequence":"additional","affiliation":[{"name":"University of Colombo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"WHO. 2017. 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