{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:17:43Z","timestamp":1788524263274,"version":"build-2803163510"},"reference-count":35,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>This study sought to understand the manifestations of violence affecting Indigenous and Afro-descendant communities in the Nari\u00f1o Pacific region, Colombia, through the framework of the social determinants of health. A qualitative research design was implemented with 60 purposively selected participants, ensuring variation by ethnicity (49 Afro-descendant and 11 Indigenous), gender (34 women and 26 men), and role (institutional and community). All participants were adults affected by the armed conflict and registered in the National Victims Registry (RUV). Data were collected through in-depth interviews and the analysis of paradigmatic cases, complemented by field notes documenting contextual aspects of the data collection process. An inductive thematic analysis was conducted using the social determinants of health as the analytical framework. The findings reveal that violence affecting communities in the Nari\u00f1o Pacific region operates as a structural determinant of health, characterized by systemic, symbolic, and historical configurations embedded within multiple social determinants (sociocultural, economic, political, environmental, and health service-related). These dynamics are reinforced by persistent symbols of domination, structural institutional crises, restricted access to fundamental rights, mistrust in the State, corruption, and the territorial control exercised by armed groups in these collective ethnic territories.<\/jats:p>","DOI":"10.1590\/0102-311xen084925","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:50:39Z","timestamp":1788522639000},"source":"Crossref","is-referenced-by-count":0,"title":["Understanding violence as a health determinant among ethnic communities in Colombia\u2019s Pacific region: a qualitative analysis"],"prefix":"10.1590","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1681-3500","authenticated-orcid":false,"given":"Anderson","family":"Rocha-Buelvas","sequence":"first","affiliation":[{"name":"Universidad de Nari\u00f1o,  Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7143-4340","authenticated-orcid":false,"given":"Ana Paola","family":"Mogoll\u00f3n-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Universidad de Nari\u00f1o,  Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"Pathologies of power: health, human rights, and the new war on the poor","author":"Farmer P","year":"2003"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/002234336900600301","article-title":"Violence, peace, and peace research","volume":"6","author":"Galtung J","year":"1969","journal-title":"J Peace Res"},{"key":"ref3","first-page":"2324","article-title":"What is a social determinant of health Back to basics","volume":"10","author":"Hahn RA","year":"2021","journal-title":"J Public Health 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conflict in Colombia consequences on health and the protection of medical missions","volume":"18","author":"Bernal O","year":"2024","journal-title":"Confl Health"},{"key":"ref13","series-title":"La situaci\u00f3n humanitaria en Colombia ha seguido deterior\u00e1ndose en 2024."},{"key":"ref14","author":"Salas Salazar LG"},{"issue":"43","key":"ref15","doi-asserted-by":"crossref","first-page":"13","DOI":"10.30578\/nomadas.n43a1","article-title":"Abyecciones violencia y capitalismo en el siglo XXI","author":"Incl\u00e1n D","year":"2015","journal-title":"N\u00f3madas"},{"key":"ref16","series-title":"Cifras de v\u00edctimas del conflicto armado en Colombia."},{"key":"ref17","series-title":"Global Humanitarian Access Overview."},{"key":"ref18","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun V","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref19","series-title":"The coding manual for qualitative researchers.","author":"Salda\u00f1a J","year":"2016","edition":"3rd"},{"key":"ref20","series-title":"Por los rincones: antolog\u00eda de m\u00e9todos cualitativos en la investigaci\u00f3n social","first-page":"113","volume-title":"Paradigmas en competencia en la investigaci\u00f3n cualitativa","author":"Guba E","year":"2000"},{"key":"ref21","series-title":"Informe de la 62\u00aa Asamblea Mundial de la Salud: A62\/9."},{"key":"ref22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13033-024-00626-w","article-title":"Mapping mental health care services for children and youth population in Colombia's Pacific potential for boundary spanning between community and formal services","volume":"18","author":"Weber S","year":"2024","journal-title":"Int J Ment Health Syst"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s12913-024-10602-2","article-title":"Macro-level system mapping of the provision of mental health services to young people living in a conflict context in Colombia","volume":"24","author":"Fenton S-J","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"ref24","series-title":"Formations of violence: the narrative of the body and political terror in Northern Ireland","author":"Feldman A","year":"1991"},{"key":"ref25","series-title":"Violence in war and peace: an anthology","first-page":"275","volume-title":"Symbolic violence","author":"Bourdieu P","year":"2007"},{"key":"ref26","series-title":"Dangerous citizens: the Greek left and the terror of the state","author":"Panourgi\u00e1 N","year":"2009"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/j.1467-8624.2008.01165.x","article-title":"Moral development in a violent society Colombian children&apos;s judgments in the context of survival and revenge","volume":"79","author":"Posada R","year":"2008","journal-title":"Child Dev"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/eip.12453","article-title":"What impact does trauma have on the at-risk mental state A systematic literature review","volume":"12","author":"Brew B","year":"2018","journal-title":"Early Interv Psychiatry"},{"key":"ref29","series-title":"Outline of a theory of practice","author":"Bourdieu P","year":"1977"},{"key":"ref30","series-title":"The devil and commodity fetishism in South America","author":"Taussig M","year":"1980"},{"key":"ref31","series-title":"Epidemiology and the people's health: theory and context","author":"Krieger N","year":"2011"},{"key":"ref32","article-title":"Necesidades y recursos comunitarios para la salud rural Estudio cualitativo descriptivo en dos municipios del posconflicto armado colombiano","volume":"99","author":"Correal-Mu\u00f1oz CA","year":"2025","journal-title":"Rev Esp Salud P\u00fablica"},{"key":"ref33","series-title":"Inequalities in mental health in conflict-affected territories of Colombia: a multidimensional approach before and during the COVID-19 pandemic","author":"Le\u00f3n S","year":"2021"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13031-024-00582-9","article-title":"Impacts of attacks to female health care workers in three territories of Colombia","volume":"18","author":"Echeverry-L\u00f3pez ME","year":"2024","journal-title":"Confl Health"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.20453\/rnp.v81i1.3267","article-title":"Violencia una prioridad de la salud p\u00fablica","volume":"81","author":"Sarabia S","year":"2018","journal-title":"Rev Neuropsiquiatr"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":["Entendendo a viol\u00eancia como determinante de sa\u00fade entre comunidades \u00e9tnicas na regi\u00e3o do Pac\u00edfico da Col\u00f4mbia: uma an\u00e1lise qualitativa"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-311X2026000105089&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:50:44Z","timestamp":1788522644000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2026000105089&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":35,"alternative-id":["S0102-311X2026000105089"],"URL":"https:\/\/doi.org\/10.1590\/0102-311xen084925","relation":{},"ISSN":["1678-4464","0102-311X"],"issn-type":[{"value":"1678-4464","type":"electronic"},{"value":"0102-311X","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e00084925"}}