The Impact of War on Public Health

The distance between Texas and Ukraine, at nearly 6,000 miles, seems vast. Despite the distance, communities here, and elsewhere across the globe, have experienced the reverberating effects of the Russian invasion of that country. The American Psychological Association reports that 80% of Americans find the Russian invasion of Ukraine to be a significant source of stress. Stress factors that coattail the economic impacts of the war showcase just the outermost layers of war's impact on public health.

But what about other, long term health consequences that may develop from war - combat stress, home invasion and displacement, economic instability, and substantial fractures of daily existence? The psychological effects, physical distress, social tolls, and economic impacts are just some of the many layers that war, regardless of location, impacts to the health of communities in both the immediate future and long term are significant. 

“It’s overwhelming when you start to think about it,” said Paula Cuccaro, PhD, assistant professor of health promotion and behavioral sciences at UTHealth School of Public Health. “There are systems in place to support communities, and when a city is invaded, every one of those resources is disrupted.” A research psychologist, Cuccaro’s research efforts focus on improving health outcomes for vulnerable youth, and she has extensive experience in trauma recovery and care. “There are individuals that will suffer from these attacks, and much of that is due in part to the disruption of the systems set in place to support the communities,” she said.

The conflict will impact a number of different groups across the region, including in Russia and the countries hosting refugees, but, of course its most direct and lasting impact will be to the Ukrainian people themselves, who amid the widespread destruction of cities and mass displacement of people, “will experience a delay in standard medical care, but also a disruption to basic health support infrastructure such as sanitation, water treatment, and access to food sources,” said Cuccaro. 

As of March 20, 2022, over 10 million Ukrainian citizens are displaced from their homes, and 3.5 million have left the country seeking refuge outside of the country. “Countries absorbing Ukrainian refugees will face the challenge of accommodating the influx of people, and providing care and treatment,” said Jack Tsai, PhD, Campus Dean of the UTHealth School of Public Health San Antonio Campus. Tsai has spent his academic and research career studying topics related to homelessness, severe mental illness, trauma, and health disparities. 

As the term ‘World War III’ is periodically referenced, many Americans consider what this may mean for their local communities and families. “There are serious implications and downstream effects,” said Tsai. “Families in the U.S. are experiencing an increased level of stress due to the economic fluctuations from international trade agreements, but it is also worrisome to be a bystander while mass murder occurs.” Recent news and media coverage has brought the war to the top of mind for viewers, exposing many to a constant stream of disheartening global updates as it relates to the war. “Our access to information through social media can increase these levels of concerns we have for those abroad and how it will impact us locally,” said Tsai. He referenced a recent figure reporting that 84% of U.S. adults agreed the Russian invasion of Ukraine has been terrifying to watch (APA, 2022). “This is also just added stress on top of the recovery from the COVID-19 pandemic.”  

Research initiated to analyze the COVID-19 media coverage proved that over-exposure to media during a crisis is directly-linked with worse mental and physical health down the line (Health Psychology, 2020).

Less than a century after World War II, US military veterans are still learning to manage the impacts of global devastation. “The U.S. Department of Veterans Affairs has issued several statements to address coping strategies, tools, and resources former military members can utilize if feeling triggered by the recent invasion,” said Tsai who has counseled veterans with posttraumatic stress disorder for years. Infrastructure designed to support healthcare needs, including direct diagnosis and treatment facilities, as well as non-care needs such as the water systems, and food sources are skewed. 

Tsai also points to the potential for mistreatment of locals of Russian-descent. “There are elements of prejudice, or ‘anti-Russian rhetoric’, that could lead to an increase of violence towards those with Russian-ties or background.”

The current crisis in Ukraine continues to cause severe trauma for citizens, while also creating ripple effects heard and felt around the world. Despite the distance of 6,000 miles, the support for the Ukrainian citizens remains steadfast within the state of Texas. “There are elements of shame that may come with needing to rely on others,” said Cuccaro, referring to the loss of independence after fleeing a home country. Initiatives such as the Ukrainian march protesting the invasion, humanitarian aid to support the refugees and those displaced, as well as grace for Russian citizens can all contribute to the efforts of coexisting and encouraging peace.