Introduction

War marks the experience of every generation to have lived in the twentieth century. Journalists, historians, and demographers have reported its direct effects on human populations, in terms of immediate death and suffering. Reliable estimates suggest that, in the twentieth century, approximately 170 million people lost their lives in all forms of war and politically imposed violence. Other estimates, based on higher casualty figures for episodes of political violence that have not been fully evaluated, would indicate that as many as 270 million people might have died in this same time period from the direct effects of war, political oppression, state-induced famine, and acts of state terror.

Until recently, despite robust precedents set by individual practitioners in the nineteenth century, the public health profession has viewed this tide of death with a silence that is strange, considering that its mission is to attend to issues of morbidity and mortality in populations. The first section of this essay looks briefly at the reasons why the profession has taken considerable time to acknowledge the acute war-caused burden of morbidity and mortality as a major public health concern. This section also addresses the particularly relevant public health-related challenges that have been raised by conflicts since the end of the Cold War.

The second section addresses the main topic of this essay: the indirect effects of war on human populations, mediated through its destruction of biological habitat. These indirect effects have received even less systematic attention from the public health community, evidenced at least in part by the fact that this study required amassing and sifting data from many disciplines.