摘要：In 2009 the American Public Health Association approved the policy statement, “The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.” Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health’s ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association’s Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy. In 2009 the American Public Health Association (APHA) approved the policy statement, “The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.” 1 Although the APHA has previously taken positions on specific wars and militarism, this policy was the most comprehensive and proactive and it specified roles for health professionals in preventing war. The policy described public health activities for secondary and tertiary prevention of the effects of war but emphasized a role for public health in primary prevention. The policy recommended that public health students be trained to employ skills such as political negotiation and communication to address the “structural” causes of war, and challenged schools of public health to develop curricula on war and peace using a public health framework. In response to the APHA policy, 1 in 2011, a working group on Teaching the Primary Prevention of War, which included the authors of this article, grew out of the Peace Caucus, an affiliated unit of the APHA. The group’s goal is to promote a multidimensional social determinants prevention framework in public health curricular offerings on war and health. The objectives of this article are to review the importance of war and conflict to public health; to point out the importance of the social determinants of war, with a particular emphasis on militarism; and to further the implementation of the 2009 APHA policy 1 by proposing public health competencies and suggesting curricular resources to address the prevention of war. The wide range of topics presented here serves as an introduction for public health professionals unfamiliar with war as a public health issue and to provide historical, ethical, and theoretical frameworks and competencies to substantiate a public health role in preventing war. Although we acknowledge that there are various causes of war, we focus on the role of militarism and its pervasive influence on US public policy as a subject that has been outside the determinants studied in most schools of public health. 2 Our analysis of multiple aspects of militarism points out not only the pervasive influence of this important social determinant of war, but also illustrates the type of analysis of the fundamental causes necessary for public health to actively engage in prevention. We use the term “prevention” to reflect the descriptions of “primary prevention” in the APHA policy. 1 Although war is a global public health issue, this article focuses on the United States, in part because of the extent of the global role and influence of the United States in war. Similar analyses for other countries would be appropriate.
