Abstract

Introduction: Non-communicable diseases (NCDs) are a leading cause of mortality globally. Armed conflict is increasing globally and impacting health of affected populations including NCD outcomes. This study examined the association between conflict intensity and mortality from cardiovascular disease, diabetes, chronic respiratory disease, and neoplasms in Afghanistan, Iraq, Syria, and Yemen between 2000 and 2023.

Methods: A longitudinal ecological panel study design was used. Multivariable panel regression analysis was conducted using three models: panel regression model, lagged effect model and country year fixed effects model.

Results: In the panel regression model, conflict intensity was positively associated with mortality from diabetes mellitus (β = 2.614, 95% CI: 1.373, 3.858, p < 0.001) and neoplasm (β = 1.997, 95% CI: 1.283, 2.71, p < 0.001). In the one-year lag model, conflict intensity was positively associated with mortality from cardiovascular disease (β = 9.641, 95% CI: 0.266, 19.015, p < 0.05), diabetes mellitus(β = 2.280, 95% CI: 1.493, 4.268, p < 0.001), and neoplasm (β = 1.626, 95% CI: 0.786, 2.467, p<0.001). In the fixed effects model, conflict intensity was positively associated with mortality from cardiovascular disease (β = 4.455, 95% CI: 1.013, 7.896, p < 0.05), diabetes mellitus (β = 0.531, 95% CI: 0.163, 0.899, p < 0.05), and neoplasm (β = 1.578, 95% CI: 1.164, 1.993, p < 0.001).No significant association was found for chronic respiratory disease mortality across all the three models.

Conclusion: Conflict intensity was associated with increased mortality from NCDs.