title: The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan.
abstract: BACKGROUND
  There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict.
  
  
  METHODS
  A cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed.
  
  
  RESULTS
  The variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency.
  
  
  CONCLUSIONS
  This study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a conflict-affected population in Southern Sudan, and highlights the importance of addressing all these influences on overall health.
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1 H 9SH, UK. bayard.roberts@lshtm.ac.uk
authors.forename: Bayard
authors.initials: B
authors.lastname: Roberts
authors.forename: Eliaba Yona
authors.initials: EY
authors.lastname: Damundu
authors.forename: Olivia
authors.initials: O
authors.lastname: Lomoro
authors.forename: Egbert
authors.initials: E
authors.lastname: Sondorp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012923:Social Class; D013397:Sudan; D011795:Surveys and Questionnaires; D014857:Warfare; D014947:Wounds and Injuries; D055815:Young Adult
references.citation: Lancet Infect Dis. 2003 May;3(5):275-81
references.pmid: 12726975
references.citation: Soc Sci Med. 2008 Jul;67(2):205-17
references.pmid: 18423959
references.citation: BMC Psychiatry. 2004 Oct 25;4:34
references.pmid: 15504233
references.citation: BMC Public Health. 2006 Oct 30;6:268
references.pmid: 17074088
references.citation: JAMA. 2000 Aug 2;284(5):578-84
references.pmid: 10918703
references.citation: J Epidemiol Community Health. 2009 Mar;63(3):227-32
references.pmid: 19028730
references.citation: Afr Health Sci. 2004 Aug;4(2):83-93
references.pmid: 15477186
references.citation: Transcult Psychiatry. 2008 Dec;45(4):611-38
references.pmid: 19091728
references.citation: BMC Psychiatry. 2009 Mar 04;9:7
references.pmid: 19261192
references.citation: Confl Health. 2008 Oct 14;2:11
references.pmid: 18854027
references.citation: Breast Cancer Res Treat. 2006 Oct;99(3):341-50
references.pmid: 16685589
references.citation: Qual Life Res. 2007 Aug;16(6):915-27
references.pmid: 17440829
references.citation: JAMA. 2001 Aug 1;286(5):555-62
references.pmid: 11476657
references.citation: Int J Epidemiol. 1998 Jun;27(3):520-4
references.pmid: 9698146
references.citation: Qual Life Res. 2002 May;11(3):193-205
references.pmid: 12074258
references.citation: Bull World Health Organ. 1982;60(2):253-60
references.pmid: 6980735
references.citation: Health Qual Life Outcomes. 2008 Dec 02;6:108
references.pmid: 19055716
references.citation: Med Care. 1996 Mar;34(3):220-33
references.pmid: 8628042
references.citation: Clin Ther. 1996 Sep-Oct;18(5):979-92
references.pmid: 8930436
references.citation: Br J Psychiatry. 1998 Dec;173:482-8
references.pmid: 9926076
references.citation: Lancet. 2006 Sep 2;368(9538):829-30
references.pmid: 16958158
references.citation: Soc Sci Med. 1998 Jun;46(12):1569-85
references.pmid: 9672396
references.citation: Qual Life Res. 1999;8(1-2):101-10
references.pmid: 10457743
references.citation: JAMA. 2000 Aug 2;284(5):569-77
references.pmid: 10918702
references.citation: Public Health. 2007 Aug;121(8):588-95
references.pmid: 17475296
references.citation: BMJ. 2008 May 17;336(7653):1093
references.pmid: 18483041
references.citation: Qual Life Res. 2003 Dec;12(8):1003-12
references.pmid: 14651418
references.citation: JAMA. 2005 Aug 3;294(5):602-12
references.pmid: 16077055