Abstract
Armed conflict, displacement, and related violence is escalating globally, concentrated among civilians and migrants in border areas, and poses grave harms to women and children. The current study investigates how women's life-course experiences of conflict and displacement are linked to maternal stress and health outcomes after childbirth at the Thailand-Myanmar border, specifically stress, mental health, and cardiometabolic outcomes. Analyses are based on a cross-sectional population-based maternal and child health survey of 701 mothers, collected in 2017–18 in northern Thailand along the Myanmar border, including in camps, worksites, and residential homes. Results suggest that how conflict violence shapes contemporary stress and health depends on the outcome, level and timing of conflict violence exposure, and subsequent contextual threats and deprivation in displacement contexts. Past conflict violence was associated with symptoms of perceived stress (PS) and generalized anxiety disorder (GAD) but not depression. It was also associated with hypothalamic-pituitary-adrenal (HPA) axis activity (hair cortisol concentration) and adiposity (waist circumference and waist-to-hip ratio). Additionally, past conflict violence that began in childhood was particularly salient for PS, GAD, and adiposity; and level and timing of violence were salient jointly for HPA activity. Post-displacement factors also independently predicted higher blood pressure and played a potentially partial mediating role in the association between conflict exposure and both PS and GAD symptoms.
Original language | English (US) |
---|---|
Article number | 107189 |
Journal | Psychoneuroendocrinology |
Volume | 171 |
DOIs | |
State | Published - Jan 2025 |
Funding
This research was supported by grants awarded to the Center for Demography and Ecology by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C HD047873), to the Center for Demography of Health and Aging by the National Institute on Aging (P30 AG17266, T32 AG00129), and to the Wisconsin National Primate Research Center by the National Institutes of Health Office of the Director (P51OD011106) at the University of Wisconsin (UW) - Madison. SMK was further supported by an individual fellowship through the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F32HD102152), and additional support from the UW Global Health Institute, Scott Kloeck-Jenson Fellowship, Mustard Seed Foundation, and the University of Michigan Center for Global Health Equity. The content is solely the responsibility of the authors and does not necessarily represent the official views of any funding institutions. This research was supported by grants awarded to the Center for Demography and Ecology by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C HD047873) and to the Center for Demography of Health and Aging by the National Institute on Aging (P30 AG17266, T32 AG00129) at the University of Wisconsin (UW) - Madison. SMK was further supported by an individual fellowship through the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F32HD102152), and additional support from the UW Global Health Institute, Scott Kloeck-Jenson Fellowship, Mustard Seed Foundation, and the University of Michigan Center for Global Health Equity. The content is solely the responsibility of the authors and does not necessarily represent the official views of any funding institutions. The authors gratefully acknowledge the outstanding assistance from the study team in Thailand, including Air Chaiwong, Collin Lash, Emily Kowey, Felicia Wolf, Gwen McGaw, Hseng Hearn Nyawn, Jai Sway, Jai Mong, Jessica Chung, Kelly Baglia, Kham Awn Lungjam, Kham Hom, Kham Jing, Kham Mart Mahad, Khamlu Lungsu, Khamtu Lunghu, Hseng Jing Lungtoon, Khur Lern, Lu Lungsaw, Meagan Jackson, Mo Ngin Hom Khampang, Mon Lungmon, Mwe Awn Mahad, Mwe Hseng, Myo Aung, Myura Pumpwong, Saimu Muling, Seelon Salaween, Suoy Eing Khamhai, Sway Meuya Mandta, and Yong Lung Pang. Additionally, the authors acknowledge the outstanding assistance from study team members in the United States, including Adara Vannarath, Alex Charland, Ailish Burns, Chelsea Sheridan, Clare Roberts, Jagkrapan Janchatree, Kathryn Giguere, Kayla Pfeiffer-Mundt, Krista Brown, Mehak Qureshi, Mehreen Buksh, Taewee Khars, and Yeseul Kim. The Ministry of Public Health in Chiang Mai Province, Fortune Foundation, and Shan Women\u2019s Action Network were instrumental in facilitating data collection. Furthermore, the author acknowledges the invaluable consultation and support on the original survey design offered by Alberto Palloni, Amanda Flaim, Ana Martinez-Donate, Deborah Ehrenthal, Jenna Nobles, and Mari Palta. This research was supported by grants awarded to the Center for Demography and Ecology by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C HD047873) and to the Center for Demography of Health and Aging by the National Institute on Aging (P30 AG17266, T32 AG00129) at the University of Wisconsin (UW) - Madison. The lead author was further supported by an individual fellowship through the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F32HD102152). Additional support was awarded to the lead author by the UW Global Health Institute, Scott Kloeck-Jenson Fellowship, Mustard Seed Foundation, and the University of Michigan Center for Global Health Equity. The content is solely the responsibility of the authors and does not necessarily represent the views of the individuals or funding institutions listed.
Keywords
- Conflict
- Displacement
- Life course health
- Maternal health
- Stress
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
- Endocrine and Autonomic Systems
- Psychiatry and Mental health
- Biological Psychiatry