International Journal of Public Health

, Volume 64, Issue 5, pp 703–711 | Cite as

The invisible wounds of five decades of armed conflict: inequalities in mental health and their determinants in Colombia

  • Jorge Cuartas Ricaurte
  • Laura Liévano Karim
  • María Alejandra Martínez Botero
  • Philipp HesselEmail author
Original article



We analyzed the relation between exposure to the armed conflict and violence with mental health disorders in Colombia and assessed the extent and determinants of socioeconomic inequalities in mental health related to differential exposure to the conflict and violence.


Regression and decomposition analyses were used in combination with the 2015 nationally representative Mental Health Survey (N = 10,853). Mental health disorders were assessed using the Self-Reporting Questionnaire (SRQ 20), and socioeconomic status by a Multidimensional Poverty Index.


3% of adults have been victim of a violent crime and 13% victim of the armed conflict. Victims of the armed conflict have 1.74 times higher odds (p < .05) of suffering mental health disorders compared to non-victims. Differential exposure to the armed conflict among lower socioeconomic groups explains 86% of total inequality in mental health disorders.


Interventions that increase quality and access of mental health treatments among victims of the conflict will not only lead to improvements in mental health among victims but also significantly reduce inequalities in mental health in Colombia.


Colombia Conflict Inequality Mental health Violence 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Jorge Cuartas Ricaurte
    • 1
  • Laura Liévano Karim
    • 2
  • María Alejandra Martínez Botero
    • 3
  • Philipp Hessel
    • 2
    Email author
  1. 1.Graduate School of EducationHarvard UniversityCambridgeUSA
  2. 2.Alberto Lleras Camargo School of GovernmentUniversity of the AndesBogotáColombia
  3. 3.Department of EconomicsUniversity of the AndesBogotáColombia

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