A team of researchers at the NYU Abu Dhabi (NYUAD) Social Science Division and Oxford University have published a new study that explores the extent that violence in a country affects uncertainty of the age at death, also referred to as lifetime uncertainty, a key – yet often underappreciated – public health indicator. After hypothesizing that violence is a key predictor of lifetime uncertainty cross-nationally, the researchers found cross-national evidence of a direct link between living in a violent setting and both a shorter and less predictable lifespan.

Uncertainty about the future, specifically uncertainty about survival, influences human behavior and practical life-course decision making, from choices about investing in education, following healthy living habits, and even whether or not to have children. At the population level, lifetime uncertainty can be measured as the spread, or inequality, in age at death. In the study titled A global assessment of the impact of violence on lifetime uncertainty published in the journal Science Advances, the researchers analyzed mortality data for 162 countries between 2008-2017 from the Global Burden of Disease Study and the Internal Peace Index. The researchers found that the most violent countries are those with the lowest life expectancy – with an estimated gap of approximately 14 years in remaining life expectancy with peaceful settings – and the highest lifetime uncertainty. Violence was shown to be a key predictor of lifetime uncertainty cross-nationally, a relationship that was especially strong in countries with ongoing conflicts and/or high levels of violence.

In the Middle East, the researchers found that conflict-related deaths at young ages are the largest contributor to lifetime uncertainty. In Latin America, a similar pattern can be attributed to high rates of homicide and interpersonal violence. Gender is also a factor. Although the effects are larger in magnitude for men, the consequences remain considerable for adolescent girls and women in their early reproductive years. It was also found that in contexts of high violence, lifetime uncertainty is linked to high premature mortality, and such early deaths are the driving factor behind the gap with peaceful nations.

An empirical link between prevailing levels of violence and lifetime uncertainty has not yet been comprehensively established worldwide. As exposure to violence entails a fundamental state of vulnerability with significant social and psychological implications, such as the increased risk of depression, alcohol abuse, suicidal behavior, and posttraumatic stress disorder, understanding the long-term impacts is critical.

“Our study has shown that the impact of violence on mortality goes beyond cutting lives short,” said Orsola Torrisi, a Post-doctoral Associate at the NYUAD Social Science Division. “To live in a violent country is to experience a double burden: lives are both shorter and less predictable. In turn, higher levels of uncertainty make individuals more likely to engage in violent behavior, creating a vicious cycle that is difficult to break.  The magnitude of lifetime uncertainty attributed to violence – even as other historical causes like disease continue to decline – highlights that it is a significant, but largely unaddressed, public health crisis in many parts of the world.”