Abstract
BackgroundThe present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia’s Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions (‘SRQ-20’), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences in mental health inequalities over time.MethodsOur study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and changes in inequalities in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities.ResultsMental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years.ConclusionsThe reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context.
Highlights
The present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia’s Peace Agreement in 2016 with the FARC guerrilla group
We can draw comparisons with the results found by Cuartas et al [8] as their study uses concentration indices for quantifying mental health inequalities related to conflict in Colombia, at a country level, for 2015
Cuartas et al [8] estimate a mental health concentration index of − 0.12, showing that mental health disorders are unevenly distributed in Colombia in the overall population, being less pronounced in comparison to Meta in 2014 where these inequalities are much more significant (− 0.189). These results show that mental health inequalities may be more critical in regions in Colombia where conflict has been more rampant and severe across time – territories that usually are characterized by higher socioeconomic inequalities
Summary
After 4 years of peace negotiations, Colombia’s government, and Fuerzas Armadas Revolucionarias de Colombia (FARC-EP), one of the most significant and influential guerilla groups in Colombia’s armed conflict, signed a peace agreement on November 24, 2016, entitled General Agreement for the End of the Conflict and the Construction of a Stable and Durable Peace. This agreement led to the demobilization of the FARC group and its incorporation as a political party in Colombia. Even though the peace process contributed to the de-escalation of direct conflict violence in Colombia, less is known about its short-run impacts on conflict-affected territories; in particular, the mental well-being of people historically affected by the armed struggle has not been sufficiently explored
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
