Displacement and self-rated health in Colombia: The moderating effect of civic participation

Colombia has one of the highest rates worldwide of displaced populations due to political violence. The aim of this presentation is to examine the potential beneficial effect of civic participation on self-rated health among displaced population. We used information from a nationally representative survey conducted in 2011 (n=3,027). Around one out of six participants (16.6%) reported that a member of their families has ever been forced to abandon their hometowns due to political violence. Relative to Colombians without lifetime family-exposure of displacement, respondent whose families suffered displacement were more likely to currently participate in either agricultural, political parties or neighborhood civic organizations (10.6% vs. 19.4%). Civic participation was higher among displaced men (20.7%) compared to women (12.3%). After controlling for socio-demographic and socioeconomic confounders, multilevel binomial models showed that displaced Colombians had higher risk of reporting fair or poor health, compared with non-displaced (RR: 1.17. 95% CI 1.04, 1.33, p=0.0008). Civic participation was not associated with worse health (RR: 1.08, 95% CI 0.96, 1.19, p=0.2). However, displaced men currently participating in civic organizations had lower risk of reporting poor/fair health (RR: 0.84, 95% CI 0.46, 0.99, p=0.0496). The moderation of civic participation was not found among women (RR: 1.23, 95% CI 0.84, 1.78, p=0.3). Although these effects could be attributed to reverse causation, unmeasured confounders or selection bias, we recommend strengthening civic participation of this vulnerable population, and promoting women representation. Mobilization of material, legal and psychosocial resources to protect human rights may lead to positive health benefits.