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First ever Global Report on Violence and Health
World Health Organisation (WHO)
October 03, 2002

http://www.who.int/mediacentre/releases/pr73/en/

GENEVA -- The World Report on Violence and Health is the first comprehensive report of its kind to address violence as a global public health problem. Violence kills more than 1.6 million people every year. Public health experts say these statistics are just the tip of the iceberg with the majority of violent acts being committed behind closed doors and going largely unreported. This report aims to shed light on these acts. In addition to the deaths, millions of people are left injured as a result of violence and suffer from physical, sexual, reproductive and mental health problems, says the first comprehensive World report on violence and health released today by the World Health Organization (WHO).

The death and disability caused by violence make it one of the leading public health issues of our time, says the report. Violence is among the leading causes of death for people aged 15-44 years of age, accounting for 14% of deaths among males and 7% of deaths among females. On an average day, 1424 people are killed in acts of homicide almost one person every minute. Roughly one person commits suicide every 40 seconds. About 35 people are killed every hour as a direct result of armed conflict. In the 20th century, an estimated 191 million people lost their lives directly or indirectly as a result of conflict, and well over half of them were civilians. Studies have shown that in some countries, health care expenditures due to violence account for up to 5% of GDP.

The report challenges us in many respects. It forces us to reach beyond our notions of what is acceptable and comfortable to challenge notions that acts of violence are simply matters of family privacy, individual choice, or inevitable facets of life, said Dr Gro Harlem Brundtland, Director-General of WHO on releasing the report. Violence is a complex problem related to patterns of thought and behaviour that are shaped by a multitude of forces within our families and communities, forces that can also transcend national borders, she added.

The World report on violence and health is the first comprehensive review of the problem of violence at a global level. It focuses not only on the scale of the problem, but also covers issues related to the causes of violence and the methods for preventing violence and reducing its adverse health and social consequences. In addition to the familiar issues of collective violence such as war or conflict, the report examines equally significant yet frequently overlooked issues such as youth violence, child abuse, elderly abuse, intimate partner violence, sexual violence, and self-inflicted violence or suicides.

The data on youth violence show that youth homicide rates have increased in many parts of the world. For every young person killed by violence, an estimated 20-40 receive injuries that require treatment. Research shows that fighting and bullying are common among young people and that drunkenness is one of the situational factors found to precipitate violence. As far as child abuse is concerned, data from selected countries suggest that about 20% of women and 5-10% of men suffered sexual abuse as children.

Women often face the greatest risk at home and in familiar settings, says the report. Almost half the women who die due to homicide are killed by their current or former husbands or boyfriends, while in some countries it can be as high as 70%. While exact numbers are hard to come by due to lack of reporting, available data suggest that nearly one in four women will experience sexual violence by an intimate partner in their lifetime. Most victims of physical aggression are subjected to multiple acts of violence over extended periods of time. A third to over half of these cases are accompanied by sexual violence. In some countries, up to one-third of adolescent girls report forced sexual initiation.

Abuse of the elderly is one of the most hidden faces of violence according to the report, and one that is likely to grow given the rapidly aging populations in many countries. Up to 6% of the elderly report having been abused. As for suicide or self-inflicted violence, it is recognised as one of the leading causes of death in the world. Among those aged 15-44 years, suicide is the fourth leading cause of death and the sixth leading cause of disability and ill-health.

The statistics are chilling but the situation is far from hopeless, say the experts. There is nothing inevitable about violence, nor is it an intrinsic part of the human condition, said Dr Etienne Krug, Director, Department of Injuries and Violence Prevention. Evidence from around the world suggests that violence can be prevented by a variety of measures aimed at individuals, families and communities, he added. As a complement to the law and order approach to violence, the report promotes a public health understanding of the complex social, psychological, economic and community underpinnings of violence. While recent research suggests that biological and other individual factors may explain some of the predisposition to aggression, these factors more often interact with family, community, cultural and other external factors to create a situation where violence is likely to occur. Understanding these situations and these causes creates opportunities to intervene before violent acts occur, providing policy-makers with a variety of concrete options to prevent violence.

Among the recommendations for prevention made by the report are primary prevention responses such as preschool and social development programmes for children and adolescents, parent training and support programmes and measures to reduce firearm injuries and improve firearm safety. Other recommendations include strengthening responses for victims of violence, promoting adherence to international treaties and laws, and improving data collection on violence.

For information on the report, visit www.who.int/violence_injury_prevention
To order a copy of the report, contact bookorders@who.int

For more information contact:
Helen Green
Communications Officer
Telephone: +41 (22) 791 3432
Email: greenh@who.int

World report on violence and health outline

http://www.who.int/violence_injury_prevention/violence/world_report/wrvh8/en/

Objectives
The specific objectives of the Report are to describe the magnitude and impact of violence throughout the world; describe the key risk factors for violence; summarize the types of intervention and policy responses that have been tried and what is known about their effectiveness; and make recommendations for action at local, national, and international levels.

Content
The Report examines a broad spectrum of violence including child abuse and neglect by caregivers, youth violence, violence by intimate partners, sexual violence, elder abuse, suicide, and collective violence. One chapter is devoted to each of these seven topics. The Report also includes a statistical annex with country and regional data derived from the WHO Mortality and Morbidity Database and a list of resources for violence prevention.

Release of the World report on violence and health
The global release of the Report and an accompanying summary took place on 3 October 2002 in Brussels. The scheduled events were hosted by the Government of Belgium and Dr Brundtland. Other personalities were invited to participate. The global release is being followed by a series of country events. These signify the beginning of a year long Global Campaign on Violence Prevention , involving discussions, debates any many other activities about violence and concrete and practical ways to implement the recommendations of the Report.

Main Messages
· Violence is a major public health problem worldwide. Each year, millions of people die as the result of injuries due to violence. Many more survive their injuries, but live with a permanent disability. Violence is among the leading causes of death among people aged 15-44 years worldwide, accounting for 14% of deaths among males and 7% of deaths among females.

• In addition to death and disability, violence contributes to a variety of other health consequences. These include depression, alcohol and substance abuse, smoking, eating and sleeping disorders, and HIV and other sexually transmitted diseases.
• Violence, however, is preventable - it is not an intractable social problem or an inevitable part of the human condition. The wide variation in violence among and within nations over time suggests that violence is the product of complex, yet modifiable social and environmental factors.
• Violence results from interplay of individual, relationship, community, and societal factors. Some of the factors associated with violence include a history of early aggression, impulsiveness, harsh punitive discipline, poor monitoring and supervision of children, associating with delinquent peers, witnessing violence, drug trafficking, access to firearms, gender and income inequality, and norms that support violence as a way to resolve conflict.
• Creating safe and healthy communities around the globe requires commitment on the part of multiple sectors at the international, national, and community levels to document the problem, build the knowledge base, promote the design and testing of prevention programs, and promote the dissemination of lessons learned.
• A science-based public health approach focused on prevention may contribute to reducing violence. Public health officials have a very important role to play in this process. Through their vision and leadership, much can be done to establish national plans and policies for violence prevention, to help facilitate the collection of data to document and respond to the problem, to build important partnerships with other sectors, and to ensure an adequate commitment of resources to prevention efforts.
  

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