Social and economic impact of violence in the Americas.

Abstract

Violence is a social and a public health problem that has grown in the Americas in recent decades that has negative effects on social, health, and the economy of countries, communities, families, and individuals. More than 115,000 people are murdered every year, the majority of them are men; other 55,000 commit suicide. In 20 to 60% of households some form of domestic violence against girls, boys, women, and the elderly occurs; juvenile gangs, involved in violent and criminal activities, increases at alarming rate. Other forms of violence are wars and internal or international conflicts, political violence, abductions, lynching, multinational violence by organized crime units involved in narcotic trafficking, sexual trade or smuggling of weapons. The public health approach is based on a methodology of work, as follows: 1. Characterization of the problem in its basic variables of person, place, time, circumstances, and related situations; 2. Identification of causes, associations, or risk factors; 3. Proposal of interventions and their evaluation; 4. Extension of the evaluated interventions. Violence is an intentional act of multicausal origin. Various factors are interconnected showing the relations among them. Those which have been primarily studied or that have shown greater evidence are discussed. A historical look is proposed, that integrates the repression and control, the prevention and the recovery of the social fabric. Violence demands an expenditure of money that represents a significant proportion of the GDP that was estimated in $168 billion dollars for Latin America. Violence can be prevented. Primary prevention projects are driven to avoid the occurrence of a violent act, but if it has already occurred it is necessary to avoid its repetition, through secondary prevention projects. Tertiary prevention is applied in order to avoid major damages; it aims at improving the quality of life of those already traumatized. The programs should be comprehensive and sustained in the medium and long terms. Finally, comments have been made on PAHO and WHO policies, in particular the recently launched World Report on Violence and Health, a working tool for violence prevention.