Violence, crime and public health

It is not often that violence and crime are linked to health. Most times, they are viewed as social issues to be addressed solely by law enforcement officials.

Overwhelming evidence is now pointing to the fact that violence, in one form or the other, is placing a significant burden on the health sector.{{more}} Research shows that crime and violence are major contributors to premature death, injury and disability across the globe, including here in St Vincent and the Grenadines. Health data places violence and injury among the leading causes of death in the country.

Personal, mainly one-to-one violence such as homicide, attempted homicide and other non-fatal assaults, places a significant strain on the health care system.

When victims utilize the health services, they use resources that could otherwise be allocated to individuals who truly need them. They place an added demand on the blood bank, with its already scarce supply. They also require costly intervention, such as emergency surgery and long-term services, such as physiotherapy and counselling.

Violence is, then, undoubtedly a public health issue. Therefore, it is vital that public health recognizes the important role it too has to play in finding sustainable long-term solutions to address this problem. Such contributions will go a long way in ultimately reducing the burden of violence and crime on the health sector.

Violence and crime can be prevented. Any public health initiative aimed at preventing them needs to combine primary, secondary and tertiary interventions, with a population-wide approach and one that identifies high-risk individuals who are more inclined to be offenders.

At the primary prevention level, approaches could involve violence prevention education in schools, parenting education, and programmes targeting communities where violence is more endemic with appropriate risk reduction strategies, such as street lighting, surveillance cameras and community policing. Even more important are the implementation of poverty reduction strategies that have proven to be effective.

At the secondary level, approaches could involve support and counselling for victims of violent crime, peer mediation techniques to resolve disputes in schools and the workplace, and home visits to families identified as being at a high risk for violence or child abuse.

The tertiary prevention level could involve treatment and rehabilitation of violent offenders, improving parent management strategies, the provision of adequate shelter for victims of domestic violence and training of health and social care professionals in the identification and referral of victims of violence.

This pointed approach, targeted at high-risk individuals or the entire population, provides for a public health strategy that is aimed, not only at prevention, but also at engendering a more proactive approach that seeks to educate and transform cultural norms and attitudes toward violence.

Violence and crime affect everyone in the country. It therefore calls for a collective response from all sectors of the society, inclusive of health, in ensuring that we live in a society that is safe and secure.

These contributions underscore the added value that public health brings to the table in addressing this important issue of national concern.

Dr Rosmond Adams is a medical doctor and a public health specialist. He may be emailed at adamsrosmond@gmail.com