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Violence Begins at Home
Last Updated: Wednesday, 26 October 2005, 19:36 GMT 20:36 UK
World report on violence
Alexander Butchart, WHO
Alexander Butchart, WHO
No country or community is untouched by violence. Here, Alexander Butchart, Prevention of Violence Coordinator at the World Health Organisation, explains why violence is a universal challenge.

It injures, it paralyses, it kills. It hurts people, families, communities and societies. It is everywhere and affects everyone. But it can be stopped.

"It" is violence - rape, murder, shooting, fighting, sexual assault and emotional abuse.

The victims are children, youth, women, men and the elderly.

Every minute of every day, someone, somewhere in the world, dies because of violence. Every day, thousands of people need emergency care. It causes depression, anxiety, alcohol and drug abuse. It tears apart families, friends and neighbourhoods, and does untold damage to societies.

Globally, there are approximately 1.6 million deaths due to violence each year. That is around half the number of deaths due to HIV/Aids, roughly equal to deaths due to tuberculosis, and 1.5 times the number of deaths due to malaria.

But fatalities are only a fraction of the full violence problem. Each year, 3.5-7.5 million people in the 15 to 29 age group receive hospital treatment for a violent injury.

For every completed suicide, local studies suggest there are 10-40 cases that present with suicidal behaviour.

In surveys from around the world, 10-69% of women reported being physically assaulted by an intimate partner at some point in their lives, with many immediate and long-term consequences.

And one in four women may experience sexual violence by an intimate partner in their lifetime, and in females aged 12 to 45 the frequency of pregnancy as a result of rape is 5-18%.

Science has clearly shown that a complex mix of factors, ranging from the biological to the political, underlie why some individuals and groups experience violence more than others.

Some of the most important risk factors cut across the different kinds of violence, including high levels of economic inequality; cultural norms that condone violence; rigid gender roles; breakdown of community support structures; poor parenting practices and family dysfunction; age; psychological and personality disorders; alcohol and substance abuse, and a history of engaging in violent behaviour or experiencing abuse.

Informed by scientific studies of these and other underlying causes, violence prevention strategies that keep people from engaging in violent behaviour have been developed.

A number of interventions have been shown to be of proven and promising effectiveness in preventing violence and reducing the harm caused when it does occur.

Prevention can be achieved by helping individuals to prevent unintended pregnancies; by improving access to prenatal and postnatal services; through pre-school enrichment programmes; through social- and life-skills training, and by providing incentives for high risk youth to complete schooling.

Strategies for working with families and peer groups that are effective in preventing child abuse and youth violence include parent training programmes; home visitation to high risk parents and infants; mentoring; partnership programmes between schools and homes, and family therapy for juvenile offenders.

And community-level interventions that show promise include lead monitoring and the removal of environmental toxins; screening by health care providers for child maltreatment; providing safe havens for children on high-risk routes to and from school; reducing alcohol availability; improvements in emergency response, trauma care and access to health services, and training health professionals in the identification and referral of victims of intimate partner violence, sexual violence and elder abuse.

At the broadest level, promising society-level interventions include changing cultural norms that support violence; reducing media violence; reforming education systems; reducing economic inequality; job creation programmes for the chronically unemployed; tackling gun violence, and strengthening police and judicial systems.

Violence is not inevitable. Rather, it is often predictable and preventable. Many factors that increase the risk for violence are modifiable, and there are many steps that governments, non-governmental organizations and public citizens can take to strengthen policies, systems and services in ways that will substantially reduce rates of violence.

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