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Alberto Concha-Eastman, MD, MSc Regional Advisor Violence and Injuries Prevention

PAHO/WHO Violence is preventable The Inter-American Coalition for the Prevention of Violence –IACPV-. Organization of American States Committee on Hemispheric Security 12 February 2007. Alberto Concha-Eastman, MD, MSc Regional Advisor Violence and Injuries Prevention conchaal@paho.org

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Alberto Concha-Eastman, MD, MSc Regional Advisor Violence and Injuries Prevention

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  1. PAHO/WHOViolence is preventableThe Inter-American Coalition for the Prevention of Violence –IACPV- Organization of American StatesCommittee on Hemispheric Security 12 February 2007 Alberto Concha-Eastman, MD, MSc Regional Advisor Violence and Injuries Prevention conchaal@paho.org PAHO / WHO Washington, DC

  2. Content:1. The IACPV2. The WHO World Report on Violence and Health - Violence is Preventable3. Youth Violence is a social conflict

  3. Inter-American Coalition for the Prevention of Violence

  4. INTER-AMERICAN COALITION FOR THE PREVENTION OF VIOLENCEAn Unprecedented Effort in the Americas Coalition Founders, June 2000: • The Centers for Disease Control • Inter-American Development Bank • Organization of American States • Pan American Health Organization/World Health Organization • United Nations Educational, Scientific, and Cultural Organization • The World Bank

  5. VIOLENCE IS A MAJOR HEALTH PROBLEM • IN THE AMERICAS: • +110,000 Homicides, 840,000 intentional injuries/year (91,523 AIDS;6 cholera cases/year) • 1st cause of death in many countries • 2.6 days/person/year are lost to violence • 30-60% emergency visits to hospitals are due to violence

  6. VIOLENCE IS A MAJOR ECONOMIC OBSTACLE: • IN THE AMERICAS: • 14.2% of G.N.P. (168,000 US million) is lost or transferred due to violence • 1.9% of G.N.P. is lost in human capital (equivalent to expenditures in primary education)

  7. VIOLENCE IS AN OBSTACLE TO SOCIAL, ECONOMIC, POLITICAL DEVELOPMENT • Violence and insecurity are major sources of concern, even in countries with low levels of violence. • Violence affects social capital. • Involvement of civil society, private sector, religious communities is not as needed • Is affecting governability at country and city levels

  8. SYNERGIES • NO SINGLE SECTOR (INSTITUTION) CAN SOLVE EXPRESSED NEEDS • EFFECTIVE SOLUTION REQUIRES A MULTISECTORAL APPROACH • DIVERSITY OF INSTITUTIONAL STRENGTHS • JOINT EFFORTS ADDS CREDIBILITY AND POLITICAL CLOUT

  9. Summit of the Americas Quebec 2001 • The General Assembly of the Summit • “encourages national institutions to work together and coordinate with all appropriate multilateral organizations to implement comprehensive violence prevention initiatives” andcalls for the “multilateral and other organizations that participate in the Inter-American Coalition for the Prevention of Violence to intensify their support and technical assistance to countries”

  10. WHO World report on violence and health 2002

  11. HEALTH DETERMINANTS Education Agriculture - Food Potable Water/Sewerage Housing Work Environment Employment Violence, insecurity unintentional injuries Addiction to narcotics Social and Economic Development Health and Well-being Health care 1. Resources 2. Administration and management 3. Opportunities Access Quality Users’ perception Social Network Condition of Life Family size Age Gender Genetics Lifestyle Adapted from the WHO

  12. Definition “Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation” World report on violence and health

  13. Definitions Typology Interpersonal Family/partner Community Child Partner Elder Acquaintance Stranger Nature of violence Physical Sexual Psychological Deprivation or neglect

  14. Global homicide rates, 2000 Source: WHO database, 2000 Numbers Interpersonal violence

  15. Risk factors Risk factors - ecological model • Societal • Community • Relationship • Individual • Examples: • Concentration of poverty • High residential mobility • High unemployment • Social isolation • Local illicit drug trade • Examples • Demographic factors • Psychological and • personality disorders • History of violent behaviour • Experienced abuse • Examples: • Inequalities • Norms that support violence • Availability of means • Weak police/criminal justice • Examples: • Poor parenting • Marital conflict • Friends who engage in • violence

  16. PAHO Youth Gangs: increasing into the thousands  SOCIAL CONFLICT +30.000 boys & girls involved in El Salvador & Honduras Jam., C. Rica, Mex., Col., Nic., Gut., Peru, U.S.A., Brazil, others Drugs, killings, rapes, assaults, robberies, move to organized crime

  17. BACKGROUND. Factors Related to the Increase in Juvenile Gangs • Accelerated Urbanization • Armed Conflicts • Privatization of Public Areas • Loss of Family Structure • Intra-family Violence • Lack of Role Models for Child Socialization • Violent Culture

  18. BACKGROUND: Factors Related to the Increase in Juvenile Gangs • Poverty • Exclusion of young people from work force • Exclusion from formal schooling • Difficulty with Self-identity

  19. Risk Factors for gang involvement Unfavorable Life Conditions Family disruption Perceived Reasons for Gang Involvement “Cost Benefit” being in Gangs Hanging Out leads to Social Recognition Access to Drugs Involvement in Gangs Socialization learned in the Street Increase in Drug use Fulfilling Violent Obligations to Remain in the Gang Barrio Adentro

  20. MODEL 2 The “COURSE” OF VIOLENCE Group involved LEVEL AND DEGREE OF VIOLENCE - CRIME HOMICIDES ROBBERIES (BANKS, ETC...) DRUGTRAFFICKING ORGANIZED CRIME VIOLATIONS ROBBERIES INJURIES HOMICIDES GANGS (JUVENILES) MINOR OFFENSES THEFTS FIGHTS : INJURIES HANGING AROUND- JUVENILE GROUPS - SOCIAL TROUBLE CONFLICTS- VIOLENCE VICT/WITNESS FAMILY - ENVIRONMENT - SOCIOECONOMIC A. Concha-Eastman

  21. Solutions Preventing violence - ecological model • Societal • Community • Family • Individual • Examples • Public information • Strengthen police and judicial systems • Reduce poverty and inequality • Educational reform • Reduce access to means • Job creation programmes • Examples • Reducing alcohol availability • Modify physical environment (lights, etc) • Identify and refer people at risk for violence • Improving trauma care and health care • access • Examples • Parenting programmes • Home visitation • Family therapy • Examples • Pre-school enrichment • Social development progs. • Vocational training

  22. Youth gangs Questions: • Who to blame? • What do gang members want? • What life expectatives and expectancy they have?

  23. Proposal: To define that youth violence represents a social conflict to be solved through a social public policy based on prevention

  24. STOP violence ONE LOVE!!! CP17602

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