Youth violence in Europe: magnitude and challenges

1. First European conference on injury prevention and safety promotion Youth violence in Europe: magnitude and challenges Inge Baumgarten, Dinesh Sethi, Francesca Racioppi Violence and Injury Prevention

2. Youthviolence: the extent of the problem

3. Violence definition Violence “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

4. Sibling Acquaintance Stranger Interpersonal violence typology Interpersonal Family/partner Community Child Partner Elder Nature of violence Physical Sexual Psychological Deprivation or neglect

5. Youth violence, globally • Considerable variation between regions and countries • Main victims and perpetrators of youth violence, almost everywhere, are themselves male adolescents and young adults • Mainly occurring in the community • Weapons used vary by region

6. Method of attack in homicides, globally

7. 25 20 15 Males Females 10 5 0 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Age group Deaths from interpersonal violence in the WHO European Region Age- and gender-specific mortality rates from interpersonal violence in the WHO European Region, 2002 Preponderance of male over female homicide victims Rates per 100,000 population Source: WHO Health for All Database

8. Nowhere in the world is the difference between poorer and wealthier countries in mortality from injury as high as inEurope Wide variations in homicide rates in all age groups in the Region and between individual countries (e.g. age group 15-29 years: in Albania 28.2 per 100.000, Russian Federation 18.0 per 100.000, UK 0.9 per 100.000, France 0.6 per 100.000,) Standardized mortality rate from all injuries in the WHO European Region for both sexes, 2002

9. 1 death 30 hospital admissions 300 emergency department visits ?? general practice visits, paramedical support or self treatment Youth homicide is the 3rd leading cause of death in Europe, and 8th leading cause of disability For every youth homicide, an estimated 20-40 victims of non-fatal violence are hospitalized and 300 require outpatient treatment in hospital emergency departments

10. Youth violence: risk factors and dynamics

11. Physical fighting, bullying, carrying of weapons • 35% of students in 35 countries report having been involved in bullying(variation in the region between 9-54% for 11 year olds, 17-94% for 13 year olds, 19-74% for 15 year olds) • 39% of students report fighting in previous year, 10% repeated fighting • With males 2-3 times more likely than females • Estonia, Hungary, Lithuania highest, Finland, Germany, FYR Macedonia lowest • Carrying of weapons was reported in 10-20% of boys and 2-5% of girls (among those reporting weapon carrying, handguns and firearms ranged from 7-22% of boys and 3-11% of girls) Source: Health behaviour in school-aged children (HBSC) study, WHO, 2004

12. Fighting, bullying and victimization occur frequently Source: WHO Health behaviour in school aged children (HBSC) study, 2004

13. Youth violence and alcohol • Alcohol is a risk factor in over 40% of cases • Binge drinking is linked to fighting, peaking on certain days and in certain locations (e.g. nightlife violence, on weekends) • Alcohol is a risk factor in the perpetrator and victim of violence

14. Public health approach Risk factors for youth violence • Societal • Community • Relationship • Individual • Examples: • Concentration of poverty • High residential mobility • High unemployment • Social isolation • Local illicit drug trade • Examples: • Biological, psychological and personality characteristics • History of violent behaviour • Experience of abuse • Examples: • Poor parenting, harsh physical punishment • Marital conflict, spouse abuse, parental separation • Friends who engage in • violence • Examples: • Inequalities • Norms that support violence • Availability of means • Weak quality of governance (legal frame, policies of social protection)

15. Links between types of violence Intimate partner violence Child maltreatment Shared risk factors (alcohol, substance abuse, parental loss, social isolation, mental illness, household poverty, crime, norms condoning violence, inequalities,…) Elder abuse Sibling violence

16. Youthviolence: the extent of the problem

17. Challenges • Harmful use of alcohol • Violence propagated through the media • Social and economic inequalities • Emphasis on “punishment”, law and order, oversight of primary prevention • Prevention strategies often based on good intention and assumption rather than evidence (“what works best?”) • Youth violence is caused by a complex interaction among multiple factors • Efforts to reduce this problem in a substantial way will need to be multifaceted

18. Public health approach to preventing youth violence Identification Surveillance (2) Risk factors - Alcohol - Weapon carrying - Attitudes/values (1) What is the problem? - High rate of violent crime among youths Public demand for more prevention Reduction in violence Develop/evaluate interventions Implementation • (4) How is it done? • - Police, judiciary etc. • Restrictions on • alcohol and weapon (3) What works? - Education - Legislation - Community involvement

19. Public Health Advocacy Services for victims Research Engaging other sectors Policy Prevention & control Injury surveillance, evaluation There is further room for the health sector to reduce the burden of injuries Providing services for victims is only one of the roles that the health sector can play. Other roles offer further opportunities to reduce the burden of injuries.

20. WHO resources on violence and injury prevention

21. Thank you for your attention! http://www.euro.who.int/violenceinjury