WHO highlights impact of violence on health

Mirza Muminovic London

Violence kills more than 1.6 million people every year, says the first comprehensive World Report on Violence and Health, released by the World Health Organization (see www.who.int/en/).

The report has taken three years to write and was drawn from evidence using the expertise of 160 experts from around the world.

In addition to those who are killed by violent acts, millions of people are left injured as a result of violence and suffer from physical, sexual, reproductive, and mental health problems.

Everyday, an average of 1424 people are killed worldwide by acts of homicide--almost one person every minute. About 191 million people lost their lives in conflicts during the 20th century, and well over half of them were civilians.

Youth homicide rates have increased in many parts of the world. For every young person killed, 20 to 40 are injured and need treatment. Research shows that fighting and bullying are common among young people and that drunkenness is one of the situational factors found to precipitate violence.

Suicide or self inflicted violence is one of the leading causes of death in the world. It is the fourth leading cause of death among those aged between 15 and 44 years, and the sixth leading cause of disability and ill health.

Suicides claimed 815 000 lives in 2000, of which 250 000 were among men aged between 15 and 44. Suicide rates were a third higher among men than women and twice as high among men over 60. The highest suicide rates were seen in Eastern Europe, with Lithuania, Belarus, and Estonia having rates more than four times that of Britain. In 1999, 4448 people killed themselves in the United Kingdom.

In 48 surveys from around the world, between 10% and 69% of women reported being physically or sexually assaulted by an intimate male partner at some point in their lives. About 20% of women were sexually abused as children.

Public health experts say the majority of violent acts are being committed behind closed doors and are therefore largely unreported.

Dr Gro Harlem Brundtland, the WHO's director general, said: "The report challenges us in many respects. It forces us to reach beyond our notions of what is acceptable and comfortable to challenge notions that acts of violence are simply matters of family privacy, individual choice, or inevitable facets of life."

The report recommends primary prevention responses such as preschool and social development programmes for children and adolescents, parent training, and support programmes. Strengthening responses for victims of violence, promoting adherence to international treaties and laws, and improving data collection on violence are among the other recommendations.