Violence in the Americas: Alarming but Preventable

Washington, DC, June 11, 2003 (PAHO)—Participants in a Pan American Health Organization (PAHO) meeting today presented alarming statistics on the impact of violence in the Americas: 120,000 people are victims of homicide each year in the Region, and 180,000 more die from suicide and traffic accidents. In countries for which data are available, 20–60 percent of women have been victims of intrafamilial violence. Among the fastest growing sources of violence are youth gangs; in El Salvador and Honduras alone, some 30,000 youths are gang members.

Dr. Alberto Concha-Eastman (left), Dr. Etienne Krug, and Dr. Marijke Velzeboer-Salcedo (clik on the photo to enlarge). [©Armando Waak/PAHO]During the conference, "Alliances for the Prevention of Violence," two recent books on these issues were presented: the World Health Organization's World Report on Violence and Health (published in October 2002) and the new PAHO publication Violence Against Women: The Health Sector Responds.

Experts emphasized that violence is preventable and that rates can be reduced through political decision-making along with measures that strengthen surveillance systems and campaigns that focus on the concrete problems faced by individual countries.

"We know the statistics on deaths by violence, but we lack data on violence that is not fatal," said Dr. Etienne Krug, head of WHO’s Injuries and Violence Prevention Department. Krug presented the World Report on Violence and Health and noted that it was the product of three years' work by 160 experts from 70 countries. It is the first report to describe in detail the global toll of violence.

Dr. Alberto Concha-Eastman, PAHO regional advisor on violence and injury prevention, presented data on homicides in the Americas. The highest annual rates are found in Colombia, with 65 homicides per 100,000 people; Honduras, with 55 per 100,000; El Salvador, with 45; Jamaica, with 44; and Venezuela, with 35 per 100,000. The lowest rates are found in Canada, which reports only 2 homicides per 100,000 people; Costa Rica, with 4 per 100,000; and in the United States, with 6.5 per 100,000.

"One high-risk social problem is youth gangs," said Concha-Eastman. "Of the thousands of kids who belong to these gangs, especially in Jamaica, Costa Rica, Peru, Guatemala, Honduras, Mexico and Nicaragua, El Salvador, the United States and Brazil, 55 percent are under 15 and only 25 percent have completed elementary school." He added that many of these youths become adults involved in organized crime.

Other participants presented successful experiences with violence prevention. Dr. Rodrigo Guerrero, of the Inter-America Coalition for Violence Prevention and former mayor of Cali, Colombia, described successful initiatives in that city and in the capital of Bogotá. "In the early 1990s, the increase in violence was alarming. For this reason, we decided to map out the violence, and we found that most homicides occurred on weekends and that 40 percent of the victims were intoxicated. Seeing that alcohol was a risk factor, we decided to restrict consumption."

This measure, combined with restrictions on discotheques’ hours, helped lower crime rates from 80 homicides per 100,000 inhabitants in 1992 to 28 per 100,000 in 2000. Guerrero explained that political awareness of the problem had been critical to addressing it, along with an approach that was not only penal but also cultural. "It was important that people understood that life was sacred and that you have to respect it," he said.

Dr. Marijke Velzeboer-Salcedo, head of PAHO’s Gender and Health Unit, presented the new PAHO book Violence Against Women: The Health Sector Responds, noting that it was the result of 10 years of work in 10 countries, involving more than 150 communities. "Gender violence is one of the most common forms of abuse and it is devastating. And in many cases, women are victims of their own partners," she said.

Researchers found that most women did not know their rights and that they encountered obstacles and misunderstanding when they approached the health system. For this reason, Velzeboer-Salcedo said it is important to work with health professionals and train them to detect cases of violence and begin to break the cycle of violence, "a cycle that causes physical and mental problems and even murder and suicide."

Dr. David Brandling-Bennett, deputy director of PAHO, noted that the Organization has been focusing on the problem of violence since 1993, when its Directing Council— which consists of the ministries of health of the Americas—defined violence as a public health problem and encouraged governments to develop national plans to prevent it.

PAHO was established in 1902 and is the world’s oldest ongoing health organization. PAHO works with all the countries of the Americas to improve health and improve the quality of life of its inhabitants. It serves as the Regional Office for the Americas of the World Health Organization.