THE NEED TO TREAT VIOLENCE AS PUBLIC HEALTH PROBLEM

Death and disability caused by injuries have risen in recent decades. A model of intervention pioneered in Cardiff and found effective around the world deserves a closer look

- K SRINATH REDDY

AMONG the major threats to human health and wellbeing. violence is seldom listed. It is regarded mostly as a law and order problem when it occurs within a country or war when it is a conflict between countries. Terrorism, whose origins may be domestic or foreign, also results in violence, which invites a police or military response. While doctors and nurses are called upon to treat victims of violence, the medical profession is seldom engaged in identifying the magnitude and principal causes of violence that occur in a community.

The Global Burden of Disease study periodically estimates the varied causes of deaths and disability due to different health disorders across the world. It reports the total disease burden due to injuries (premature deaths or prolonged disability) has risen across the world in the last three decades and accounted for 247.7 million disability-adjusted life years lost in 2020. With increasing levels of domestic and regional conflicts since then, the disease burden due to injuries is likely to have been even higher in 2023 (yet to be reported).

However, these estimates are likely to be lower than reality, as many cases of violence are not reported to the police, who maintain and report such data. Injuries from domestic violence, street brawls, and school bullying are among the causes of injury that may not come to the attention of the police. Even victims of acid attacks, sexual offences and criminal extortion are often afraid to report to the police, having been threatened against approaching law enforcement agencies.