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© 2003 American Public Health Association
EDITOR'S CHOICE |
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Violence occurs every day on a massive scale, not only in situations of armed conflict but also in our communities, on our streets, and in our homes. The recent war in Iraq has prompted a resurgence of critical reflection on the boundaries of our individual and collective responsibility to prevent violence. If each of us has a responsibility as an individual and a member of civil society to speak out against all forms of violence, we have an even greater responsibility as public health professionals to identify its root causes and mitigate its impact on individual and population health.
This month the Journal brings together a range of perspectives on violence. While any discussion of violence is by its very nature complex, the work presented here helps to better elucidate the root causes of violence, identify its multifaceted expressions, quantify its existence, and formulate ways to go about reducing both its incidence and its effects.
To address violence in its various forms requires engagement with health and social domains unfamiliar to many public health practitioners. It requires attention to the causes and effects of violence in such diverse areas as open warfare, civil strife, youth violence, intimate partner violence, neglect and maltreatment of children by caregivers, elder abuse, sexual violence, and the structural and institutional violence that permeates our societies. While each of these manifestations of violence requires its own approach to redressing harm, our greatest strength in tackling violence in its myriad forms may be in the diversity of disciplines and approaches encompassed within the public health community. The fields of epidemiology, clinical medicine, psychology, law, ethics, economics, social and behavioral sciences, and human rights, to name a few, all have a role to play in violence prevention. Bringing these disciplines and their associated methods together amplifies considerably our power to understand the issues at stake and meaningfully act upon them.
The examples provided in this issue of the Journal, as well as in the WHO World Report on Violence and Health (Geneva, Switzerland: World Health Organization; 2002) and this year’s violence issue of the journal Health and Human Rights (Vol. 6, No.2), make it clear that the perspectives offered by our various fields build upon complementary values, ideologies, and practical applications. Implicitly or explicitly, drawing upon a range of approaches may also provide a coherent framework for linking violence to other broad societal determinants of health, such as economic, social, and gender inequalities, which, in turn, have been understood to define the levels of vulnerability of individuals, communities, and populations to a wide array of communicable and noncommunicable diseases.
While multi- and interdisciplinary work is always challenging, our diverse perspectives may help to inform one another. Further, the potential benefits to be derived by public health and other professionals who come together to explore connections and identify common approaches would seem to be well worth any difficulties encountered along the way. Together, we can better ensure that research carried out on violence in its myriad forms will be used to further public health goals, that violence prevention policies and programs are informed by evidence and are debated openly, and that prevention measures are successfully implemented and carefully evaluated.
Violence or health? Public health has a critical role to play in deciding the answer.
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