Intentional Injury

An injury resulting from an act intended to inflict injury. –Examples??? Intentional Injury patterns –Access to firearms, maleness, certain childhood experiences, and- most important- income disparity and poverty

Violence Portrayed –Stranger violence (mugging and random acts) –Associated with deviant worlds of gang warfare and drug dealing –A problem of the young Actual –Homicide usually involves acquaintances and family members –Legal alcohol use and maleness are the factors usually associated with interpersonal violence –Actually a problem of the poor

Nonfatal Assaultive Violence Assaulted Violence- personal violence where physical force or other means is used by one person with the intent of causing harm, injury, or death to another For every one homicide death there were 33 hospitalizations and 534 ER visits for assault Data collected on nonfatal assaults is not as reliable as homicide data- Why?

Homicide Homicide is death resulting from injuries inflicted by another person with the intent to injure or kill –In 2002, there were 31,655 suicide deaths and 17,638 homicide deaths in the U.S. –Homicide is the cause of over 11% of all injury deaths –For ages 1 to 9 years, homicide is the 4th leading cause of death –For ages 15 to 24 years, it is the 2nd leading cause of death

Homicide Males are 3 times more likely to be killed and almost 8 times more likely to commit homicide than females 48 homicide deaths for each day of the year in 2002 Homicide rates for young people are higher in the U.S. than in any other developed nation The major factor is neither race or age, but poverty –Why poverty

Child Abuse Child Maltreatment an act or failure to act by a parent, caretaker, or other person which results in physical abuse, neglect, medical neglect, sexual abuse, emotional abuse, or an act or failure to act which presents an imminent risk of serious harm to a child

Child Fatalities - 900,000 children were victims of child abuse or neglect in Children under 3 had the highest rates of victimization Deaths caused by an injury resulting from abuse or neglect, or where abuse or neglect were contributing factors

Child Abuse Prevention Substance abuse treatment is a promising avenue for the prevention of child abuse

Child Abuse Prevention con’t Needed –Uniform definitions of child maltreatment, better reporting and surveillance methods, and nation- wide consistency regarding child autopsies and death investigations Child death review teams- allow for in-depth study of suspicious and confirmed intentional deaths and provides a clearer picture of what is going on and how we can prevent such deaths

Elder Abuse Elder abuse can include neglect and psychological abuse, as well as physical violence –As the elderly population grows, the rate of elder abuse increases Victims are usually old-old (75 years and older) and usually reside with the abuser

Types, Signs, and Prevention SIGNS of elder abuse include: –Frequent arguments or tension between the caregiver and the elderly person –Changes in personality or behavior in the elder –Unexplained signs of injury such as bruises, welts, or scars. –Broken bones, sprains, or dislocations –Threatening, belittling, or controlling caregiver behavior that you witness

Types, Signs, and Prevention con’t Physical, emotional, sexual, neglect or abandonment, financial exploitation, and healthcare fraud, are all different TYPES of elder abuse. PREVENTION: Listening to seniors and their caregivers Intervening when you suspect elder abuse Educating others about how to recognize and report elder abuse

Distribution of Violence The distribution of violence reflects the disparities of wealth and income in society Victimization rates decrease as family income increases Overrepresentation of minority groups and youth as perpetrators and victims of violence is a proxy indicator for poverty

What is the most common type of violence???

Spousal/ Dating Violence –Sometimes referred to as: Intimate Partner Violence or IPV

Intimate Partner Violence - Actual or threatened physical or sexual violence or psychological and emotional abuse directed towards a spouse, ex-spouse, or current or former dating partner

IPV continued… In 2005, 1,510 people in the United States died at the hands of an intimate partner. The National Violence Against Women survey found that 22.1% of women and 7.4% of men experienced physical forms of IPV at some point in their lives.

Many Forms of IPV Forms of IPV –Physical violence- most extreme –Sexual violence –Psychological damage Can involve women or men as victims and perpetrators –Predominantly it is women that are seriously injured (physical violence) –Men can be injured both physically and psychologically as well.

Contributing Factors Unemployment, drug or alcohol use, and guns Low social status and objectification of women also contribute Sexism??? Vdi2s

Medical Care When victims seek medical care, clinicians do not screen for and identify domestic violence Research doesn’t even exist to guide clinicians on how to screen for domestic violence Clinicians lack confidence in their ability to manage and care for victims of domestic abuse

Effective Interventions To design effective Interventions –Researchers must identify the social norms and beliefs that support these types of violence –Find ways to alter or replace them with ones that prevent violence Even when such violent behaviors are not considered “acceptable” –Cultural attitudes and beliefs may exacerbate these problems –Blaming victims and supporting these attitudes and behaviors creates a social atmosphere conducive to such violence

Intervention Pitfalls Interventions focus on changing just one risk factor –Usually focuses on the individual rather than the social and environmental characteristics Have to be more comprehensive and address multiple root causes –Poverty, unemployment, oppression, substance abuse, educational failure, fragmented failure, witnessing or experiencing failure, and feelings of powerlessness

Public Health Approach Surveillance Identification of risk factors Developing interventions Empowering communities Training Evaluation WHY? Because…

Because… Injuries happen quickly and often when least expected

Conclusion Policymakers continue to fund crime fighting and after-the-fact incarceration Politicians continue to resist efforts to reduce firearm injuries Funding has to be made available for injury prevention research and programs Public health can bring important skills and insight to injury prevention