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Violence: a challenge for public health and for all
  1. A Concha-Eastman
  1. Pan American Health Organisation/World Health Organisation, 525 23rd Street NW, Washington, DC 20037, USA
  1. Dr Concha-Eastman (conchaal{at}

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Violence is both a public health and a social problem. Although there is not only one type of violence nor a unique concept of what it means, the following concept has gained consensus, particularly among those working intersectorally with a public health approach: “Violence is an intentional use of physical force against another person or against oneself, which either result in or has a high likelihood of resulting in injury or death”.1 This definition has two main components: the intention and the harm it produces. It is also focused on the event itself: hence it is either case or victim oriented, as in many public health situations. Its usefulness relies upon the possibility of linking the case with the specific circumstances that led to or ended in violence.

Some common cases are worth illustrating: a woman with bruises on her face; a child with a burn on their back; a young man with a firearm generated wound, an adult killed in an assault on a bank. We ask ourselves: were they accidental? The answer is no. They were all intentionally inflicted. They were man/woman made, on purpose. So, the challenge for health professionals is not only to carry out a proper and adequate bandaging, stitching or operating on the cases who look for care at health facilities. Actually, the challenge goes beyond the emergency unit. The challenge is how to develop preventive interventions to avoid the occurrence of cases such as these.

In doing so, there are many problems to face. To start with, it is necessary to state that good and reliable data, to measure the burden and trend of the problem, are required worldwide. Although the data are not complete, it has been established that the Americas has the highest rate of homicide in the world, higher …

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