Lethal Violence in Latin America Andrés Villaveces M.D., Ph.D. Epidemiologist Senior Violence Prevention Specialist World Bank

Transcription

1 Lethal Violence in Latin America Andrés Villaveces M.D., Ph.D. Epidemiologist Senior Violence Prevention Specialist World Bank IOM - Forum on Global Violence Prevention, Means of Violence December 18 19, 2014, Washington DC 1

2 Outline Approaches Firearm Injuries and fatalities Data systems and injuries in Latin America Some examples Gaps and needs 2

3 Different approaches Criminological Focus on who commits crime On places where crime occurs Theories of opportunity Theories of evolution of places Public Health Focused at the population level Focus on prevention through modification of risk and protective factors Socio-ecological framework Primary, secondary and tertiary prevention Culture of Citizenship Focused on understanding how culture of violence and illegality develop Integrates data on behaviors and events seeking to create interventions aimed at promoting peace, stimulating respect for the law, concepts of good citizenship, and promotion of pro-social behaviors as tools to reduce violence Use of symbols, programs Change of social norms 3

4 Firearm injuries Latin America: Roughly 8.5% of global population but 30% of deaths due to violence Firearms are the most common mechanism of fatal intentional injuries in several Latin American countries Wide regional, national, subnational, and local variations 4

5 Firearm-related violence Source: Crime and Violence In Central America. Volume II. Report No LAC, The World Bank, Sept 2010, Washington DC. 5

6 Regional variation Tasa de homicidios por habitantes Endemic limit % of countries have a violence epidemic Source: Multiple country data sources. 6

7 National and subnational variation Source: Crime and Violence In Central America. Volume II. Report No LAC, The World Bank, Sept 2010, Washington DC. 7

8 Strategies Violence Prevention Improvement and standardization of indicators (Definitions, surveillance systems, surveys) Improvement of governance, institutional strengthening, accountability Evaluation of interventions Application of legislative approaches or policies to address violence Risk factor modifications (Children, youth, gender-based, schools, community) Addressing other social factors: Employment, education Dealing with global problems: Organized crime and group violence 8

9 Observatories of crime Observatories identified; with contact person, and fully systematized Identified Observatories 198 Observatories With ID d contact 166 Systematized Observatories 66 Source: Srur, J Editor. Qué observan los que observan el delito? Pasado, presente y futuro de los observatorios del crimen y la violencia en América latina y el Caribe. IADB document # IDB-DP-364, Washington DC,

10 Institutional collaboration Use of surveillance systems (observatories) to describe problem, inform policies, evaluate interventions Tools for integrating different institutions to address a problem Applied mostly in metropolitan areas Policies linked directly to restrictions of carrying of weapons Some policies enhanced with alcohol control restrictions Increasingly used for spatial identification of events and targeting by police and civilian authorities 10

11 Responses Restriction of means Intermittent program applied Reduction of 13% and 14% in Bogota and Cali respectively Multiple replications of disarmament strategy Source: Villaveces A, Cummings P, Espitia VE, Koepsell TD, McKnight B, Kellermann AL. Effect of a ban on carrying firearms on homicide rates in 2 Colombian cities. JAMA 2000;283(9):

12 Modifications of Infrastructure Comparison: Pre- and post-metrocable intervention Comparison of exposed neighborhoods (n=25) with unexposed neighborhoods (n=23) Homicide Incidence Rate Ratio (IRR): 0.33, 95% CI (0.18, 0.61) Reduction in violence events reports IRR: 0.25, 95% CI (0.11, 0.67) Source: Reducing Violence by Transforming Neighborhoods: A Natural Experiment in Medellín, Colombia. Cerdá, M., Morenoff JD, Hansen BB, Tessari Hicks KJ, Duque LF, Restrepo A, Diez-Roux AV. Am. J. Epidemiol. (2012) 175 (10):

13 Community diagnoses El Progreso Honduras Hot spots based on victimization survey 2008 Crime risk perceptions, 2008 Source: Galeana, F. Understanding Natural Hazard and Crime and Violence Risks in a Spatial Dimension: A Case Study of El Progreso, Honduras. World Bank Report,

14 Complex Data Approaches Homicide in Bogota,

15 15

16 16

17 17

18 18

19 Gaps and needs Information systems: Increased demand regionally!! Further improvement of indicators (quality and underreporting) Barriers to development of observatories: Funds (26%) Difficulty accessing information (12%) Lack of political support (12%) Lack of personnel (8%) Persistent deficiencies in information systems (6%) Corruption (data manipulation) Predictive analyses and capabilities Firearm-related issues: Strengthening of governance and protective policies (large regional disparities) Needs for evaluation and translational and implementation research Capacity building Links between urban violence internal conflicts or organized crime International policies (suppliers and consumers) 19