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Community-Based Participatory Research Studies on Interpersonal Violence

Ending the Cycle of Poverty and Violence

steven s. coughlin, phd

This chapter provides an overview of the population health significance of interpersonal violence, its causes, and the prevention of interpersonal violence and intimate partner violence through evidence-based interventions. The roles of poverty and lack of economic opportunity in fueling youth violence, violence against women, and other forms of interpersonal violence are highlighted, as is the important role of CBPR studies in addressing interpersonal violence in diverse communities. Finally, lessons learned from CBPR studies on interpersonal violence are discussed and recommendations offered for further research including studies that examine the combined effectiveness of programs for violence prevention and creating economic opportunities.

The Population Health Importance of Interpersonal Violence

Each year, violence causes more than 1.6 million deaths worldwide.1-2 More than 90% of these deaths occur in low- and middle-income countries.3 Worldwide, an estimated 200,000 youth aged 10 to 29 years are murdered each year; about 83% of these deaths occur in males. Homicide is the fourth leading cause of death in young people. In addition to age and gender, disparities in homicide mortality have been identified according to race, ethnicity, socioeconomic status, and geographic locality.4 Homicide rates also vary widely between countries. For example, in some countries in Latin America and Africa, youth homicide rates are > 100 times higher than rates for countries in Western Europe and the Western Pacific.1-3

Youth violence includes bullying, slapping, hitting, and more serious acts such as robbery and assault that can result in injury or death. Young people can be a victim, an offender, or a witness to the violence.5 People exposed to violence can develop mental health conditions such as posttraumatic stress disorder, major depression, and alcohol or drug abuse, and they are at increased risk of suicide.3-6 The relation between exposure to violence-related trauma and posttraumatic stress disorder is one of dual causality. People suffering from posttraumatic stress disorder may attempt to self-medicate with alcohol or illicit drugs, which increases their risk of interpersonal violence, disrupted family relationships, unsafe sex, and becoming homeless or a victim of sexual violence.6

Other important categories of interpersonal violence include child abuse (physical, sexual, or emotional abuse), intimate partner violence (physical, sexual, or psychological harm by a current or former partner or spouse), and elder abuse.5 In 2013, there were 678,932 victims of child abuse and neglect reported to Child Protective Services in the United States.5 About 1,520 children died from abuse and neglect in 2013. Intimate partner violence is also frequent. About one in three women in the United States report ever having experienced physical violence, rape, or stalking by an intimate partner.7 Important disparities in intimate partner violence and other forms of domestic violence have been identified. For example, male-to-female domestic violence is over two times more frequent among Hispanics and African Americans than among non-Hispanic Whites.8

Because behavior is influenced by events and exposures during earlier stages in life and early child development, a life-course approach can contribute to understanding the causes of interpersonal violence.3 Maltreated children are at increased risk of either perpetrating or becoming the victim of interpersonal violence later in life. Many factors account for youth violence including individual characteristics (e.g., a history of involvement in crime, aggressive behavior, psychological conditions such as conduct disorder or substance abuse); family factors (e.g., poor parental supervision or parental involvement in crime); relationships with peers; and community characteristics such as poverty, income inequality, unemployment, neighborhood crime, gangs, and ease of access to guns and illicit drugs.3

 
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