Violence is a major public health concern that impacts individuals, families, communities, and countries worldwide. Globally, violence results in more than 1.3 million deaths per year with many more suffering from non-fatal injuries and chronic conditions due to violence.[1] Reacting to violence after it has occurred is costly and often does not tackle root causes. While enforcement-based violence reduction methods are most popular and can create immediate results, they have not necessarily been shown to lead to deeper social change in the long term.[2] This approach has done little to interrupt the cyclical, inter-generational and systemic nature of violence which pervades many countries. Several scholars and practitioners have argued that real and lasting change must address the root causes and social norms that perpetuate violence and homicides. One such strategy is the use of the public health approach.
The good news - violence is preventable.
As stated by the World Health Organization, “[t]he factors that contribute to violent responses – whether they are factors of attitude and behaviour or related to larger social, economic, political and cultural conditions – can be changed. Violence can be prevented. This is not an article of faith, but a statement based on evidence.”[1] Communities throughout the world are investigating various approaches to prevent and reduce violence and Jamaica is no different.
Crime and violence are serious issues in Jamaica. In comparison to other countries in the Latin America and Caribbean region, Jamaica’s homicide rate is noticeably higher. In 2017, the homicide rate was 56 per 100,000, the second highest rate globally.[3] Also in 2017, interpersonal violence was among the top ten causes of death and disability in Jamaica.[4]
Youth are the major segment of the population that are affected by crime and violence, both as victims and perpetrators. For many children, exposure to violence begins at home. Boys, children from poorer households and children in rural communities are most likely to be subjected to violent discipline.[6] In Jamaica, younger children are more likely to be subjected to physical punishment compared to their older counterparts. Violence not only occurs in the home, but also in schools as corporal punishment still occurs in Jamaica. Bullying is another issue that children face as 6 in 10 Jamaican students say they have been bullied at some point in their lives.[7]
The Violence Prevention Alliance (VPA) works within the framework of a public health approach that targets the root causes of violence and recognizes the need for improved services to mitigate the harmful effects of violence and create a violence-free and safe Jamaica. Ultimately, a preventative approach will break the inter-generational cycle of violence.[8] There are many factors to address when preventing violence. Factors can include education, employment, income, family dynamics, and social and cultural norms. As a result, interventions to prevent violence need to tackle all of these factors. VPA supports many projects that target violence against children and youth, interpersonal violence, and violence-related injuries.
The Change Your Future project offers training for at-risk and unattached youth to improve their hard and soft skills, as well as prepare participants for HEART training. Evidence illustrates that there are higher rates of crime in areas with a high level of unattached youth, particularly males. Additionally, unattached youth tend to require remedial education to gain employment. This project includes training, education, and employment opportunities. Additionally, it addresses barriers to participating through weekly stipends for lunch and transportation, as well as social support.
The Child Resiliency Programme is an after school programme that provides academic support, life skills training, music and arts, sports, parenting and family support, and nutrition. It is based on the growing evidence of both external and internal factors that protect adolescents from engaging in early unprotected sex, violence, drug use or other health risk behaviour. After one year of the program, there was a 75% reduction in the frequency and intensity of conflicts, 65% increase in anger management in children, and 70% improvement in the ability to resolve conflicts.
In 2017, VPA prepared the Cost of Care Project: An Analysis of the Epidemiology and Cost of Violence-related Injuries (VRIs) and Road Traffic Crashes (RTCs) to the Health Care System of Jamaica. The project reviewed cases of VRIs and RCTs from April to June 2014 at seven major hospitals in Jamaica. It also investigated the profile of the victims and perpetrators of violent injuries seen at hospital. It was found that VRIs cost Jamaica 8.6 billion dollars, RTCs cost 3.2 billion dollars, suicide and attempted suicide .8 billion dollars, totaling 12.6 billion.
In partnership with the Citizen Security and Justice Programme and DFID, VPA conducted community and asset mapping and women’s community safety profile plans. As part of this project, focus groups were conducted on violence, especially violence against women and children. The focus groups discussed general violence over the last five years, police-community relations, views on manhood and womanhood, intimate partner violence and its impact on children, ages at which parents expect their children to leave home, sexual relations, especially those between older men and schoolgirls and older women and schoolboys, child discipline and child abuse at home and in school.
Prevention is a key strategy to reducing violence in Jamaica. Greater attention and resources should be placed on taking an active role in reducing violence. The Violence Prevention Alliance aims to do just that.
References
[1] World Health Organization, Violence Prevention: The Evidence (Geneva, Switzerland: WHO, 2010), http://www.who.int/violence_injury_prevention/violence/4th_milestones_meeting/evidence_briefings_all.pdf.
[2] Butts J, Roman C, Bostwick L, & Porter J (2015) Cure Violence: A Public Health Approach. Annu Rev Public Health 36:39-53.
[3] Jamaica Constabulary Forces (JCF) Statistics 2017.
[4] http://www.who.int/violenceprevention/approach/definition/en/
[5] United Nations Children’s Fund. A Familiar Face: Violence in the lives of children and adolescents (New York:
UNICEF, 2017)
[6] Statistical Institute of Jamaica. Multiple Indicator Cluster Survey- Jamaica (Kingston, Jamaica: STATIN, 2011)
[7] https://www.unicef.org/jamaica/media_37374.html
[8] https://www.ncbi.nlm.nih.gov/books/NBK236956/#sec_00011of
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