Interpersonal violence: An important risk factor for disease and injury in South Africa

Norman, Rosana, Schneider, Michelle, Bradshaw, Debbie, Jewkes, Rachel, Abrahams, Naeemah, Matzopoulos, Richard and Vos, Theo (2010) Interpersonal violence: An important risk factor for disease and injury in South Africa. Population Health Metrics, 8 32: 1-12. doi:10.1186/1478-7954-8-32

Author Norman, Rosana
Schneider, Michelle
Bradshaw, Debbie
Jewkes, Rachel
Abrahams, Naeemah
Matzopoulos, Richard
Vos, Theo
Title Interpersonal violence: An important risk factor for disease and injury in South Africa
Journal name Population Health Metrics   Check publisher's open access policy
ISSN 1478-7954
Publication date 2010-12-01
Sub-type Article (original research)
DOI 10.1186/1478-7954-8-32
Open Access Status DOI
Volume 8
Issue 32
Start page 1
End page 12
Total pages 12
Editor Christopher J. L. Murray
Alan D. Lopez
Place of publication London United Kingdom
Publisher BioMed Central
Collection year 2011
Language eng
Formatted abstract
Background: Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa.

Methods: The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence.

Results: Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs) or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5%) in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs.

Conclusions: The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring the disease burden from interpersonal violence as a risk factor and the need to improve the epidemiological data on the prevalence and risks for the different forms of interpersonal violence to complete the picture. Given the extent of the burden, it is essential that innovative research be supported to identify social policy and other interventions that address both the individual and societal aspects of violence.
Keyword Aggressive behavior
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 17 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 22 Feb 2011, 14:51:24 EST by Geraldine Fitzgerald on behalf of School of Public Health