Fractured lives in fractured cities: towards a critical Public Health approach to urban violence

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Borde
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Latin American ◽  
Comparative Case Study ◽  
Public Health Approach ◽  
Urban Landscapes ◽  
Urban Violence ◽  
Market Driven ◽  
Critical Public Health ◽  
American Cities

Abstract Background 43 of the 50 cities with the highest homicide rates worldwide are Latin American. Although the mechanisms through which urban violence is (re-)produced are complex, the inequalities that shape fragmented Latin American urban landscapes and define the patterns of urban violence have been forged by sociopolitical processes including market-driven urban restructuring processes in the realm of “actually existing” neoliberalism. The comparative case study on two neighborhoods in Bogotá and Rio de Janeiro seeks to contribute to the development of a critical Public Health approach to urban violence that moves beyond the description of death registries and the association of discrete risk factors. Methods The case studies are based on qualitative analyses of 4 focus groups and 46 semi-structured interviews with residents and specialists (2016 and 2019) using the Framework Method as well as comprehensive literature reviews. Results Both cases reveal nuanced processes through which urban violence is produced and reproduced by different actors and suggest that violence is inherent in the market-driven territorial making and un-making of increasingly “fragmented” cities. The cases suggest that violence is implied in threats of eviction, “necropolitical” police/military interventions and in the silent imposition of a “slow death” on urban infrastructure and entire neighborhoods, which bring about health consequences that include injuries but also shape other health problems. Both cases provide evidence to suggest selective and contradictory state presence that implies, admits or reinforces violence. Conclusions The cases combat simplistic readings of Latin American urban violence as a phenomenon exclusively related to confrontations between rival drug gangs and the police or aggressive individuals by revealing a great variety of actors and processes involved in (re-)producing urban violence that have serious implications for life and health in Latin American cities. Key messages Need for a critical Public Health approach to urban violence that moves beyond the description of death registries and the association of discrete risk factors. A great variety of actors and processes is involved in (re-) producing urban violence that have serious implications for life and health in Latin American cities.

scholarly journals Urban violence and public health in Latin America: a sociological explanatory framework

2005 ◽  
Vol 21 (6) ◽  
pp. 1629-1648 ◽  
Author(s):  
Roberto Briceño-León
Keyword(s):  
Public Health ◽  
Latin America ◽  
Latin American ◽  
Interpersonal Violence ◽  
Drug Market ◽  
Urban Life ◽  
Urban Violence ◽  
Health Issues ◽  
American Cities ◽  
Social Level

Interpersonal violence has become one of the main public health issues in Latin American cities. This article presents a framework for sociological interpretation that operates on three levels, expressed in the factors that originate, foment, or facilitate violence. Macro-social factors include: social inequality due to the increase in wealth versus poverty; the paradox of more schooling with fewer employment opportunities; increasing expectations and the impossibility of meeting them; changes in family structure; and loss of importance of religion in daily life. At the meso-social level the analysis highlights: increased density in poor areas and urban segregation; masculinity cult; and changes in the local drug market. The micro-social level includes: an increase in the number of firearms; alcohol consumption; and difficulties in verbal expression of feelings. The article concludes with an analysis of how violence is leading to the breakdown not only of urban life but also of citizenship as a whole in Latin America.

scholarly journals Physician Suicide: A Scoping Review to Highlight Opportunities for Prevention

2019 ◽  
Author(s):  
Tiffany I. Leung ◽  
Sima S. Pendharkar ◽  
Chwen-Yuen Angie Chen ◽  
Rebecca Snyder
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Scoping Review ◽  
Suicide Risk ◽  
English Language ◽  
Data Extraction ◽  
Early Warning Systems ◽  
Public Health Approach ◽  
Data Limitations ◽  
Suicide Risk Factors

AbstractObjectiveThe aim of this scoping review is to map the current landscape of published research and perspectives on physician suicide. Findings could serve as a roadmap for further investigations and potentially inform efforts to prevent physician suicide.MethodsOvid MEDLINE, PsycInfo, and Scopus were searched for English-language publications from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that were non-English, or those that only mentioned physician burnout, mental health or substance use disorders were excluded. Data extraction was performed by two authors.ResultsThe search yielded 1,596 articles, of which 347 articles passed to the full-text review round. The oldest article was an editorial from 1903; 210 (60.3%) articles were published from 2000 to present. Authors originated from 37 countries and 143 (41.2%) were opinion articles. Most discussed were suicide risk factors and culture of practice issues, while least discussed themes included public health and postvention.ConclusionsConsistency and reliability of data and information about physician suicides could be improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for physicians have been explored, and several remain poorly understood. Based on this scoping review, a public health approach, including surveillance and early warning systems, investigations of sentinel cases, and postvention may be impactful next steps in preventing physician deaths by suicide.

Development of a Tool to Improve Screening Rates for Cardiometabolic Risk Factors Associated with Mental Illness

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Newcomer ◽  
D. Haupt
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Cardiometabolic Risk ◽  
Plasma Lipids ◽  
Drug Effects ◽  
Premature Mortality ◽  
Public Health Approach

Major mental illness is associated with premature mortality, primarily from cardiovascular disease. Modifiable risk factors include obesity, smoking, hyperglycemia, dyslipidemia and hypertension, all prevalent in this population, and commonly underrecognized and undertreated. Public health guidelines for screening and interventions to lower risk have reduced cardiovascular mortality in the general population, but these improvements have not extended to mentally ill populations. Recent recommendations to screen in this population have come from psychiatric professional groups, and in relation to regulatory warnings on potential adverse drug effects. However, recent studies suggest low levels of monitoring, both pre- and post-guidelines and warnings.Public health interest is now directed at improving screening in this population. One of the barriers to increasing screening is limited awareness among mental health professionals of the details of existing public health guidelines that define specific risk thresholds, diagnostic values and treatment targets for adiposity, blood pressure, plasma glucose and plasma lipids levels. Quality assurance/quality improvement (QA/QI) tools to facilitate screening include data collection forms that educate about risk parameters and organize patient data in a manner that helps to track risk over time.This presentation will describe a specific QA/QI tool for screening and monitoring cardiometabolic risk in the mentally ill, based on published guidelines from the European Association for the Study of Diabetes (EASD) and the European Society for Cardiology (ESC). Cardiometabolic screening, along with treatment approaches and interventions to reduce risk, offers an established public health approach to lower morbidity and mortality in vulnerable populations.

scholarly journals Developing services for a public health approach to child maltreatment

2012 ◽  
Vol 20 (3) ◽  
pp. 323-342 ◽  
Author(s):  
Ruth Gilbert ◽  
Jenny Woodman ◽  
Stuart Logan
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cost Effectiveness ◽  
Child Maltreatment ◽  
Health Services ◽  
Child Protection ◽  
Public Health Approach ◽  
Protection Systems ◽  
Reduce Risk ◽  
The Right

Calls for a public health approach to child maltreatment – a strategy that aims primarily to reduce risk factors for maltreatment - have been based on four main arguments. (O’Donnellet al. 2008; Reading et al. 2009; Barlow and Calam, 2011) The right of children to be protected from harm in the first place. The frequency of child maltreatment, which, if all occurrences were notified, would overwhelm child protection systems. The inaccuracy of identification systems, which miss the large majority of maltreated children. And fourth, the effectiveness and cost effectiveness of intervening to prevent child maltreatment comparing with intervention once child maltreatment has occurred. We review the evidence to support these arguments and trace the development of UK policy and health services towards a public health approach.

scholarly journals Chagas disease at the crossroad of international migration and public health policies: why a national screening might not be enough

2011 ◽  
Vol 16 (37) ◽  
Author(s):  
C Di Girolamo ◽  
C Bodini ◽  
B L Marta ◽  
A Ciannameo ◽  
F Cacciatore
Keyword(s):  
Public Health ◽  
Chagas Disease ◽  
Latin American ◽  
Social Issues ◽  
International Health ◽  
Health Priorities ◽  
Public Health Approach ◽  
Disciplinary Boundaries ◽  
The One ◽  
Year 2000

Since the year 2000, Chagas disease, traditionally known as a rural Latin American affliction, has been rising in the ranking of international health priorities due to the growing migration flows from endemic areas to non-endemic ones. Using the example of Italy and reporting preliminary results of a study carried out in the district of Bologna, the paper will argue that a disease-centred public health approach might be inadequate when dealing with complex and uncertain situations, in which complete statistical data are not available or not reliable, and in which the involved actors, health professionals on the one side, migrants on the other, appear to be unaware of the issue, or might even be denying it. In such a context, an effective public health approach should be capable of crossing disciplinary boundaries and bridging the gap between health services and communities, as well as between health and social issues.

Public health and terrorism

2018 ◽  
pp. 499-502
Author(s):  
Kamaldeep Bhui
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Criminal Justice ◽  
Protective Factors ◽  
Potential Risk ◽  
Public Health Approach ◽  
Potential Risk Factors ◽  
Research Findings ◽  
Pros And Cons ◽  
Public Health Strategies

This chapter describes terrorism and radicalization as processes that are usually managed by the criminal justice system, and erroneously applying information from convicted offenders to populations. Terrorism and radicalization are now proposed to be helpful targets of public health strategies, in order to shift potential risk factors and protective factors into more favourable profiles. Although the field is in its infancy, this chapter sets out some of the pros and cons of adopting a public health approach to tackle terrorism. Public health approaches to tackling violence are discussed, alongside research findings on how these might be adapted for tackling terrorism.

Suicide Prevention Pathways: linking risk and behaviour within the Maltese context

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Cachia
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Risk Factors ◽  
Health System ◽  
Suicide Prevention ◽  
Acute Stress ◽  
Clinical Information ◽  
Public Health Approach ◽  
Age Related ◽  
Increased Risk

Abstract Background People engage in suicidal behaviour as a result of several risk factors, such as acute stress, severe depression, violence, sexual abuse, etc. Beyond such evidence from literature, a mental public health approach to suicide prevention needs also to take into account specific country characteristics and to look beyond the demographic characteristics of deaths by suicide. Available clinical information can help identify and quantify risk, analyse patterns of behaviour, explore links between risk and behaviour and provide possible suicide prevention pathways. Methods In this study, the 128 deaths by suicide for the period 2015-2019 in Malta are analysed against available clinical information. Major sources of detailed clinical information include obligatory notifications to the Commissioner for Mental Health of all cases involuntarily admitted to acute psychiatric services and other medical records held within the Maltese public mental health system. Results 84% of 128 deaths by suicide for the period 2015-2019 were males, two-thirds of them between 25 and 54 years. The preliminary findings have confirmed that less than 50% of these deaths had previous contact with the public health system. The two main diagnostic criteria among deaths with recent psychiatric admission/s were acute stress reaction to personal life events and very severe mood disturbances, particularly depression. There seems to be increased risk among migrants and foreign workers residing and working in Malta. The frequency of prior admissions, age-related issues, the time-event relationships and relevance of elicited clinical findings are still being evaluated, and will be presented in more detail in the workshop. Conclusions Exploring risk factors within the history of cases of suicide and attempted suicide through available clinical information can contribute to the development of suicide prevention pathways, relevant to the specific context of local communities.

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