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much the same way as public health has exploited such variations in cancer and other diseases to identify prevention strategies. He also noted that the interrelationship between sexual violence and sexually transmitted diseases, coupled with approximately 5 million new cases of HIV reported each year, dramatically highlights the important interconnection between HIV and violence prevention.

As director of the IOM Board on Global Health, Dr. Kelley expanded on the board’s growing awareness that global health, and America’s vital interest in it, must be seen in a larger context than infectious disease prevention and management. The consequences of violence are transnational and transgenerational; they emphasize the need for America’s increased interest in and support for alleviating the burdensome toll and costs that pervasive violence disproportionately exacts on developing countries and their people. These consequences affect the political and economic stability of societies and their institutions; the ability of children to grow into productive adults capable of community and family leadership; and the ability of women to protect themselves from HIV/AIDS and other reproductive health problems. In conclusion, he identified the important role for workshop participants to disseminate its messages to those who can use the tools of public health and policy making, not only to elevate violence prevention to the center of the global public health agenda, but also to help identify how the U.S. government and other leaders with resources can more effectively support violence prevention programming.


Dr. Mark Rosenberg, the chair of the workshop planning committee, focused his opening remarks on differentiating the public health approach from that of health care; providing a brief, selective history of violence and public health; explaining the tenets of a public health approach; and lastly, exploring the relationships among different types of violence to help lay the foundation for the ensuing discussions. To begin, the major difference between approaches is that health care is focused on providing help to those who present to its facilities, while public health is focused on the health of everyone—regardless of whether they are known to us, where they may live, the families to whom they belong, or whether they have yet to be born. The public health focus also takes into account what the 90 percent of people who bear the burden of interpersonal and self-directed violence in developing countries have faced for their survival and what they may face in the future. While many recognize the importance of treating the major epidemics that are ravaging the world to facilitate economic and social development, more must come to believe that these efforts must include violence prevention.

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