Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 1
1
Introduction
The costs of violence are borne by all segments of society, but their
measurement and impact are difficult to quantify. Traditional approaches,
consisting mostly of measuring the direct economic effects of healthcare
utilization and productivity loss, vastly underestimate the additional social
and developmental costs of both morbidity and mortality.
Beyond the measurable costs, violence causes pain and suffering, can
lead to chronic trauma, affects child development, and can increase the risk
of chronic health outcomes later in life (Repetti et al., 2002). As well, vio-
lence affects communities and societies, leading to losses in business sectors,
financial divestment, and increased burden on the healthcare and justice
systems. Although some methodologies exist for estimating such social or
indirect costs, many are confounded by uncertainties in definitions and lack
of rigorous evidence of causative factors.
Nevertheless, even initial and crude estimates of both the cost of vio-
lence and the cost of prevention show the financial benefits of early in-
tervention. In most cases, the cost of implementing successful preventive
interventions is less than the cost to individuals and society of inaction.
On April 28-29, 2011, the Institute of Medicine’s (IOM’s) Forum on
Global Violence Prevention convened its second workshop to explore the
social and economic costs of violence. Part of the Forum’s mandate is
to engage in multisectoral, multidirectional dialogue that explores cross-
cutting public health approaches to violence prevention. To that end, the
workshop was designed to examine these approaches from multiple per-
spectives and at multiple levels of society. In particular, the workshop was
focused on exploring the successes and challenges presented by calculating
1
OCR for page 2
2 SOCIAL AND ECONOMIC COSTS OF VIOLENCE
and categorizing both direct and indirect costs at multiple levels of society,
as well as the potential cost-effectiveness of intervention. Speakers were
invited to share the progress and outcomes of their work and to engage in
dialogue exploring gaps and opportunities in the field.
The workshop was planned by a formally appointed committee of the
IOM, whose members created an agenda and identified relevant speakers.
Because the topic is large and the field is broad, presentations at this event
represent only a sample of the research currently being undertaken. Speak-
ers were chosen to present a global, balanced perspective, but by no means
a comprehensive one. Given time and resource constraints, the planning
committee members chose speakers who could provide diverse perspectives
upon which further discussion could occur. The agenda for this workshop
can be found in Appendix A.
ORGANIZATION OF THE REPORT
This summary provides a factual account of the presentations given at
the workshop. Opinions expressed within this summary are not those of the
Institute of Medicine, the Forum, or its agents, but rather of the present-
ers themselves. Statements are the views of the speakers and do not reflect
conclusions or recommendations of a formally appointed committee. This
summary was authored by a designated rapporteur based on the workshop
presentations and discussions and does not represent the views of the insti-
tution, nor does it constitute a full or exhaustive overview of the field.
The workshop summary is organized thematically, covering the major
topics that arose during the 2-day workshop, so as to provide a larger con-
text for these issues in a more compelling and comprehensive way. In addi-
tion, the thematic organization allows the summary to serve as an overview
resource of important issues in the field. The themes were chosen as the most
frequent, cross-cutting, and essential elements that arose from the workshop,
but do not represent the views of the IOM or a formal consensus process.
The first part of this report consists of four chapters, which provide
the summary of the workshop; the second part consists of submitted papers
and commentary from speakers regarding the substance of the work they
presented at the workshop. These papers were solicited from speakers to
provide further information about their work, though not all speakers con-
tributed papers. The appendix contains additional information regarding
the agenda and participants.
DEFINITIONS AND CONTEXT
Violence is defined by the World Health Organization (WHO) as “the
intentional use of physical force or power, threatened or actual, against
OCR for page 3
3
INTRODUCTION
oneself, another person, or against a group or community that either results
in or has a high likelihood of resulting in injury, death, psychological harm,
maldevelopment, or deprivation” (WHO, 2002). WHO further categorizes
violence into seven types: child and elder abuse, sexual and intimate part-
ner violence, youth and collective violence, and self-directed violence. This
workshop examined all seven types of violence, as well as the underlying
common risk factors and common outcomes.
The workshop explored both social and economic costs—the latter
more easily quantifiable than the former—at four ecological levels: indi-
vidual, family, community, and societal. While costs, benefits, outcomes,
and measurement indicators can be defined differently, all workshop par-
ticipants provided the context of their presentations and attempted to relate
their content to a common framework. Speakers endeavored to enumerate
costs and benefits where possible and to describe other potential costs where
no suitable accounting methodology exists. Costs included not just the im-
mediate and direct, but also the longer-term, widespread, and indirect.
The next four chapters examine the four major themes that arose from
participants’ presentations and discussions: approaches to measurement
and costing methodology (Chapter 2), challenges in calculating cost (Chap-
ter 3), the creation of a bigger picture of the costs of violence (Chapter 4),
and the promise of investing in violence prevention (Chapter 5). The three
chapters in Part II include the submitted papers, organized as direct and
indirect costs (Chapter 6), context and place (Chapter 7), and investing in
prevention (Chapter 8).
Finally, the appendixes consist of the agenda (A), the speakers’ biogra-
phies (B), the planning committee members’ biographies (C), and the Forum
on Global Violence Prevention members’ biographies (D).
ACKNOWLEDGMENTS
The Forum on Global Violence Prevention was established to address a
need to develop multisectoral collaboration among stakeholders. Violence
prevention is a cross-disciplinary field that could benefit from increased
dialogue among researchers, policy makers, funders, and practitioners. As
awareness of the insidious and pervasive nature of violence grows, so too
does the imperative to mitigate and prevent it.
A number of individuals contributed to the successful development
of this workshop and report. These include IOM staff: Rosemary Chalk,
Angela Christian, Patrick Kelley, Elena Nightingale, Julie Wiltshire, and
Jordan Wyndelts. The Forum staff, including Deepali Patel, Megan Perez,
Rachel Pittluck, and Rachel Taylor, also put forth considerable effort to
ensure this workshop’s success. The staff at the Kaiser Family Foundation’s
Barbara Jordan Conference Center provided excellent support for the event.
OCR for page 4
4 SOCIAL AND ECONOMIC COSTS OF VIOLENCE
The planning committee contributed several hours of service to de-
velop and execute the agenda, with the guidance of Forum membership.
Reviewers also provided thoughtful remarks in reading the draft manu-
script. These efforts would not be possible without the work of the Forum
membership itself, an esteemed body of individuals dedicated to the concept
that violence is preventable. Their names and biographies can be found in
Appendix D.
The overall successful functioning of the Forum and its activities rests
on the foundation of its sponsorship. Financial support for the Forum on
Global Violence Prevention is provided by the Department of Health and
Human Services: Administration on Aging, Administration on Children,
Youth, and Families, Office on Women’s Health; Anheuser-Busch InBev;
Avon Foundation for Women; BD (Becton, Dickinson and Company);
Catholic Health Initiatives; Centers for Disease Control and Prevention; Eli
Lilly and Company; Department of Education: Office of Safe and Drug-Free
Schools; Department of Justice: National Institute of Justice; Fetzer Insti-
tute; F. Felix Foundation; Foundation to Promote Open Society; The Joyce
Foundation; Kaiser Permanente; National Institutes of Health: National
Institute on Alcoholism and Alcohol Abuse, National Institute on Drug
Abuse, Office of Research on Women’s Health, John E. Fogarty Interna-
tional Center; Robert Wood Johnson Foundation; and the Substance Abuse
and Mental Health Services Administration.
REFERENCES
Repetti, R. L., S. E. Taylor, and T. E. Seeman. 2002. Risky families: Family social environ-
ments and the mental and physical health of offspring. Psychological Bulletin 128(2):
330-366.
WHO (World Health Organization). 2002. World report on violence and health. Geneva.
