EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART III - HEALTH CAUSES, FACTORS AND DETERMINANTS

10. HEALTH DETERMINANTS

10.6. Social determinants

10.6.3. Violence and other behaviours against society

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10.6.3. Violence and other behaviours against society

 

 

10.6.3.1. Introduction

 

Assaults and threats are forms of behaviour which have very bad consequences on the social texture of affected communities. Interpersonal violence accounts for 2% of fatal injuries of all age groups in the EU27 and in particular for 5% in the 1-4 years age group. Violence is not distributed evenly among sex or age groups. More men than women are victims of violence.

 However, the definition of violence according to the World Health Organisation includes neglect and psychological violence (including bullying). The results of this sort of violence are harder to detect and quantify. Thus, the issue is under-addressed. Yet unlike a physical injury, this sort of violence may be endured over a period of time, and in the privacy and supposed safety of one’s home. Moreover, it is the most vulnerable members of societychildren, the elderly, and some categories of women – who are the victims of this kind of violence

 

10.6.3.2. Data sources

 

The WHO has a website (http://www.euro.who.int/violenceinjury/violence/20050208_1) dedicated to violence information and prevention. The WHO World Report on Violence and Health contains interesting facts on the global perspective of the problem of violence (WHO, 2002).

 

The EUICS Consortium maintains a website (http://www.europeansafetyobservatory.eu/) with information retrieved by means of survey-based comparative measurement of a large sample of the European public. The EUICS Consortium activities developed a new instrument, the European Crime and Safety Survey which follows on from the International Crime Victims Surveys (ICVSs), and which addresses new needs for European comparative data for policy-makers. EUICS publishedcomparative analysis of crime and safety in Europe  (EUICS, 2005).

 

Additional sources of information on violence (e.g. homicides, are quoted in Chapter 7.

 

 

10.6.3.3. Data description and analysis

 

Homicides: As far as homicides are concerned, a detailed analysis has been carried out in Chapter 7 (See figure 7.17).

 

Contact crimes: The three contact crimes in the European Crime and Safety Survey are robbery, sexual incidents, assaults and threats. Sexual incidents are divided into sexual assault and what victims describe as offensive sexual behaviour. Assaults and threats can be separated into assaults with force and threats only. It should be borne in mind that risks are relatively low for each type of contact crime. Firm conclusions about relative vulnerability are therefore hard to draw.

 

Sexual offences: Measuring sexual incidents is extremely difficult in victimisation surveys, since perceptions as to what is an unacceptable sexual behaviour may differ across countries, as well as readiness the to report incidents to an interviewer over the phone. It is feasible that women in countries where gender equality is less advanced are less inclined to report sexual incidents, thereby deflating the national rates. The measures, then, need to be interpreted with great caution. In the 2005 sweep of the EU ICS the question was put to both female and male respondents45. Positive answers from male respondents were much lower than from females. On average, 0.5% of male respondents recorded a sexual incident. Somewhat higher percentages were recorded only in Denmark (1.9%) and in the Netherlands (1.4%). On average, 1.7% of women reported a victimisation. In order to maintain comparability with the results of previous ICVS sweeps, the rates have been calculated only for women. Margins of error around the rates for sexual offences are therefore larger than for other offences. Figure 10.6.3.1. shows the results. Some countries, notably Spain, Finland, Estonia, Poland and France show remarkable decreases in sexual incidents compared to previous years.

 

Assaults and threats: Overall, 3% of respondents to the question asked to identify assaults and threats indicated that they had been a victim of an assault with force or threat of force.46 The United Kingdom, Ireland and the Netherlands reported higher than average rates (4% and above). The lowest levels were reported in Italy, Portugal, Hungary and Spain (below 2%). Figure 10.6.3.1. shows national rates.

 

Figure 10.6.3.1. Prevalence rates for robbery, sexual offences of women, assaults and threats

 

Physical and sexual assaults occur daily, though precise national and international estimates of this sort of offences are lacking (see Tables 9.5.5 and 9.5.6). Not all assaults result in injuries severe enough to require medical attention and – even among those that do result in serious injuriessurveillance systems for reporting and compiling these injuries are in many countries either lacking or still being developed. Obviously, hospital discharge data only give a rough picture of the circumstances of non-fatal injuries due to homicide, assault and other violence.

 

Interpersonal violence is an issue of growing public concern and includes domestic violence, child abuse, abuse of the elderly and youth violence. Interpersonal violence has many forms (physical, mental and sexual), occurs in different environments (in the family, between intimate partners, in the community, in institutions and at work) and undermines social and economic conditions in society. No single factor explains why some individuals behave violently towards others or why violence is more prevalent in some communities than in others.

 

The inadequacy of the data, and thus of society’s knowledge on the suffering of non-physical violence including child neglect and abuse, is clear from the major limitations of the tables. Unfortunately, this sort of neglect enters into the statistics only when it reaches the extremes of unavoidable physical manifestation or death. It is not possible to undertake surveys on infants or  house-bound frail elderly to ask their abuse rate. Moreover, some abuse to both children and the elderly actually occurs in institutions. Both domestic and institutional abuse are a problem and a challenge requiring much more active investigation in Europe.

 

At international level, the Secretary General of the United Nations, the World Health Organisation, and the International Society for the Prevention of Child Abuse and Neglect (IPSCAN) are seeking to address this challenge with each seeking to establish measures and compile national statistics. But within Europe the challenge is yet to be strongly addressed. One current project is a strand on Inter-Personal Violence within the Public Health Actions for a Safer Europe (PHASE) project, but this is limited to main physical injuries.

 

10.6.3.4. Control tools and policies

 

Violence is the result of the complex interplay of individual, relationship, social, cultural and environmental factors. Understanding how these factors are related to violence is one of the most important steps in the public health approach for preventing violence. As violence is a multifaceted problem with biological, psychological, social and environmental roots, it needs to be immediately confronted at several different levels. The recording of violence by the police is not sufficiently accurate or detailed. In addition, the issue is heavily under-reported due to the reluctance of victims to make reports. There is a need for more systematic documentation and dissemination of violence prevention practices, in particular involving the health sector in collaboration with the police, justice and welfare system. Stakeholders need to be empowered by the provision of tools for planning, implementing and evaluating violence prevention projects. Dealing with violence on a range of levels involves addressing all the following issues:

 

·          Addressing individual risk factors and taking steps to modify individual risk behaviours, including the use of alcohol;

·          Influencing close personal relationships and working to create healthy family environments, as well as providing professional help and support to dysfunctional families;

·          Monitoring public places such as schools, workplaces and neighbourhoods and taking steps to address problems that might lead to violence;

·          Addressing gender inequality, and adverse cultural attitudes and practices; and

·          Addressing the larger cultural, social and economic factors that contribute to violence and taking steps to change them, including measures to close the gap between the rich and poor and to ensure equitable access to goods, services and opportunities.

 

The perception of safety is naturally related to crime rates and the risk for victimization. However, looking at the subjective perception of safety, it is especially the occurrence of physical or environmental cues in the residential environment that leads to insecurity and feelings of not being safe. Such cues can be physical incivilities such as deterioration of neighbourhoods, trash or graffiti (indicating a low community spirit and, in effect, a low social control), and social incivilities such as conspicuous youth groups or people with a strange behaviour (questioning the degree to which social norms and customs may be kept). Overall, people are more likely to maximize the use of outdoor space if the area is perceived as safe. Street lighting, police patrols and adequate environmental and building design improvements show crime reduction effects and increase the confidence of residents at night-time.

 

 

 

10.6.3.5. References

 

EUICS (2005): The Burden of Crime in the EU [on-line publication available at: http://www.europeansafetyobservatory.eu/downloads/EUICS_The%20Burden%20of%20Crime%20in%20the%20EU.pdf].

 

WHO (2002): World Report on Violence and Health [on-line publication available at: http://www.who.int/violence_injury_prevention/violence/world_report/en/]

 

 





45    The question put to respondents was: "First, a rather personal question. People sometimes grab, touch or assault others for sexual reasons in a really offensive way. This can happen either at home, or elsewhere, for instance in a pub, street, at school, on public transport, in cinemas, on the beach, or at one's workplace. Over the past five years, has anyone done this to you? Please take your time to think about this."



46    The question was: 'Apart from the incidents just covered, have you over the past five years been personally attacked or threatened by someone in a way that really frightened you, either at home or elsewhere, such as in a pub, in the street, at school, on public transport, on the beach, or at your workplace?'