VIOLENCE PREVENTION IN LOW- AND MIDDLE-INCOME COUNTRIES: Finding a Place on the Global Agenda by Institute of Medicine of the National Academies

Author:Institute of Medicine of the National Academies
Language: eng
Format: epub
Tags: Behavioral and Social Sciences
Publisher: NATIONAL ACADEMY PRESS
Published: 2008-01-25T00:00:00+00:00

Reduce Access to Lethal Means

The lethality of interpersonal, self-directed, and collective violence is affected by the means people use to carry out this violence. Reducing access to these lethal means may help to minimize the health consequences of violence. For example, a primary means of attempting and completing suicide in many developing countries is self-poisoning by use of pesticides. In Samoa, the introduction of paraquat was associated with a 367 percent increase in suicide rates between 1972 and 1981. 49 Efforts to control access to paraquat began in 1981 and the suicide rate dropped by more than two-thirds by 1988. Similarly, controlling access to lethal doses of sedatives such as barbiturates has also been found to help reduce suicide. 50

Firearms are another common means for committing homicide and suicide. A wide variety of strategies have been employed to restrict access to firearms, such as mandating waiting periods before purchase, promoting safe storage, and limiting where firearms can and cannot be carried. In the mid 1990s, Colombian officials in Bogotá and Cali, noting that homicide rates increased during weekends following paydays and national holidays and near elections, implemented a ban on carrying handguns during these times, resulting in an almost 14 percent reduction in homicide rates. 51 In the Australian state of Victoria, firearm-related suicides, assaults, and unintentional deaths decreased following two periods of legislative reform: the 1988 implementation of legislation requiring the registration of all firearms and the 1996 strengthening of licensing regulations and addition of a mandatory waiting period. 52 However, the evidence to determine whether or not such strategies are effective in reducing firearm-related homicides is currently insufficient, 53 although several policies hold promise. 54 , 55

There is some evidence that homicide rates tend to increase after wars. 56 One factor contributing to this may be that weapons remaining in war-stricken regions contribute to mortality and injuries even after wars are over. 57 Many of the weapons used during the wars in Mozambique, Angola, and Namibia, for example, are now in the hands of criminals. 58 The relationship between collective and interpersonal violence may help explain why in regions like sub-Saharan Africa rates of both homicide and war-related deaths are high. 11 Efforts to disarm former combatants may help to reduce the lethality of violence that often occurs in the aftermath of wars.

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