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Abstract
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The devastating effects of violence experienced by individuals is decimating homes, neighborhoods, and communities across the US. Since 2019, US homicide rates have increased by 35%, to 8.1 per 100 000 population in 2021,1 rising in parallel with an overall increase in violent crimes. The complex public health problem of violence can present in many forms, including assault, homicide, suicide, intimate partner violence, child abuse, elder abuse, and others. These preventable violent injuries and deaths impose a steep human toll and have important economic consequences, including costs for acute care, the need for long-term home health care, loss of productivity, and the inability to reintegrate back into society.
According to estimates from the National Center for Injury Prevention and Control, nearly 2 million people were treated in US hospital emergency departments in 2020 for assault-related injuries.2 Child physical abuse is experienced by approximately one-quarter of children at some point in their lives and by as many as 1 in 5 girls are sexually abused during childhood.3 Intimate partner violence has been experienced by about one-third of both women and men,4 and half of homicides among women are related to intimate partner violence.5 Elder abuse, in the form of physical, sexual, and psychological abuse, is experienced by approximately 10% to 15% of people aged 60 years or older living in the US,6 with an estimated 95% of incidents going unreported. Violence across these ages, genders, and vulnerable populations adversely affects urban, suburban, and rural communities. Violence is one of the most extreme manifestations of racial, ethnic, and economic disparities in the US, with substantially higher rates in historically disadvantaged communities.7 Few health problems exhibit such large inequities in incidence and outcome. Over the past 3 years, the COVID-19 pandemic and associated social isolation caused a rise in all forms of violence, with a substantial increase in homicides. The pandemic disrupted all aspects of life, including the ability of people experiencing intimate partner and other forms of violence to seek care.
Violence accounted for 75 121 deaths in the US in 2021.1 These deaths involved family members, loved ones, and individuals who represent the social fabric of communities. Each loss of life has a ripple effect that spreads across cities and states, and more often affects communities with high proportions of racial and ethnic minority populations. In addition, those who survive violent incidents often experience profound physical and mental health effects. Scientific investigations evaluating the effects of violence on health have depicted changes in the brain's white and gray matter structure, volume and functional connectivity, neurotransmitter metabolism, and chronic inflammation, as well as epigenetic effects and changes in the microbiome.7 Decades of research have also demonstrated how adverse childhood experiences, defined by the Centers for Disease Control and Prevention as potentially traumatic events that occur in childhood (ages 0-17 years), are associated with negative effects on physical and mental health throughout adulthood...
Language: en |