Primary Prevention of Physical Violence and Abuse in British Columbia

Physical violence and abuse related injuries are a significant public health concern. The burden of injury from physical violence and abuse is difficult to ascertain, however morbidity and mortality data from BC have assisted in elucidating the prevalence of assault-related deaths and injuries in the province.

Assault-related mortalities in BC demonstrated the following trends:

  • Males presented higher assault-related deaths when compared to females at a ratio of 3:1 with assault-related deaths peaking among those aged 20-24 years.
  • Between 1990 and 2003, assault-related mortality rates in BC declined among both males and females, which is consistent with national declines in assault-related mortality rates attributed to demographic, social and economic factors.
  • The leading method of injury for assault -related deaths among males was firearms and explosives (37%), predominantly among male s aged 15-64 years. Among females, cutting and stabbing (27%) was the leading cause among females aged 15-75+ years.
  • Assault related deaths occurred primarily at home (53%), suggesting that domestic or intimate partner violence should be evaluated as a potential precipitating factor for assault-related deaths.

Assault-related hospital separations in BC demonstrated the following trends:

  • Males accounted for a higher number of assault-related hospital separations when compared to females at an approximately 5:1 ratio, peaking among males aged 15-24 and declining among males aged 25-69 years.
  • Between 1990-2003, there was a similar pattern of decline for assault-related hospital separation rates among both males and females in BC.
  • The leading cause of injury for assault-related hospital separations among both males and females was bodily force (60.7%) among persons aged 15-75 years.
  • Forty-five percent of assault-related hospital separations occurred in an unspecified place, indicating that additional surveillance may be required to determine the location of injury occurrence.

To address physical violence and abuse, the BC Ministry of Health commissioned this systematic review to determine how physical violence and abuse injuries may be reduced by utilizing primary prevention initiatives, within a public health model. The review focuses on the strength of evidence supporting which interventions have demonstrated effectiveness in the primary prevention of physical violence and abuse. The results of this review will be used to inform programming and planning for the primary prevention of physical violence and abuse by health authorities in BC.

To ensure that evidence-based practices were ecologically valid, the Spectrum of Injury Prevention Model (Cohen & Swift, 1999) was used. The Spectrum of Prevention Tool is a multifaceted systems approach to injury prevention targeting the individual, family, community and policymakers (Cohen & Swift, 1999). The Spectrum of Prevention Tool consists of six levels of increasing scope, and encourages an overall strategy to injury prevention.

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