Violence as a global health challenge: A case analysis of Jamaica using an interdisciplinary approach

Interpersonal violence has devastating effects on human society because of long-term impacts on economic, health, and human development. It has been recently recognized as a major global health problem contributing significantly to the global burden of disease. Jamaica has the third highest murder rate in the world and a long history of politically motivated violence.The purpose of this study was to use a public health approach to investigate the problem of violence in Jamaica. The research design included the application of the epidemiologic model of injuries to a dataset of violence-related injuries. Data were collected and analyzed on reported murders (n = 4873) between 1998--2002. Specific variables related to the location of the murder incidents were reclassified, case narratives were reviewed and additional variables created for more detailed analysis. Semi-structured interviews were conducted with 26 key informants. Both datasets were triangulated.In Jamaica, males are nine times more likely to be murder victims. Persons 0--14 years are more likely to be killed because of domestic disputes; 15--44 years because of reprisals; and 45 years and older because of robbery. Males are mainly killed due to reprisals; women due to domestic disputes.Guns are the main weapons in murders and are primarily used in reprisals. Reclassified variables reveal that murders are concentrated in urban areas of all parishes and 15.1% of the murders occur in the home.Key informant interview data suggest the main causes for murder are related to breakdown in family values, economic stress, lack of access to the justice system and weak institutions in civic society. One main problem is the failure of the government to implement sustainable plans to reduce violence.Recommendations include improving data collection and classification to guide data-driven strategies; institutionalizing conflict management education and increasing protective factors for boys. There is the need to develop a national violence prevention plan based on timely and accurate data to target specific groups at risk. These policies must be multi-sectoral and non-partisan for sustainability and longevity. Epidemiologic surveillance must also be an integral part in violence prevention strategies for evaluation and timely modification of strategies as needs evolve