Hyman Ilene, Vahabi Mandana, Bailey Annette, Patel Sejal, Guruge Sepali, Wilson-Mitchell Karline, Wong Josephine Pui-Hing
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Daphne Cockwell School of Nursing, Toronto, Canada.
Glob Health Res Policy. 2016 Jul 15;1:6. doi: 10.1186/s41256-016-0006-7. eCollection 2016.
Violence is a critical public health problem associated with compromised health and social suffering that are preventable. The Centre for Global Health and Health Equity organized a forum in 2014 to identify: (1) priority issues related to violence affecting different population groups in Canada, and (2) strategies to take action on priority issues to reduce violence-related health inequities in Canada. In this paper, we present findings from the roundtable discussions held at the Forum, offer insights on the socio-political implications of these findings, and provide recommendations for action to reduce violence through research, policy and practice.
Over 60 academic researchers, health and social service agency staff, community advocates and graduate students attended the daylong Forum, which included presentations on structural violence, community violence, gender-based violence, and violence against marginalized groups. Detailed notes taken at the roundtables were analyzed by the first author using a thematic analysis technique.
The thematic analysis identified four thematic areas: 1) structural violence perpetuates interpersonal violence - the historical, social, political and economic marginalization that contributes to personal and community violence. 2) social norms of gender-based violence-the role of dominant social norms in perpetuating the practice of violence, especially towards women, children and older adults; 3) violence prevention and mitigation programs-the need for policy and programming to address violence at the individual/interpersonal, community, and societal levels; and 4) research gaps-the need for comprehensive research evidence made up of systematic reviews, community-based intervention and evaluation of implementation research to identify effective programming to address violence.
The proceedings from the Global Health and Health Equity Forum underscored the importance of recognizing violence as a public health issue that requires immediate and meaningful communal and structural investment to break its historic cycles. Based on our thematic analysis and literature review, four recommendations are offered: (1) Support and adopt policies to prevent or reduce structural violence; (2) Adopt multi-pronged strategies to transform dominant social norms associated with violence; (3) Establish standards and ensure adequate funding for violence prevention programs and services; and (4) Fund higher level ecological research on violence prevention and mitigation.
暴力是一个严重的公共卫生问题，会导致健康受损和社会痛苦，而这些都是可以预防的。全球卫生与健康公平中心于2014年组织了一次论坛，以确定：（1）与影响加拿大不同人群的暴力相关的优先问题，以及（2）针对优先问题采取行动以减少加拿大与暴力相关的健康不平等的策略。在本文中，我们展示了在该论坛上举行的圆桌讨论的结果，对这些结果的社会政治影响提供见解，并为通过研究、政策和实践减少暴力的行动提供建议。
60多名学术研究人员、卫生和社会服务机构工作人员、社区倡导者和研究生参加了为期一天的论坛，其中包括关于结构性暴力、社区暴力、基于性别的暴力以及针对边缘化群体的暴力的演讲。第一作者使用主题分析技术对圆桌会议上的详细笔记进行了分析。
主题分析确定了四个主题领域：1）结构性暴力使人际暴力长期存在——历史、社会、政治和经济边缘化导致个人和社区暴力。2）基于性别的暴力的社会规范——占主导地位的社会规范在使暴力行为长期存在方面所起的作用，特别是对妇女、儿童和老年人的暴力；3）暴力预防和缓解计划——需要政策和计划来解决个人/人际、社区和社会层面的暴力问题；4）研究差距——需要由系统评价、基于社区的干预以及实施研究的评估组成的全面研究证据，以确定解决暴力问题的有效计划。
全球卫生与健康公平论坛的会议记录强调了将暴力视为一个公共卫生问题的重要性，这需要立即进行有意义的社区和结构性投资，以打破其历史循环。基于我们的主题分析和文献综述，提出了四项建议：（1）支持并采用预防或减少结构性暴力的政策；（2）采取多管齐下的策略来改变与暴力相关的占主导地位的社会规范；（3）为暴力预防计划和服务制定标准并确保充足的资金；（4）资助关于暴力预防和缓解的更高级别的生态研究。
