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World: WHO Issues Landmark Report On Violence As Global Health Problem

The World Health Organization has come out with a landmark report on violence as a global health problem. According to RFE/RL health correspondent Julie Moffett, the document contains startling findings about suicide in Eastern Europe and the former Soviet Union.

Washington, 25 October 2002 (RFE/RL) -- A report recently issued by the World Health Organization, or WHO, says violence kills more than 1.6 million people around the world annually and that half of those deaths are suicides.

The study is the first comprehensive report of its kind to address violence as a global health problem. It says violence is among the leading causes of death for people aged 15 to 44 and accounts for 14 percent of deaths among males and 7 percent of deaths among females worldwide.

The report says that on an average day, a person commits suicide every 40 seconds, that more than 1,400 people are the victims of homicide, and that nearly 35 people are killed every hour as a result of war or armed conflict.

One of the most stunning revelations was that suicides account for half of all violent deaths.

Alexander Butchart, director of the Department of Injuries and Violence Prevention at the WHO, told RFE/RL from Switzerland that there are 815,000 suicides a year around the world, compared with 520,000 homicides and just over 300,000 war-related deaths. "I think the impression everyone has from watching the media is that violence due to war is the main cause of death, when in fact, it's not. It's suicide and homicide -- everyday violence among everyday people," Butchart said.

Butchart said the causes for suicide are complex, including physical abuse; depression; alcohol and drug abuse; loss of employment; and cultural, social, and economic factors.

Another disturbing finding, he said, is that three times as many elderly people -- those more than 75 years of age -- kill themselves as 15- to 35-year-olds. "And perhaps that is one of the reasons why the suicide rates are so extensive because, unlike homicides, which affect mainly young people, suicide affects both the old and the young. So you kind of have two waves of the problem," Butchart said.

Eastern Europeans have the highest rates of suicide. Butchart said the overall suicide rate in Eastern Europe and the former Soviet Union is 8.4 suicides per 100,000 people. It is five suicides per 100,000 people in Western Europe, 4.1 in North America, and 3.1 in Africa. Butchart said, "So if we compare Eastern Europe to North America, it's over twice as likely that a person would kill themselves there as in North America."

Suicide rates for some of the countries in RFE/RL's broadcast region are 42 per 100,000 people in Belarus, 38 in Estonia, 11 in Uzbekistan, seven in Tajikistan, five in Georgia, and one in Azerbaijan.

Lithuania has the highest rate of suicide in the world, at 52 for every 100,000 people. Suicide rates in Russia are 43 for every 100,000 people. Butchart said these rates compare with about 16 suicides for every 100,000 people in Switzerland and about eight or so in the United Kingdom.

Butchart said there is no single reason attributable for the high rate of suicide in Lithuania. As for Russia, he said, there was a sharp increase in the number of suicides starting in the mid-1980s, just before the collapse of the Soviet Union. He said the increase appears to be associated with a "socioeconomic disintegration" that left people without any sense of social support or without gainful employment.

Interestingly, Butchart noted that one suicide trend can be clearly established in Latvia, Estonia, and Slovakia. He said that after the collapse of the Soviet Union, elderly rural women in these countries committed suicide in abnormally high numbers, apparently because of the massive movement toward cities by young people, which left these women alone and without social support.

Overall, Butchart said, researchers remarked upon the sheer pervasiveness of violence, be it suicide, homicide, or war-related deaths, and how such violence occurs in every country, race, culture, and age group. Butchart said the report offers some sobering statistics.

For example, up to 70 percent of women report being physically assaulted by their partners -- a partner is either a husband or a lover -- at least once during their lives. This statistic holds true both in wealthy North American cities and poor African villages. The study also found that 15 percent of women worldwide are victims of sexual assaults.

Butchart noted that abuse of the elderly is one of the hidden faces of violence and one that is likely to grow given the world's rapidly aging population. Statistics indicate that in many countries, up to 6 percent of the elderly report having been abused.

The report says that, overall, the 20th century was one of the most violent in history. During the past 100 years, nearly 191 million people lost their lives in wars or other armed conflicts.

Butchart said the report reveals that violence is a public-health problem. He said studies have shown that in some countries, health-care expenses due to violence account for up to 5 percent of gross domestic product. "When you bring it all together, interpersonal violence and suicide is a huge public-health problem, and something needs to be done [about] it," Butchart said.

Butchart said the report makes several recommendations to help governments address the pervasive problem of violence, including national violence-prevention programs, parental training, better education, and the promotion of gender and social equality.