Violence as a Threatening Factor to Public Health.

Violence is a great challenge threatening the world peace. It includes a wide range of behaviors like; fight, war and genocide. There are different definitions of violence. Therefore, providing a suitable definition is necessary. In literature, according to the cultural and social text, there are different definitions for violence. The definitions are provided based on the goal of research and text. The best definition is provided by WHO: “It covers a wide range of acts, going beyond physical acts to include threats and intimidation. It also includes the myriad and often less obvious consequences of violent behavior, such as physical harm, deprivation and mal development that compromise the well-being of individuals, families and communities.”(1).

According to the definition, WHO provides an especial typology for violence that it determines the kinds of violence and their relationship (Table 1).

Table 1:

Typology of violence (3)

Nature of violence	Sub groups	description
Self-directed violence	Self-abuse	Self-mutilation
	Suicide	Attempting to kill oneself
Interpersonal violence	Domestic violence	Family and intimate partner violence
	Social violence	Violence between individuals who are unrelated
Collective violence	Social	The instrumental use of violence by people who identify themselves as members of a group against another group
	Political
	Economical

Of course, there are some other forms of typology, but none of them are widely accepted as it is presented by WHO (1, 2).

Moreover, violence can be presented as physical, sexual, psychological and deprivation forms. Physical violence against children, sexual abuse and deprivation of children are the clear examples of such violence.

According to the existing data, about 1.6 million people are affected by violence in our world. Considering that, most of events are not reported. Everyone would be threatening by risk of violence.

People with mental problems, women, children and seniors (old people) are more at risk of violence.

The question is that; how violence affects the public health? Today, it is determined that violence in any form, is a challenge to public health. Victims are more at risk of physical and mental problems (Fig. 1).

Fig. 1:

Health consequences of violence in lifespan (4)

Based on the providing reports, a lot of people would die or be damaged due to violence.

For example, ethnical and religious violence in Afghanistan, Pakistan, Iraq, Egypt and Syria lead to the death of hundreds of people. Most victims are children and women. The effects of violence can be described into the following categories: physical impairments, mental/behavioral/affective disorders, social/educational/job impairments and risky behaviors (Table 2).

Table 2:

Effects of violence on public health

Categories	Descriptions
Physical injuries	Physical injuries are common among victims. Body aches and bruises, broken teeth and bones, brain injuries caused by rape and sexually transmitted diseases (like AIDS) are most common.
Mental/behavioral/affective disorders	Depression, anxiety psychosomatic disorders and PTSD are the common mental disorders
Social/educational/job impairments	Violence has negative effects on interaction with family, friends and society. Victims have problems in education and job.
Risky behaviors	Eating disorders, sleep disorders, alcoholism, substance abuse are common among victims. Afraid of violence decrease the social and physical activities.

Based on the results of violence on public health, decrease of violence and preventing strategies are the great goal of public health system.

Interventions in relation with violence are classically divided into three levels:

Primary preventions: it aims for prevention before emerging violence

Secondary preventions: it focuses on early reaction against violence, like: emergency services and treating services

Tertiary preventions: it focuses on long term cares of victims, like: rehabilitation services, decreasing the results of events and decreasing the disabilities of violence (6).

Therefore, public health system with providing a preventing program decreases the unpleasant consequences of violence. In Table 3, useful preventing strategies are provided.

Table 3:

Strategies for preventing violence and its unpleasant consequences

Strategies	Descriptions
Support of family	Using interventions for developing parenting skills, supporting family, and avoiding physical and sexual abuse in family
Developing life skills in children	Designing programs for increasing social skills in children and adolescence (avoiding skills, protection against violence)
Attention to adolescence and risky groups	Crime behaviors and activity and being a member of crime groups are the suitable background for increasing violence. Therefore they should be more protected.
Limiting the access to substance and alcohol	Substance abuse is a critical factor that increases violence. Therefore, limitation of access to substance decreases the violence.
Changing social and cultural norms	Some social and cultural conditions (using down with slogan, sex inequality, loose of individual and social ethics) increase the aggression behaviors in society.
Identification, care and protection	Identification of victims and providing an effective instruction for caring and preventing deal to decrease of violence and it consequences.
Encourage and promotion of kindness	Educating at home, kindergarten and school

Conclusion

Violence as great challenge in our world has a long term and short term effects on social public health. Physical injuries, mental/behaviorral/affecttive disorders, social/educational/job impairments and emerging risks are the most common consequences of violence in public health. Children, women and old people are more likely at risk of violence. Therefore, according to the negative effects of violence on public health, it is tried to provide a preventing program based on the three prevention levels. It is important that social and cultural conditions should be attended in all designed programs.

Violence, in Iran, is transformed to the social impairment. The limited form of violence (street harassment, using bad names, and damaging public properties) and widespread form of violence (suicide, homicide, abuse, sectarian violence) both exist in Iran. Physical and sexual abuse of children and women are common in counties of Iran. Most of events are covered under the social and cultural features. Sometimes, criminals are supported by laws. The important factor that increases the violence in Iran is the loss of ethical foundation. Therefore, the codification of comprehensive program against violence is necessary and for providing such national program, cooperation between experts and professionals are essential.