211851 Water shortage as a form of structural violence

Wednesday, November 11, 2009: 12:50 PM

James Gilligan, MD , School of Arts and Science, New York University, New York, NY
As Gandhi saw, "the deadliest form of violence is poverty." The truth of Gandhi's generalization has been confirmed repeatedly by empirical research showing how death rates increase when poverty rates increase, in both cross-cultural and longitudinal studies. In fact, the difference in death rates suffered by poor nations, compared with wealthy ones, has been shown to be far greater than the death rates caused by all forms of violent behavior put together, including homicide, suicide and warfare. Johann Galtung and others, including the "liberation theologians" of Latin America , have coined the term "structural violence" to refer to the increased death rates that the poor suffer, relative to the rich, and have contrasted it with "behavioral violence." Why should we consider poverty a form of violence? If we define violence as the infliction of injury (especially lethal injury) on people by people, then we have to include the various forms of poverty, including lack of access to unpolluted water, as a form of violence, since it causes injury and death, and is caused by the actions of humans. Structural violence, however, is not only the deadliest form of violence, it is also the most powerful cause of the other form, behavioral violence (especially homicide and warfare). That is, cross-national and longitudinal research have also shown that rates of those forms of behavioral violence correlate positively with the rates of relative poverty suffered by the populations in question, including lack of access to natural resources that are necessary for life.

Learning Objectives:
1. Describe "structural violence" and its significance to public health practice; 2. Discuss the research underlying Gandhi's observation that "the deadliest form of violence is poverty"; and 3. Describe why a lack of access to unpolluted water is a form of violence.

Keywords: Violence, Poverty

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. James Gilligan is a psychiatrist who has practiced psycho-analytic psychotherapy for more than thirty years. At Harvard Medical School he was a faculty member and Director of The Institute of Law and Psychiatry. He is former director of the Bridgewater State Hospital for the criminally insane and was director of mental health for the Massachusetts prison system. He is the President of the Center for the Study and Prevention of Violence, a private nonprofit research and consulting firm. Currently he is Clinical Professor of Psychiatry, School of Medicine, Adjunct Professor, School of Law, Collegiate Professor, School of Arts and Science, New York University
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.