Epidemiology of Violence

Within the last ten years, many studies have shown that violence shares the characteristics of epidemic diseases (see Slutkin 2012 for list). Like a contagious disease, violence exhibits characteristics of both cluster and spread, indications of interpersonal transmission.  This presentation will examine the transmission process for violence to explain how violence affects individuals who are exposed to it. Based on these findings, we will take the position that violence should be considered a type of epidemic disease.

We will start by describing the method of transmission, exploring the ways in which people are exposed to violence, the effects of different kinds of exposure, and modulating factors such as age, dose, and immunity.  We will also look at the physiological effects of violence, particularly neurological effects including the process of modeling, the role of mirror neurons, desensitization, hyper-arousal, dissociative reactions, and other effects.  We will then describe the natural history of violence as a disease and describe the pathogenesis of violence, including susceptibility, latency, incubation, and the possible clinical courses based on exposure.  To the extent that they are available, we will discuss levels of risk based on exposure for different types of violence, including child abuse, war violence, religious and ethnic violence, and community violence.

We will conclude with a discussion of the implications for this understanding of violence, including strategies for addressing violence as a disease.  This discussion will include roles for health professionals in how to detect and treat persons exposed to violence and steps for communities to take to treat violence as a disease, and examples of current health approaches that treat violence like a disease.