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Hyder AA, Ambrosio NS, García-Ponce O, Barberia L. Peace and health: exploring the nexus in the Americas. BMJ Glob Health 2022; 7:bmjgh-2022-009402. [PMID: 36210066 PMCID: PMC9535176 DOI: 10.1136/bmjgh-2022-009402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/01/2022] [Indexed: 11/03/2022] Open
Abstract
The relationship between peace and health is complex, multifactorial and fraught with challenges of definitions, measurements and outcomes. This exploratory commentary on this nexus within a focus on the Americas posits this challenge clearly and calls for more scholarship and empirical work on this issue from an interdisciplinary perspective. The overall goal of this paper is to try and explore the elements that impact the relationship between peace and health with a focus on the Americas (defined as countries spanning from Canada to Argentina) in the post-Cold war period. Focusing on the 1990s and onwards, we seek to underscore why violence continues to permeate these societies despite a third and lasting wave of democratisation in the hemisphere. We hope this will allow a more robust dialogue on peace and health in the regional and global health literature.
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Affiliation(s)
- Adnan A Hyder
- Department of Global Health, George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
| | - Natalia S Ambrosio
- The George Washington University Elliott School of International Affairs, Washington, District of Columbia, USA
| | - Omar García-Ponce
- Department of Political Science, The George Washington University Columbian College of Arts and Sciences, Washington, District of Columbia, USA
| | - Lorena Barberia
- Department of Political Science, Sao Paulo University—Chacara Santo Antonio I Campus, Sao Paulo, Brazil
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Blair KJ, de Virgilio M, Dissak-Delon FN, Dang LE, Christie SA, Carvalho M, Oke R, Mbianyor MA, Hubbard AE, Etoundi AM, Kinge T, Njock RL, Nkusu DN, Tsiagadigui JG, Dicker RA, Chichom-Mefire A, Juillard C. Associations between social determinants of health and interpersonal violence-related injury in Cameroon: a cross-sectional study. BMJ Glob Health 2022; 7:bmjgh-2021-007220. [PMID: 35022181 PMCID: PMC8756282 DOI: 10.1136/bmjgh-2021-007220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Risk factors for interpersonal violence-related injury (IPVRI) in low-income and middle-income countries (LMICs) remain poorly defined. We describe associations between IPVRI and select social determinants of health (SDH) in Cameroon. Methods We conducted a cross-sectional analysis of prospective trauma registry data collected from injured patients >15 years old between October 2017 and January 2020 at four Cameroonian hospitals. Our primary outcome was IPVRI, compared with unintentional injury. Explanatory SDH variables included education level, employment status, household socioeconomic status (SES) and alcohol use. The EconomicClusters model grouped patients into household SES clusters: rural, urban poor, urban middle-class (MC) homeowners, urban MC tenants and urban wealthy. Results were stratified by sex. Categorical variables were compared via Pearson’s χ2 statistic. Associations with IPVRI were estimated using adjusted odds ratios (aOR) with 95% confidence intervals (95%CI). Results Among 7605 patients, 5488 (72.2%) were men. Unemployment was associated with increased odds of IPVRI for men (aOR 2.44 (95% CI 1.95 to 3.06), p<0.001) and women (aOR 2.53 (95% CI 1.35 to 4.72), p=0.004), as was alcohol use (men: aOR 2.33 (95% CI 1.91 to 2.83), p<0.001; women: aOR 3.71 (95% CI 2.41 to 5.72), p<0.001). Male patients from rural (aOR 1.45 (95% CI 1.04 to 2.03), p=0.028) or urban poor (aOR 2.08 (95% CI 1.27 to 3.41), p=0.004) compared with urban wealthy households had increased odds of IPVRI, as did female patients with primary-level/no formal (aOR 1.78 (95% CI 1.10 to 2.87), p=0.019) or secondary-level (aOR 1.54 (95% CI 1.03 to 2.32), p=0.037) compared with tertiary-level education. Conclusion Lower educational attainment, unemployment, lower household SES and alcohol use are risk factors for IPVRI in Cameroon. Future research should explore LMIC-appropriate interventions to address SDH risk factors for IPVRI.
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Affiliation(s)
- Kevin J Blair
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Michael de Virgilio
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Lauren Eyler Dang
- Division of Biostatistics, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - S Ariane Christie
- Department of Trauma and Acute Care Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Melissa Carvalho
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Rasheedat Oke
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Mbiarikai Agbor Mbianyor
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Alan E Hubbard
- Division of Biostatistics, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Alain Mballa Etoundi
- Department of Disease Epidemic and Pandemic Control, Cameroon Ministry of Public Health, Yaoundé, Cameroon
| | - Thompson Kinge
- Hospital Administration, Limbe Regional Hospital, Limbe, Southwest Region, Cameroon
| | - Richard L Njock
- Hospital Administration, Hopital Laquintinie de Duoala, Duoala, Cameroon
| | - Daniel N Nkusu
- Hospital Administration, Catholic Hospital of Pouma, Pouma, Cameroon
| | | | - Rochelle A Dicker
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Alain Chichom-Mefire
- Department of Surgery and Obs/Gyn, University of Buea Faculty of Health Sciences, Buea, Cameroon
| | - Catherine Juillard
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
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Vecino-Ortiz AI, Guzman-Tordecilla DN. Gun-carrying restrictions and gun-related mortality, Colombia: a difference-in-difference design with fixed effects. Bull World Health Organ 2020; 98:170-176. [PMID: 32132751 PMCID: PMC7047021 DOI: 10.2471/blt.19.236646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the effect of a permanent gun-carrying restriction on gun-related mortality in Colombia between 2008 and 2014, and determine differences in the effect of the restriction by place of death and sex. Methods In 2012, Bogotá and Medellín introduced a permanent gun-carrying restriction. We compared gun-related mortality rates in these cities (intervention cities) with the rates in all other Colombian cities with more than 500 000 inhabitants (control cities). We used data from the Colombian National Department of Statistics to calculate monthly gun-related mortality rates between 2008 and 2014 for intervention and control cities. We used a differences-in-differences method with fixed effects to assess differences in gun-related mortality in intervention and control cities before and after the introduction of the gun-carrying restriction. We stratified effects by place of death (public area or residence) and sex. We made robustness checks to test the assumptions of the models. Findings Gun-related deaths in the control and intervention cities decreased between 2008 and 2014; however, the decrease was greater in the intervention cities (from 20.29 to 14.93 per 100 000 population; 26.4%) than in the control cities (from 37.88 to 34.56 per 100 000 population; 8.8%). The restriction led to a 22.3% reduction in the monthly gun-related mortality rate in Bogotá and Medellín. The reduction was greater in public areas and for males. Robustness checks supported the assumptions of the models. Conclusion The permanent restriction on carrying guns reduced gun-related deaths. This policy could be used to reduce gun-related injuries in urban centres of other countries with large numbers of gun-related deaths.
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Affiliation(s)
- Andres I Vecino-Ortiz
- Department of International Health, Johns Hopkins School of Public Health, 615 N Wolfe Street, Suite E8620, Baltimore, Maryland 21205, United States of America
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