Franco Agudelo S. Violencia y salud en Colombia. [Violence and health in Colombia.] Revista Panamericana de Salud Pública [Pan Amerian Journal of Public Health]. 1997 February; 2(3):170-180.

Objective: Analyze violence in Colombia as a public health problem.

Methdology: Epidemiological analysis.

Results: The author emphasizes the relational nature of violence as a conscious and reasoned human activity, with clear ends that, upon being expressed in concrete acts and in distinct historical contexts, produce new responses and processes. In the last decade there were more than 230,000 homicides in Colombia , encompassing in 1994 70% of all recorded violent deaths. From 1987 to 1994 the homicide rate increased from 36 to 127 per 100,000 inhabitants. The age group of 15 to 24 fell victim to 34.2% of all the countrys homicides in 1994. When the decade of the 1990s began, homicide was the second greatest cause of death among those 15 to 24 years old. The author breaks down the category of external causes of death, as contained in the International Classification of Diseases, into its three principal components--homicides, traffic accidents, and suicides. He confirms that the last two have been maintained at low levels, with a notable increase in homicides. Colombia ranks first in the Americas in deaths by violent causes.

The author analyzes other forms of day-to-day violence, such as violence within families, whose principal victims are women and children. Of these children, 25% have been mistreated by their parents. The author notes the existence of hired assassins, as well as massacres.

The consequences of violence in all its forms have damaged social relations and have brought about a serious loss in the quality of life, as measured through the rates of illness and the reduction in years of healthy life. In 1991, homicides and accidents represented 39.9% of total years of potential life lost, while perinatal causes occupied second place at 13.3%. If one considers that present life expectancy of the average Colombian is 69 and that the average age of homicide victims is 29, then one deduces that for each assassination an average of 40 years of potential life are lost. The figure of 30,000 homicides annually means that the country loses in this way 1,200,000 years of potential life.

A study focusing on the Latin American and Caribbean countries points out that the cost of care given to 50% of the victims who died and to 100% of those who suffered either light or serious wounds fluctuated between $3.6 and $5.6 billion, which equals from 4 to 7%, respectively, of total health expenditures in all countries of the region.

The author also takes into consideration the lack of training among professional, technical, and auxiliary personnel to understand and to deal with these problems, and he likewise finds notable the violence that targets those employed in healthcare services.

Conclusions: Violence as a mechanism to resolve conflict has penetrated all strata of Colombian society, bringing a risk that a violent social order will be accepted with a consequent normalization of violence. Confronting this problem requires a multifaceted effort involving politics, economics, education, and health, as well as inter-institutional coordination on the local, state, and national levels. This effort would aim to end apathy toward and tolerance of violence.