Violence:: a public health issue

The recent recognition by the World Health Organization of the impact of violence on public health is based on convergent data derived from different specialized areas of medicine: 1. Paediatrics: enriched by 3 decades of research on the maltreatment and sexual abuse of children, it has been the revealer of the long unsuspected scope of these phenomena. 2. Emergency medicine: according to the sources, 2-30% of women who consult in an emergency department present clinical characteristics compatible with inflicted violence. 3. Maxillofacial surgery and neurosurgery: in several European countries, violence has been identified as a major cause of facial trauma. This also applies to brain lesions in the United States. 4. Obstetrics: prospective surveys have shown that about 10% of pregnant women are victims of physical violence during pregnancy 5. Psychiatry: the impact of violence on mental health is particularly drawn from the study of post-traumatic stress disorders, whose clinical outlines have been more clearly specified over the last few years. 6. Epidemiology: according to world health statistics, 4% of the global burden of morbidity can be attributed to intentional violence. Every specialized area of medicine may be confronted with problems linked to violence and should strive to assess the impact of Violence on its own field of activity. Specific help to the victims, going beyond urgent somatic care, should be implemented within health systems, as exemplified by the Interdisciplinary Consultation of Medicine and Prevention of Violence, recently created at the University Hospitals of Geneva.