The WHO Regional Office for Europe World Health Organization Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. Nations created in 1948 with the primary E-mail: [email protected] responsibility for international health matters Web site: www.euro.who.int and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany For more detail, see the following publication: Greece Sethi D et al., Preventing injuries in Europe: from international collaboration Hungary to local implementation. Copenhagen, WHO Regional Office for Europe, 2010 Iceland (http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/ Ireland violence-and-injuries/publications) Israel Italy Kazakhstan © World Health Organization 2010 Kyrgyzstan Latvia Lithuania for permission to reproduce or translate its publications, in part or in full. Luxembourg The designations employed and the presentation of the material in this publication do not imply the Malta expression of any opinion whatsoever on the part of the World Health Organization concerning the legal Monaco status of any country, territory, city or area or of its authorities, or concerning the delimitation of its Montenegro frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may Netherlands not yet be full agreement. Norway Poland Portugal are endorsed or recommended by the World Health Organization in preference to others of a similar Republic of Moldova nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are Romania distinguished by initial capital letters. Russian Federation All reasonable precautions have been taken by the World Health Organization to verify the information San Marino contained in this publication. However, the published material is being distributed without warranty of Serbia any kind, either express or implied. The responsibility for the interpretation and use of the material lies Slovakia with the reader. In no event shall the World Health Organization be liable for damages arising from its Slovenia use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions Spain or the stated policy of the World Health Organization. Sweden Switzerland The responsibility for the content of this report lies with the authors, and the content does not represent Tajikistan the views of the European Commission; nor is the Commission responsible for any use that may be The former Yugoslav made of the information contained herein. Republic of Macedonia Turkey Cover photos (left to right): CDC, M. Sedlák, iStockphoto Turkmenistan Inside photo: iStockphoto Ukraine Design: Inís Communication – www.iniscommunication.com United Kingdom Editing: David Breuer Uzbekistan The WHO Regional Office for Europe World Health Organization Regional Office for Europe ON REPORT EUROPEAN The World Health Organization (WHO) Scher gsvej 8, DK-2100 Copenhagen Ø, Denmark EUROPEAN REPORT ON is a specialized agency of the United Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. Nations created in 1948 with the primary E-mail: [email protected] responsibility for international health matters Web site: www.euro.who.int and public health. The WHO Regional Office for Europe is one of six regional offices PREVENTING throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. AND PREVENTING VIOLENCE VIOLENCE PREVENTING VIOLENCE Member States Albania Andorra Armenia KNIFE CRIME Austria Azerbaijan Belarus AMONG Belgium YOUNG PEOPLE Bosnia and Herzegovina Bulgaria Croatia AND Cyprus Czech Republic CRIME KNIFE Denmark Estonia Finland France Georgia Germany AMONG Greece Hungary Iceland YOUNG PEOPLE YOUNG Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan a Abstract This report highlights interpersonal violence as the third leading cause of death and a leading cause of disability among people aged 10–29 years in the 53 countries of the WHO European Region. This burden is unequally distributed, and 9 of 10 homicide deaths in the Region occur in low- and middle-income countries. Irrespective of country income, interpersonal violence disproportionately affects young people from deprived sections of society and males, who comprise 4 of 5 homicide deaths. Numerous biological, social, cultural, economic and environmental factors interact to increase young people’s risk of being involved in violence and knife-related crime. Factors that can protect against violence developing among young people include good social skills, self-esteem, academic achievement, strong bonds with parents, positive peer groups, good attachment to school, community involvement and access to social support. Good evidence indicates that reducing risk factors and enhancing protective factors will reduce violence among young people. The experience accumulated by several countries in the Region and elsewhere shows that social policy and sustained and systematic approaches that address the underlying causes of violence can make countries in the Region much safer. These make compelling arguments for advocating for increased investment in prevention and for mainstreaming objectives for preventing violence among young people into other areas of health and social policy. Keywords ADOLESCENT VIOLENCE – prevention and control CRIME – prevention and control WOUNDS AND INJURIES – prevention and control SOCIOECONOMIC FACTORS EUROPE ISBN 978 92 890 0202 8 Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2010 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Text editing: David Breuer Design: Inís Communication – www.iniscommunication.com Printed in Rome, Italy by Servizi Tipografici Carlo Colombo, Rome, Italy FRONT COVER PHOTO CREDITS Top: Istockphoto Bottom: Bigstockphoto and Liverpool John Moores University (ambulance) INNER TEXT PHOTO CREDITS Istockphoto: pp 17, 32, 55, 76 Bigstockphoto: pp 11, 22, 30, 33, 34, 35, 39, 42, 54, 79 Liverpool John Moores University: pp 38, 57, 59, 66, 78, 79 WHO: p 81 Northumbria Police: p 62 European report on preventing violence and knife crime among young people Editors Dinesh Sethi, Karen Hughes, Mark Bellis, Francesco Mitis and Francesca Racioppi CONTENTS Acronyms i 3. Risk factors for violence among young people and violence using knives 28 Acknowledgements ii 3.1 Introduction 28 3.2 Individual factors 29 Foreword iv 3.3 Relationship factors 34 3.4 Community and society factors 37 Executive summary v 3.5 Factors protecting against violence among young 1. Overview: violence among young people people and violence involving knives 41 in the WHO European Region 1 3.7 References 42 1.1 General introduction 1 4. Effective interventions and programming 50 1.2 Why young people need special attention 2 4.1 Introduction 50 1.3 Why violence among young people is an important public 4.2 Indirect primary prevention approaches 52 health issue in the European Region 3 4.3 Direct primary prevention approaches 57 1.4 Inequality in violence among young people in