Cross-sectional comparisons of violence and injuries in an urban community, South Africa

Abstract

Urbanisation has brought different challenges in terms of violence and injuries in South Africa (SA). Injuries related to violence have contributed to a high disease burden in SA as compared to other parts of the world. Apartheid made the problems of urbanisation more complex particularly for black people. For generations, urbanisation of black people was difficult because they were forced to live in townships far from the main cities. Poverty and socio-economic disparities in these townships are risk factors for violence and injuries. There is paucity in literature of information on the trends of violence and injuries among this urban population. It was therefore imperative to explore the different forms of violence and injuries in an urban area over a long period of time and to foster a transdisciplinary collaboration to address the problem. The aim of this research was to give a description of violence and injuries among a sample of adults aged 35 to 70 years at the time of enrolment into a study, living in an urban area within North-West Province, SA over a period of 10 years. The Prospective Urban and Rural Epidemiological (PURE) study, designed as a prospective, observational, cohort study was used. A significant decrease was observed in the occurrence of serious injuries over the 10- year period, except in 2010 where a significant increase was observed for injuries related to physical assault and domestic violence. Urban characteristics like employment status and alcohol use were significantly associated with domestic violence and sustaining a serious injury respectively. Despite a significant decrease observed in the occurrence of violence and injuries over the 10-year period, violence and injuries remained endemic and they were triggered by socio-economic factors in the urban context. Failure to address socio-economic inequalities implies violence and injuries will perpetually contribute to the quadruple burden of diseases in SA. Traditional mono-disciplinary or sector-based approaches have proved limited when it comes to addressing the complexity of violence and injuries in SA. Moreover, the activities of different stakeholders are determined more by particular interests, which can be economic, political, etc., and less need to build a system that is equitable and sustainable. A transdisciplinary approach is therefore indispensable for the development of sustainable and equitable violence and injuries prevention interventions within urban context