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Disease burden and costs of violence-related injuries

Ziektelast en kosten van letsel door geweld


Disease burden is defined as the health impact of disease and premature death within a population. Up to now, the disease burden of "violence- related injuries" used to be defined as the number of people dying prematurely as a result of this type of injuries. The physical and psychological impact of (non-fatal) violence-related injuries are not yet included in the disease burden. If it were, the total disease burden of violence-related injuries would rise by 73 percent. Of this increase, 80 percent is attributable to physical violence and 20 percent to the psychological impact (PTSD and depression) on victims of violence. The above sums up the outcomes of a study commissioned by the Ministry of Health, Welfare and Sport and the Ministry of Security and Justice covering the period 2009 2013. The calculations presented in the study report enhance our insight in the disease burden of violence- related injuries. The results of the new calculations still represent an underestimation of the real figures because certain information, including data on victims not registered at emergency departments, is not known. The disease burden of violence-related injuries can be subdivided according to the type of violence depending on the purpose of the perpetrator: expressive violence (expressing emotions, 54 percent) and instrumental violence (aimed at (im)material gain, such as money and power, 12 percent). The types of violence at the root of the remaining portion of the disease burden are not known. In the Netherlands, the disease burden caused by violence represents 3 percent of the total disease burden for all types of injury, including traffic accidents, sports injuries and suicide attempts. This percentage is comparable to that in other European countries. The comparison is based on figures from the WHO's Global Burden of Disease (GBD) study. Estimates of the costs of medical care and absenteeism associated with physical violence-related injuries for the study period (2009-2013) average out at 30 million and 66 million euros per year, respectively. The estimated costs of the psychological impact of violence-related injuries (PTSD and depression) are considerably lower (5.2 million euros). This amount does not cover the costs resulting from intimidation (a very common form of violence), nor the societal costs of the impact on people close to the victims (relatives, witnesses). The study was conducted by the Erasmus University Medical Centre of Rotterdam (Erasmus MC) and the Dutch Consumer Safety Institute (Stichting VeiligheidNL) under the auspices of the National Institute for Public Health and the Environment (RIVM).

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