Estimating the economic impact of interpersonal violence in Mexico in 2021: projecting three hypothetical scenarios for 2030 / Estimación del impacto económico de la violencia interpersonal en México en el 2021: proyección de tres escenarios hipotéticos para el 2030 / Estimativa do impacto econômico da violência interpessoal no México em 2021: projeção de três cenários hipotéticos para 2030

ABSTRACT Objective. To calculate the economic impact of violence across Mexico in 2021 and project costs for 2021-2030. Methods. Incidence data was obtained from the Executive Secretariat of the National Public Security System, (SESNSP), National Population Council (CONAPO), National Institute of Statistics and Geography (INEGI), and the National Survey of Victimization and Perception of Public Safety (ENVIPE). Our model incorporates incidence estimates of the costs of events associated with violence (e.g., homicides, hospitalizations, rapes, extortions, robbery, etc). Results. The economic impact of crime and violence in Mexico for the year 2021 has been estimated at about $192 billion US dollars, which corresponds to 14.6% of the national GDP. By reducing violence 50% by 2030, we estimate savings of at least US$110 billion dollars. This represents a saving of US$1 376 372 for each company and more than US$66 771 for each Mexican. Conclusion. Violence and homicides have become one of the most pressing public health and economic concerns for their effect on health, development, and economic growth. Due to low cost and high impact, prevention is the most efficient way to respond to crime and violence while also being an essential component of sustainable strategies aimed at improving citizen security.

RESUMEN Objetivo. Calcular el impacto económico de la violencia en el 2021 en todo México y proyectar sus costos para el período 2021-2030. Métodos. Los datos de incidencia se obtuvieron del Secretariado Ejecutivo del Sistema Nacional de Seguridad Pública (SESNSP), el Consejo Nacional de Población (CONAPO), el Instituto Nacional de Estadística y Geografía (INEGI), y la Encuesta Nacional de Victimización y Percepción sobre Seguridad Pública (ENVIPE). Nuestro modelo incorpora estimaciones de la incidencia de los costos de los eventos asociados a la violencia (por ejemplo, homicidios, hospitalizaciones, violaciones, extorsiones, robos, etc.) Resultados. Se ha estimado que el impacto económico del delito y la violencia en México para el año 2021 es de alrededor de US$ 192 000 millones de dólares estadounidenses, lo que corresponde al 14,6% del PIB nacional. Estimamos que una reducción del 50% de la violencia para el 2030 supondría un ahorro de al menos US$110 000 millones. Esto representa un ahorro de US$1 376 372 para cada empresa y de más de US$66 771 para cada mexicano. Conclusión. La violencia y los homicidios se han convertido en una de las preocupaciones económicas y de salud pública más apremiantes por su efecto sobre la salud, el desarrollo y el crecimiento económico. Debido a su bajo costo y alto impacto, la prevención es la forma más eficiente de responder al delito y la violencia, al tiempo que es un componente esencial de las estrategias sostenibles dirigidas a mejorar la seguridad ciudadana.

RESUMO Objetivo. Estimar o impacto econômico da violência no México em 2021 e fazer a projeção de custos para o período 2021-2030. Métodos. Os dados de incidência da violência no país foram obtidos da Secretaria Executiva do Sistema Nacional de Segurança Pública (SESNSP), do Conselho Nacional de População (CONAPO), do Instituto Nacional de Estatística e Geografia (INEGI) e da Pesquisa Nacional de Vitimização e Percepção de Segurança Pública (ENVIPE). O modelo incorpora estimativas de incidência de custos de eventos associados à violência (como homicídios, internações hospitalares, estupros, extorsões e roubos). Resultados. O impacto econômico da criminalidade e da violência no México foi estimado em torno de US$192 bilhões em 2021, o que equivale a 14,6% do produto interno bruto (PIB) nacional. Estima-se que reduzir a violência em 50% até 2030 pode resultar em uma economia de US$ 110 bilhões ou mais, o que representa uma redução de gastos de US$1 376 372 para cada empresa e de mais de US$66 771 para cada cidadão do México. Conclusão. A violência e os homicídios são um dos problemas econômicos e de saúde pública mais prementes por suas consequências à saúde, ao desenvolvimento e ao crescimento econômico do país. Devido ao seu baixo custo e alto impacto, a prevenção é a forma mais eficiente de combater a criminalidade e a violência, além de ser um componente essencial de qualquer estratégia sustentável para aumentar a segurança da população.

Violências e juventude em um território da Área Metropolitana de Brasília, Brasil: uma abordagem socioespacial / Violence and youth in a territory of the Metropolitan Area of Brasília, Brazil: a socio-spatial approach

As juventudes na contemporaneidade sofrem o impacto de relações estabelecidas em contexto de violências multidimensionais distribuídas nos espaços privados e públicos dos territórios urbanos. O artigo apresenta as vivências de violências sofridas e praticadas por jovens que moram em um território na Área Metropolitana de Brasília. Trata-se de pesquisa transversal, descritiva, de abordagem quantitativa com amostragem de conveniência de 190 jovens, do sexo masculino e feminino, com idades entre 15 e 24 anos. Utilizou-se instrumento de coleta de dados contendo 44 questões do tipo sistema fechado, que foram desenvolvidas e validadas em pesquisas anteriores. Quanto às vivências de violências, 51% afirmaram ter sofrido algum tipo ao longo da vida, e 24%, nos últimos 12 meses. Os jovens que sofreram algum episódio de violência ao longo da vida também declararam que o território onde vivem não promove bem-estar urbano para os moradores (p < 0,023), expressaram sentimentos compatíveis com depressão (p = 001) e autorreferiram sua condição de saúde como ruim (p= 000). As vivências de violências e os processos de vulnerabilidades dos jovens foram abordados no contexto da injustiça social e limitações das capacidades humanas.

Young people are impacted by the relations established in the context of multidimensional violence distributed in private and public spaces of urban areas. This article presents stories of violence suffered and committed by young individuals who live in Itapoã, part of the Metropolitan Area of Brasilia. This is a transversal and descriptive study, using a quantitative approach and a convenience sample of 190 young men and women aged 15 to 24 years. Forty-four questions previously validated were used as the data collection instrument. As for the experiences of violence, 51% reported having experienced some sort throughout life, and 24% in the last 12 months. Young people who have experienced some episode of violence throughout life also declared that the area or neighborhood where they live does not promote urban well-being for its residents (p <0.023); they expressed feelings compatible with depression (p = 001); and self-reported their health condition as bad (p = 000). The experiences of violence and youth vulnerabilities processes were discussed in the context of social injustice and limitations of human capabilities.

Factores causales de la explotación sexual infantil en niños, niñas y adolescentes en Colombia / Causal factors of child sexual exploitation in boys, girls, and adolescents in Colombia

El propósito de la presente investigación fue identificar factores causales de laexplotación sexual comercial en la infancia y la adolescencia en Colombia. Para ello se analizaron tres casos de estudio: Medellín, Sincelejo y Magangué. Se realizaron talleres y se aplicaron encuestas en cada una de las ciudades en Instituciones gubernamentales encargadas de intervenir el fenómeno y en algunas instituciones educativas, con la participación de funcionarios, profesionales, docentes, directivosy estudiantes. Para el análisis de datos se realizó una matriz explicativa con laparticipación de 4 jurados. Las categorías de análisis fueron factores medioambientales, familiares e individuales.

The purpose of this piece of research aimed to identify causal factors of trade sexual exploitation on children and adolescents in Colombia. For this purpose, three case studies were analyzed: Medellín, Sincelejo, and Magangué. Workshops wereconducted and surveys were implemented in each of the cities in both governmental institutions, in charge of intervening the phenomenon and in some educationalinstitutions, with the participation of officials, professionals, teachers, directors, and students. As for the data analysis, an explanatory matrix was carried out, with the participation of 4 judges. The categories of analysis were those related to the environment, the family, and the individual.

Análisis de la figura humana en niños y niñas desplazados en Colombia / Analysis of the human figure in displaced children in Colombia

Esta es una investigación exploratoria cuyo objetivo es analizar las características psicológicasproyectadas en el dibujo de la figura humana en 45 niños y niñas en situación de desplazadosen Colombia. El estudio se ha realizó en el departamento del Quindío, a partir de la aplicación del Test del Dibujo de la Figura Humana de Karen Machover a niños y niñas en situación dedesplazamiento forzado. Muchos niños y niñas presentan problemas de ajuste a los nuevos entornos de socialización como efecto de las secuelas del conflicto armado evidentes en áreas conflictivas proyectadas en el dibujo tales como cabeza, expresiones faciales, extremidades, tronco y escases de movimiento. El conflicto persiste de formas simbólicas en los niños yniñas, lo cual dificulta sus habilidades sociales, la relación intrafamiliar y el aprendizaje, mostrando en muchos casos reacciones defensivas tales como, elevados niveles de ansiedad,depresión, ensimismamiento, al igual que impulsividad, agresión y aptitudes desafiantes.

This is an exploratory research that aims to analyze the psychological characteristics in analyzing the human figure in 45 displaced children in Colombia. The study was conductedin the State of Quindío, based on the application of the Karen Machover - Human Figure Drawing Test to children in a situation of forced displacement. Many children experience problems adjusting to new environments of socialization as a result of the aftermath of the armed conflict, which are made evident in conflict areas projected in the drawing, such as head, facial expressions, limbs, trunk and scarcity of movement. The conflict persists ofsymbolic forms in children, which hinders their social skills, family relationship and learning, showing in many cases defensive reactions such as high levels of anxiety, depression andself-absorption, as well as impulsivity, aggression, and challenging abilities.

Gustavo Rojas Pinilla: dictadura o presidencia: la hegemonía conservadora en contravía de la lucha popular / Gustavo Rojas Pinilla: dictatorship or presidency: the conservative hegemony in contravention with the popular fight

El presente texto derivado de investigación, tiene como objetivo analizar los discursos de Rojas Pinilla y la influencia que tuvo sobre ellos, los aires fascistas de finales del siglo XIX y principios del XX y como crearon enemigos del pueblo, con el fin de justificar su accionar sobre sectores de la sociedad por parte del ejército,como garantizador de un orden social.

The current text, derived from a piece of research, aims to analyze the discourses of Rojas Pinilla and the influence played by the fascist hints of the late nineteenth century and the early twentieth century and how they created enemies of the people in order to justify their actions on sectors of society by the army as a guarantor of a social order.

Factores de riesgo para el desplazamiento, protección de tierras y garantías de no repetición en zonas vulnerables de antioquia / Socio-demographic profile of Displaced population in antioquia

El siguiente artículo es un informe de investigación que recoge apartes del documento sobre el estado actual del Goce Efectivo de Derechos de la población víctima del desplazamiento Forzado en Antioquia. El artículo se centra, en particular, en establecer de manera estadística tanto el comportamiento anual del desplazamiento forzado desde 1997 como de algunos indicadores del conflicto armado en territorios vulnerables del departamento (reconocidos como aquellos sobre los cuales han recaído alertas tempranas). Para tal efecto el artículo da cuenta de la metodología utilizada para dimensionar el nivel de protección que cuentan los territorios, ofrece un balance de algunas afectaciones que vulneran la seguridad de tales zonas (acciones armadas, homicidios, eventos de minas antipersona) y establece el estado y alcance actual de la protección de tierras en Antioquia.

This article contains the main results of a research oriented to the carrying out of a demographic characterization of the population victim of displacement in Antioquia. In order to carry out a rigorous exercise that would pick up the conditions of life of this population, the research team designed a methodological strategy starting from the crossing of different official databases. Such a strategy enabled the characterization of reliable, up-to-date and verifiable data on more than the third part of the population.

Impactos del paramilitarismo en la región urabá/chocó 1998-2006. claves para la lectura de las afectaciones colectivas / Horizontality, expression, and shared knowledge: an approach on pproach on psychological processes of acccompanient to victm of political violence in colombia

Este informe de investigación recoge los resultados de una exploración sobre la naturaleza de las afectaciones de un grupo armado, lo paramilitares, en una región colombiana; este ejercicio ha sido la antesala para planteamiento de una investigación que, recientemente aprobada, se propone ofrecer pautas para dar cuenta de aquellos impactos de la guerra que puedan ser definidos como “daño colectivo”. En este orden de ideas, este artículo se propone exponer de la los resultados de esta aproximación preliminar que, a la manera de un estudio de caso, permiten establecer los alcances y limites analíticos de las aproximaciones de este carácter para dar cuenta de la dimensión de los daños colectivos a partir de la inspección de los tipos y naturaleza de las acciones paramilitares en el Chocó y Urabá antioqueños, durante el periodo 1998-2006.

The following article presents a deep discussion about the processes of psychosocial intervention with victims of political violence, in the light of their life stories in a context of research on the role of memory in the reconstruction of the social fabric. The category of the psychosocial emerged as a result of these life stories and discussion groups and allowed a critical look at the intervention processes that take place in Colombia, from the voice and the testimony of the participants. Finally, it also collects proposals from this same voice, that of the people, and forms of action involving a revision to the individualistic, pathological, vertical, technocratic, and bureaucratic models of the action, to propose comprehensive and systemic actions for the recovery of dignity and the subjective transformation from participation, dialogue of knowledge, playful and performative expression, and horizontal relationships, mutual support and construction of citizenship and subjectivity of rights.

la acción y el enfoque psicosocial de la intervención en contextos sociales: ¿podemos pasar de la moda a la precisión teórica, epistemológica y metodológica? / The action and the psychosocial approach of the intervention in social contexts: can we move from the fashion to the theoretical, epistemological, and methodological precision?

El siguiente artículo derivado de investigación, se plantea la pregunta en torno a una realidad que viene creciendo en Colombia: el incremento de los proyectos de intervención psicosocial en diversos sectores sociales, especialmente con víctimas del conflicto armado, violencia social, violencia de género e intrafamiliar, entre otras; además de población en situación de pobreza extrema, desplazamiento forzado y víctimas de catástrofes naturales. En relación con esta lógica de intervención y de acción, la reflexión académica aún sigue siendo escasa, poco clara y repetitiva de concepciones y disquisiciones internas de las disciplinas sociales, especialmente de la psicología. Por lo tanto, desde la experiencia de trabajo, desde la propia investigación y desde los procesos de acompañamiento psicosocial desarrollados por cerca de 15 años, el autor presenta una propuesta de reflexión, que implica una mirada desde el pensamiento crítico social y una postura que permita darle un marco a la acción psicosocial en una perspectiva emancipatoria.

The following article, derived from research, poses the question about a growing issue in Colombia: the increase in projects of psychosocial intervention in diverse social sectors, particularly with victims of the armed conflict, social violence, violence of gender and family, etc., as well as population in a situation of extreme poverty, forced displacement and victims of natural disasters. In relation to this logic of intervention and action, the academic reflection tends to be scarce, unclear and repetitive of concepts and internal disquisitions of the social disciplines, especially of psychology. Therefore, from the work experience, from the research itself and from the processes of psychosocial accompaniment for about 15 years, the author presents a reflective proposal, which implies a look from the social critical thought and a stance that allows to give a framework for the psychosocial action in an emancipatory perspective.

Violencia y adicciones: problemas de salud pública / Violence and addictions: public health problems

La violencia y las adicciones constituyen problemas de gran impacto en las personas, las familias y las comunidades, pues alteran el normal desenvolvimiento y la posibilidad de desarrollarse plenamente. En su presentación participan múltiples factores que obligan a que las alternativas de solución sean articuladas desde diferentes sectores y con una mirada integradora. Las perspectivas de un buen desarrollo individual y colectivo dependerán de la eficacia de las acciones que se tomen, desde la mirada de la Salud Pública.

Violence and addictions produce a great impact over persons, families, and communities. They impair their normal development and affect the possibility of individuals to fully grow. There are many different factors involved in their presentation, so proposed solutions must come from different sectors with an integrated point of view. The prospects of an adequate individual and collective development depend on the efficacy of the actions taken, from the public health point of view.

Results of an exercise to estimate the costs of interpersonal violence in Jamaica / Resultados de un ejercicio para estimar el costo de la violencia interpersonal en Jamaica

This report describes the application of a draft version of the World Health Organization (WHO)/ United States Centers for Disease Control and Prevention (CDC) Manual for estimating the economic costs of injuries due to interpersonal and self-directed violence to measure costs of injuries from interpersonal violence. METHODS: Fatal incidence data was obtained from the Jamaica Constabulary Force. The incidence of nonfatal violence-related injuries that required hospitalization was estimated using data obtained from patients treated at and/or admitted to three Type A government hospitals in 2006. RESULTS: During 2006, direct medical cost (J$2.1 billion) of injuries due to interpersonal violence accounted for about 12% of Jamaica's total health budget while productivity losses due to violence-related injuries accounted for approximately J$27.5 billion or 160% of Jamaica's total health expenditure and 4% of Jamaica's Gross Domestic Product. CONCLUSIONS: The availability of accurate and reliable data of the highest quality from health-related information systems is critical for providing useful data on the burden of violence and injury to decision-makers. As Ministries of Health take a leading role in violence and injury prevention, data collection and information systems must have a central role. This study describes the results of one approach to examining the economic burden of interpersonal violence in developing countries where the burden of violence is heaviest. The WHO-CDC manual also tested in Thailand and Brazil is a first step towards generating a reference point for resource allocation, priority setting and prevention advocacy.

Este reporte describe la aplicación de una versión preliminar del Manual de Centros de Estados Unidos para el control y prevención de enfermedades (CDC)/Organización Mundial de la Salud (OMS), para estimar el costo económico de las heridas debidas a la violencia interpersonal y la violencia auto-dirigida, con el fin de evaluar los costos de las heridas por violencia interpersonal. MÉTODOS: Datos sobre las incidencias fatales fueron obtenidos de las Oficinas de la Policía de Jamaica. La incidencia de las heridas no fatales relacionadas con la violencia, pero que no obstante requirieron hospitalización, se calculó a partir de pacientes tratados o ingresados en hospitales gubernamentales del tipo A, en el año 2006. RESULTADOS: Durante el 2006, el costo médico directo (2.1 billones JMD) por heridas a causa de violencia interpersonal, representó alrededor del 12% del total del presupuesto para la salud en Jamaica, mientras que las pérdidas de productividad debido a heridas relacionadas con la violencia, representaron aproximadamente 37.5 billones JMD, o 160% del total de gastos de salud y el 4% del producto interno bruto de Jamaica. CONCLUSIONES: Disponer de datos confiables y exactos de la más alta calidad provenientes de los sistemas de información relacionados con la salud, resulta crucial a las hora de suministrar datos útiles sobre la carga de la violencia y las heridas para quienes tienen a su cargo las tomas de decisiones. Como que los Ministros de Salud desempeñan un papel dirigente en la prevención de las heridas y la violencia, la recogida de datos y los sistemas de información tienen que jugar un papel central. Este estudio describe los resultados de un enfoque para examinar la carga económica de la violencia interpersonal en los países en vías de desarrollo, en los cuales la carga de la violencia es más pesada. El manual CDC-OMS también probado en Tailandia y Brasil, es un primer paso hacia la generación de un punto de referencia para asignar recursos, establecer prioridades y defender la prevención.

Os custos da violência para o sistema público de saúde no Brasil: informações disponíveis e possibilidades de estimação / The cost of violence for the public health system in Brazil: available data and possibilities for estimation

O orçamento público em saúde era da ordem de 53 bilhões de Reais em 2003. Dentro desse orçamento, qual é a parcela referente ao tratamento de vítimas da violência? Devido às limitações dos dados disponíveis não é possível calcular diretamente essa parcela. Neste artigo propomos uma metodologia para estimar o custo da violência para o sistema público de saúde que utiliza informações do Sistema Único de Saúde, dos orçamentos estaduais e municipais e estimativas sobre a demanda por atendimento ambulatorial da Pesquisa Nacional por Amostra de Domicílios. Segundo nossos resultados, em 2004 o tratamento de vítimas de causas externas, de agressões e de acidentes de transporte teria custado ao setor público R$ 2,2 bilhões, R$ 119 milhões e R$ 453 milhões, respectivamente. Esses valores são cerca de quatro vezes maiores que aqueles verificados em trabalhos que computaram apenas os custos com internações.

The Brazilian public budget for health was R$ 53 billion (approximately U$ 20 billion) in 2003. What share of this total was to treat victims of violence? It is impossible to estimate that proportion directly, due to limitations in the available data. This paper proposes a methodology to estimate the cost of violence for the public health system, using data from the Unified National Health System, the government budget, and the demand for public medical services (National Household Sample Survey). According to our estimates, in 2004 the costs of treatment for victims of external causes, aggressions, and traffic accidents were R$ 2.2 billion, R$ 119 million, and R$ 453 million, respectively. These findings were approximately four times higher than those observed in other studies.

Gastos do Sistema Único de Saúde com internações por causas externas em São José dos Campos, São Paulo, Brasil / Unified National Health System costs in São José dos Campos, São Paulo State, Brazil, for hospital admissions due to external causes

O objetivo do estudo foi mensurar os gastos diretos do Sistema Único de Saúde (SUS) com internações por causas externas em São José dos Campos, São Paulo, Brasil. Foram estudadas as internações por lesões decorrentes de causas externas, respectivamente capítulos XIX e XX da CID-10, no primeiro semestre de 2003, no Hospital Municipal Dr. José de Carvalho Florence. Foram analisados os valores pagos através do SUS, após a verificação da qualidade dos dados nos prontuários de 976 internações. Os maiores gastos totais foram por internações decorrentes de acidentes de transporte e quedas. O maior gasto médio de internação foi por acidentes de transporte (R$ 614,63), seguido das agressões (R$ 594,90). As lesões que representaram maior gasto médio foram as fraturas de pescoço (R$ 1.191,42) e traumatismo intracraniano (R$ 1.000,44). As internações com maior custo-dia foram fraturas do crânio e dos ossos da face (R$ 166,72) e traumatismo intra-abdominal (R$ 148,26). Os resultados encontrados demonstraram que os acidentes de transporte, as quedas e as agressões são importantes fontes de gastos com internações por causas externas no município.

The objective of this study was to identify direct expenditures for hospitalizations due to external causes in the Unified National Health System (SUS) in the city of São José dos Campos, São Paulo State, Brazil. Admissions to the Dr. José de Carvalho Florence Municipal Hospital resulting from external causes or injuries - ICD-10, chapters XIX and XX respectively - were analyzed for the first semester of 2003. 976 patient admission forms were analyzed, after data evaluation. Admissions with the highest total cost were those resulting from motor vehicle accidents and falls. The highest mean cost for hospitalization for injury was due to motor vehicle accidents (BRL 614.63), followed by assault (BRL 594.90). The highest mean cost for hospitalization due to injury was for cervical fractures (BRL 1,191.42) and head injuries (BRL 1,000.44). Hospitalizations with the highest daily cost were skull and facial fractures (BRL 166.72) and abdominal trauma (BRL 148.26). The study confirmed that motor vehicle accidents, falls, and assault are an important source of costs due to hospitalization for injuries.

Costs of injuries due to interpersonal and self-directed violence in Thailand, 2005.

Violence, a serious public health problem in Thailand, remains largely unknown for its economic costs. This study is a national-level economic cost-estimates of injury from interpersonal and self-directed violence for Thailand during 2005 using the World Health Organization-US Centers for Disease Control and Prevention's guidelines. Direct medical costs from self-directed violence totaled 569 million Baht (THB) while the cost of interpersonal violence was THB 1.3 billion. Productivity losses for injuries due to self-directed violence were estimated at THB 12.2 billion and those for interpersonal violence were THB 14.4 billion. The total direct medical cost, thus, accounted for about 4% of Thailand's total health budget while the productivity losses accounted for approximately 0.4% of Thailand s GDP In summary, interpersonal and self-directed violence caused a total loss of 33.8 billion baht for Thailand in 2005. More than 90% of the economic loss was incurred from productivity loss and about four-fifths came from men.

Agresividad, trastorno antisocial y violencia / Aggressiveness, antisocial upheaval and violence

La violencia interpersonal y colectiva es tan antigua como el hombre; en nuestra generación con la globalización, se observa un aumento de la exportación de la violencia y su incremento en todo el mundo. Los factores de su origen son múltiples: social, familiar, educativo, cultural, económico, biológico, etc. Los sociólogos y los neurocientíficos siguen estudiando intensamente las relaciones entre la conducta humana y la función cerebral. Por otra parte, es indispensable que la sociedad hondureña identifique las formas de violencia que se desarrollan en el entorno doméstico, familiar, laboral y escolar, incluyendo el maltrato a los animales. Esta revisión desarrolla los diferentes aspectos del origen, expresión y resultado de la violencia en la sociedad...

Violencia y salud en Colombia / Violence and health in Colombia

In Colombia, violence seems uncontrollable. Along with massacres and group killings of astonishing cruelty, there are also kidnappings and disappearances, abuse of children and the elderly, and rape of young adolescents. Every day, without respite, Colombians are witnesses or victims of street crimes as well as racial, sexual, and socioeconomic discrimination. Unwillingly, they become agents of aggression in public transport, at home, at school, and at work. Colombia has the highest rates of mortality from homicide in the world. Apart from the enormous institutional burden that violence imposes on the health services and forensic medicine, it now constitutes the principal public health problem in the country. To confront it, the health sector must develop policies and finance actions, develop innovative ways to train personnel, implement public education processes, and devote more effort and greater creativity to research, which up to now has provided some, but not enough, important answers. Violence, which is the substitution of force for any type of dialogue, must be considered within the context of life and health. This it not merely an attempt to rationalize violence, much less to substitute words or reflection for action, but rather an attempt to understand it in depth in order to search for alternatives. With that goal, this article analyzes the subject of violence in Colombia, principally from the perspective of its effect on the health of the citizens and its implications for the health sector. The author fully recognizes the subjectivity and limitations of the views he expresses herein

La violencia en Colombia parece incontenible. A las masacres y asesinatos colectivos, de una crueldad desconcertante, se suman los secuestros y desapariciones, el maltrato de niños y ancianos y las violaciones de adolescentes. Cada día, sin tregua, los colombianos son espectadores o víctimas de atracos callejeros y de discriminación racial, sexual y socioeconómica. Sin quererlo, se convierten en agentes de agresiones en el transporte urbano, el hogar, la escuela y el trabajo. Colombia tiene las tasas de mortalidad por homicidio más altas del mundo. Independientemente de la enorme sobrecarga institucional que impone a los servicios de salud y medicina legal, la violencia constituye actualmente en Colombia el principal problema de salud pública. Para hacerle frente, el sector de la salud debe elaborar políticas y financiar acciones; crear nuevos procesos de formación de personal, poner en marcha procesos de educación pública, y dedicar mayor esfuerzo y creatividad al campo de la investigación, que hasta ahora ha dado respuestas importantes pero aún insuficientes. Al reflexionar sobre la violencia, que es la sustitución de toda argumentación por la fuerza, es necesario ubicarla en el contexto de la vida y la salud. No se pretende solo racionalizarla, y menos aún sustituir la acción por la palabra o por las reflexiones, sino tratar de comprenderla a fondo con el objeto de buscarle alternativas. En el presente artículo se analiza, con esta finalidad, el tema de la violencia en Colombia, principalmente desde el punto de vista de su efecto en la salud de los colombianos y de sus implicaciones para el sector sanitario. El autor expone sus puntos de vista con plena conciencia de su subjetividad y limitaciones