Variation in youth and young adult homicide rates and their association with city characteristics in Latin America: the SALURBAL study.

Background: Latin America and the Caribbean (LAC) is one of the most urbanized and violent regions worldwide. Homicides in youth (15-24 years old, yo) and young adults (25-39yo) are an especially pressing public health problem. Yet there is little research on how city characteristics relate to homicide rates in youth and young adults. We aimed to describe homicide rates among youth and young adults, as well as their association with socioeconomic and built environment factors across 315 cities in eight LAC countries. Methods: This is an ecological study. We estimated homicide rates in youth and young adults for the period 2010-2016. We investigated associations of homicide rates with sub-city education and GDP, Gini, density, landscape isolation, population and population growth using sex-stratified negative binomial models with city and sub-city level random intercepts, and country-level fixed effects. Findings: The mean sub-city homicide rate per 100,000 in persons aged 15-24 was 76.9 (SD = 95.9) in male and 6.7 (SD = 8.5) in female, and in persons aged 25-39 was 69.4 (SD = 68.9) in male and 6.0 (SD = 6.7) in female. Rates were higher in Brazil, Colombia, Mexico and El Salvador than in Argentina, Chile, Panama and Peru. There was significant variation in rates across cities and sub-cities, even after accounting for the country. In fully adjusted models, higher sub-city education scores and higher city GDP were associated with a lower homicide rate among male and female (rate ratios (RR) per SD higher value in male and female, respectively, 0.87 (CI 0.84-0.90) and 0.90 (CI 0.86-0.93) for education and 0.87 (CI 0.81-0.92) and 0.92 (CI 0.87-0.97) for GDP). A higher city Gini index was associated with higher homicide rates (RR 1.28 (CI 1.10-1.48) and 1.21 (CI 1.07-1.36) in male and female, respectively). Greater isolation da was also associated with higher homicide rates (RR 1.13 (CI 1.07-1.21) and 1.07 (CI 1.02-1.12) in male and female, respectively). Interpretation: City and sub-city factors are associated with homicide rates. Improvements to education, social conditions and inequality and physical integration of cities may contribute to the reduction of homicides in the region. Funding: The Wellcome Trust [205177/Z/16/Z].

Herd culture and herd immunity. / Cultura de rebaño e inmunidad de rebaño.

Although communicable diseases affect our bodies, they occur in a society that interprets and gives them meaning. Herd immunity provides the body protection; however, long-term protection requires shifts in the way people interpret and respond to disease, cultural transformation that enables the development of the knowledge, habits and skills that make herd immunity feasible and sustainable. Herd culture allows individuals to protect themselves and restrict their liberty in order to protect others; it is a form of exercising positive liberty and a necessary complement to herd immunity in a democratic society.

Aunque las enfermedades transmisibles afectan nuestros cuerpos, ocurren en una sociedad que las interpreta y dota de significado, y cuyos individuos causan o evitan. La inmunidad de rebaño permite lograr una protección del cuerpo, sin embargo, para su sustentabilidad, se requiere de cambios en la manera cómo las personas interpretan y responden a la enfermedad, de transformaciones culturales que permitan desarrollar conocimientos, hábitos y destrezas que hagan factible y sostenible la inmunidad de rebaño. La cultura de rebaño permite a los individuos protegerse y restringir su libertad para proteger a los demás, es una forma de ejercicio de la libertad positiva y el complemento necesario de la inmunidad del rebaño en la sociedad democrática.

Cultura de rebaño e inmunidad de rebaño / Herd culture and herd immunity

Resumen Aunque las enfermedades transmisibles afectan nuestros cuerpos, ocurren en una sociedad que las interpreta y dota de significado, y cuyos individuos causan o evitan. La inmunidad de rebaño permite lograr una protección del cuerpo, sin embargo, para su sustentabilidad, se requiere de cambios en la manera cómo las personas interpretan y responden a la enfermedad, de transformaciones culturales que permitan desarrollar conocimientos, hábitos y destrezas que hagan factible y sostenible la inmunidad de rebaño. La cultura de rebaño permite a los individuos protegerse y restringir su libertad para proteger a los demás, es una forma de ejercicio de la libertad positiva y el complemento necesario de la inmunidad del rebaño en la sociedad democrática.

Abstract Although communicable diseases affect our bodies, they occur in a society that interprets and gives them meaning. Herd immunity provides the body protection; however, long-term protection requires shifts in the way people interpret and respond to disease, cultural transformation that enables the development of the knowledge, habits and skills that make herd immunity feasible and sustainable. Herd culture allows individuals to protect themselves and restrict their liberty in order to protect others; it is a form of exercising positive liberty and a necessary complement to herd immunity in a democratic society.

Violence against indigenous children and adolescents in Venezuela.

Research on violence in indigenous communities refers to traditional practices of competition for scarce goods and clashes with other populations over their territories. Violence against children is not described, and authors of some studies state a tradition of good treatment towards them. In our study we shows that the situation has changed and new forms of violence are affecting 725,000 inhabitants from 51 indigenous groups of Venezuela, especially those composed of children and adolescents. The method used was interviews with key informants and for secondary census, civil society data and journalists' reports. Results describe the existence of four types of violence: (a) structural violence, derived from the shortage of food and medicines that have caused deaths due to malnutrition and lack of medical attention, prostitution, girl trafficking and forced emigration; (b) violence of organized crime, which exercise control of illegal mining and affect the Yanomami and Pemón peoples, as workforce for the production of coca and drug trafficking with the Yupka people; and contraband of gasoline in the Wayúu people; (c) domestic violence due to cultural changes derived from new patterns of alcohol consumption or the use of physical punishment of children between Piaroa and Yekuana peoples; and (d) the illegal violence of the State for the imposition of mining with the Pemón people or the repression for the protests with the Warao and Inga peoples. In the article we show the great difference between the official discourse of protection of indigenous peoples and the realities of violence, criminal exploitation and violation of rights suffered by indigenous children and adolescents.

Violence against indigenous children and adolescents in Venezuela / Violencia contra niños y adolescentes indígenas en Venezuela / Violência contra crianças e adolescentes indígenas na Venezuela

Abstract: Research on violence in indigenous communities refers to traditional practices of competition for scarce goods and clashes with other populations over their territories. Violence against children is not described, and authors of some studies state a tradition of good treatment towards them. In our study we shows that the situation has changed and new forms of violence are affecting 725,000 inhabitants from 51 indigenous groups of Venezuela, especially those composed of children and adolescents. The method used was interviews with key informants and for secondary census, civil society data and journalists' reports. Results describe the existence of four types of violence: (a) structural violence, derived from the shortage of food and medicines that have caused deaths due to malnutrition and lack of medical attention, prostitution, girl trafficking and forced emigration; (b) violence of organized crime, which exercise control of illegal mining and affect the Yanomami and Pemón peoples, as workforce for the production of coca and drug trafficking with the Yupka people; and contraband of gasoline in the Wayúu people; (c) domestic violence due to cultural changes derived from new patterns of alcohol consumption or the use of physical punishment of children between Piaroa and Yekuana peoples; and (d) the illegal violence of the State for the imposition of mining with the Pemón people or the repression for the protests with the Warao and Inga peoples. In the article we show the great difference between the official discourse of protection of indigenous peoples and the realities of violence, criminal exploitation and violation of rights suffered by indigenous children and adolescents.

Resumen: La investigación sobre la violencia en las comunidades indígenas se refiere a las prácticas tradicionales de competencia por los bienes escasos y enfrentamientos con otras poblaciones por sus territorios. La violencia contra los niños no se ha conocido, y algunos estudios afirman la existencia de una tradición de buen trato hacia ellos. Este estudio muestra que la situación cambió y que nuevas formas de violencia están afectando a 725.000 habitantes de los 51 grupos indígenas de Venezuela, especialmente niños y adolescentes. El método utilizado fue entrevistas con informantes clave, un censo secundario, así como datos de la sociedad civil e informes de periodistas. Los resultados describen la existencia de cuatro tipos de violencia: (a) violencia estructural, derivada de la escasez de comida y medicinas, que ha causado muertes debido a la malnutrición y falta de atención médica; prostitución, tráfico de niñas y emigración forzosa; (b) la violencia del crimen organizado, que ejerce el control de la minería ilegal y afecta a los Yanomami y Pemón, como fuerza de trabajo para la producción de coca y tráfico de drogas en el caso de los Yupka; además de contrabando de gasolina con los Wayúu; (c) la violencia doméstica, debido a los cambios culturales, derivada de nuevos patrones de consumo de alcohol o la aplicación del castigo físico de niños entre los Piaroa y Yekuana; y (d) la violencia ilegal del estado para la imposición de la minería con los Pemón o la represión de las protestas con los Warao e Inga. El artículo expone la gran diferencia entre el discurso oficial de protección a los indígenas y las realidades de violencia, explotación criminal y violación de los derechos sufridos por los niños y adolescentes indígenas.

Resumo: A pesquisa sobre violência em comunidades indígenas se refere a práticas tradicionais de disputa por bens escassos e confrontos com outras populações pela posse de seus territórios. A violência contra crianças ainda não foi descrita, e alguns estudos afirmam uma tradição de bom tratamento em relação a elas. O estudo mostra que a situação já mudou, e que novas formas de violência estão afetando 725.000 habitantes de 51 grupos indígenas na Venezuela, especialmente contra crianças e adolescentes. O método utilizado teve como base entrevistas com informantes-chave e acesso a dados censitários e de fontes da sociedade civil, além de relatos de jornalistas. Os resultados descrevem a existência de quatro tipos violência: (a) violência estrutural, derivada da escassez de alimentos e medicamentos, que provoca mortes devido à desnutrição e à falta de atendimento médico; prostituição e tráfico de meninas, além de emigração forçada; (b) violência praticada pelo crime organizado, com o controle da mineração ilegal e que afeta os povos Yanomami e Pemón, como força de trabalho na produção de coca e no tráfico de drogas no povo Yupka e o contrabando de gasolina no povo Wayúu; (c) violência doméstica em função de mudanças culturais derivadas dos novos padrões de consumo de álcool ou do uso de castigo físico de crianças, entre os povos Piaroa e Yekuana; e (d) violência ilegal praticada pelo estado pela imposição da mineração no povo Pemón ou com a repressão de protestos pelos povos Warao e Inga. O artigo mostra a grande diferença entre o discurso oficial da proteção dos indígenas e a realidade de violência, exploração criminosa e violação dos direitos das crianças e adolescentes indígenas na Venezuela.

Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study.

BACKGROUND: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. METHODS: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated. FINDINGS: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations. INTERPRETATION: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems. FUNDING: The Lowitja Institute.

La Comprensión de los Homicidios en América Latina: ¿Pobreza o Institucionalidad? / Understanding homicides in Latin America: poverty or institutionalization?

Los homicidios ocurren en todo el mundo, pero no están homogéneamente distribuidos, cambian por zonas geográficas: continentes, países, regiones; en periodos de tiempo largos o cortos o por lo grupos sociales: edad, sexo, clase social o etnia. ¿Por qué en unos países hay más homicidios que en otros? ¿Por qué en unos países disminuyen los asesinatos y en otros se incrementan? Las explicaciones sociales de la violencia han tenido dos vertientes fundamentales: las teorías que la atribuyen a la pobreza y la desigualdad y las teorías de la institucionalidad o las normas sociales. Para discutir esas teorías el artículo analiza y compara los cambios ocurridos en Colombia, Venezuela y Brasil en la primera década del siglo XXI donde respectivamente disminuye, aumenta y se mantiene igual la tasa de homicidios. Utilizando la medición de seis variables (pobreza, desigualdad, desempleo, riqueza nacional, desarrollo humano y gobierno de la ley) y la técnica del análisis de trayectorias se encontró que la institucionalidad tiene una mayor fuerza explicativa en los cambios observados que la pobreza y la desigualdad. El texto concluye que la pobreza o la desigualdad influyen en la criminalidad y en los homicidios, aunque no de manera directa, sino mediadas por las instituciones.

Homicides occur the world over, but they are not homogeneously distributed by geographical areas (continents, countries, regions), either over long or short periods of time, or in social groups, namely age, gender, social class or ethnicity. Why are there more homicides in some countries than in others? Why do killings increase in some countries, while they decrease in others? There are two fundamental schools of thought for social explanations of crime and violence: those attributing its origins to poverty and inequality and those blaming institutionalization or social norms. To discuss these theories, this paper analyzes and compares the changes in Colombia, Venezuela and Brazil in the first decade of the twenty-first century, where the homicide rate has decreased, increased and remained the same, respectively. Using the measurement of six variables (poverty, inequality, unemployment, national wealth, human development and the rule of law) and the technique of trajectory analysis, the results revealed that institutionalization is more to blame for the change than poverty and inequality. The text concludes that poverty and inequality affect crime and homicides, although not directly, but mediated by the institutions instead.

Tres fases de la violencia homicida en Venezuela / Three phases of homicidal violence in Venezuela

Venezuela era considerado uno de los países menos violentos de América Latina, sin embargo para el año 2010 estaba entre los que mostraban la más alta tasa de homicidios. Este artículo analiza la evolución de los homicidios ocurridos en Venezuela entre 1989 y 2010 y plantea la existencia de tres etapas que se corresponden a distintos momentos de la institucionalidad social y política del país. La primera de 1985 a 1993, caracterizada por la crisis social de los saqueos de 1989 y los golpes de estado de 1992, cuando por primera vez se incrementa la tasa de homicidios de 8 a 20. La segunda fase va desde 1994 hasta 1998 que fue un periodo de recuperación de la institucionalidad y de estabilidad política cuando la tasa de homicidios se mantuvo sin variaciones alrededor de 20. Y la tercera fase que se inicía en 1999 con el gobierno de H Chávez y la destrucción institucional que ocurre con la revolución bolivariana y que provocó un incremento de la tasa de 20 a 57 homicidios por 100 mil habitantes. El artículo sostiene que la explicación de los cambios en las fases debe buscarse en las transformaciones de la institucionalidad social y política.

Venezuela was considered one of the least violent countries in Latin America, however by 2010 it was among the countries with the highest homicide rate. This article analyzes the evolution of homicides in Venezuela between 1985 and 2010 and proposes the existence of three stages which correspond to trends in social and political institutions of the country. The first from 1985 to 1993, characterized by the looting of 1989 and the coups d'état of 1992, when for the first time the homicide rate rose from 8 to 20. The second phase from 1994 to 1998 was a recovery period of the institutional and political stability when the homicide rate remained constant at around 20. The third phase began in 1999 with the H Chavez government and the institutional destruction that comes with the Bolivarian revolution and caused an increase in the rate of 20 to 57 homicides per 100 thousand inhabitants. This article argues that the explanation for the changes in the phases is to be found in the transformation of social and political institutions.

[Understanding homicides in Latin America: poverty or institutionalization?]. / La comprensión de los homicidios en América Latina: ¿pobreza o institucionalidad?

Homicides occur the world over, but they are not homogeneously distributed by geographical areas (continents, countries, regions), either over long or short periods of time, or in social groups, namely age, gender, social class or ethnicity. Why are there more homicides in some countries than in others? Why do killings increase in some countries, while they decrease in others? There are two fundamental schools of thought for social explanations of crime and violence: those attributing its origins to poverty and inequality and those blaming institutionalization or social norms. To discuss these theories, this paper analyzes and compares the changes in Colombia, Venezuela and Brazil in the first decade of the twenty-first century, where the homicide rate has decreased, increased and remained the same, respectively. Using the measurement of six variables (poverty, inequality, unemployment, national wealth, human development and the rule of law) and the technique of trajectory analysis, the results revealed that institutionalization is more to blame for the change than poverty and inequality. The text concludes that poverty and inequality affect crime and homicides, although not directly, but mediated by the institutions instead.

[Three phases of homicidal violence in Venezuela]. / Tres fases de la violencia homicida en Venezuela.

Venezuela was considered one of the least violent countries in Latin America, however by 2010 it was among the countries with the highest homicide rate. This article analyzes the evolution of homicides in Venezuela between 1985 and 2010 and proposes the existence of three stages which correspond to trends in social and political institutions of the country. The first from 1985 to 1993, characterized by the looting of 1989 and the coups d'état of 1992, when for the first time the homicide rate rose from 8 to 20. The second phase from 1994 to 1998 was a recovery period of the institutional and political stability when the homicide rate remained constant at around 20. The third phase began in 1999 with the H Chavez government and the institutional destruction that comes with the Bolivarian revolution and caused an increase in the rate of 20 to 57 homicides per 100 thousand inhabitants. This article argues that the explanation for the changes in the phases is to be found in the transformation of social and political institutions.

Arnoldo Gabaldón, (1909-1989) / Biblioteca Biográfica Venezolana / Arnoldo Gabaldón, (1909-1989)

Arnoldo Gabaldón (1909-1989) fue uno de los grandes médicos sanitaristas venezolanos con proyección latinoamericana y mundial. Director fundador de la Dirección Especial de Malariología (1936) su visión multidisciplinaria juntó elementos de la medicina, la biología, la ingeniería y la sociología, la importancia que siempre le dio a la investigación, a la formulación e implementación de políticas sanitarias apropiadas y a la evaluación estadística pública de sus resultados, aunados a su tesón, su mística y su extraordinaria capacidad organizativa hacen de la exitosa lucha venezolana contra la malaria y otras enfermedades tropicales una experiencia señera que se proyectó mundialmente al adoptarse muchos de los métodos y técnicas que impulsó en otras regiones tropicales del mundo. Su pulcritud en el manejo de los fondos políticas, la rectitud de sus convicciones sociales, su habilidad política y su insistencia en la formación, preparación y motivación de los funcionarios de la dirección, las visitadoras rurales, los voluntarios y en general de todos el personal que podía contribuir al control y erradicación de estas terribles enfermedades, contribuyeron a una continuidad y ampliación de una labor vital para todos los venezolanos y que logró sobrevivir a las viscitudes políticas que sufrió Venezuela durante cincuenta años. (AU)

[Chagas disease in the Americas: an ecohealth perspective]. / La enfermedad de Chagas en las Américas: una perspectiva de ecosalud.

The historical processes involved in Chagas disease transmission relate to the patterns and conditions of human settlements, especially in rural areas, due to proximity to forest areas, where both vectors and Trypanosoma cruzi can occur, combined with precarious housing conditions and underlying poverty. However, seasonal and permanent rural-urban migration has played a major role in re-mobilizing vectors, T. cruzi, and Chagas-infected individuals. A new agricultural frontier in the Amazon has led to a new transmission pattern, especially with palm trees located close to houses. Improved blood bank surveillance has decreased transmission by blood transfusions. International migration also plays a role in Chagas disease epidemiology. The United States and Spain, where specific health services for Chagas disease diagnosis and treatment are largely absent, harbor an unknown number of individuals with Chagas, probably infected decades ago. The article discusses major strides in Chagas disease knowledge and control, besides identifying persistent gaps, such as the need for housing improvements, especially in poor rural areas in the Americas.

La enfermedad de Chagas en las Américas: una perspectiva de ecosalud / Chagas disease in the Americas: an ecohealth perspective

The historical processes involved in Chagas disease transmission relate to the patterns and conditions of human settlements, especially in rural areas, due to proximity to forest areas, where both vectors and Trypanosoma cruzi can occur, combined with precarious housing conditions and underlying poverty. However, seasonal and permanent rural-urban migration has played a major role in re-mobilizing vectors, T. cruzi, and Chagas-infected individuals. A new agricultural frontier in the Amazon has led to a new transmission pattern, especially with palm trees located close to houses. Improved blood bank surveillance has decreased transmission by blood transfusions. International migration also plays a role in Chagas disease epidemiology. The United States and Spain, where specific health services for Chagas disease diagnosis and treatment are largely absent, harbor an unknown number of individuals with Chagas, probably infected decades ago. The article discusses major strides in Chagas disease knowledge and control, besides identifying persistent gaps, such as the need for housing improvements, especially in poor rural areas in the Americas.

El proceso de transmisión de la enfermedad de Chagas ha estado históricamente relacionado con los patrones de ocupación territorial de los asentamientos humanos. En las áreas rurales puede ocurrir más fácilmente el encuentro del vector, los agentes patógenos y los seres humanos, por las condiciones de la vivienda y la pobreza existente en estas zonas. Los procesos migratorios permanentes o estacionales han jugado un papel igualmente importante en el transporte de los vectores y en la infección de la población en las zonas urbanas. Las nuevas fronteras agrícolas del Amazonas se han establecido nuevas áreas de transmisión de la enfermedad. La atención dada a los bancos de sangre ha permitido disminuir la transmisión transfusional, pero la inmigración internacional ha cambiado la situación epidemiológica, pues en Estados Unidos y España viven miles de enfermos que habían sido infectados décadas antes y no encuentran adecuada atención. Los avances en el conocimiento y el control de la enfermedad son mostrados en el artículo, señalando las limitaciones existentes en cuanto al mejoramiento de las condiciones ambientales y de vivienda de los pobres.

La enfermedad de Chagas en una historia de vida: conocer la enfermedad, cambiar el mundo. Entrevista a João Carlos Pinto Dias / Chagas disease in a life story: unveiling the disease, changing the world. Interview with João Carlos Pinto Dias

No es fácil olvidar su pequeña figura moviéndose ante el auditorio, gesticulando con energía, modulando la voz entre tonos bajos, reflexivos y llenos de sentimiento para hablar de las madres y los enfermos, o sus fuertes imprecaciones para criticar o ironizar sobre los poderes constituidos: es João Carlos Pinto Dias, una de la autoridades mundiales en el estudio y la lucha contra la enfermedad de Chagas. João Carlos Pinto Dias es un científico y un ciudadano íntegro que enorgulllece a Brasil y Latinoamérica, ha ocupado posiciones relevantes en el ámbito académico y en el sector público. Pese a que nació en Río de Janeiro en 1938, su vida y gran parte de su obra la ha desarrollado en Minas Gerais, donde vive y trabaja en Centro de Pesquisas René Rachou de la Fundação Oswaldo Cruz [CPqRR/FIOCRUZ]. [AU]

Understanding the uneven distribution of the incidence of homicide in Latin America.

BACKGROUND: Throughout the final years of the twentieth century and into the beginning of the twenty-first, violence has been one of the main public health issues in Latin America, a region which has some of the highest mortality rates due to violence in the world. However, there seems to be an uneven geographical distribution of such instances. METHODS: We reviewed epidemiological data on violence globally and in Latin America, and here, we discuss differences between the Latin American countries in the context of a sociological framework as well as from a public health perspective. RESULTS: Our results indicate marked differences by country in terms of rates of violence. Countries such as Argentina, Chile, Costa Rica, and Uruguay, have low violence mortality rates; Peru, Nicaragua, Ecuador, Dominican Republic, Panama, and Paraguay have moderate rates, and Brazil, Mexico, Colombia, El Salvador, Honduras and Venezuela have high to extremely high mortality rates. Factors related to violence include social inequalities, lack of employment opportunities, urban segregation, a culture of masculinity, local drug markets, and the availability of firearms and widespread use of alcohol. CONCLUSION: The observed homicide variability between Latin American countries can be explained largely by differences in the countries' social contexts and political models. In those countries where homicide rates are extremely high, governments should review their current policies and take preventive actions. Fortunately increasingly nowadays there are promising advancements in that direction.