The current state of science in violence prevention reveals progress, promise, and a number of remaining challenges. In order to fully examine the issue of global violence prevention, the Institute of Medicine in collaboration with Global Violence Prevention Advocacy, convened a workshop and released the workshop summary entitled, Violence Prevention in Low-and Middle-Income Countries. The workshop brought together participants with a wide array of expertise in fields related to health, criminal justice, public policy, and economic development, to study and articulate specific opportunities for the U.S. government and other leaders with resources to more effectively support programming for prevention of the many types of violence. Participants highlighted the need for the timely development of an integrated, science-based approach and agenda to support research, clinical practice, program development, policy analysis, and advocacy for violence prevention.

Violence against women and children is a serious public health concern, with costs at multiple levels of society. Although violence is a threat to everyone, women and children are particularly susceptible to victimization because they often have fewer rights or lack appropriate means of protection. In some societies certain types of violence are deemed socially or legally acceptable, thereby contributing further to the risk to women and children. In the past decade research has documented the growing magnitude of such violence, but gaps in the data still remain. Victims of violence of any type fear stigmatization or societal condemnation and thus often hesitate to report crimes. The issue is compounded by the fact that for women and children the perpetrators are often people they know and because some countries lack laws or regulations protecting victims. Some of the data that have been collected suggest that rates of violence against women range from 15 to 71 percent in some countries and that rates of violence against children top 80 percent. These data demonstrate that violence poses a high burden on global health and that violence against women and children is common and universal. Preventing Violence Against Women and Children focuses on these elements of the cycle as they relate to interrupting this transmission of violence. Intervention strategies include preventing violence before it starts as well as preventing recurrence, preventing adverse effects (such as trauma or the consequences of trauma), and preventing the spread of violence to the next generation or social level. Successful strategies consider the context of the violence, such as family, school, community, national, or regional settings, in order to determine the best programs.

Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine's Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims' needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings. Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.

The current state of science in violence prevention reveals progress, promise, and a number of remaining challenges. In order to fully examine the issue of global violence prevention, the Institute of Medicine in collaboration with Global Violence Prevention Advocacy, convened a workshop and released the workshop summary entitled, "Violence Prevention in Low-and Middle-Income Countries." The workshop brought together participants with a wide array of expertise in fields related to health, criminal justice, public policy, and economic development, to study and articulate specific opportunities for the U.S. government and other leaders with resources to more effectively support programming for prevention of the many types of violence. Participants highlighted the need for the timely development of an integrated, science-based approach and agenda to support research, clinical practice, program development, policy analysis, and advocacy for violence prevention.

The past 25 years have seen a major paradigm shift in the field of violence prevention, from the assumption that violence is inevitable to the recognition that violence is preventable. Part of this shift has occurred in thinking about why violence occurs, and where intervention points might lie. In exploring the occurrence of violence, researchers have recognized the tendency for violent acts to cluster, to spread from place to place, and to mutate from one type to another. Furthermore, violent acts are often preceded or followed by other violent acts. In the field of public health, such a process has also been seen in the infectious disease model, in which an agent or vector initiates a specific biological pathway leading to symptoms of disease and infectivity. The agent transmits from individual to individual, and levels of the disease in the population above the baseline constitute an epidemic. Although violence does not have a readily observable biological agent as an initiator, it can follow similar epidemiological pathways. On April 30-May 1, 2012, the Institute of Medicine (IOM) Forum on Global Violence Prevention convened a workshop to explore the contagious nature of violence. Part of the Forum's mandate is to engage in multisectoral, multidirectional dialogue that explores crosscutting, evidence-based approaches to violence prevention, and the Forum has convened four workshops to this point exploring various elements of violence prevention. The workshops are designed to examine such approaches from multiple perspectives and at multiple levels of society. In particular, the workshop on the contagion of violence focused on exploring the epidemiology of the contagion, describing possible processes and mechanisms by which violence is transmitted, examining how contextual factors mitigate or exacerbate the issue. Contagion of Violence: Workshop Summary covers the major topics that arose during the 2-day workshop. It is organized by important elements of the infectious disease model so as to present the contagion of violence in a larger context and in a more compelling and comprehensive way.

Violent conflicts today are complex and increasingly protracted, involving more nonstate groups and regional and international actors. It is estimated that by 2030—the horizon set by the international community for achieving the Sustainable Development Goals—more than half of the world’s poor will be living in countries affected by high levels of violence. Information and communication technology, population movements, and climate change are also creating shared risks that must be managed at both national and international levels. Pathways for Peace is a joint United Nations†“World Bank Group study that originates from the conviction that the international community’s attention must urgently be refocused on prevention. A scaled-up system for preventive action would save between US$5 billion and US$70 billion per year, which could be reinvested in reducing poverty and improving the well-being of populations. The study aims to improve the way in which domestic development processes interact with security, diplomacy, mediation, and other efforts to prevent conflicts from becoming violent. It stresses the importance of grievances related to exclusion—from access to power, natural resources, security and justice, for example—that are at the root of many violent conflicts today. Based on a review of cases in which prevention has been successful, the study makes recommendations for countries facing emerging risks of violent conflict as well as for the international community. Development policies and programs must be a core part of preventive efforts; when risks are high or building up, inclusive solutions through dialogue, adapted macroeconomic policies, institutional reform, and redistributive policies are required. Inclusion is key, and preventive action needs to adopt a more people-centered approach that includes mainstreaming citizen engagement. Enhancing the participation of women and youth in decision making is fundamental to sustaining peace, as well as long-term policies to address the aspirations of women and young people.

Violence against women is one factor in the growing wave of alarm about violence in American society. High-profile cases such as the O.J. Simpson trial call attention to the thousands of lesser-known but no less tragic situations in which women's lives are shattered by beatings or sexual assault. The search for solutions has highlighted not only what we know about violence against women but also what we do not know. How can we achieve the best understanding of this problem and its complex ramifications? What research efforts will yield the greatest benefit? What are the questions that must be answered? Understanding Violence Against Women presents a comprehensive overview of current knowledge and identifies four areas with the greatest potential return from a research investment by increasing the understanding of and responding to domestic violence and rape: What interventions are designed to do, whom they are reaching, and how to reach the many victims who do not seek help. Factors that put people at risk of violence and that precipitate violence, including characteristics of offenders. The scope of domestic violence and sexual assault in America and its conequences to individuals, families, and society, including costs. How to structure the study of violence against women to yield more useful knowledge. Despite the news coverage and talk shows, the real fundamental nature of violence against women remains unexplored and often misunderstood. Understanding Violence Against Women provides direction for increasing knowledge that can help ameliorate this national problem.