Alcohol Related Street Violence

1 Alcohol Related Street Violence Introduction Violence of any nature reflects badly on the normal functioning of the society due to the intimidation and trauma it brings to the victims. It is therefore incumbent upon any government institution involved in providing security and administration of justice to deal with the vice with the seriousness it deserves. The first step involves dealing with the root causes of violent behavior. Street violence is one such type of violence whose occurrence can be traced to a variety of causes ranging from gang wars, accidental street encounters with drug peddlers and junkies, muggings and sporadic outbursts due to the effects of alcohol and substance abuse.

According to Morgan & McAtamney, “there is strong evidence of an association between the consumption of alcohol and violence.” The violence from alcohol-related intake in Australia is costly given the fact that conservative estimates indicate that between 2004 and 2005, alcohol related violence cost the nation $1.7 billion in social costs, excluding that of prosecution and death. Due to such startling effects on the nation, the impacts of alcohol related street violence cannot be ignored.

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2 Alcohol related street violence and many other negative impacts of alcohol consumption for that matter have effects on a country’s health and health promotion strategies that it undertakes in its health policies (Palk 2008:40). The concept of health promotion strategies where first emphasized on a global level by the WHO through the first international health promotion conference held in 1986 in Ottawa, Canada: The Ottawa Charter. Subsequent conferences have been held through the years in other cities around the world such as Jakarta, Bangkok and Nairobi all in an effort to improve on recommendations and resolutions of the Ottawa Charter. This essay looks at individual capacity and institutions in strategic public policy development and enforcement in health promotion with regards to strategies currently in use in Australia (Williams 2001:190).

Health promotion theory Health promotion as a theory has evolved ever since its introduction on the global stage in 1986 in Ottawa. Its evolution has seen countries now focus on how partnerships and policies should be on the centre of a nation’s development (The Bangkok Charter 2005:1). Such policy implementation ensures that the community owns up to social evils such as robbery and violence that may endanger the health of the nation, hence the reason why health promotion is regarded as a critical human right (The Nairobi Call for Action 2009:4). When a victim of street violence suffers rape, the trauma and the possible health risks that they are exposed to, if left unchecked, end up affecting the productivity of an individual negatively especially when depression sets in.

In order to prevent inherent negative effects on individuals, social policies should be geared towards promoting individuals to view the concept of health promotion as a personal endeavor, whereby persons are encouraged to always be taking the first step and initiative towards protecting and safeguarding their personal health (Morgan & McAtamney 2009:5-6).

3 Alcohol related street violence-forms, causes and effects Australia is faced by major alcohol related problems due to the widespread use of alcohol throughout the country (Williams 2001:165). Some of these problems include: Family strife caused by alcoholism, street violence, car accidents from drunken driving, physical abuse, increase in drug use, increase of prostitution due to the nature of association of alcohol and moral decay in the society, street violence, and verbal abuse. The seriousness of the matter was highlighted in a 2007 report of the National Drug Strategy Household Survey (NDSHS) which gave startling statistics about the most prevalent drug that is abused in the country, alcohol. The study revealed that the rates of verbal and physical abuse in alcohol related incidents were more than double those of other drugs. The perpetrators of these crimes are usually heavy drinkers who normally become violent with every increasing drink they take. However, the study also revealed that most of the victims of alcohol abuse happened to also be under the influence of alcohol with up to 38% of them being under the influence of alcohol during the incident (Morgan & McAtamney 2009:1).

The violence that results from alcohol consumption is caused by the behavioral changes that different people have after imbibing a drink or two. The reason for these behavioral changes normally originates from the fragile mix of situational and individual factors that come into play during the consumption process (Williams 2001:19-21). The young and particularly males are the most vulnerable group that is susceptible to being either victims or perpetrators of abuse and violence. The reason is that unlike women, men are more prone to be physical in their confrontations with every additional drink they take and in cases where drinking starts early, by the time it clocks the late night hours, most incidents of violence inevitably start to occur. It is for this reason that majority of violent incidents are normally reported during the wee hours of the

4 night of between midnight and 5 a.m. The danger of these violent outbursts occurring at such late hours is that the victims are normally also under the influence of alcohol and may not be mentally equipped to deal with undertaking emergency procedures incase of an attack. The major challenge with respect to health response is the availability of 24 hour emergency medical facilities throughout the nation (Willis, Reynolds & Keleher 2009:206). Emergency room facilities are usually far away from places where violence takes place from. The result is, unless law enforcement is nearby, victims often find it difficult to access badly needed emergency medical care.

Health promotion Strategies The basis of all health promotion strategies is based on the fact that health ought to be observed as an all inclusive concept which if not properly observed can end up being a determent to the wellbeing of life (The Nairobi Call for Action for Closing the Implementation Gap in Health Promotion, 2009:2). The various strategies that exist all rely on the application of various techniques that enable the evaluation of public policies, capacity reinforcement of communities, capacity development of various healthcare systems and supporting individual capacities that encourage preventative health measures (Fleming & Parker 2007:9-10).

In poor neighborhoods strategies such as controlling the operation time of alcohol selling establishment may reduce the alcoholic intake, in a wealthy suburb, such measures might not work as the individuals have the capacity to stock alcohol in bulk in their homes or private clubs where such a law has zero effect on consumption levels (Fleming 2008:14). Every strategy is unique in terms of application; for example there are those strategies that work best in low income neighborhoods and may not do particularly well in an affluent community. The strategy that is chosen also goes a long way in determining the outcome of the process; for instance

5 beefing up security in high risk neighborhoods will reduce the severity of drunken-induced incidents in the case of an occurrence (Palk 2008:57).

Building Capacity The strategy of building capacity is the most effective means of ensuring that a health promotion strategy is successful (The Jakarta Declaration 1997). Health promotion should be regarded as a key investment in the capacity building of a nation. Research has revealed that emphasis on individual capacity efforts in dealing with health care challenges is the most effective way for a nation in health promotion (Tannahill 2008:386). The reason for this is because among the major determinants of economic growth is an unhealthy and sickly populace.

Therefore all efforts that are undertaken ought to be geared towards ensuring that the populace is free of any form of avoidable illness or medical condition. Australian legislation has been focusing on the reduction and hopefully complete eradication of STIs. On the issues of alcohol and how it relates to violence, health promotion becomes a key factor in the prevention of death and the spread of sexually transmitted infections (STIs) that face victims of rape (De Visser et al 2003:148). However, inequalities and crimes that result in rapes have been a major cause of concern as victims, due to the fear of social stigma, are in most cases embarrassed and do not come forward or delay in seeking emergency medical care, which has resulted in continued prevalence.

Policy and Human rights Another useful strategy that can be used in dealing with alcohol related street violence is the enactment of legislation that caters for preventative measures. The passage of the South Australian Public Health Act of 2011 went a long way in the health promotion of the South Australia as it aimed to provide and promote health protection by aiming towards the reduction

6 of preventable injury, disability, diseases, and illness. Such a strategy relates the various forms of violence that victims face and how government and social institutions help in terms of treatment, advice and counseling and the prevention of future occurrence of incidences and justice (Williams 2001:191). Such a law caters sufficiently for some of the results of alcohol violence which might include STIs, broken limbs and trauma. By viewing health as a human right, appropriate interventions can be undertaken in both social and personal levels. Such interventions ensure that health policies are tailor made towards health issues such as medical care for victims of violence (Wronka 2008:110).

Healthcare approach A healthcare approach that is aimed at providing quick and appropriate medical response to victims of violence in the form of first aide and fast emergency room care is the most appropriate short term measure that victims of street violence need (Willis, Reynolds & Keleher 2009:158). This strategy of health promotion has been shown to work effectively especially in rape victims to prevent STIs and victims of gun injuries during the prevention of loss of life (DHS 2005:8). The reason this strategy works best, in addition to the emergency help it offers, is because it is based on the basic human right of the right to life that states that life is sacred and efforts should always be made to save it whenever it is in danger; in short it shows that life indeed matters (London 2008:2). In essence, effective healthcare becomes pivotal when it comes to dealing and implementing health promotion strategies, as it sits on the base of mitigating the effects of injury to violence victims.

Social work approach This strategy is a consultative one that makes use of social workers and other stakeholders in the society such as healthcare experts, police, law courts, and government

7 agencies (Nutbeam, 1998:8). This strategy emphasizes more on the preventative aspect of alcohol related violence by embarking on sensitization campaigns that aim at preventing would be victims from suffering attacks. It also involves owners of bars and other alcoholic dens in ensuring that they discourage sale of alcohol to rowdy individuals in their establishments so as to guarantee the safety of other patrons (Ward & Verrinder 2008:117). Law courts should be encouraged to dish out harsh sentences to perpetrators so as to encourage other victims to come forward and in the process also get appropriate medical care in addition to justice. Public participation of reporting perpetrators should also be encouraged so that police can be able to smoothly carry out their job of protecting the entire public. The strategy of making use of social work is among the most effective as it goes right towards changing the perception of the citizenry, if done properly, it makes the formulation and subsequent application of policies and legislation more potent in dealing with social vices that face the nation, in this case alcohol related street violence.

Conclusion The transformation of health promotion policies from a social issue to that which requires an individual approach has transformed how health and the right to health is viewed in Australia. Adoption of the international health conventions’ environmental resources and structural conditions into Australian policy and legislation has made the country to become well equipped in the provision of appropriate strategies to deal with alcohol related street violence.

The health impacts of this violence such as the increased prevalence of STIs and psychological trauma, if left unchecked by stakeholders in the healthcare and justice system, will end up infringing on the basic human right of the populace of a right to life through access to quality healthcare.

8 List of References De Visser, R, Smith, A, Rissel, C, Richters, J & Grulich, AE 2003, ‘Sex in Australia: Heterosexual experience and recent heterosexual encounters among a representative sample of adults’, Australian and New Zealand Journal of Public Health, Vol. 27, no. 2, pp. 146-154.

DHS (Department of Human Services) 2005, ‘Planning for effective health promotion and evaluation’, Primary and Community Health, State of Victoria, Melbourne.

Fleming, J 2008, ‘Rules of engagement: Policing anti-social behavior and alcohol-related violence in and around licensed premises’, NSW Bureau of Crime Statistics and Research, State of New South Wales, Sydney.

Fleming, M & Parker, E 2007, Health promotion: Principles and practice in the Australian Context. 3rd ed, Crow’s Nest: Allen & Unwin.

London, L 2008, ‘What is a human rights-based approach to health and does it matter?’ Health and Human Rights, Vol. 10, no. 1, pp. 1-16.

Morgan, A & McAtamney, A 2009, ‘Key issues in alcohol-related violence’, Australia's National Research and Knowledge Centre on Crime and Justice, Research in practice, Summary Paper No. 04, December, 2009 Nutbeam, D 1998, ‘Health promotion glossary’, World Health Organization (WHO) collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, Australia.

Palk, G 2008, ‘Policing alcohol-related violence’, PhD Thesis, Queensland University of Technology

9 Tannahill, A 2008, ‘Beyond evidence to ethics: A decision-making framework for health promotion, public health and health improvement’, Health Promotion International, Vol. 23, no. 4, pp. 380-390 The Bangkok Charter for Health Promotion in a Globalized World, 2005, 6th Global Conference on Health Promotion, Bangkok, Thailand, August 2005.

The Jakarta Declaration on Leading Health Promotion into the 21st Century, 1997, The Fourth International Conference on Health Promotion: New Players for a New Era - 42 Leading Health Promotion into the 21st Century, Jakarta, Indonesia, July, 1997.

The Nairobi Call for Action for Closing the Implementation Gap in Health Promotion, 2009, 7th Global Conference on Health Promotion, Nairobi, Kenya, October 2009 The Ottawa Charter for Health Promotion, 1986, First International Conference on Health Promotion, Ottawa, Canada, November 1986.

Ward, B & Verrinder, G 2008, ‘Young people and alcohol misuse: How can nurses use the Ottawa Charter for health promotion?’ Australian Journal of Advanced Nursing, Vol. 25, no. 4, pp. 114-119.

Williams, P 2001, ‘Alcohol, young persons and violence’, Australian Institute of Criminology Research and Public Policy Series No.35, Australian Institute of Criminology.

Willis, E, Reynolds, L & Keleher, H 2009, Understanding the Australian health care system, Chatswood: MOSBY Elsevier.

Wronka, J 2008, Human rights and social justice: social action and service for the helping and health professions, Thousand Oaks, CA: Sage publications.