Fractured lives in fractured cities: towards a critical Public Health approach to urban violence

Abstract

Abstract Background 43 of the 50 cities with the highest homicide rates worldwide are Latin American. Although the mechanisms through which urban violence is (re-)produced are complex, the inequalities that shape fragmented Latin American urban landscapes and define the patterns of urban violence have been forged by sociopolitical processes including market-driven urban restructuring processes in the realm of “actually existing” neoliberalism. The comparative case study on two neighborhoods in Bogotá and Rio de Janeiro seeks to contribute to the development of a critical Public Health approach to urban violence that moves beyond the description of death registries and the association of discrete risk factors. Methods The case studies are based on qualitative analyses of 4 focus groups and 46 semi-structured interviews with residents and specialists (2016 and 2019) using the Framework Method as well as comprehensive literature reviews. Results Both cases reveal nuanced processes through which urban violence is produced and reproduced by different actors and suggest that violence is inherent in the market-driven territorial making and un-making of increasingly “fragmented” cities. The cases suggest that violence is implied in threats of eviction, “necropolitical” police/military interventions and in the silent imposition of a “slow death” on urban infrastructure and entire neighborhoods, which bring about health consequences that include injuries but also shape other health problems. Both cases provide evidence to suggest selective and contradictory state presence that implies, admits or reinforces violence. Conclusions The cases combat simplistic readings of Latin American urban violence as a phenomenon exclusively related to confrontations between rival drug gangs and the police or aggressive individuals by revealing a great variety of actors and processes involved in (re-)producing urban violence that have serious implications for life and health in Latin American cities. Key messages Need for a critical Public Health approach to urban violence that moves beyond the description of death registries and the association of discrete risk factors. A great variety of actors and processes is involved in (re-) producing urban violence that have serious implications for life and health in Latin American cities.