Abstract

Objectives Despite the ubiquity of violence and its possible impact on individual and collective health, the role and causal pathways of this phenomenon as a health determinant have not been widely studied. The present study was conducted between 2005 and 2008 in the Basque Region of Spain and aimed to estimate the health effects of collective violence on its primary victims. Methods A purposive sample of 33 primary victims (direct victims of collective violence and the first degree relatives of murder victims) was matched (1:5 ratio) with a random selection of persons drawn from a representative sample of the population aged more than 16 years old living in the Basque Region. Matching criteria were age, sex, educational level and province of residence. All participants completed a questionnaire that included health status measures (WHO-DAS-II-12, GHQ-12, SF-12, loneliness and stigma scales) and other potentially mediating variables such as social support and emotional climate. The results were assessed by regression analysis conditional to exposure to collective violence. Results The odds of perceiving worse physical and emotional health were 4 to 7 times higher among primary victims than among the general population and were 8 times higher for experiencing functional disability. Primary victims also perceived more loneliness and stigma and negatively valued their social support and emotional climate. No significant impact was found among the general population with some experience of interpersonal violence. Conclusions These results suggest that collective violence is associated with substantial impairment in health status. More specific studies to assess the health effects of collective violence in the general population are warranted.

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