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- Title
The Inter-Relationship Between Employment Status and Interpersonal Violence in Malawi: A Trauma Center Experience.
- Authors
Purcell, Laura N.; Kayange, Linda; Gallaher, Jared; Varela, Carlos; Charles, Anthony
- Abstract
Introduction: As a proportion of the overall population, sub-Saharan Africa (SSA) has the highest youth demographic, composing 60% of Africa's unemployed. With the worsening economic crisis in low- and middle-income countries, unengaged youth are susceptible to gang violence and anti-government demonstrations, resulting in political instability. Methods: We performed a retrospective review of the Kamuzu Central Hospital Trauma Registry from 2008–2018. All adult patients (>14 years) injured by interpersonal violence (IPV) were included. Age was categorized as 15–24 (youth), 25–45, and >45 years. A bivariate analysis (IPV versus unintentional injury), and Poisson multivariable analysis were performed to identify factors increasing the risk of IPV. Results: During the study, 87,338 trauma patients presented; 30,532 (35.0%) were injured following IPV. Patients injured following IPV (28 years, IQR 23–34) were younger than those unintentionally injured (30 years, IQR 23–39, p < 0.001). More patients injured following IPV were unemployed (n = 7,178, 23.6% vs. n = 10,148, 17.9%, p < 0.001), injured at night (n = 19,346, 63.7% vs. n = 10,148, 17.9%, p < 0.001), and reported alcohol use (n = 4.973, 16.4% vs n = 2,461, 4.4%, p < 0.001). Being unemployed (RR 1.25, 95% CI 1.22–1.27), youth compared to age >45 years (RR 1.72, 1.66–1.79), and those injured at night (RR 2.18, 95% CI 2.14–2.23) had increased the risk of being victims of IPV. Conclusion: In Malawi, there is an interrelationship between unemployment and IPV, particularly in the youth population. Given impending demographic realities, government and non-government organizations should prioritize youth employment to help defer political instability in vulnerable nation-states.
- Subjects
MALAWI; SUB-Saharan Africa; TRAUMA centers; POLITICAL stability; GANG violence; YOUTH employment; TRAUMA registries
- Publication
World Journal of Surgery, 2020, Vol 44, Issue 9, p2927
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-020-05592-1