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Modeling How Violence Permeates Health and Health Care

Data show that violence against health care workers is becoming more common. But while violence resulting from wars or civil conflicts is a documented occupational hazard for health care workers, little is known about the impact on these workers and corresponding health services as a result of violence caused by widespread organized crime activity.

New research from the University of Pennsylvania School of Nursing (Penn Nursing) articulates a dynamic process of the spread and permeation of violence on Mexican health care services and providers. The study, published in the Journal of Interpersonal Violence, is among the first to focus on how violence outside of an official war zone impacts local health care service providers. It also makes a case for violence as a structural contributor to health and health disparities in Mexico.

“Our study focuses on health care services and health in the context of widespread organized crime violence. Our research sheds more light on what we know about the multi-level impacts of violence on health care and health, which can inform the development and testing of interventions for providers, patients, and communities struggling everyday with violence,” says Laura Vargas, PhD, LMSW, MPA, Vice-Provost post-doctoral fellow at the Penn Injury Science Center at Penn Nursing and lead investigator of the study.

The investigators also developed a model to illustrate how violence permeates health care services over geographic space and time. The model describes a process that begins by looking at how violence spreads over geographic space and time, with enduring consequences for health services, providers and communities. In this process of permeation, violence impacts health care centers and providers, leading to adaptations of both, and ultimately has consequences for the health of community members.

The article, “The Permeating Effects of Violence on Health Services and Health in Mexico,” is available online. Co-authors include Therese S. Richmond, PhD, RN, FAAN, the Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation at Penn Nursing; Zachary F. Meisel at the University of Pennsylvania Perelman School of Medicine; Carolina Vélez-Grau of New York University; and David Camacho of Weill Cornell Medicine in New York.