Mon | Jul 16, 2018

Editorial | Violence a public-health crisis

Published:Sunday | June 25, 2017 | 12:00 AM

Jamaica is confronting a major, and worsening, public-health crisis with seriously disruptive pathologies, even if it isn't being formally labelled as such.

It's called criminal violence. Should there be any doubt about the condition, or the problem that it wreaks, ask Drs Ann Jackson-Gibson and Elizabeth Ward, who last week testified before a joint parliamentary committee that is reviewing the latest laws with which the Government proposes to tackle crime. Much of what they had to say would not, for people who follow these things, have been entirely new. Except that they placed the data in a stark and frightening context.

But importantly, for a perceptive Government, they highlighted creative ways to help finance solution to the crisis, apart from having to find big bucks to pour into hardware. Or more precisely, it was about a more efficient and far less painful way of prioritising the allocation of resources - a matter over which Prime Minister Andrew Holness has recently publicly agonised.

Dr Jackson-Gibson is an anaesthetist. She works at Kingston Public Hospital (KPH), which treats far more trauma cases than any other hospital in the English-speaking Caribbean. Dr Ward is an epidemiologist who has been researching the health and economic implications of violence in Jamaica for a long time.

At her hospital, which in 2016 admitted 1,059 patients with bullet wounds, Dr Jackson-Gibson told legislators that in under six months this year, it cost nearly J$80 million, or around J$400,000 a day, to treat gunshot victims.


Resources spent on emergencies


But it is not the economic cost of providing care for intentionally inflicted trauma that is at issue. There is, too, the displacement it causes to other patients, because, as Dr Jackson-Gibson puts it, "the resources are spent on emergencies".

While the health-care costs for criminal violence are most acute at KPH, it is not limited to that institution. The problem is across Jamaica. Dr Ward, for instance, revealed that a study of the 2014 data from the Government's 22 hospitals showed that it cost J$3.68 billion to care for victims of violence. This was seven per cent of the Government's recurrent spending on health care.

Just accounting for inflation would mean a rise in these costs. But there has also been a spike in the cases. While murders, over 80 per cent of which are committed with guns, jumped 20 per cent to 1,350 in 2016, the number of patients with bullet wounds climbed 40 per cent to 916. Blunt object trauma patients rose by 10 per cent.

Dr Ward pointed out that there were requests for spending J$1.3 billion in the community "hotspots" to support violence-mitigation efforts, which, when that happened, translated to a halving of murders in some communities. But these allocations, to support the efforts of NGOs, have fallen.

Reduced violence reduces the burden on hospitals and lessens, or at least brings greater rationality to, the cost of delivering health care. Further, there are many studies which show that less crime, including a murder rate in low double digits - Jamaica's is now around 60/100,000 - would lift economic growth by around seven per cent.

With such returns, we marvel that Mr Holness finds a dilemma in how to prioritise resources.