1. Controlling guns and alcohol consumption Andrés Villaveces Izquierdo M.D., M.P.H., Ph.D. Senior Citizen Security Specialist 1

2. MODIFICATION OF RISK FACTORS THROUGH CHANGES IN: ENVIRONMENT, LEGISLATION, EDUCATION 2 Person Agent producing injury Environment Society and culture Community, institutions, organizations Interpersonal relationships

3. DIFFERENT APPROACHES Crime control Who commits crimes? Modification of environmental conditions Control of key risk factors Enforcement and legislation Unequal distribution of crime Informed by administrative data Many times randomization is NOT possible 3

4. 4 10% 70% StreetsCrime Crime and space Source: Weisburd et. Al, 2012

5. PERCENT DISTRIBUTION OF CRIME BY TYPE IN SELECTED LAC COUNTRIES - 2012 Kidnappings Robberies Theft Domestic violence Sexual violence Homicide

6. REPORTED ROBBERIES AND THEFT Low Medium High

7. HOMICIDE RATES BY COUNTRY Low Medium High

8. REPORTED SEXUAL AND DOMESTIC VIOLENCE Low Medium High

9. CONTROL OF RISK FACTORS Alcohol and violence in urban settings Evaluation of density of alcohol outlets Regulation of access to alcohol 9

10. LEGISLATION Looking at alcohol outlet density and violence Street violence Domestic violence 50% to 70% of substance abuse due to alcohol consumption in LAC Greater dsensity of outlets associated with increased reports of violence (Gouvis Roman, Reid, Bhati et al. 2008; Laranjeira y Hinkly 2002; Zhu, Gorman y Horel 2004; Gorman, Zhu and Horel 2005; Livingston 2008; Livingston 2010; Livingston 2011; Xu, Yu, Scribner et al. 2012) Alcohol sales retrictions and homicide 10

11. DENSITY OF ALCOHOL OUTLETS AND PERSONAL INJURIES (WEEKENDS AND NIGHTS) 11 Source: Gouvis, et. al, NIJ, 2008

12. POLICIES FOR ALCOHOL CONTROL Three different decrees evaluating restrictions of alcohol sales 25% reduction of homicide Additional benefits related to reduced traffic fatalities 12 Source: Sánchez, et. al. 2010 Rate per 100,000 population Restrictive Intermediate Lax

13. LEGISLATION Firearm carrying restrictions Global restrictions Search for illegal carriers Legislation regarding firearm safety devices Buy back programs 13

14. FIREARM CARRYING RESTRICTIONS Políticy directed towards control and search of illegal carrying of firearms Reduction of firearm homicide in en Kansas City, Missouri, USA Cali and Bogotá, Colombia (1993 -1997) – evaluation of an intermittent ban on firearm carrying 14

15. 15 0 20 40 60 80 100 120 140 160 180 200 0102030405060 Week Rate per 100,000 population No Disarmament With Disarmament Source: Desepaz, Cali, 1995 Homicide rates by week in Cali, Colombia 1994

16. 16 Intermittent program applied Reduction of 13% and 14% of homicides in Bogota and Cali respectively Multiple replications of disarmement strategy

17. FIREARM SAFETY DEVICES Effect of the use of safety devices in weapons kept in homes Reduction of 80% of injuries at home among children and adolescents using safes and keeping firearms locked and unloaded Buy back programs. Only one program showed modest effects in Milwaukee, WI, USA 17 Source: Grossman, et. al, 2005

18. PRIORITY INFORMED BY DATA Administrative data sources Importance of linking information (police, public health, legislation) Relevant to evaluate interventions where randomization is not possible 18