#1Local solutions to gun violence. The experience of Cali, Colombia Gun Violence in the Americas Webinar Rodrigo Guerrero V., MD., M. Sc. Hyg., Dr. PH Mayor of Cali, Colombia 1992-1995 and 2012 - 2015 1#2Tasa x 100K habs. 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 Historical perspective of homicide rates in Colombia 1938-2014 Political violence Political and Drug traffic violence Colombia 27.8 0.0 1938 1943 1948 1953 1958 1963 1968 1973 1978 1983 1988 1993 1998 2003 2008 2013 Año 2#3Age-adjusted Mortality Rate due to Homicides by Sex and type of Weapon, 2010 Latin America Central Latin America Tropical Sub S Africa Southern Caribbean Sub S Africa Central Europe Eastern Latin AmericaAndean Sub Saharan Africa... Latin America... Asia Central Asia Southeast Oceania SubSaharan Africa-... North America High... Male Asia South North Africa-Middle... Europe Central Asia East Australasia Europe Western Asia Pacific High... Rate per 100,000 male 0.0 20.0 40.0 60.0 Firearm ■Sharp Other Sub Sa haran Africa Southern Ca rib bean Latin America Central Europe Eastern Latin America Tropical Oceania Sub Sa haran Africa Central Sub Saharan Africa East Sub Saharan Africa-West Latin AmericaAndean Asia Southeast North America High Income Asia Central Latin America Southern Asia South North Africa-Middle East Europe Central Australasia Asia Pacific High Income Asia East Europe Western -1.0 Female Rate per 100,000 female 4.0 9.0 14.0 ■Firearm Sharp Other Source: IHME, 2012 3#4Cali applied a multifactorial approach to violence prevention and control ORGANIZED CRIME DEFICIENT Theoretical model for addressing urban violence LAW ENFORCEMENT AVAILABILITY OF FIREARMS CHILD ABUSE VIOLENCE ALCOHOL INEQUITY AND POVERTY CULTURAL FACTORS 4#5Risk factors associated with violence prevention and control Availability of firearms. • Alcohol consumption Cultural norms • Organized crime 5#6Availability of firearms Type of Weapon in Homicides Cali, 1993 79% 17% 4% OTHER SHARP OBJECTS FIREARMS 6#7Alcohol Consumption and Homicide Blood and alcohol level of homicide victims Medellin, 1980 - 1989 57 % 43 % 50mg o > <50mg %#8Evidence-based policies Restriction of alcohol sales in public. places ■ Weekdays 2 AM ■ Weekends 3 AM Restriction of firearms carrying permits, on evidence-based high-risk weekends 8#9Alcohol Consumption and Homicide Restriction of alcohol sales in bars as a policy for controlling homicide First tested in London, UK • Replicated as a natural experiment in Cali Evaluation of 3 decrees closing bars between: Restrictive: 02:00am-10:00am Moderate: 03:00am-10:00am Cali, 2005-2008 Rate per 100 000 person-years Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2011: all rights reserved. International Journal of Epidemiology 2011;1-101 doi: 10.1093/ije/dyr051 Policies for alcohol restriction and their association with interpersonal violence: a time-series analysis of homicides in Cali, Colombia Álvaro I Sánchez,12 Andrés Villaveces,2,3,4 Robert T Krafty, Taeyoung Park, Harold B Weiss," Anthony Fabio,8,9 Juan Carlos Puyana' and María I Gutiérrez² All homicides 8 8 80- 100- 97.46 79.81 60- 65.15 40- 20- Rate per 100 000 person-years 100 80- Firearm homicides 79.74 60 69.10 54.99 40 20 0- 0- Most restrictive Lax: 04:00am-10:00am Moderately restrictive Alcohol control policies Lax Most restrictive Moderately restrictive Alcohol control policies Lax No. of cases: 1724 5966 594 No. of cases: 1455 5165 486 Stab/knife homicides Unintentional injury deaths Significant reductions in firearm-related mortality Rate per 100 000 person-years 40- 88 80- 100- 20- 7.90 15.10 8.27 Rate per 100 000 person-years 100- 80- 60- 40- 20- 6.54 6.07 6.73 0- 오 0- Most restrictive Moderately restrictive Alcohol control policies Lax Most restrictive Moderately restrictive Lax Alcohol control policies 9 No. of cases: 209 618 92 No. of cases: 173 454 41#10Evaluation Alcohol and firearms restriction in Cali 1994 Percent Reduction in Homicide Without interventions With interventions Firearms 14% less Alcohol + guns 35% less 10#11Firearm rates 120.0 100.0 80.0 60.0 40.0 20.0 PROHIBITION TO CARRY FIREARMS CALI 2013 Rates of Homicide per 100,000 population due to firearms, Cali. 1983-2018 National Government 25.0 restriction 0.0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Firearm -Sharp objects Source: Cali Observatory of Security. 20.0 15.0 10.0 5.0 0.0 Sharp object rates 11#12CULTURAL REGULATION OF FIREARM USE "Firearms rest in peace” campaign Bogotá. 1995 ✓ ✓ Pedagogical educational campaign to reduce firearm use and homicides Churches Educational Institutions ✓ Pedagogical strategies for sensitizing population in educational settings 201 Paz y descanso para las armas Alcaldía Mayor de Santa Fe de Bogotá, D.C. Arquidiócesis de Santa Fe de Bogotá...hivi ma BP Colombia IMPRENTA DISTRITAL 12#13Firearm buy-out program in Bogotá 2003 488 firearms, 10.264 ammunition 8 Hand grenades Not formally evaluated ALCALDIA MAYOR DE BOGOTÁ D.C. ARMAS A LA BASURA ¡VidA MA EGURA! Entregue su arma el próximo 31 de agosto* y reciba un bono intercambiable por productos de los almacenes Exito, Pomona y Ley En las parroquias: La Veracruz Madre Divina Gracia San Cristobal (Calle 16 No. 7-19) (Cra. 105 No. 138-43) (Diag. 13 Sur No. 3B-91E) Informes: 3813000 Exts: 1040 1041-1042 13#14THANK YOU