literature review of structural violence

Systems and subversion: A review of structural violence and im/migrant health

Affiliations.

• 1 Dept of Family Medicine and Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: [email protected].
• 2 Dept of Family Medicine and Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX, USA.
• 3 School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
• PMID: 36001924
• DOI: 10.1016/j.copsyc.2022.101431

Im/migrants in the United States are at heightened risk for a host of adverse behavioral, mental, and physical health disparities, which increase their vulnerability to disease and death. Our review of the literature shows how their health disparities are linked to structural factors that can limit their access to political, legal, and economic resources and manifest at different levels of social influence. However, scholars studying structural violence also show how im/migrants simultaneously are subject to and subvert structural violence. Efforts to address health inequities and learning how to dismantle structural violence must center im/migrant experiences and voices.

Keywords: Health equity; Im/migration; Resistance; Structural violence.

Copyright © 2022 Elsevier Ltd. All rights reserved.

Publication types

• Transients and Migrants*
• United States

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Structural and social determinants of inequities in violence risk: A review of indicators

Theresa l. armstead.

1 Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Natalie Wilkins

2 Division of Analysis, Research, and Practice Integration, Centers for Disease Control and Prevention, Atlanta, Georgia

Maury Nation

3 Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee

There is disproportionate risk for violence conditioned on inequities due to race, socioeconomic status, gender, and where people live. Consequently, some communities are more vulnerable to violence and its repercussions than other communities. This study aims to share indicators that might be useful for violence prevention researchers interested in measuring structural or social determinants that position communities for differential risk of experiencing violence. An existing database of indicators identified in a previous review was reassessed for measures of factors that shape community structures and conditions, which place people at risk for violence. Indicators of 86 community constructs are reported. These indicators may help to advance the field by offering innovative metrics that can be used to investigate further the structural and social determinants that serve as root causes of inequities in violence risk.

1 |. INTRODUCTION

More than 75 years ago, Shaw and McKay (1942) reported a relationship between the characteristics of communities and the prevalence of juvenile crime and delinquency in Chicago. Since this original research, there have been thousands of studies, from several disciplines, examining indicators and mechanisms explaining the connections between community characteristics and individual behavior. The studies that have focused on violence have established that violence affects all people, at all ages, regardless of race, gender, or socioeconomic status; but some people are at greater risk of violence conditioned on inequities due to race, gender, socioeconomic status, and where people live ( Centers for Disease Control and Prevention [CDC], 2016 ; Krivo, Peterson, & Kuhl, 2009 ). Many studies have emerged from this line of research and have contributed to the current understanding of violence, and provided the foundation for contemporary studies on social disorganization theory ( Bursik & Grasmick, 1999 ), social and physical disorder ( Skogan, 1992 ), and collective efficacy and related social processes ( Sampson, Raudenbush, & Earls, 1997 ). These theories and concepts have highlighted the demographic characteristics of residents, the social and physical characteristics of the neighborhood environment, and some of the social processes occurring among residents of the most affected neighborhoods, often with the implication that violence is primarily a byproduct of these factors.

To varying degrees, these theories also acknowledge broader issues in the social structure that contribute to the uneven distribution of people and resources. However, it is only relatively recently that public health frameworks have emerged that have focused discussion on systemic marginalization, income inequality, and other structural and social determinants of health that create communities that are stratified based on race and socioeconomic factors ( World Health Organization [WHO], 2010 ). In contrast to primarily focusing on the characteristics of neighborhood residents, these frameworks highlight the need to understand and intervene in the structural mechanisms that result in varying communities’ and residents’ differential exposure and vulnerability to violence and its repercussions.

The purpose of this article is to provide a review of indicators that measure the structural conditions that place communities at greater risk for violence. The review is organized using the World Health Organization (WHO) Social Determinants of Health and Health Inequity Framework (SDOH Framework; WHO, 2010 ) to identify indicators related to the socioeconomic and political context (e.g., macroeconomics and social policies), socioeconomic community conditions (e.g., access to resources, services, and economic opportunities) and the social and physical environment (e.g., crowding and residential segregation). For the purpose of this paper, indicators are defined as observable and measurable metrics (e.g., percentage, number, rate, or other unit) used to measure a community construct related to structural and social determinants of inequity in violence risk. Indicators are value neutral. The interpretation of high or low observations are determined based on theoretical or empirical relationships between the community construct and the outcome of interest.

2 |. BACKGROUND

2.1 |. social determinants of health equity.

The WHO SDOH Framework 1 is a conceptual framework that describes the root causes of differences in health and well-being ( WHO, 2010 ). The central elements of the SDOH Framework are the structural determinants of health inequities , which include the socioeconomic context and socioeconomic status; and the intermediary determinants of health , which include material conditions of living and working, behavioral and biological factors, and social factors. The SDOH Framework describes how social, economic, and political factors, such as health, housing, and education policies, affect the socioeconomic positions of people in communities. These disparities in individuals’ socioeconomic positions, in turn, determine the distribution of specific determinants of health (such as living and working conditions, stress) that subsequently and directly impact individual differences in health and well-being. The SDOH Framework also includes feedback loops that represent the nonlinear and iterative nature of social determinants. For example, an individual’s health (outcome) can compromise living and working conditions (intermediate determinants) which may in turn compromise employment opportunities and income (structural determinants).

Many structural and intermediate determinants of health (e.g., income inequality, diminished economic opportunity, and access to mental health or substance abuse services) are also risk or protective factors for multiple forms of violence ( Wilkins, Tsao, Hertz, Davis, & Klevens, 2014 ). For example, income inequality is a risk factor associated with bullying, child abuse and neglect, intimate partner violence, sexual violence, and youth violence perpetration (e.g., Eckenrode, Smith, McCarthy, & Dineen, 2014 ). Diminished economic opportunity, operationalized by measures of concentrated disadvantage and unemployment, is a risk factor associated with child abuse and neglect, intimate partner violence, sexual violence, suicide, and youth violence perpetration (e.g., Pinchevsky & Wright, 2012 ). Access to mental health and substance abuse services is a protective factor for child abuse and neglect and suicide (e.g., Klevens, Barnett, Florence, & Moore, 2015 ). Risk and protective factors for violence at the community and societal levels of the social ecology share the same community constructs as structural and intermediate determinants of health in the SDOH Framework. They are a complement to more traditional approaches and frameworks to violence prevention, which have conceptualized each form of violence separately. This shift in focus toward these shared risk and protective factors at the community and societal level (or SDOH) addresses their common “root causes” and provides an opportunity to more efficiently prevent multiple forms of violence ( Wilkins, Myers, Kuehl, Bauman, & Hertz, 2018 ).

2.2 |. Structural violence

The SDOH Framework makes the invisible visible by elucidating the relationship between structural and intermediate determinants of health inequity, and health outcomes. While the SDOH Framework does not explicitly situate violence within its model, other similar concepts, such as structural violence, articulate the links between broader social structures and violent outcomes. Structural violence is described as the invisible, structured social arrangements (i.e., disparate access to resources, political power, education, healthcare) that exclude or marginalize groups of people and normalize some forms of harm as legitimate, making violence ubiquitous or a consequence of “bad” actors ( Farmer, Nizeye, Stulac, & Keshavjee, 2006 ; Scheper-Hughes, 2004 ). While research to date on the concept, measurement, and consequences of structural violence is fairly sparse, a growing body of research demonstrates a direct association between social and structural determinants of health and violence outcomes (e.g., Benson, Wooldredge, Thistlethwaite, & Fox, 2004 ; Hipp, 2007 ; Jogerst, Dawson, Hartz, Ely, & Schweitzer, 2000 ).

2.3 |. Social and structural determinants of health and structural violence

2.3.1 |. socioeconomic and political context and violence.

Broader socioeconomic and political conditions have been linked to increased rates of multiple forms of violence. For example, higher levels of income inequality (the degree to which income in a given geographic area is distributed equally or unequally) at the county level has been linked to higher rates of child abuse and neglect even when controlling for child poverty ( Eckenrode et al., 2014 ). Income inequality at the census tract level has also been linked to higher rates of violent crime, and this association has been shown to outweigh that of poverty and violent crime ( Hipp, 2007 ). Aspects of the sociopolitical environment have also been measured and linked to violence outcomes. For example, Hatzenbuehler (2011) found that lesbian, gay, and bisexual teens living in counties with a more discriminatory social environment (e.g., lower proportion of schools with antidiscrimination policies that included sexual orientation, etc.) were more likely to report attempting suicide than those living in counties with less discriminatory social environments. These findings demonstrate that socioeconomic and sociopolitical environmental factors shape differential risk for violence.

2.3.2 |. Socioeconomic community conditions and violence

Concentrated disadvantage, affluence, available resources, and related constructs are important for understanding the socioeconomic community conditions that make populations more vulnerable to or protected from violence. Benson et al. (2004) , measured neighborhood disadvantage as the percentage of residents who were unemployed, the percentage of single parents, the percentage of households receiving public assistance, and the percentage of residents living below the poverty line in a study of the effects of ecological factors on the perpetration of domestic violence by Black and White men. They found the rates of domestic violence were positively related to neighborhood disadvantage for both groups and that for both races, the rates of domestic violence doubled in neighborhoods with greater disadvantage than neighborhoods with less disadvantage. Conversely, Martinez, Stowell, and Cancino (2008) caution that “focusing on the pernicious effects of concentrated disadvantage is necessary but it may obscure the potential protective effects of affluence” (p. 6). They found, in their study of neighborhood effects on homicide in two border cities, a consistent, positive and significant relationship between neighborhood disadvantage and homicide in both cities and an inverse relationship between affluence (the percentage of the population working in professional occupations) and homicide in one city. Their findings suggest that, at least for one city, the percentage of professionals in a community served as a buffer against violence. The findings supported the theory that relatively affluent neighborhoods have access to social and institutional resources that may help to control violence in their communities.

Available resources in a community provide an important safety net that can reduce violence risk by helping to increase reporting or prevent violence particularly among more vulnerable populations such as children and the elderly ( Klein, 2011 ). For example, Jogerst et al. (2000) found a correlation between available healthcare resources and detection of elder abuse. Specifically, they found that a greater number of hospital beds and nonfederal hospitals were associated with higher levels of reported elder abuse, while those resources plus available primary care physicians, general internists, and chiropractors were strongly associated with higher levels of substantiated elder abuse. Additionally Jogerst et al. (2000) found an effect at the administrative district level served by the Department of Human Services for substantiated elder abuse. The findings suggest that in communities with fewer of these resources available, elder abuse may be underreported and go undetected. These findings, together with the WHO position that the distribution of health services and resources demonstrate the value society places on health in a population ( WHO, 2010 ), highlight the importance of available resources for understanding socioeconomic community conditions and inequities in violence risk.

2.3.3 |. Social and physical environments and violence

The premise of social disorganization theory is that some social and physical structures within communities function as barriers to residents developing collective efficacy through shared values and working to solve shared problems ( Kaylen & Pridemore, 2011 ). The community constructs associated with social disorganization such as residential mobility, residential instability or stability, population density, racial or ethnic heterogeneity, and social and physical disorder have been empirically associated with community violence and violence inequity ( Barkan, Rocque, & Houle, 2013 ; Martinez, Rosenfeld, & Mares, 2008 ; Wei, Hipwell, Pardini, Beyers, & Loeber, 2005 ). For example, Barkan et al. (2013) found residential stability helped explain the differences in suicide rates between the western region of the United States and other regions, and across states. The western United States and states with higher suicide rates had lower residential stability. Wei et al. (2005) found physical disorder was significantly and positively associated with rates of crime, firearm injuries and deaths, and teen births, while controlling for concentrated poverty and minority population.

Institutional racism and inequity is another aspect of the social environment that impacts risk for violence. Societal values are reflected in how opportunities are structured and values are assigned to people on the basis of how they look, which unfairly advantages and disadvantages some individuals and communities ( Richardson & Norris, 2010 ). Richardson and Norris (2010) , in their review of inequities in access to health and healthcare, used the following definition of racism: “an organized system that categorizes population groups into races and uses this ranking to preferentially allocate societal goods and resources to groups regarded as superior (p. 171).” They defined institutional racism as the, “differential access to the goods, services, and opportunities of society by race (p. 171)”; further describing it as normative, sometimes legalized, and manifested in both material living conditions and access to power. Krivo et al. (2009) found, in their study of the influence of citywide racial residential segregation on levels of violent crime, that residential segregation was positively associated with violent crime regardless of the racial/ethnic composition of neighborhoods. However, they found violence risk varied by race due to neighborhood advantage/disadvantage: White residents lived in more advantaged neighborhoods and African Americans and Latinos lived in more disadvantaged communities. Therefore, residential segregation and measures of the dissimilarity index, defined by Borg and Parker (2001) as unevenness in the distribution of racial groups across census tracts within a city, are reflective of the social and physical environments that structure inequities in violence risk.

Social stratification is another aspect of the social environment that has been linked with violence. Social disorganization theory is largely focused on how characteristics of the physical and social environment influence the relationship between collective efficacy (informal social control) and violence ( Sampson et al., 1997 ). Some scholars, such as Borg and Parker (2001) , have noted there is less research on how community social structures influence the relationship between formal social control (policing) and violence. In particular, they examined the relationship between community-level stratification (defined as any uneven distribution of the material conditions of existence) and homicide clearance rates (the rate of solved crimes). They found support for the theory that cities with greater levels of inequity (stratification) have higher clearance rates as their results showed police were more likely to solve homicide cases in cities with greater disparities in unemployment, educational attainment, and income between Black and White residents. In addition, police were more likely to solve homicide cases where racial residential segregation was more pronounced. These findings support a theory that greater inequality results in greater formal, governmental social control (policing-type constructs) over the informal social control found in communities with greater advantages.

2.3.4 |. Community dynamics and violence

Policing, social capital, and other forms of social control are community dynamics that bridge social determinants of health with violence outcomes. Kane (2005) found patterns in the relationship between the antecedents of police legitimacy (i.e., police misconduct and inequitable police responsiveness to communities) and violence differed in neighborhoods with low, high, and extreme structurally disadvantaged precincts. In precincts characterized with low structural disadvantage, police legitimacy indicators had no significant effect on violent crime. For highly disadvantaged precincts, police misconduct (defined as a career ending deviance that achieved official organizational recognition (through termination or dismissal), including voluntary resignations or retirements under questionable circumstances) was significantly related to the community risk of experiencing violent crime. Police responsiveness was unrelated to the outcome. For precincts characterized by extreme structural disadvantage, both police misconduct and over-policing (when the mean police responsiveness was higher than the standardized average) predicted increases in violent crime. In summary, the findings support the study author’s assertions that compromised police legitimacy, due to perceived mistreatment and marginalization by police, may lead to increases in violence as some residents in structurally disadvantaged communities cease cooperating with police ( Kane, 2005 ).

The placement of social capital and its related constructs in the SDOH Framework falls between structural and intermediate determinants of health. This placement is in part a reflection of the various definitions of social capital, the implications of those definitions for modifying the effects of intermediate determinants on health outcomes, and the scientific argument that some definitions serve to absolve institutions and governments of responsibility to address inequities ( WHO, 2010 ). However, Lederman, Loayza, and Menendez (2002) found only social capital measuring trust—the belief that most people can be trusted, in community members reduced the incidence of violent crimes. Therefore, in this review, both social capital and collective efficacy (defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good; Sampson et al., 1997 ) are considered protective factors and extensions of trust relationships among individuals, groups, networks, and institutions. Both are considered to be developed and maintained through social circles ( social networks ) that are occupied as a consequence of socioeconomic status (e.g., education, employment, and wealth).

2.3.5 |. Indicators of structural and social determinants of violence inequity

The main goal of this review is to share indicators that might be useful for violence prevention researchers interested in measuring structural or social determinants that position communities at differential risk for violence. Specifically, indicators of community constructs related to structural and social determinants are categorized based on a simplified organization of the SDOH Framework ( Figure 1 ). Similar to the SDOH Framework, the categories of structural and social determinants of violence risk have feedback loops between each determinant of health. The socioeconomic and political context , socioeconomic community condition , and socioeconomic position categories fall within structural determinants of inequities in violence risk. The SDOH Framework describes intermediate determinants as the material circumstances (e.g., living and working conditions) and psychological and behavioral factors that impact equity in health and well-being. Material circumstances reflecting characteristics of the living and working conditions in a community, including aggregated individual characteristics, are reported in the social and physical environment category. Psychological and behavioral factors are individual characteristics that are not addressed in this review.

Structural and social determinant categories and community construct examples (adapted from the World Health Organization’s Commission on Social Determinants of Health Framework)

Social cohesion, social capital, and similar concepts fall within the bridging community dynamics category. The latter categories of social and physical environment and bridging community dynamics fall under intermediary determinants of inequities in violence risk. This review is focused on community-level indicators therefore no indicators of socioeconomic position are reported except as part of aggregate measures of constructs in the socioeconomic and political context (e.g., income inequality) or socioeconomic community condition (e.g., concentrated disadvantage) categories. Finally, as the focus of the review is on identifying indicators of determinants of inequities in violence risk, identifying indicators of violence are outside the scope of this review (see Armstead, Wilkins, & Doreson, 2018 ).

3 |. METHOD

3.1 |. data source.

This review is a secondary analysis that reassesses indicators of community constructs from an existing database ( Armstead et al., 2018 ) for their alignment with social and structural determinants of violence inequities. Data from the original analysis were collected in 2014. The original search returned 2,880 articles, 259 of which met inclusion and exclusion criteria that are relevant for this study. Detailed explanations of the criteria can be found in the previous publication, but in brief, articles reviewed:

• were published in peer-reviewed journals,
• were published in English using US-based samples,
• measured community constructs,
• relied on secondary data when using aggregate individual-data,
• used data that were available at the state or local level, and
• measured a community or societal level risk or protective factor for violence or a related construct.

Some excluded articles ( n = 4) in the original review were included in this review because they address important structural determinants of violence inequity, bringing the total number of articles reviewed in this study to 263.

3.2 |. Coding procedure

Indicators were coded according to their alignment with the model in Figure 1 by one reviewer. For each unique community construct only one set of indicators was reported. Preference was given to indicators not previously reported by Armstead et al. (2018) . Exceptions were made when there was only one set of indicators for the community construct. While unreported in this article, violence and poverty constructs and their associated indicators can be found in the previous review ( Armstead et al., 2018 ). Poverty is predominantly measured as the percentage or proportion of residents, individuals, or families living below the poverty line. However, community constructs that use poverty indicators, such as deprivation, are reported.

Seven community constructs were excluded because they did not fit the operationalization of structural and social determinants used in this review. Three of the seven were constructs related to harmful gender norms or norms that support aggression (i.e., sexist humor, sexist humor supporting violence against women, and structural stigma of sexual minorities). Although societal values are a central tenet of the SDOH Framework, the placement of noninstitutionalized norms in the framework is unclear. Another three constructs were firearm-related policies (e.g., categories of persons under Federal law who can possess or receive a firearm; child access prevention laws (CAP), which establish criminal penalties for unsecured firearms in the home). These policies also do not fit the operationalization of structural or social determinants used in this review. The final indicator excluded due to a misfit with the use of the framework was a program delivery indicator (i.e., preventive services delivery).

Other reasons why constructs were excluded include the data source, or indicators were unclear or not widely available ( n = 9; e.g., crowding, gender social services, healthcare and education access, and inequality in police protection); or the construct validity was weak and not supported in the study in which it was used ( n = 1; i.e., instability). In total, indicators of community constructs from 199 articles were excluded. Remaining in the review, and presented in the results tables, are indicators of 86 community constructs from 64 articles (see Table 1 ). Findings are summarized at the community construct level in the results section and are described in detail in the appendices (i.e., construct, citation, indicators, and data source).

Community constructs by social determinants of health

Source: Adapted from the WHO Social Determinants of Health Framework.

4 |. RESULTS

4.1 |. socioeconomic and political context.

Indicators of 13 community constructs involving the socioeconomic and political context are largely measures of income inequality ( n = 5), which is a noted structural determinant of health and a risk factor for multiple forms of violence (see Table A1 for details). Policy-related indicators accounted for two of the reported community constructs. Five community constructs represent institutionalized societal values through indicators of socio-economic, political, education, and legislative opportunities by gender. Finally, indicators of the macroeconomic climate are reported.

4.2 |. Socioeconomic community conditions

Structural disadvantage and all its related constructs typically aggregate modifiable and nonmodifiable individual-level characteristics of people living in communities with measures of economic opportunities or support. Of the 32 community construct indicators reported in the socioeconomic community conditions table, four measured some form of socioeconomic disadvantage or deprivation (see Table A2 for details). Disadvantage consistently included indicators of economic opportunity and deprivation. Deprivation was often simply measured using poverty indicators.

Indicators of three constructs measured economic opportunities at the local level through employment opportunities (including economic independence) and four measured the presence of businesses in communities. Access to medical care, early care and education, substance abuse, housing, recreation, law enforcement and other community services accounted for 12 community constructs indicators in the socioeconomic community conditions table. Of the remaining nine constructs, three measured affluence or advantage, two measured inequities in income distribution or educational resources, and four measured city or resident investment, through homeownership, in the local community.

4.3 |. Social and physical environments

Social disorganization is often measured using a compilation of socioeconomic factors that vary from study to study. Indicators of social disorganization and related constructs account for 20 of the 25 community constructs in the social and physical environments table (see Table A3 for details). Related to the premise of social disorganization theory that some population compositions present a challenge to social cohesion and collective efficacy, three of the remaining community constructs (i.e., concentration of registered sex offenders, crime-prone population, and street gang density) address population composition. Another two are physical environment constructs (i.e., neighborhood esthetics and physical environment as a risk factor for crime).

4.4 |. Bridging community dynamics

Indicators of 16 community constructs reported in the bridging community dynamics table include seven for social capital, collective efficacy, or related constructs (see Table A4 for details). These include different forms of social capital and the availability of neighborhood social support. Six additional community constructs reflect community interactions with law enforcement including homicide clearance rate, juvenile arrests, police responsiveness to communities, and police use of force. The final three constructs are indicators of general and specific social networks and social ties (e.g., gang concentration and religious integration).

5 |. DISCUSSION

Structural and social determinants of health equity are seemingly difficult to influence but the WHO Call to Action (2010) suggests they are modifiable. However, the WHO cautions that addressing social determinants of health alone may reinforce disparities if we do not also address the structural forces that create more or less advantaged population groups due to inequitable distributions of social determinants. Though gender, ethnicity, and cultural background are individual-level determinants of health and are nonmodifiable; communities that are structurally marginalized or isolated based on these factors concentrate advantage or disadvantage along racial and ethnic lines. The fact that communities are structurally marginalized by race and experience concentrated disadvantage has historically made it difficult to separate violence causes from these individual-level determinants of health, especially when the measurement of disadvantage includes race and ethnicity as indicators ( Benson et al., 2004 ). Other challenges with the measurement of disadvantage includes indicators of female-headed single-parent households ( Peterson, Krivo, & Harris, 2000 ). Singling out the gender of single-parent families is problematic from a gender equity perspective. However, single parents are often less economically advantaged than married couples (often with dual incomes; US Census Bureau, 2017 ).

It must be noted that many of the studies measuring social disorganization theory-related constructs were not using the social disorganization theory framing. In addition, findings related to violence outcomes were mixed even in the presence of other social environmental determinants (e.g., drug activity and violent crime; Martinez et al., 2008 ). However, for these and all studies reviewed, overall considerations for the differences in the relationships between the community constructs they measure and violence include the type of violence under study, geographical context (e.g., rural vs. urban; Kaylen & Pridemore, 2011 ), or indicators used to measure the construct. The use of different indicators to measure the same construct across different studies may be due to practical considerations such as data availability or more disciplinary reasons such as differing theories and frameworks across disciplines. The differences in indicators may account for the differences in outcomes across studies measuring the same community constructs. It also suggests a deeper review of the literature is needed to tease out differences in reported outcomes and provide a better understanding of the relationship between structural and social determinants and violence to guide prevention. In addition, more research is needed to assess the strength of the relationships between determinants and violence and to inform how we might intervene to prevent violence from ever occurring in the first place.

5.1 |. Limitations

This literature review relied on an existing indicator database that has several limitations. First, it shares the limitations of Armstead et al. (2018) : The literature search was comprehensive but not systematic; the review and the findings were limited to, and have greater applicability in, the United States; the data were collected in 2014 and therefore do not reflect new indicators that have emerged in more recent research literature. Second, the database was limited by the purpose and review criteria of the original review and may not be inclusive of structural and social determinants of inequities in violence risk that are not related to community-level shared risk or protective factors for violence. The shared limitations are a byproduct of conducting secondary data analysis. However, both reviews share the same strength in that the database search in the original review returned over 2,000 articles, which increases confidence in the saturation of potential indicators, especially as the review demonstrated many researchers reuse indicators over time.

Third, having one coder, even with subject matter expertise, decreases the validity of the categorizations because it is unknown whether a different coder would have categorized the community constructs in the same way. One coder also introduces bias and credibility concerns. In recognition of these concerns, and as a precaution, the coder limited the exclusion of community constructs to objective criteria. Constructs were only excluded if the data source for the construct could not be determined, the validity of the construct was not supported in the study it was used, or the WHO Social Determinants of Health Framework did not address it (i.e., social norms). Any exception was documented in the coding procedures. The coder also took process notes to justify every exclusion and promote transparency in decision-making. Finally, and similar to the original review, the indicators found through this review are simply reported as they are used in the research literature with very limited editing and no further guidance is provided on how these indicators may be used in future research or evaluation efforts.

5.2 |. Conclusion

There is little question that exposure to violence and violence risks have health and developmental consequences ( Kane, 2011 ; Li et al., 2010 ; Messer, Maxson, & Miranda, 2013 ; Pruchno, Wilson-Genderson, & Cartwright, 2012 ). The indicators from this review and SDOH Framework provide a challenge for the field of violence prevention. Specifically, they prompt questions about the most effective and feasible ways to disrupt the relationships between structural inequities and violence. While there are promising approaches for addressing these structural inequities, there is great need for additional work in this area and strong indicators to measure their effectiveness and build the evidence base. For example, while research suggests that upwardly mobile individuals benefit from socioeconomic and geographic movement ( Chetty & Hendren, 2018 ; McAdoo, 1982 ), attempts to implement scalable interventions that move individuals out of neighborhoods that expose them to inordinate levels of risk have had mixed outcomes. As illustrated by the “Moving To Opportunity” for fair housing initiative (a 10-year program and research demonstration that moved very low-income families to higher income neighborhood), the effects of this kind of approach are complex and not universally positive ( Chetty, Hendren, & Katz, 2016 ). In fact, multiple longitudinal studies of this initiative ( Chetty et al., 2016 ; Sanbonmatsu, Kling, Duncan & Brooks-Gunn, 2006 ) found that older youth and males did not benefit from the moves, and in some cases experienced iatrogenic effects that involved disrupting many of the mechanisms (e.g., social relationships) that promoted resilience among the participating children and families. This suggests there is still much to be learned regarding the ways in which structural and social factors can be addressed to optimize protection and minimize risk related to violence.

Another approach for addressing structural inequities involves efforts to change neighborhood conditions. Ohmer, Teixeira, Booth, Zuberi, and Kolke (2016) , for example, argue for using organizing strategies as a mechanism for promoting collective efficacy among neighborhood residents, a factor shown to be associated with lower levels of neighborhood violence. Community organizing interventions have been successful in gaining social and political power to address several problems that are associated with marginalized neighborhoods, including issues related to policing, food insecurity, and environmental hazards ( Bass, 2000 ; Freudenberg, Pastor & Israel, 2011 ; Pothukuchi, 2015 ). Organizing has also been central to initiatives to prevent gun and youth violence ( Frattaroli, 2003 ; Griffith et al., 2008 ). However, there is limited evidence on the ability to scale these approaches to address the communities that could benefit from intervention, or the variation in how the inequities manifest across those communities. This review might contribute to this literature and practice by suggesting additional levers that community organizers might use to promote change.

Finally, this review provides a reminder that structural and social determinants place communities at different levels of risk for violence but also provides an opportunity for prevention. CDC’s technical packages provide guidance for policymakers on the best available evidence of prevention strategies and approaches that have the potential to address structural and social determinants of violence risk ( CDC, 2018 ). Examples of the approaches included in the technical packages involve policies that strengthen economic supports to families such as the Earned Income Tax Credit, housing stabilization policies, family–friendly work policies, and family assistance policies (e.g., Temporary Assistance for Needy Families [TANF] and Supplemental Nutrition Assistance Program [SNAP]). These example approaches address the socioeconomic conditions that place individuals, families, and communities at higher risk for violence ( CDC, 2018 ). The contents of this review provide additional indicators for measuring the impact of such prevention strategies on violence outcomes at a community, county, or state level.

ACKNOWLEDGMENT

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Socioeconomic and Political Context

Socioeconomic community conditions

Social and physical environments

Bridging community dynamics

1 https://www.who.int/social_determinants/thecommission/en/ .

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• Open access
• Published: 15 July 2016

Taking action on violence through research, policy, and practice

• Ilene Hyman   ORCID: orcid.org/0000-0001-5097-3773 1 ,
• Mandana Vahabi 2 , 3 , 4 , 5 ,
• Annette Bailey 6 , 7 ,
• Sejal Patel 8 , 9 ,
• Sepali Guruge 10 , 11 , 12 , 13 , 14 ,
• Karline Wilson-Mitchell 15 , 16 &
• Josephine Pui-Hing Wong 17 , 18 , 19  

Global Health Research and Policy volume  1 , Article number:  6 ( 2016 ) Cite this article

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Violence is a critical public health problem associated with compromised health and social suffering that are preventable. The Centre for Global Health and Health Equity organized a forum in 2014 to identify: (1) priority issues related to violence affecting different population groups in Canada, and (2) strategies to take action on priority issues to reduce violence-related health inequities in Canada. In this paper, we present findings from the roundtable discussions held at the Forum, offer insights on the socio-political implications of these findings, and provide recommendations for action to reduce violence through research, policy and practice.

Over 60 academic researchers, health and social service agency staff, community advocates and graduate students attended the daylong Forum, which included presentations on structural violence, community violence, gender-based violence, and violence against marginalized groups. Detailed notes taken at the roundtables were analyzed by the first author using a thematic analysis technique.

The thematic analysis identified four thematic areas: 1) structural violence perpetuates interpersonal violence - the historical, social, political and economic marginalization that contributes to personal and community violence. 2) social norms of gender-based violence—the role of dominant social norms in perpetuating the practice of violence, especially towards women, children and older adults; 3) violence prevention and mitigation programs—the need for policy and programming to address violence at the individual/interpersonal, community, and societal levels; and 4) research gaps—the need for comprehensive research evidence made up of systematic reviews, community-based intervention and evaluation of implementation research to identify effective programming to address violence.

Conclusions

The proceedings from the Global Health and Health Equity Forum underscored the importance of recognizing violence as a public health issue that requires immediate and meaningful communal and structural investment to break its historic cycles. Based on our thematic analysis and literature review, four recommendations are offered: (1) Support and adopt policies to prevent or reduce structural violence; (2) Adopt multi-pronged strategies to transform dominant social norms associated with violence; (3) Establish standards and ensure adequate funding for violence prevention programs and services; and (4) Fund higher level ecological research on violence prevention and mitigation.

Violence is a critical public health problem associated with compromised health and social suffering that are preventable. It is also a complex phenomenon that involves a spectrum of behavioral and social interactions that vary across the lifespan and different social, political and economic contexts. The 2014 World Health Organization (WHO) Global Status Report on Violence Prevention indicates that the overall rate for victims of homicide worldwide in 2012 was 6.7 per 100,000 population [ 47 ]. While fatal violence is alarming to society and traumatic to the victims’ families and loved ones, it constitutes a small portion of interpersonal violence. Non-fatal physical, sexual and psychological violence make up the majority of interpersonal violence and these particularly affect children, women and seniors. For instance, an estimated 30 % of adult women worldwide experienced physical and/or sexual violence by an intimate partner (IPV) at some point in their lives [ 46 ], 22.6 % experienced physical abuse, and 36.3 % experienced emotional abuse as a child [ 33 ]. Data also show that 6 % of older adults reported significant abuse in the past month [ 8 ]. Furthermore, incidents of non-fatal violence are often under-reported, thus, actual rates are much higher.

In 2014, only few of the 133 countries surveyed by the WHO implemented prevention programs at a level commensurate with the scale and severity of the problem [ 47 ]. Canada fell short in elder abuse prevention, victim law reforms, and initiatives to promote gender equity [ 47 ]. The WHO [ 47 ] recommended that effective and sustainable global violence prevention efforts must be comprehensive and tackle a wide range of social conditions and structural determinants that fuel violence; that is, economic marginalization, ageism and gender inequality. The WHO’s recommendations imply that the notion of violence must be understood beyond interpersonal violence to make visible the impact of structural violence .

Structural violence, a term first coined by Johan Galtung [ 19 ], is defined as the difference between the potential and actual physical, mental, social and spiritual wellbeing of persons affected. Galtung asserted that interpersonal violence can only be understood in the context of structural violence, which is systemic in nature and often remains invisible. Expanding on Galtung’s work, Paul Farmer [ 17 ] illustrated that inequitable distribution of power and resources across different groups in society produces differential life chances that shape their everyday lived experiences. Wong [ 40 ] considers structural violence as a system of interlocking oppressions manifested in the form of social and economic deprivation, limiting marginalized people’s ability to reach their full physical, emotional, cultural and spiritual potential. She also emphasized that structural violence is an avoidable cause of health disparities that can be addressed through research, policy and practice.

The use of structural violence as an analytical lens to understand health disparities is aligned with evidence generated by research on social determinants of health in a neoliberal advanced capitalist globalized economy (see [ 4 , 10 ]). As in other advanced capitalist countries, the 1970s marked a turning point in Canada from a post-war Keynesian Welfare state that focused on redistributive justice policies, to a free-market neoliberal state that emphasizes competitive individualism and consumption as a source of identity and means for social participation [ 9 ]. It is important to note that neoliberalism did not translate into total withdrawal of the state. Rather, neoliberalism has transformed state intervention from redistributive justice of social welfare for the poor to redistribution of wealth from the ordinary people to the elite; for example, in the form of bailouts or corporate welfare [ 1 ]. In Canada, neoliberal public policies and practices resulted in reduced access to welfare and the social security system. Examples include, welfare-to-work programs that required education and employment participation in order to receive benefits: deregulation of the market, privatization of public services, restructuring of the Unemployment Insurance program to what is now known as Employment Insurance: and the replacement of the Canadian Assistance Plan by the Canada Health and Social Transfer [ 3 ]. To a large extent, neoliberal practice perpetuates structural violence against vulnerable groups. For instance, neoliberal discourse of individual responsibility further marginalizes women who are welfare recipients when they are constructed as the cause of government fiscal deficits [ 6 ], or portrayed in the media and our popular imagination as lazy and undeserving freeloaders. Structural violence embedded in public policy and social institutions is invisible and yet powerful in perpetuating interpersonal violence, which is deemed to be private, random, and individual events. The interlocking cycle of structural and interpersonal violence disempowers individuals and communities, particularly those marginalized at the intersections of gender, race and class [ 5 ], and reinforces health disparities [ 16 , 39 ].

Ryerson University’ Centre for Global Health and Health Equity, in dialogue with external research networks, organized and implemented a forum to explore issues relating to violence. The objectives of the Forum were to identify: (1) priority issues related to violence affecting different population groups in Canada, and (2) strategies to take action on priority issues to reduce violence-related health inequities in Canada. In this paper, we present findings from discussion and dialogue at the Forum, offer insights on the socio-political implications of these findings, and provide recommendations for action to reduce violence through research, policy and practice.

Description of the forum and methods

The Global Health and Equity Forum was held in Toronto, Canada in 2014. Invitations were sent to hospitals, community health centres, non-profit community organizations working with vulnerable groups, universities, and public health units in the Greater Toronto Area. Over 60 researchers, health and social service agency staff, community advocates and graduate students attended the daylong Forum, which included presentations on structural violence, community violence, gender-based violence, and violence against marginalized groups. The presentations were followed by five concurrent roundtable discussions. Participants were invited to join one of five roundtables that interested them: children, youth, women, men and older adults. Each roundtable was attended by 10-12 participants; it was facilitated by a member of Centre for Global Health and Health Equity team and the discussion lasted approximately an hour. Being more participant-driven than researcher-driven, the Roundtable were considered to be an effective strategy for promoting critical dialogues. The composition of each Roundtable is presented in Table  1 .

Roundtable participants were asked to discuss priority issues related to violence based on their current professional experience and observations, and identify strategies for addressing these violence-related priorities and resulting health inequities. A graduate student or member of Centre for Global Health and Health Equity team was assigned to each roundtable as the note-taker to capture the composition of each roundtable group, and notes on the discussion. Notes from the roundtables were circulated to the facilitator of each roundtable for review and to insert additional reflective comments. Upon receiving all the reviewed notes, the first author used thematic analysis as the method to identify and organize findings into relevant themes and categories [ 34 ]. These themes were shared and discussed with the research team members who facilitated the roundtables to reach analytical consensus that inform this paper.

Findings from the forum

Through thematic analysis, we identified four priority areas from the participants’ discussions:

structural violence perpetuates interpersonal violence

social norms of gender-based violence

violence prevention and mitigation programs; and

research gaps.

Structural violence perpetuates interpersonal violence

The notion of structural violence was used by Forum participants to describe the historical, social and economic marginalization that contributes to interpersonal and community violence. Participants in many of the roundtable groups provided examples of factors related to structural violence, including poverty, gender inequity, transphobia, homophobia, racism, and other forms of discrimination and social exclusion. For instance, participants at the Women’s Roundtable identified the association between interpersonal violence and systemic discrimination. They suggested that underlying social inequities in the forms of women’s economic and legal dependency on men, economic and educational exclusion, and neoliberal practice which limits access and opportunities, all contribute indirectly to violence against women. As one participant explained, “People will deny that patriarchal values are still an issue today. We must shed light on the root causes; the sociological values that are embedded into our society and behavior (direct quote captured by note-taker).” Similarly, participants at the Men’s Roundtable highlighted men’s differential access to privilege and power when compared to women and children. However, participants also highlighted that in Canada and other White settler societies, not all men share similar access to privilege and power. Men of marginalized social positions experience structural violence in the form of neocolonialism, racism, homophobia, transphobia, ableism, economic marginalization and other intersecting oppressions that compromise their health and social wellbeing. At the Older Adult’s Roundtable, participants raised concerns about immigration policies, particularly with respect to sponsorship, which combine with racism, classism and ageism, to foster power imbalance and dependency in immigrant families. Participants at the Children and Youth Roundtable recommended that it is important for all people, but especially parents and families, to become aware of the impacts of structural violence on access to safe living environments, education, and aspiration for children and youth.

An overarching theme that emerged across all roundtables was the importance of addressing violence at the level of public policy. Participants identified the need to target policy makers and government leaders to raise awareness of the impact of structural violence in the forms of policies and laws, and to push for commitment of resources to address the structural forms of violence (e.g., poverty, racism, sexism) because education alone is not sufficient to reduce violence-related inequities. Many participants identified the lack of intersectoral approaches (i.e., involving health, employment, social, educational, housing and criminal justice sectors) that require commitment and coordinated efforts across different levels of government and different ministries or departments. For example, effective strategies to reduce youth related violence must include increasing access to inclusive employment and educational opportunities for youth and providing financial and social supports for parents to help reduce the risks that are associated with violence and inequitable outcomes. Participants also suggested that decision-makers and administrators of institutions (e.g., hospitals, police, group homes, and the child welfare system) must examine how structural violence is produced and sustained through their organizational policies and practices that act as barriers to disempower individuals and communities. For example, racial profiling or the discriminatory practice by law enforcement officials to target individuals for suspicion of crime based on the individuals’ racialized background, ethnicity, religion or national origin is found to be common practice in Canada [ 7 , 35 ].

Social norms of gender-based violence

Participants across the different roundtables identified social norms as a powerful force behind interpersonal violence in different populations.

For example, at the Women’s Roundtable, participants noted that in Canada and elsewhere, there exists a culture of gender-based violence manifested in a culture of rape and victim blaming that is very challenging to shift. Women continue to be objectified in the media, which produces and reproduces stereotypes, reinforces power differentials and normalizes violence against women (VAW). As one participant stated, “Women in advertisements become objects. They lose their face and humanism, which is the first step towards making violence more acceptable (direct quote recorded by note-taker).” Women felt that gender-based violence is embedded in Canadian social norms that do not value the equitable participation of women in leadership capacities.

At the Men’s Roundtable, participants identified the need to engage men, especially marginalized men, to (re)define “what it means to be men”. They suggested that gendered norms often condone violence as an expected masculine role expectations and practice, which reinforce self-harm and violence against women and other men (e.g., violence in sports, dating violence, violence against gay men). Men who experience social and economic marginalization are often pushed into street economies that increased their involvement in violence.

Participants at the Youth Roundtable highlighted that children and youth are also expected to fit with gendered norms and role expectation. In addition, they suggested that children and youth often encounter an additional layer of social norms based on age. Forum participants reported, based on their professional experience, that societal norms and adult judgments (e.g., from parents, teachers, and community workers) often produce negative stereotypes about children and youth that are stigmatizing and disempowering; children and youth in marginalized communities bear the brunt of these stereotypes.

Many participants felt that shifting broader social norms and gendered expectations is a necessary prerequisite to the adoption of laws and policies to reduce structural violence and interpersonal violence. For example, social norms for gender-based interactions are taken up by children as they observe adults’ involvement and responses to violence. Furthermore, participants identified the need to deconstruct the neoliberal agenda and practice in which violence is constructed as individual behaviors, and freedom from violence is achieved through individual vigilance and efforts. They emphasized the need to make visible that interpersonal violence is produced through power relations and social structures, and the negative impact of intergenerational violence, as experienced by the Indigenous peoples of Canada and elsewhere. These forms of violence, especially among Indigenous populations, must be addressed through deliberate efforts based on the principles of social justice and equity.

Violence prevention and mitigation programs

Forum participants noted that changing dominant social norms requires strategies of critical dialogue, stakeholder engagement, and political action at multiple levels: (1) at the societal level, there is a need to make visible how neoliberal practice, manifested in current regressive social welfare policies, reinforces structural violence that contributes to social and health inequities, including interpersonal violence; (2) at the community level, there is a need for sector leaders, service providers, activists and community members alike to recognize violence, in its myriad forms, as a priority for health and social wellbeing requiring collective action; and (3) at the individual and interpersonal level, there is a need for critical understanding of the (re)production of dominant social norms and gendered expectations that normalize violence behaviors.

Participants also spoke about the advantage of engaging broader and more diverse stakeholder groups - including the media, faith leaders, health and social service providers, researchers, policy-makers, community members (including older adults, women, men, children and youth), advocates - as agents of change in transforming social norms that perpetuate violence. Although Forum participants recognized that most victims of intimate partner violence are women and most abusers are men, they considered it necessary to engage men in politicized popular education strategies that interrogate the practice of violence against women in the historical, social, economic and political contexts. They also emphasized the importance of promoting critical community dialogue about hegemonic masculinities and the consistent use of gender equity messages by leaders and influential figures.

On a pragmatic note, Forum participants advocated for educational and skills development programs for the primary prevention of interpersonal violence. Examples provided by participants included school-based and community-based educational programming for children and youth that focus on gender relations and gender identities; family dynamics; healthy relationships; anger management, as well as supporting children and youth to develop skills in recognizing problematic behaviors associated with violence and abuse in the home environment, personal relationships, and beyond. Others identified training for health and social service providers as critical to improving consistency and comfort levels in the screening of individuals experiencing abuse and in providing inclusive and culturally safe care.

Participants at the Women’s Roundtable recommended educating young women and men on VAW help address the general belief among younger generation that the issue of VAW has been resolved or is no longer relevant. They also suggested that educational programs do not focus only on VAW. As one participant shared, “You can teach the makeup of a respectful relationship and educate about conflict resolution without even having to mention violence”.

Participants at the Men’s Roundtable recommended strategies and programming designed specifically for boys and men that focus on masculine identities, self-love, and mutually empowering relationships. They suggested the use of cross-sector partnerships that involve leaders and mentors from diverse sectors (e.g., arts, media, sports) to encourage boys and men in expressing their stress and negative emotions through non-threatening or non-harmful outlets such as martial arts and sports. They also emphasized the importance of providing safe gender-specific spaces for boys and men to critically deconstruct masculine expectations such as toughness, stoicism, and emotional disconnectedness as ways to promote their health and social wellbeing. At the same time, some participants identified mandatory community programs for male abusers as an important mitigating strategy to reduce VAW. It is recognized that the evidence to date to support this strategy is inconclusive.

Research gaps on violence

Forum participants identified numerous research gaps related to violence. They felt that there is a need for comprehensive evidence derived from: systematic reviews on violence; community-based research that capture different forms of violence at the grassroots level; community-based interventions that inform violence prevention practice; and evaluation research on multi-sectoral services for individuals experiencing violence. Participants also highlighted the importance of implementation research, which provide evidence-informed strategies for effective program adoption and adaptation to reduce violence.

There was consensus among participants on the need for research that identify and evaluate promising practices in violence prevention and mitigation. Furthermore, participants emphasized the need to translate this research evidence into products that are readily available and accessible to policy-makers and decision-makers in order to inform policy and practice. Some examples of comprehensive implementation evidences include: what works for different age-specific and gender-specific populations in different communities (e.g., neighbourhoods, ethno-specific, socio-economic); and how to create relevant and effective social marketing messages for different populations.

Forum participants recommended the use of community-based and participatory action research to explore the experiences of violence in diverse populations and to capture perspectives of service providers and other community stakeholders. They were also aware of the challenges and barriers in establishing meaningful and sustainable community-research partnerships due to the historical level of community distrust and the potential competing interests among the stakeholder groups, particularly in the current context of neoliberal practice that promotes individualistic competitiveness, and the diminishing resources for non-profit organizations.

The priority issues for Canada raised by the Forum participants were consistent with current global scholarship and practice in violence prevention and mitigation. The recognition of interpersonal violence as a manifestation of structural violence is critical in shifting the focus of blame from marginalized communities that have been further victimized by neoliberal practice holds government and institutions accountable for the inequitable distribution of power and resources that produces and reproduces violence in the first place. This is especially true in Indigenous communities where (neo)colonialism, resulting in imposed loss of land, languages and cultures, and intergenerational trauma, has and continues to pose devastating impact on indigenous people’s individual and collective health and wellbeing, as evidenced in the high rates of poverty, unemployment, substance use, low educational attainment, family violence, disproportionate burden of physical and mental illnesses, and premature deaths (Health [ 2 , 21 , 23 , 26 ]).

The second priority issue identified was consistent with existing evidences that demonstrate the strong association between dominant social norms and violent practices; for example, patriarchy and corporal punishment; gender inequities and normalized VAW; hegemonic masculinities and violence against gay men [ 24 , 31 , 37 ]. There is abundant empirical evidence to illustrate the perpetuating cycle of social norms and violence: values and beliefs that condone violence are shaped and reinforced by patriarchal ideologies; they, in turn, contribute to and perpetuate violent behaviours at the micro- (individual), meso- (community) and macro- (societal) levels and promote a greater tolerance of men’s violent behaviors [ 11 , 28 , 38 ]. Notions of male honor, male dominance, female subordination, female modesty and female chastity are exemplars of how patriarchal beliefs and fundamentalist religious doctrines intersect to perpetuate and sanction VAW [ 14 , 20 , 37 ]. Research evidence also suggests that children who witness violence or are victims of violence are more likely to adopt violent behaviors [ 27 ].

Most of the violence prevention and mitigation strategies identified by Forum participants are consistent with the evidence-based strategies recently endorsed by the WHO (2014) for the violence prevention and response efforts. These include: (1) developing safe, stable and nurturing relationships between children and their parents and caregivers [ 42 ]; (2) developing life skills and relationship skills in children and adolescents; for example, programs designed to help children and adolescents manage anger, resolve conflicts in a non-violent way and develop social problem-solving skills [ 43 ]; and comprehensive intimate partner violence (IPV) prevention interventions to reduce IPV perpetration and victimization among adolescents [ 12 ]; (3) promoting gender equality to prevent and reduce VAW [ 44 ]; (4) changing cultural and social norms that normalize and support violence [ 41 ]; and (5) victim identification, care and support programs [ 45 ].

One unique and important idea about violence prevention and mitigation proposed by the Forum participants was the engagement of intersectoral stakeholders that go beyond the conventional legal, health and social service sectors. Existing literature on intersectoral services for victims of violence tend to report on the effectiveness of the provision of legal, housing, financial and safety advice; and facilitation of access to and the use of community resources such as shelters, emergency housing, and psychological interventions [ 30 ]. Addressing the needs of victims with trauma-focused care, cognitive behavioral therapy or other low-intensity psychological interventions and mental health services can potentially mitigate the serious mental health outcomes of violence [ 15 , 29 ]. However, our Forum participants emphasized the importance of engaging stakeholders and leaders beyond the conventional sectors to include stakeholders and leaders from faith-based, arts, sports and media sectors to transform dominant social norms and support boys and men to engage in positive and healthy outlets of stress and emotions. Their suggestion is critical in that it promotes critical dialogue about violence prevention in the social space of boys’ and men’s everyday life. The involvement of respected community leaders is considered to be very effective in changing social norms [ 13 , 36 ].

Many international bodies, such as the WHO, International Confederation of Midwives, Pan-American Health Organization as well as provincial health agencies in Canada are increasingly looking at the role of healthcare providers in the provision of quality care defined in multidimensional terms such as respect, equity, access, patient centredness and effectivness. Quality also denotes care underpinned by respect for the human rights of women, children and marginalized groups (e.g., right to informed consent, right to refuse treatment, right to equal treatment, right to access healthcare, right to health, right to privacy, right to live) [ 18 , 32 ]. In the context of violence prevention and mitigation, quality care denotes care providers’ competence in screening their clients for actual and potential experience of violence, and provision of care that maximize their clients’ safety and wellbeing and minimize the risk and impact of trauma associated with violence. Quality care also includes contributions to violence prevention through research, advocacy, policy and practice.

Finally, the research gaps identified by the participants are consistent with the current landscape of research on violence, which reflects an imbalance of research that focuses more on violence at the individual and interpersonal level (e.g., personal history of violence, interpersonal violence with peers, intimate partners or family members) and less on violence at the community level, whereby relationships are embedded in social spaces such as schools, workplaces, and neighborhoods, or structural violence at the societal level in the forms of social norms, institutional practices and public polices [ 25 ]. In 1999, the WHO Violence Prevention Alliance adopted an ecological framework developed by Heise [ 22 ] to illustrate how the complex interplay of individual, relationship, social, cultural and environmental factors are associated with intimate partner violence [ 25 ]. Research that promotes a better understanding of how socio-ecological factors interact to perpetuate or reduce violence is a key step to developing effective public health approaches to address violence.

Limitations

While the organizing committee aimed to be inclusive in inviting individuals from diverse sectors, the Forum participants are not representative of all stakeholder groups. For example, there were fewer practitioners from law enforcement, education, and legal services, and fewer community members or public participants. Given the importance of community participation in, and community as the setting for violence prevention, the inclusion of the views of the public would have been informative and important. We relied on taking detailed notes to capture participants’ ideas and perspectives since audio-recording of these dialogues was not feasible in the context of a forum with many concurrent discussion taking place in the same room.

Conclusion and Recommendations

The proceedings from the Global Health and Health Equity Forum underscore the importance of recognizing violence as a public health issue that requires immediate and meaningful communal and structural investment to break its historic cycles. In order to do so, it is important to bring together community members, grassroots organizations, researchers, policy-makers, educators, students and cross-sector stakeholders to advance discussions about effective policy and programming for different forms of violence. Given the nature of structural and interpersonal violence, any significant and lasting change will require intersectoral efforts. This Forum is just one example of the continued efforts needed to solidify violence prevention policies, services, and practices. However, we recognize that effective and sustainable solutions must surpass forums of discussion to actualize policies and regulations that can effectively transform oppressive social structures, address the gaps in violence prevention and mitigation, and reinstate societal responsibility for violence prevention.

Based on our thematic analysis of the information from the forum, the members of the Centre for Global Health and Equity at Ryerson offers the following recommendations:

Support and adopt policies to prevent and reduce structural violence.

Reducing social disparities through social policy reform is essential for both violence prevention and reduction. Social policy reforms must address the root cause of violence, that is, inequitable distribution of power and resources resulting in differential access to social and economic opportunities between the dominant groups and the marginalized groups. While these broad considerations must be central to social policies in general, understanding the specific needs of marginalized groups negatively impacted by racism, sexism, ageism, homophobia, transphobia, poverty and other oppressions is a priority. In recognition of violence as a structural issue, finding solutions requires a political and intersectoral approach (i.e., involving health, employment, social service, educational, housing and criminal justice sectors). For example, strategies to reduce youth related violence should include increasing employment and educational opportunities for youth and providing financial and social supports for parents to help reduce the risks that are associated with violence and inequitable outcomes. Similar actions are needed to inform and ensure that institutions (e.g., hospitals, police, group homes, and the child welfare system) review and revise their organizational policies and procedures to address structural violence that creates barriers to providing inclusive and respectful services to marginalized individuals and communities.

Adopt multi-pronged strategies to change dominant social norms associated with violence.

Since a multiplicity of external and internal pressures function to maintain dominant cultural and social norms, multi-pronged approaches that engage diverse stakeholders to influence community opinions, inform mass media messages and transform public policy or legislation must be used to address violence. Mass media campaigns can be used to convey messages about empowering relationships and social interactions to broad populations via television, radio, the Internet, newspapers, magazines and other social mediums. Legislation is an important strategy in changing cultural perceptions and social norms when violent behaviors are redefined as a criminal offence and the offenders have to face legal consequences. Political will and social accountability are also critical because the presence of legislation without the necessary infrastructure of public education, access to legal services, and person-centred services for victims of violence does not guarantee that the legislation will be carried out effectively.

Establish standards and ensure adequate funding for violence prevention program and services.

Comprehensive research evidence is needed to establish promising practices and reorient services to meet the individual and collective needs of affected groups and communities to reduce violence and its related impact. Community-based services must be strengthened through sustained government funding to promote community empowerment in the continuum of violence prevention and reduction programs. Adequate funding for coordinated and sustainable capacity building programming at the community level is critical to the establishment of effective responses to interpersonal and community violence and to reduce the loss of community capacity to address violence due to resource competition among stakeholder groups.

Fund higher-level ecological research on violence prevention.

The current research agenda, with its focus on violence at the personal or interpersonal level does not provide the necessary knowledge and evidence to inform policy development and change. Adequate resources are needed to support research that investigate the outcomes of upstream policies on violent prevention, the impact of intersectoral interventions to transform dominant social norms, and the effectiveness of population-specific interventions on primary violence prevention.

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Acknowledgements

The authors would like to acknowledge the significant contribution of all workshop participants, volunteers and presenters to the Forum.

Funding for the Forum was provided by Ryerson University.

Presentation and roundtable notes can be made available for review.

Authors’ contributions

All authors: Made substantial contributions to conception and design, or acquisition of data, analysis and interpretation of data; Were involved in drafting the manuscript or revising it critically for important intellectual content; Gave final approval of the version to be published. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.

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Ilene Hyman

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Annette Bailey

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Urban Health, Daphne Cockwell School of Nursing, Toronto, Canada

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Exposure to Family Violence and School Bullying Perpetration among Children and Adolescents: Serial Mediating Roles of Parental Support and Depression

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Previous studies have found links of intimate partner violence exposure and child maltreatment with school bullying among children and adolescents. However, little is known about how exposure to family violence may influence child and adolescent bullying perpetration and the mediating mechanism underlying this relationship. This study aimed to examine the relationship between exposure to family violence and school bullying perpetration, as well as the mediating roles of parental support and depression in this relationship. The sample consisted of 3,199 Chinese primary and secondary school students from grades four through twelve (mean age 13.4 years, 50.8% boys). Participants responded to validated self-report questionnaires in 2021. Generalized structural equation modeling was analyzed. The study found that exposure to family violence was significantly and positively associated with school bullying perpetration. Furthermore, parental support and depression, in this order, mediated the effect of exposure to family violence on bullying perpetration. Moreover, the overall mediating effect on traditional bullying perpetration is larger than that on cyber bullying perpetration. Less parental support and depression acted as risk factors for the negative effect of exposure to family violence on child and adolescent bullying perpetration. The importance of these two factors can motivate future intervention initiatives to prevent bullying perpetration from an integrated perspective.

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Acknowledgements

We would like to thank all the participants in the study.

This research was supported by the National Social Science Youth Project of China (Grant Number: 19CSH070), the Educational Science Key Project of Jiangsu Province, China (Grant Number: B/2022/01/07), the Qinglan Project of Jiangsu Province, China, the 2023 Youth Project of Shenzhen Philosophy and Social Sciences Planning Project (SZ2023C010), the Special Funding Project of Shenzhen University Marxist Theory and Ideological and Political Education (23MSZX10), and the Shenzhen University Humanities and Social Sciences High-level Team Project for Enhancing Youth Innovation (24QNCG08).

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Nie, W., Gao, L. Exposure to Family Violence and School Bullying Perpetration among Children and Adolescents: Serial Mediating Roles of Parental Support and Depression. Applied Research Quality Life (2024). https://doi.org/10.1007/s11482-024-10293-1

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The violence of literature review and the imperative to ask new questions

Writing the literature review is not a neutral act. In fact, the key central aim of consolidating work in a particular research area is to demonstrate one’s knowledge of this area; that is, one must know the ‘conversations’ concerning the research topic. Literature review becomes violent in the Bourdieusian sense because it imposes particular configurations of privileged knowledge on researchers. Thus, in this paper, we argue that literature review is an enactment of symbolic violence and, in the process, epistemic theft, and central to this practice is the construction of research questions. Literature review, as a site of scholarly conversations, dictates the kinds of questions we ask, thus unwittingly framing our research according to the epistemic demands of past and recent studies. By asking a different set of questions, ‘new’ or different understandings about certain social phenomena may emerge.

1 Introduction

When it comes to the dominant practice of literature review, it is unlikely that ‘autonomous knowledge’ ( Alatas 1979 , 2022 ) is achieved. According to Guillermo (2023) , for example, “[s]ocial scientists in the dependent centres of academic production are obliged to acquaint themselves, if not master, both the classics and the latest theoretical trends emanating from the dominant centres” (p. 4), and this can concretely be observed in literature review.

A researcher, according to Boote and Beile (2005) “cannot perform significant research without first understanding the literature in the field” (p. 3). What this means is that a literature review which is essentially mapping the field of research in order to identify key topics, scholars and controversies, is a prerequisite for producing ‘significant’ research. Literature review in this sense is the demonstration of knowledge of the field. What we want to problematize in this paper is what constitutes knowledge of the field and how the process of consolidating privileged knowledge is a violent process.

Thus, in this paper we argue that literature review as described above is an enactment of symbolic violence and, in the process, epistemic theft, and central to this practice is the construction of research questions. We show this through the design of a research project on attitudes of Filipino professional writers of English towards a named variety of English called ‘Philippine English’. By asking a different set of questions, we discovered that the writers conceptualize their own use of English in ways which radically depart from mainstream conceptualization of ‘Philippine English’. Literature review, as a site of scholarly conversations, dictates the kinds of questions we ask, thus unwittingly framing our research according to the epistemic demands of past and recent studies. By asking a different set of questions, ‘new’ or different understandings about certain social phenomena may emerge.

When we (the authors) conceptualized the research, we thought we had a pretty straightforward project. Based on the recent literature that we explored both on ‘Philippine English’ and, more broadly, on world Englishes, much work centred on investigating people’s attitudes towards these localized varieties of English (e.g., Alieto and Rillo 2018 ; Ambele and Boonsuk 2021 ; Gustilo and Dimaculangan 2018 ). We claimed that there has been substantial work describing the structural features of these varieties, unpacking the political dynamics of their uses and their users, as well as exploring the attitudes of different stakeholders towards these varieties. However less work has been done on professional writers themselves, even with a few scholars enquiring into the same topic ( Buripakdi 2012 ; Gritsenko and Laletina 2016 ).

As we constructed our research design, however, especially with our main research questions, we slowly developed a discomfort over what we aimed to do. Study after study, investigations into language attitudes towards varieties of English not only generate broadly predictable results but, more importantly, there emerged a particular configuration of knowledge circulation which essentially reproduces itself, thus also serving as an ideological anchor point to affirm/confirm researchers’ stand on indigenized Englishes. ‘Predictable results’ here do not point to an objective reality called Philippine English, but a discursive reality described as ‘Philippine English’ but is uninterrogated as such. Attitudes towards localized Englishes are generally conflicted or ambivalent ( Bae 2015 ; Dimaculangan 2022 ; Jeong et al. 2022 ), showing positive attitudes towards them as indexes of local identities and interpersonal relations, but increasingly more negative, unaccepting or even hostile in the formal contexts of teaching and learning, as well as if viewed through the lens of ‘global’ communication ( Jindapitak and Teo 2012 ; Tan and Tan 2008 ). In other words, compared with standard English(es) – it does not matter if they are vaguely defined phenomena – localized varieties of English are generally less favoured by speakers, especially teachers, students and educational policy makers.

Consequently, many studies confirm what we already know: that standard English(es) are preferred in the classroom and other formal workplaces and contexts. Research into language attitudes and ideologies confirms as legitimate the same attitudes and ideologies which circulate in the epistemic community. In short, research reproduces what we already know or what people hold to be true and accurate and validates recommendations based on such research in educational policy and practice. To put it in another way, research in general (see Ahl 2004 ; Herndl 1993 ; Potts and Brown 2015 ) acts as a social practice of legitimizing knowledge which society has also – in fact, already  – validated as legitimate. However, the case of ‘local’ scholars investigating their own indigenized language practices complicates the dynamics of knowledge production even more: the ‘field’ that they legitimize through the practice of literature review becomes complicit with stealing away the complexities of their own indigenous language practices. This is because while we already know what we know, the ‘object’ of such knowledge – ‘Philippine English’ – is explored through the lens of literature review which presupposes and legitimizes its so-called objective reality and, in the process, obscures its discursive constructedness. This explains why in this paper named varieties of English such as ‘Philippine English’ and ‘Thai English’, among many others, are placed in single quotation marks to point to an understanding of these named varieties as epistemic constructs rather than, as mentioned, objective facts generated through ‘scientific’ investigations.

Therefore, we sought to re-view our research questions in the light of their socially legitimizing function. In the same literature we consulted (e.g., Borlongan 2009 ; Tan 2019 ), the approaches to language attitudes towards ‘Philippine English’, or other localized Englishes for that matter, have been through particular direct and indirect enquiries. On the one hand, respondents are usually asked directly what they think of ‘Philippine English’, or ‘Thai English’, or ‘Malaysian English’. On the other hand, matched-guise tests have been used as well, thus indirectly asking respondents about their views of certain varieties of English. In both types of investigation, however, the assumption remains the same: these nationally named Englishes exist. But after completing 12 online interviews with Filipino professionals, we discovered one very important point: they did not refer to their own English as ‘Philippine English’, and in cases where they described their own use of the language in relation to their career trajectories, they defined their own use in ways that were not ‘national’ in nature such as what is assumed by ‘national’ Englishes. We were able to characterize elite use of English in the country in terms of the mobilization of flexible language resources along the lines of formality/informality, access to quality education and cultural capital, by the professional writers to keep themselves useful and marketable within their professional world. Indeed, we were able to put forward the view that ‘Philippine English’ – and ‘world Englishes’ in general – is an academic construction. Varieties of English may exist culturally and linguistically, but they are apprehended differently by people who are positioned differently in society.

Thus, when asking people what they think of ‘Philippine English’, we/researchers as in-group members assume that ‘Philippine English’ is an objective fact, and that it is understood in exactly the same way by everybody. In this way, legitimate knowledge is reproduced and imposed on how we should work with it in the practice of our professional, family, and everyday lives. This is how academic writing – reviewing the literature and constructing research questions – becomes a practice of symbolic violence and epistemic theft. Epistemic practices “are the socially organized and interactionally accomplished ways that members of a group propose, communicate, evaluate, and legitimize knowledge claims” ( Kelly and Licona 2018 , p. 140). Thus, through the mechanism of symbolic violence, they impose worldviews and ways of doing things which make us scholars as members of a social group both instruments and agents in the making of legitimatized but constructed knowledge(s). On the other hand, the mobilization of ‘Philippine English’ constitutes epistemic theft as it becomes complicit with epistemic practices of scholars who take away nuances and diversities of experiences of English language use of Filipino speakers, and then establish such ‘Philippine English’ as legitimate knowledge about all speakers. This does not in any way invalidate the usefulness of literature review, only that we need to be critically aware of what it does to us as we practice it. We must constantly question ‘knowledge’ that we recognize and erase, resist the temptation of yielding to dominant frames of understanding our ‘field’, and (re)imagine alternative tracks in pursuing what constitutes legitimate knowledge in our own research areas. We must engage in what Guillermo (2023) describes in Filipino as ‘pagsasariling-atin’, or engaging in the “process of immersion within a living and evolving dialogical space, what used to belong to only a part of the community can become ‘ours’ in the same way that something which used to be external to the community can also become ‘ours’. But in such a process, the self itself is transformed” (p. 14, italics as original). We take this to mean not only as taking ownership over the content of our research but, more importantly, over the process of producing knowledge itself, including the choice of questions we want to ask. We remain committed to engaging in dialogue with all knowledge sources available.

2 Literature review, symbolic violence, and epistemic theft

Literature review as symbolic violence and academic theft is the main argument of this paper. Literature review and symbolic violence are research topics which have been explored extensively by scholars in a wide range of fields, from the health and medical sciences ( de Caux 2021 ; Kovacs 2017 ) to the social sciences ( Roumbanis 2019 ; Yin and Mu 2022 ), to make sense of the interweaving of academic writing practices and the lives of the academics themselves. Much less extensively but no less importantly, epistemic theft has been discussed in several studies as well ( Steers-McCrum 2020 ). However, these topics have not been explored together yet.

Much of research on reviewing literature is centred on clarifying its role in the whole gamut of academic writing and practice, usually as the practice of demonstrating one’s knowledge of the relevant field of study, being able to make generalizations and articulating future directions of the field, for example through narrating past studies and doing meta-analysis ( Baumeister 2013 ; Paul and Criado 2020 ; Webster and Watson 2002 ). Critical approaches across different disciplines typically discuss literature review in the broader politics of citation practices, and understandably so because the former is deeply embedded in broader mechanisms of power and disempowerment which can be traced to structures of colonialism and neoliberal globalization ( Jackson 2020 ; Smith 1999 ). Aside from the much-studied genres of academic writing ( Hyland 2008 ), scholars have also explored how we as academics have all been socialized into particular practices of writing and thinking collectively described as ‘academic’. Thus, academic writing is a process of becoming a particular kind of person and, more specifically, a particular kind of scholar or academic ( French 2020 ; Hyland 2002 ); the other, but also complementing, side of becoming as taking on privileged identities in the academic world is the unlearning of some scholars’ indigenous or local ways of talking, writing, reading, listening and knowing in order to join the transnational knowledge work of academics ( Jackson 2020 ; Smith 1999 ).

As social practice, academic writing has been characterized as engaged in privileged conversations shaped by unequal power relations, necessitating the learning of new vocabularies and polite/objective/neutral language, and practising particular ways of citing/acknowledging sources in order to be admitted into the inner circles of “knowledge-producing communities” ( Abasi and Graves 2008 ; Kelly and Licona 2018 , p. 161; Lillis 2019 ). Through the lens of geopolitics, academic writing is also framed in terms of unequal exchange of knowledge between so-called theory-builders who are typically sited in Northern centres of knowledge production, and theory consumers who are deemed sited in Southern contexts of research and teaching ( Canagarajah 2002 ; Tupas 2020 ).

However, these socialization processes, identity formation practices and geopolitically shaped knowledge exchanges have rarely been framed or studied in terms of enactments of symbolic violence through the practice of reviewing related literature and formulating research questions. More broadly as ‘English academic discourse’, Bennett (2007) has done so through the lens of epistemicide or “the systematic destruction of rival forms of knowledge” (p. 154). While we take the position that literature review is embedded in broader structures and mechanisms of power, we also acknowledge that there are specific practices associated with the writing of the literature review – for example, constructing research questions and citing so-called classic texts – from which emerge particular configurations of symbolic violence which shape but at the same time “violate[s]” ( Dlamini et al. 2018 , p. 3) scholars’ professional being ( Scanlon 2011 ).

Bourdieu (1991) is typically associated with the notion of symbolic violence which has been deployed in innumerable studies across probably all disciplines in academia. The term refers to “violence which is exercised upon a social agent with his or her complicity” ( Bourdieu and Wacquant 2002 , p. 167). Such violence is symbolic because it is inflicted on the mind and the body through means other than the use of brute and physical force. The receiver of such violence, precisely because it is not perceived or recognized as violence, acts as an agent of complicity or consent, thus enacting symbolic violence as if it is something that benefits them (or at least does not affect them). Symbolic violence, thus, thrives on what Bourdieu ( Bourdieu and Wacquant 2002 ) also refers to as ‘misrecognition’. Academics in general, for example, misrecognize particular institutional demands such as publishing as part of “playing the game” ( Bennett 2007 ; Gordon and Zainuddin 2020 ; Guillermo 2023 ; Kalfa et al. 2018 ), taking it seriously and reorienting their lives towards it. Such demands, in fact, have the “intent to enforce and sustain managerialist practices” ( Kalfa et al. 2018 , p. 276) which, among many things, force staff to compete “against each other” (p. 286). Symbolic violence has been used substantively to make sense of academics’ troubled relationship with the neoliberal infrastructures of their professional workplaces. The aim is generally to show how market-driven agendas of universities in the form of ideologies and practices oriented towards profit-making, resilience and individual responsibilisation enact symbolic violence upon academics as “knowledge workers in the neoliberal university” ( Yin and Mu 2022 , p. 2) who misrecognize such demands and conditions as part of their life as academics ( Gordon and Zainuddin 2020 ; Roumbanis 2019 ).

Our paper follows Dlamini et al.’s (2018) mobilization of symbolic violence specifically as central to understanding the logics of academic research, although we unpack it further in the more specific context of formulating research questions and reviewing related studies through Jackson (2020) and Smith and Smith’s (2018) view of citational practice as one concrete site for the suppression, erasure and/or devaluing of Indigenous, non-western and other local knowledges. Academic writing as embodied in the practice of literature review is participating in a “conversation” which requires knowledge of (White, Northern based) scholars, their work and the important issues which constitute such a conversation ( Guillermo 2023 ). This is akin to what Dlamini et al. (2018) describe as “participating in institutional rituals or ‘behaving’ in accordance with racialised, classed or gendered expectations” (p. 2–3).

Canagarajah (2002) early in his career as a scholar from an academic periphery (Sri Lanka) narrates a personal experience of getting an academic paper published in a top tier journal when an original manuscript written in a personalized way and with “no literature review or explicit creation of a disciplinary niche” (p. 22), was rejected but ultimately accepted when he responded to reviewers’ feedback asking him to acknowledge past work on the topic he was exploring. A comparison between the two versions of the paper did not reveal any substantial change in his argument. However, in the revision, he needed to locate such an argument within recognizable/recognized areas of research in the West (such as contrastive rhetoric) with a pre-determined citation line of studies which demonstrates his ‘knowledge’ of work in these areas. The revised paper also had to be written in an academic language that dispossesses him of ownership over his argument derived from the lived experiences of people in his community. In the most literal sense, the revised paper endeavoured “to begin with a citation” (p. 25) and then “go on a bit of disciplinary niche creation by invoking the field of contrastive rhetoric”.

Notice our reference to ‘force’ and ‘dispossession’ because more than simply a change of identity and joining a conversation, we highlight the symbolic violence wrought upon scholars when they engage in the practice of literature review and formulating research questions. There is no one body of knowledge which applies to all cultures and communities in the world. However, because of the unequal ways the production of knowledge is configured, some ways of knowing and doing, including ways of writing, have been delegitimized and destroyed – Bennett (2007) refers to this process as epistemicide or symbolic genocide – by the combined forces of technologies of power and control linked with colonialism, coloniality and neoliberal capitalism. “The academia that we know today”, remarks Reyes Cruz (2008 , p. 653), “continues to be a site where that knowledge is produced and legitimated, a place where those with access to it can insert themselves in the reproduction of the kind of capital that allows a few to say what counts as valid for the rest of us”. To decolonize ourselves and our work, according to Smith (1999) , does not mean total rejection of Western theories and practices but “it is about centring our concerns and world views and then coming to know and understand theory and research from our own perspectives and for our own purposes” (p. 39). However, in the case of Canagarajah (2002) concerning that particular manuscript at the beginning of his scholarly career, and the case of many of us who attempt to ‘insert’ ourselves in the reproduction of knowledge and capital in order to gain entry into the inner circle of academic publishing, de-centring our own concerns and theorizing and researching through the lens of our own experiences and worldviews is only one part of the story. The other part is that we “consent” ( Dlamini et al. 2018 , p. 3) to being forced to use language and cite studies which silence or delegitimize our own arguments and voices. This is the logic of symbolic violence: it “violates how we think” (p. 2) and how we do things in everyday life because when we are forced to think in particular ways, we are also forced to change how we do things. Ironically, for our writing to be legitimized it “has to be inserted in colonial traditions, one has to identify, claim, locate oneself within legitimized intellectual production or at least, speak like one knows the West and so has the right to challenge it” ( Reyes Cruz 2008 , pp. 655–656).

This is where the notion of epistemic theft complicates the whole dynamics of knowledge (re)production when applied to the complicit work of ‘local’ scholars whose own language practices, cultures and communities are the subject of their own investigation. For Steers-McCrum (2020 , p. 242), epistemic theft refers to the phenomenon of ‘self-appointed speaking for’ which essentially means, in our case, scholars who assign themselves, wittingly or unwittingly, the role of speaking for the causes and agendas of other communities. Ndlovu-Gatsheni (2021) refers to ‘theft of history’ as part of the logics of epistemicides which are operations of refusal and denial of multiple ways people make sense of their own realities, and these are accomplished in sites of theft and destruction such as schools, universities and churches. In the case of our paper, however, we see the blurring of distinction between dominant and dominated communities, or the mobilizers and the receivers of violence. Because literature review commits us politically and ideologically to particular practices of consolidating knowledge in order produce what was earlier referred to as ‘significant’ research ( Boote and Beile 2005 , p. 3), there is always the possibility that we as scholars of our own communities participate in stealing away nuances and diversities of our own cultures, identities and knowledges. We participate in the mobilization of violence inflicted upon us.

3 Literature review as symbolic violence: an example

In this section, we elaborate on our argument that literature review, which includes the formulation of research questions, exacts symbolic violence on the lives of scholars and their communities and, in the process, make some of these scholars complicit with epistemic theft. This happens when scholars – as consenting and (sub)consciously complicit academics – engage in practices of thinking, writing and navigating the academic professional landscape which, on the one hand, they misrecognize as a means of scaffolding their participation in the privileged world of scholarly practice but, on the other hand, are actually hurting or damaging their sense of self, their world and their knowledge of the world. We track instantiations of “the formation and procedure of symbolic violence” ( Nas 2015 ; p. 38) as we engage in some introspective reflection spawned by our collective thinking with and through the process of research design, data collection and data analysis. To put it in another way, the operations of symbolic violence and epistemic theft in our research are slowly exposed throughout the research process as we begin to ‘recognize’ the destructive mechanisms of reviewing related studies.

Let us begin with our interview below with Dennis (not his real name), one of the 12 Filipino professional writers of English we interviewed for our research project on ‘Philippine English’ described earlier in the paper. In all the interviews, we began by asking the interviewees to describe the nature of their work and then pick up cues from their answers to ask about challenges at work which may have to do with their roles as writers in English. As we shared earlier in the paper, the questions we asked aimed at moving away from the kind of questioning that typically appears in the language attitudinal literature on ‘World Englishes’, and specifically ‘Philippine English’. ‘Symbolic violence’ was furthest from our minds, but we knew we needed to steer the interviews towards questions and answers which might generate new information or knowledge about ‘Philippine English’ beyond the predictable ones – that people at best have ambivalent attitudes towards it ( Bautista 2000 ; 2001 ; Martin 2014 ; Tupas 2006 ). Alieto and Rillo (2018) report positive attitudes but a different data set from Torres and Alieto (2019) reports limited acceptance. We knew, also based on our conventional literature review, that views of elite professional writers in English were less studied than other speakers such as teachers, pupils and parents, but we feared that we would simply generate similar patterns of attitudes towards the unexamined ‘Philippine English’. However, as we re-visited our data, especially in relation to the manner by which we generated them, we found that changing the kinds of questions we asked led us to deconstructing our own understanding of the literature review process. We were aware of citational politics and inequities in knowledge production ( Santos 2014 ; Smith 1999 ), but, interestingly, not the specific configurations of the central of role of literature review itself in the enablement of legitimized knowledges and, in the process, in the (self)erasure of other forms of knowledge, especially the ones not accessible to and devalued by Western scholarship.

Before the exchange below, Dennis introduces himself as a digital content creator and director for a well-known fashion magazine brand in the Philippines – Magazine Fashionista (MF, not the real name of the magazine) – who believes that his climb to the top of the corporate ladder was due to his ‘flexible’ way of communicating. The magazine produces different versions or editions which cater to different types of readers from the ‘masa’ crowd (the masses) to the elite crowd, thus requiring different styles of writing. Consequently, when asked to describe his kind of English, he repeatedly describes it as flexible (six times throughout the interview) as he says he is able to switch between different styles when communicating fashion to different communities of readers. There is no reference to his use of English as a Filipino, or English as shaped by Philippine culture(s). Without our prodding, he describes his English when writing for the elite as ‘Westernized’, thus we dig deeper into this point to possibly draw up connections between being flexible, being fluent in English and being westernized. This could also potentially lead us to getting him to talk about ‘Philippine English’ which, of course, did not happen. In the exchange below, [1] one of us, Ruanni, asks if being flexible and westernized had something to do with the quality of English.

R: [with your director or senior], was there a discussion about the quality of English that you have to produce? Like, should it be westernized? For the kind of flexibility that you mentioned, do you have to write in most instances in the westernized way, or Americanized way?

D: There was a specific instruction to be like westernized or American. But this specific instruction was really more on we have to communicate to the elite. So, I guess in a way I assumed it as it should be westernized. Because when we’re talking to the elite, we’re speaking of them getting education abroad. So, in a way din siguro [perhaps], it can be assumed as a westernized way, and somehow, yes, we, actually ano, ah oo nga no parang [we uhm ah it seems like you’re right], our standard or siguro my [perhaps my] standard through writing for MF because I used some words or writing from like, for example elite international magazine like Vogue, Harper’s Bazaar, British Vogue or British GQ. So, it’s kind of like more on yeah, more on westernized. Yeah. Sorry, I just realized that now that you mentioned.

Three related things, to be elaborated on below, can be said about this exchange which we also argue are discernible patterns from our other interviews. The first is the academic construction of an idea referred to as ‘localized’ English, and in the case of our study, ‘Philippine English’. Dennis defies a static view of language in general as can be gleaned through his point that the instruction to be more ‘westernized’ ‘was really more on we have to communicate to the elite’. It must be recalled that MF caters to different sectors of readers so Dennis’ point in the exchange, and in fact the rest of our interview with him, is that his English cannot be boxed into one variety or type of English; it is dynamic because it is deployed flexibly depending on the readers being addressed. Without direct questioning about people’s views of ‘Philippine English’, and instead asking about the nature of interviewees’ work, including key challenges they face in the workplace, and then “follow” ( Spinney 2015 , p. 232) their answers instead of directing them, these less obtrusive questions open up the conceptualization of localization of English in terms which do not align with our academic understanding of it such as use of English mediated by a national culture. Moreover, localized uses tend to respond to contextualized demands of communication, rather than represent internalized cultural identities which then are assumed to dictate the shape of the language variety such as ‘Philippine English’.

Secondly, it reminds us to be sceptical about centring knowledge through our own research practices. Our questions about ‘quality of English’, ‘westernized’ or ‘Americanized’ writing, and ‘flexibility’ emerged from Dennis’ own reflection on his communicative experiences and challenges in the workplace and are not imposed terms or categories from us. Thirdly, it consequently reminds us that the questions we ask generate particular forms and kinds of knowledge, thus we see a case of research where existing knowledge, produced and constrained by literature review, is perpetuated and legitimized. A possible way out of this epistemic trap is to ask a different set of questions, especially ones which allow people as much as possible to talk freely about themselves and their experiences, rather than through the lens of pre-determined (read: constructed) linguistic and social phenomena. This has led Dennis to newer realizations such as when he surmises that quality of English might indeed be linked to his own deep-rooted assumptions about communicating with the elite as communicating in a westernized or Americanized way: “Sorry, I just realized that now that you mentioned.” In our discussion below, we describe these three overlaying ideological knowledge-perpetuating mechanisms of reviewing related studies as instantiations of symbolic violence and, consequently, implicating epistemic theft.

3.1 The violence of an academically constructed phenomenon

One of the most, if not the first, uses of writing a literature review is to carve out a space for one’s own research, but in order to do this one must demonstrate ‘knowledge of the field’ and acknowledge the scholars and their work associated with the particular topic being explored. In the case of our research project, we acknowledged substantive work on attitudes in the area of ‘World Englishes’ ( Boonsuk et al. 2023 ; Lee and Green 2016 ; Rezaei et al. 2019 ; Tan and Tan 2008 ) and, specifically, ‘Philippine English’ (references cited earlier), thus our research emerged from these studies. In fact, in recent years there has been “a concentration of work on languages attitudes” ( Tan 2019 , p. 70), necessitating asking a different set of questions from research in the 1980s until early 2000s during which the main agenda among scholars was to show evidence of the existence of the different national Englishes. Since then, “[r]esearchers have begun to look away from the English varieties, but have started to ask questions about how English speakers view and use the different varieties of English” (p. 70). This could be mainly due to the fact that the desired legitimacy of ‘non-native’ varieties of English remains contested and questioned. Our research thus aimed to ask the same questions in exploring the attitudes of elite Filipino writers of English towards ‘Philippine English’. These questions emerged from our broad and historical understanding of work on the pluralization and globalization of English, associated mainly with the Kachruvian paradigm ( Kachru 1986 ; 1992 ; Smith 1991 ) which takes on a postcolonial perspective on ‘non-native’ speakers’ cultural and political intervention in the global spread of the language through both structural/linguistic and political research. Therefore, in our attempt to demonstrate our deep knowledge of the field through the exercise of literature review, we have been framed to ask the same questions as the recent studies, taking on two related epistemic stances: an epistemic stance affirming the existence of Philippine English, and an epistemic stance legitimizing the centrality of Philippine English in the lives of the speakers. In the process, these stances cancel out all possibilities of complexity and nuance in the nature of English language use as it is localised and pluralized, and gets entangled with the everyday lives of speakers.

For the first stance, it may sound counter-intuitive, but this is what the literature review does – to provide us with pre-set assumptions about the field(s) upon which our research rests ( Denney and Tewksbury 2013 ; Wolgemuth et al. 2017 ). These assumptions are rarely questioned. Sociolinguistically and structurally speaking, many studies have produced empirical evidence and well-reasoned arguments pointing to the existence of localized varieties of English shaped culturally and ideologically by their speakers. However, in what form does ‘Philippine English’ exist? Do ‘Philippine English’ speakers believe ‘Philippine English’ exists? Academic studies give us structural descriptions of the variety, as well as pragmatic functions which are purportedly culturally unique to Filipino speakers of English, which then collectively construct our notion of ‘Philippine English’. More than an objective reality, in other words, a constructed notion of ‘Philippine English’ serves as the epistemic anchor of work on ‘Philippine English’ which, through its ‘data’, provides evidence that ‘it’ exists in some particular shape.

For a number of decades now critical language and discourse scholars have also reminded us that descriptive work is never neutral; it is, in fact, normative and ideological through and through. Our descriptions (and of course, especially our interpretations of language use) are choices we make and are, thus, exclusionary in nature. For our descriptive work to be ‘accurate’, we decide which patterns of language use are legitimate or not, and exclude those which we deem unimportant or insignificant ( Beal et al. 2023 ; Fairclough 1989 ; Ottenhoff 1996 ). Related to this point, our data also limit the things we can say or not about our research topic. For the past few years, a few Filipino scholars have begun to question ‘Philippine English’ as it has been constructed academically through the years, for example by alerting us to the pluralized variety of ‘Philippine English’ – thus, Philippine English es ( Berowa and Regala-Flores 2020 ; Gonzales 2017 ; Martin 2014 ; Tupas 2006 ). Much of ‘Philippine English’ has been produced through research sited either in Manila, where most of the elite universities are, or specific communities of speakers whose linguistic repertoire is constituted by Tagalog and English, rather than constituted by multiple languages/language practices which are more common among speakers outside the political and educational centre, Manila. In the words of Gonzales (2017) , “by generalizing findings based on an unrepresented ‘Philippine English,’ we could be ignoring other minorities and groups affected by other social factors, indirectly advocating elitism” (p. 82). Berowa and Regala-Flores (2020) also highlight that the ‘Philippine English’ mobilized in the literature is “elitist-Manila-centric" (p. 214) which reminds us that our conceptualization of what constitutes the variety is incomplete at best. Many of these studies propagate the same view of description as neutral – “purely descriptive” (p. 214) – but the point here is that ‘Philippine English’ which circulates in the literature and is circulated by scholars themselves is assumed to have an objective existence and the role of scholars is to account for it through research. Therefore, working within the framework of literature review as a demonstration of knowledge of the field and, consequently, as an act of identifying a gap in the studies, scholars take on a particular stance as a starting point of their research – that ‘Philippine English’ exists, and it exists in the manner by which scholars have described it. Thus, working within the same logic of literature review, many of us participate in acts of stealing away crucial knowledges about our own communities and the various ways we envision and shape our language practices.

3.2 The violence of centred knowledge

As a consequence of imposing a particular view of language use through the academic literature which legitimizes its existence, a second epistemic stance in our research which generally remains undetected is the imposition of an assumption which puts the centrality of our topic of choice at the centre of people’s lives. A narrated experience of Tupas (2014) , for example, maps out a particular Indonesian seaside community’s rhythm of everyday life through one of the English teachers he worked with for a Southeast Asian project in curriculum development. On the motorcycle to a seaside school where the English teacher was working part-time, they had a conversation about ‘World Englishes’. According to his Indonesian colleague who, along many others in institutions of higher learning in their region, were attending an academic workshop on curriculum development, he was well aware of ‘World Englishes’ and the phenomenon of English as increasingly being localized, nativized or indigenized. As English teachers, he said, they must be sensitive to such sociolinguistically differentiated use(s) of English both inside and outside the classroom. As they continued to motor to the seaside school, however, it was beginning to be clear what the Indonesian teacher’s argument was about: in a community where the symbolic power of English was tied to pupils being seen and viewed as learning English, not necessarily being fluent in the language, an English teacher’s concern would be to get the pupils to experience learning the language, perhaps construct basic English sentences and listen to its sounds. More than that, what immediate use would fluency of English be for if everyday life draws on survivability which requires literacy in the community language? In other words, there is an a priori assumption in our research as sociolinguists and applied linguists that language, English and, most specifically, a localized English, is central to the speakers’ daily lives (also Tupas 2022 ). In the case of our interview with Dennis and, again, with other interviewees, we also sought to decenter language, specifically ‘Philippine English’, and map out the role of localized English(es) as they emerge from the interviewees’ narration of their own professional working conditions and experiences. In the end, the nature of localized English(es) which emerges from the interviewees’ stories is different from the typically nationally and culturally defined varieties as conceptualized in the dominant literature review.

Indeed, this is what literature review also does: it centres particular kinds and forms of knowledge which scholars then assume to be true when they design their own research. In the case of our research project, we find that the academic construction of ‘Philippine English’ intersects with the legitimizing practice of constructing ‘Philippine English’ as central to people’s (Filipinos’) lives, that as academics we unknowingly submit to this epistemic bias in our work. We argue that this is symbolic violence because it forces us to create knowledge about the rhythm of people’s lives at the centre of which is language or, more specifically in our case, their localized use of English. In the process of creating such knowledge, we take away people’s lived experiences and render them invisible in our writing. We note that this is not a peculiar observation; in fact, much of sociolinguistics, precisely because it foregrounds language in society, also begins with the same apriori assumption about the centrality of language. This is seen, for example, through the kinds of questions we ask, such as ‘How does language mobilize the lives of speakers of (name of a community)?’ which automatically directs us to language as our object of analysis because it is central to the speakers’ lives ( Tupas 2022 ). Our entry into our research sites, in other words, already imposes a particular of view of community life at the centre of which is language. The same critical comment has been put forward by Pennycook (2008) in the area of the sociolinguistics of linguistic landscape where much of the focus, he says, is on what analysts see as important, rather than what is in fact “salient” to ordinary people who walk around the linguistic landscape. In community-driven participatory research, Canieso-Doronila (1996 ; 2001 ) also shows how a focus on the over-all welfare of the community, identifying people’s everyday social problems, clarifies the role of language – and literacy – within the intricate political and cultural matrix of the community. We centre language and literacy in community life, thus teaching people how to read and write. However, one respondent in the Canieso-Doronila (2001) study encapsulates what we hope to argue in this section: “It is not easy to say, ‘This is our land’ when one has no land” (p. 271). Communities have been dispossessed of land and other indigenous resources, and these would seem to take precedence over questions of language and literacy, even if they are in the end also imbedded in people’s daily material struggles.

3.3 The violence of literature review-driven research questions

This brings us to another and related form of violence enacted through the process of reviewing the literature from a modern, Western-Eurocentric perspective. Typically, research questions are processed or generated through our appraisal of the literature. We can call these questions our research interventions in the sense that they are justified in relation to the kinds of questions which have been asked – and have not been asked – thus far. The logic behind this is simple – the significance of our research is drawn from the way we position our research vis-a-vis all other similar research conducted ( Jesson et al. 2011 ; Walker 2015 ). If our questions are not anchored in our understanding of related studies, our research might be viewed with suspicion because it does not participate in established conversations in the field. Indeed, our research will not be deemed ‘significant’. Thus, specifically in relation now to our research project on attitudes of Filipino professional writers of English, the kinds of research questions we initially formulated followed conversations in the area of ‘World Englishes’ and related fields. That is, in investigating language attitudes towards ‘Philippine English’, our primary question was explicitly to ask about the writers’ views of ‘Philippine English’.

We mention earlier in the paper that this takes on two related stances, one legitimizing the existence of Philippine English (or a particular form of it), and another legitimizing its centrality in the speakers’ lives. Other than these two, however, formulating research questions as constitutive of symbolic violence highlights the privileged status of academic knowledge as the generator of legitimate/legitimized questions of inquiry rather than, for example, everyday ground realities as the entry point for scholarly inquiry. Our research questions, in other words, do not typically draw upon “local cultures as sources (not targets ) of knowledge which can only be understood in its own terms” ( Arinto 1996 , p. 13, emphasis as original). In the process, we see how seemingly harmless research questions produce knowledge which invalidates the complex and unique social life of particular groups or communities of speakers. This is referred to as epistemicide ( Bennett 2007 ; Santos 2014 ) or the violent, albeit symbolic, destruction or erasure of local knowledges and experiences because of research questions which mispresent the speakers’ everyday lives and worldviews ( Phyak 2021 ).

As has been argued earlier, a substantial amount of scholarly work on attitudes of ‘Philippine English’ has been overwhelmingly conducted through direct questioning ( Alieto and Rillo 2018 ; Borlongan 2009 ; Gustillo and Dimaculangan 2018 ; Hernandez 2020a ; 2020b ; Torres and Alieto 2019 ). That is, whether through questionnaire surveys or interviews, respondents were asked to rate their attitudes towards ‘Philippine English’. This would be represented by a survey item asking respondents (e.g., parents, teachers, students) to rate their attitudes towards ‘Philippine English’, usually along the clines of favorability and acceptability. Studies then report varied results, from positive to negative attitudes, or from acceptable to unacceptable, especially in relation to teaching and using them in the classroom. Many studies also use indirect elicitation mainly through the matched-guise test which explicitly names to respondents the variety of English being investigated ( Cavallaro et al. 2014 ; Jindapitak and Teo 2012 ; Tan 2019 ). However, while this is indeed ‘indirect’, the assumption is that the variety in question exists, and that it exists in a particular form as evidenced by the kind of language items being tested for acceptability or awareness. In almost all of these direct or indirect studies, the existence of ‘Philippine English’ is assumed, that it is a notable issue that everyone should be concerned with, and that respondents agree to what ‘Philippine English’ is. In many of these studies, in fact, authors either provide or assume their own definition of ‘Philippine English’ as they use it in their work, without alerting the readers to the possibility that the scholars’ definition may not necessarily be what the respondents have in mind ( Borlongan 2009 ; Mendoza 2020 ).

Thus, central to the reformulation of our research questions was not only to avoid asking respondents directly about their views on ‘Philippine English’, but to also avoid making a priori understanding of what constitutes it. Instead, we asked them to narrate their communication experiences in their respective workplaces (including any communication challenges), then planned to “follow” ( Spinney 2015 , p. 232) their answers and stories. It turned out that in asking the writers to narrate their communication and language challenges, ‘Philippine English’ was rarely invoked, and in those times it was mentioned by three interviewees, it was because they encountered the term in graduate school, and they mentioned it in the context of their justification for not subscribing to it in their respective workplaces.

We cannot underestimate the importance of asking new questions in our research to replace those which have been responsible for constructing prevalent and dominant knowledge in the field, but which destroys – or devalues at least – all other possible ways about knowing ‘our world’. Phyak (2021) urges the formulation of new questions to be asked of multilingual communities in the context of policymaking because the usual questions not only violently destroy community experiences and knowledges, but also make scholars complicit in epistemic thief within their own local communities. In the context of multilingual Nepali communities, for example, local populations are asked to choose which among particular languages they want to learn most and based on the results, it would be English while the mother tongue is ‘rejected’. This is, according to Phyak, extremely discriminatory and represents the politics of questioning in research which erases and invisibilizes the multilingual repertoires and epistemologies of the communities. Simply put, these either/or questions “misrecognize what multilingual parents in the periphery actually need for their children’s education” (p. 226) because they are based on a monolingual view of the communities. Consequently, “multilingual speakers’ epistemologies, ideologies, and identities are misrepresented in empirical language policy research" (p. 229). In Phyak’s dialogic interviewing, he asks new questions which recognize the multiple multilingual and multicultural knowledge bases of the communities, such as the following (p. 226):

a. Do you want your children to be proficient in English only?

b. Do you want your children to be proficient in Nepali only?

c. Do you want your children to be taught in mother tongue only?

d. Do you want your children to be proficient in all of these languages?

e. Do you want your children to be proficient in other subjects such as social studies, mathematics, and science?

With these “counter questions” (p. 230), radically different knowledges are foregrounded – in fact, ‘returned’ to multilingual speakers and communities – foremost of which would be parents’ desire for their children to be educated in multiple languages. These questions “recognize the struggles and knowledge of the historically marginalized communities” (p. 230).

4 Conclusions

In the case of our research on ‘Philippine English’ and Filipino professional writers’ views of it, our decision to ask a different set of questions has radically changed our understanding of ‘Philippine English’ – that among our respondents at least, it does not exist in the form and manner assumed in the academic literature, and that the Filipino writers configure their world as privileged speakers of English in ways that have redefined our understanding of such world. They force us to problematize dominant epistemologies which underpin our scholarly work, and generate knowledges about ourselves, our cultures and our worlds which we have known before. It may be argued – and correctly so – that ‘Philippine English’ as an academic construction has on its own been mobilized to demystify Standard English, the native speaker, and ownership of language ( Bautista 2000 ; Tupas 2006 ). The entire World Englishes paradigm, especially its early articulations (e.g., Kachru 1986 ) has had powerful decolonial stances. The notion of linguistic equality was deployed to counter the disparaging mockery and devaluing of ‘non-standard’ Englishes and their speakers ( Tupas 2004 ). The point of this paper is to push the conversations forward by accounting for slippages and erasures in the use of ‘Philippine English’ in order to cut open the term and welcome new (read: stolen or erased) knowledges about the communities and users of ‘Philippine English’. This does not propose an alternative referent point for the objective reality of a Filipino variety of English; in fact, it demonstrates how all understandings of social phenomena are mediated by discourse, power and culture. The manner by which Filipino writers of English in our research talk about their communicative practices framed through own ‘new’ questions is also a discursive construction.

Nevertheless, there is nothing particularly new about our claim that academic writing, specifically the practice of literature review, is a political and ideological undertaking. As has been discussed in the paper, citational politics has been unpacked and exposed as extremely problematic especially in relation to its role in privileging as well as erasing particular bodies of knowledge and the communities within which they are mobilized ( Guillermo 2023 ; Kim 2020 ). A decolonial lens pushes us to question our citation lines and explore alternative sources of knowledge, or what Smith (1999) refers to as our dissent lines. A geopolitical lens ( Canagarajah 2002 ; Tupas 2020 ) highlights the unequal production of academic knowledge, in particular how indeed our citation lines reflect the dominance not only of research from and in the more prosperous academic sites in the North, but also the dominance of Western modes of thinking and doing knowledge work.

Our paper zeroes in on literature review and the formulation of research questions that goes with it not only because they concretely capture the massively political and ideological nature of academic writing, but they also serve as a sufficiently graspable or legible academic phenomenon through which we can map out specific logics of symbolic violence and epistemic thief. Not only are researchers engaged in literature review, but teachers also teach students how to do it. In other words, there is much value in exposing the symbolically violent nature of literature review because almost everyone in the academe is invested in it, even to the point of demonstrating “a method for teaching students some of the key techniques for writing literature reviews” ( Zorn and Campbell 2006 , p. 172). To put it in another way, literature review is a locus of multiple layers of symbolic violence, shaping our own practices of doing academic research, controlling what we know and how we should know the world – and ourselves.

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