A multi-country study conducted by the World Health Organization (WHO) found that up to 71 percent of women aged 15 to 49 reported physical and/or sexual violence at some point in their lives.  Violence against women commonly becomes a vicious cycle in families thus creating generational dysfunction and disease.  The complete social framework of society is at risk when we let violence happen in our homes.  Physical, mental and emotional abuse are major public health problems and violations of women’s human rights. Currently, there are few global interventions that have been proven effective at preventing violence against women. This is likely the result of the deep rooted familial and cultural strongholds that will continue to repeat themselves until we personally take responsibility and change it.  Action is not solely up to governments, organizations or groups -- It starts with you.  Violence has major health consequencesPhysical and sexual violence have serious short and long-term health implications.   Abuse effects mental health, reproductive health and a vast array of other physical health problems such as increased rates of cancer, HIV and other STI’s.  In some cases, fatal injuries can result.  Other health effects have been found to include headaches, back pain, abdominal pain, fibromyalgia and digestive disorders according to WHO.  Sadly, violence can lead to unintended pregnancies, induced abortions, miscarriage, pre-term delivery, low birth weight and stillbirth. Violence starts harming our children before they’re even born.   Violence can also cause the misuse of tobacco, drugs and alcohol.  The overall combination can lead to future depression, post-traumatic stress disorder, difficulty sleeping, eating disorders, emotional distress and possible suicide.  It has also been shown to increase risky sexual behaviors and one to pursue and stay in known dysfunctional relationships.   Escalating financial & societal costsSexual violence against girls and women is most common but it also happens against boys.  WHO reports that international studies have revealed 20 percent of women and 5 to 10 percent of men have reported being victims of sexual violence as a child.  This abuse directly translates into violence throughout the individual’s life.  Children become who they see.  Abuse early in life will set up a cascade of negative outcomes throughout life that will have high social and economic costs.  Events such as missing school, visiting doctors, poor performance, lack of interest and poor overall lifestyle will cost society and it’s future positive advancement.  Our children are our future and they are looking to you as an example.  Women often suffer isolation, inability to work, loss of wages and lack participation in activities.  All of these aspects will prevent and limit their ability to care for themselves and their children.  The side effects of abuse often causes more abuse. Am I at risk of abuse?Coincidently, many of the risk factors of being a victim and being the abuser are very similar.  It’s the way we are raised as children -- what we are exposed to, how we cope and what we learn to be acceptable behavior in families, communities and the wider society.  Abused boys become the abusers, abused girls become the victims. The vicious cycle continues. One of the major preventable risk factors is education.  Education does not mean whether an individual is smart or not. It’s usually just a reflection of inward, personal and self-preservation thoughts versus outward and societal-impact thoughts.  The greater one’s education, the greater the understanding of their actions have on others and society.  Education provides us with greater responsibility -- to our children, our spouse, our community and our society.It is a known fact that males who have multiple partners or are suspected by their partners of infidelity to have higher rates of abuse.  This is also true for marital discord and dissatisfaction.  In many cultures it involves the ideology of sexual entitlement and power.  All of these are not passed down through genetics, it’s our choices.  Choices can be changed.How can I prevent violence?School-based programs to prevent violence within dating relationships have been found to be the most effective.  However, this intervention technique requires such a program to exist to be effective.  If it does not exist, find community-based initiatives that address gender inequality, communication and relationship skills.  Other primary prevention strategies include increased awareness, improved education, reduced access to alcohol and the elimination of drug use.  Cultural gender norms are usually not "normal”, but common.  The "normal” of tomorrow can be changed by applying the prevention techniques and reducing the risk factors.Legislation and policy developmentTo achieve lasting change, it is important to enact legislation and develop policies that protect women.  Are there strict consequences of violence in place?  A multi-sectoral response is needed to address the needs of the victims and the survivors of violence.  An appropriate response from the health sector should help prevent violence by increasing awareness and by supporting community-based initiatives.  Support cannot only be in the private sector.  Preventing childhood abuseIt is important to talk to your children sexual abuse in age-appropriate terms.  Set standards by teaching children that some parts of their body are private and off limits to everyone.  Let them know that other people should not be touching or looking at their private parts.  Teach them to communicate to a trusted adult as soon as possible. The best way to identify if there is a problem is to be involved in your child’s life.  Sexual abuse can cause changes in mood, connectedness, joy or other emotions that can be identified through communication with your child.  Get to know their friends and their parents.  We can help decrease sexual abuse and violence by speaking out, educating ourselves and others. The vicious cycle cannot continue, change is coming.  We must move our culture away from the violence that is crippling us.  When you ask your children, "What do you dream about?”, would you be content to hear them say "I dream to be an abuser or a victim”?  It’s up to us to be the change that we want to see in the world. Dr. Cory Couillard works in collaboration with the World Health Organization’s goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement. Facebook: Cory CouillardTwitter: Cory_Couillard