How can we put a stop to violence? Gary Slutkin, MD, believes the key is treating it as we would any contagious disease. The epidemiologist and Founder/Executive Director of Cure Violence recently spoke at TEDMED 2013 about utilizing public health and science-based strategies to prevent violence in communities.

“The greatest predictor of a case of violence is a preceding case of violence,” said Slutkin.

And as with an epidemic such as cholera, the way to stop violence is to find those “first cases” and interrupt the transmission. Cure Violence’s model involves violence interrupters who play a similar role as health workers during epidemics, going into communities to help re-frame issues and cool down situations that could lead to violence. At the same time, outreach workers help people change their behavior and—in time—change the social norms of a community.

>> Watch the full TEDMED presentation.

>>Read more about the public health approach to public safety from Cure Violence.

One in Five Kids At Risk for Suicide Live in Homes with Guns
Nearly one in five children and teens found to be at risk for suicide report that there are guns in their homes and fifteen percent of those with guns in their home said they know how to access both the guns and the bullets, according to a study presented at the Pediatric Academic Societies annual meeting in Washington, D.C.

The study researchers recommend that emergency department doctors screen all children and teens for suicide risk. Suicide is the second leading cause of death among young people ages 10 to 24 years in the United States, according to Centers for Disease Control and Prevention. Nearly half of young people who die by suicide use a gun. Read more on injury prevention.

Teen Girls Who Exercise Are Less Likely to be Violent
A study from the Columbia University Mailman School of Public Health finds that high school girls who play sports or run have a lower risk of being in fights or in a gang. Researchers at the school reviewed results of a 2008 survey completed by 1,312 students at four inner-city high schools in New York to determine if there was an association between regular exercise and violence-related behaviors.

The survey results found that girls who had exercised more than 10 days in the last month had decreased odds of being in a gang, those who did more than 20 sit-ups in the past four weeks had decreased odds of carrying a weapon or being in a gang and those who reported running more than 20 minutes the last time they ran had lower odds of carrying a weapon. Girls who participated in team sports in the past year had decreased odds of carrying a weapon, being in a fight, or being in a gang.

Among boys, none of the exercise measures were linked to decrease in violence-related behaviors. But the researchers say that a connection may not have been found because a smaller percentage of boys than girls completed the survey and that more research is needed to see if exercise interventions can reduce youth violence. Read more on violence.

USDA Announces New Rules to Fund Broadband Service in Underserved Rural Communities
The USDA has announced new rules that simplify the proposals to request funds for internet broadband access in rural areas. USDA broadband funds have provided internet access for nearly 65,000 rural households, businesses, and community organizations such as libraries, schools and first responders. Read more on preparedness.

Crime and violence in U.S. inner cities has a profound impact on public health. The question is how best to combat it. According to recent studies, one answer could be as simple as assigning more police officers to foot patrols in crime hotspots.

With funding in part from the Robert Wood Johnson Foundation’s Public Health Law Research program, researchers from Temple University worked with the Philadelphia Police Department to conduct a study on the impact of police foot patrols on inner city crime. Findings published in Criminology in 2011 found foot patrols helped reduce violent crime — at least temporarily — by 23 percent in high-crime areas of the city. A recent follow-up study in Policing and Society revealed a qualitative look at how the participating officers developed extensive local knowledge and formed community relationships — both of which contributed to the cuts in crime.

These and other results demonstrate the need to involve officers on foot patrol in the development of violence prevention strategies, according to researchers.

>> Read more about the study.

HUD Grants $72M to Improve Local Homeless Programs, Services
The U.S. Department of Housing and Urban Development (HUD) has announced $72 million in grants to strengthen more than 500 homeless housing and service programs. The grants, which are part of HUD’s Continuum of Care Program, will go toward local programs such as street outreach, client assessment and directing housing assistance. This is the second round of HUD funding this year; the agency gave more than $1.5 billion in grants in March and intends to give a third round later in the year. “We know these modest investments in housing and serving our homeless neighbors not only saves money, but saves lives,” said HUD Secretary Shaun Donovan. Read more on housing.

Survey: 90 Percent of Parents Admit to Driving Distracted with Kids in the Car
Approximately 90 percent of parents who drove a child between the ages of 1 and 12 in the past month admit they were distracted by some sort of technology while they were behind the wheel, according to survey findings discussed at the annual meeting of the Pediatric Academic Societies in Washington, D.C. The most common distraction was phone calls, with 70 percent. The survey also found that about that same percentage was distracted by either feeding or dealing with the child, or with self-grooming. "A lot of the attention on the distracted-driving issue has focused on teens and new drivers," said author Michelle Macy, MD, a clinical lecturer in the departments of emergency medicine and pediatrics at the University of Michigan. "But our study is showing that most parents say they were distracted an average of four times when driving their child in the last month, which is more frequent than I had expected.” Read more on safety.

Kids Routinely Injured, Killed by Gun Violence; Easy Access a Serious Issue
While it is often the biggest and scariest incidents that garner media coverage, youth are “routinely” injured or killed by gun violence, according to a new study in the Journal of the American Medical Association. Researchers looked at trauma admissions in two Colorado emergency departments over nine years, finding that 129 of the 6,920 children sought treatment for gunshot wounds. “In 14 percent of these cases children managed to get access to unlocked, loaded guns,” said author Angela Sauaia, MD, associate professor at the Colorado School of Public Health and the University of Colorado School of Medicine. “In an area with so much disagreement, I think we can all agree that children should not have unsupervised access to unlocked, loaded guns.” Sauaia noted that as this only includes kids who went to emergency rooms, the actual totals are likely much higher. Read more on violence.

Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. In this Idea Gallery, Bryan Samuels, Commissioner of the Administration on Children, Youth and Families, provides his perspective on how communities and organizations and families can work together to keep children safe, in honor of Child Abuse Prevention Month.

Nancy Barrand, Senior Adviser for Program Development at the Robert Wood Johnson Foundation (RWJF), also weighed in to provide some context for Commissioner Samuels' post:

Few events are more traumatic for children than being removed from their families and entered into the foster care system. In 2010, the Robert Wood Johnson Foundation funded the Corporation for Supportive Housing to develop and implement a pilot program in New York City that uses supportive housing to offer stability to families with children who are at risk of recurring involvement in the child welfare system. The New York pilot initiative, called Keeping Families Together (KFT), showed positive results in keeping and reuniting children with their families in a safe, stable environment. A 2011 evaluation indicates that the KFT pilot generated a 91 percent housing retention rate among participating families. By the end of the evaluation, 61 percent of the child welfare cases open at the time of placement in supportive housing had been closed, and there were fewer repeat incidents of child maltreatment.

Now, RWJF has partnered with the U.S. Department of Health and Human Services, Administration on Children Youth and Families and three private foundations – the Annie E. Casey Foundation, Casey Family Programs, and the Edna McConnell Clark Foundation – to jointly fund a $35.5 million initiative to further test how supportive housing can help stabilize highly vulnerable families. The national replication effort will be evaluated and we’re anxious to see whether, again, secure and affordable housing, when paired with the right services for struggling families, can reduce instances of child abuse and neglect.  The long-term gains in health and well-being, and costs saved, could be tremendous.

Commissioner Bryan Samuels on Child Abuse Prevention

Throughout the month of April, we turn our attention to the prevention of child abuse and neglect, celebrating those efforts in neighborhoods, faith communities, and schools that keep children safe and help families thrive. Whether formal or informal, these efforts involve wrapping caregivers and children in supports that reduce risk factors for maltreatment and promote protective factors, by decreasing stress, boosting parenting skills, and helping parents manage substance abuse or mental health issues.

Last year, more than 675,000 U.S. children were victims of maltreatment. These children are more likely than their peers to have emotional and behavioral problems, struggles in school, and difficulty forming and maintaining relationships. The effects of abuse and neglect can be pernicious and lifelong.

In recent years, we’ve come a long way in learning what it takes to help children who have experienced abuse and neglect heal and recover. We have interventions that help put families back together after maltreatment has occurred. But preventing abuse and neglect in the first place by giving families the support they need, when they need it, yields the best outcomes.

Small Amounts of Daily Exercise Can Help Teens Quit Smoking
As little as 30 minutes of daily exercise can help kids quit smoking, according to a new study in the Journal of Adolescent Health. It can also help to reduce tobacco use. Researchers found that daily smokers were more likely to reduce or quit smoking if they combined a fitness program with a smoking cessation program, rather than just a cessation program alone. Every teen in the study smoked an average of half a pack of cigarettes each weekday and a full pack a day on weekends. And that was just one of the poor health habits of many of the participants. "It is not unusual for teenage smokers to engage in other unhealthy habits,” said author Kimberly Horn, associate dean for research at the George Washington University School of Public Health and Health Services. “Smoking and physical inactivity, for instance, often go hand in hand.” According to the U.S. Centers for Disease Control and Prevention, about 13 percent of Americans age 18 and under smoke tobacco. Read more on tobacco.

Study: Low Food Security, Exposure to Violence Closely Linked
There is a close correlation between low food security and exposure to violence, according to a new study in Public Health Nutrition. Researchers spoke with forty-four mothers of children age 3 and under who participated in public assistance programs, finding increased exposure to violence, which in turn increased the chance of negative mental health, an inability to continue school and an inability to make a living wage.  The violence included child abuse, neglect and rape. The study clearly demonstrates the need to consider and include violence prevention efforts when establishing policies to deal with hunger. Read more on violence.

Size of Parents’ Social Groups Can Affect Whether Kids are Vaccinated
What they hear from friends and the people in their social group may affect whether parents have their children vaccinated, according to a new study in the journal Pediatrics. Parents who were less likely to vaccinate were also more likely to have large social groups and rely on books, pamphlets and the Internet for information on vaccines. "I think that what needs to be done is that everybody needs to understand the importance of vaccines,” said Joseph Anthony Bocchini, Jr., MD, chairman of Pediatrics Medicine at Louisiana State University Health Sciences Center in Shreveport. “And they're not only important for the people who receive them but they're also important for the community." About 95 percent of kindergarten-aged children are appropriately vaccinated, according to the U.S. Centers for Disease Control and Prevention. Read more on vaccines.

Media Coverage of Mass Shootings Harms Attitudes on Mental Illness
Media coverage of mass shootings by people with mental illness can increase support for policies to reduce gun violence, but can also increase the stigmatization of people with mental illness and lessens the chance they will seek help, according to a new study in the American Journal of Psychiatry. “The aftermath of mass shootings is often viewed as a window of opportunity to garner support for policies to reduce gun violence, and this study finds public support for such policies increases after reading news stories about a mass shooting,” said study author Emma E. McGinty, MS, a PhD candidate with the Johns Hopkins Center for Gun Policy and Research, part of the Johns Hopkins Bloomberg School of Public Health. “However, we also found that the public’s negative attitudes toward persons with serious mental illness are exacerbated by news media accounts of mass shootings involving a shooter with mental illness.” Read more on violence.

Study Links Excessive Television Viewing, Antisocial Behavior in Young Children
Antisocial behavior is more likely in young children who watch three or more hours of television a day, according to a new study in the Archives of Disease in Childhood. Researchers found that five-year-olds in that demographic were more likely to exhibit such behavior by the age of seven. Study author Alison Parkes, of the University of Glasgow in Scotland, said the findings support the decision by many parents to limit television time. Still, the researchers noted that this correlation does not equal causation. Excessive television watching by kids has also been linked to poorer physical health and performance in classrooms. Read more on mental health.

Cutting Medical Interns’ Hours Reduces Training Time, Increase Risks to Patients
Efforts to increase the amount of sleep by medical interns by reducing the number of continuous hours they work actually decreases the number of training opportunities and increases the risk to patients, according to a new study in the journal JAMA Internal Medicine. They also don’t get any more sleep in an average week. "Despite the best of intentions, the reduced work hours are handcuffing training programs, and benefits to patient safety and trainee well-being have not been systematically demonstrated," said study leader Sanjay Desai, an assistant professor of medicine at the Johns Hopkins University School of Medicine and director of the internal medicine residency program at the Johns Hopkins Hospital. "We need a rigorous study. We need data to inform this critical issue." Read more on access to health care.

On July 20, 2012, during a midnight showing at a local movie theatre in Aurora, Colorado, a gunman opened fire, killing and injuring unsuspecting moviegoers. Ultimately the massacre killed 12 and injured 57 — presenting an enormous challenge for local emergency dispatch, fire departments, police, hospitals, public health, and more, and requiring all to work together on an integrated response in the midst and the wake of a chaotic, unprecedented active shooter situation. Partners came together to share their lessons learned at the 2013 Public Health Preparedness Summit.

>>Read continued NewPublicHealth coverage from the Summit.

When the first 9-1-1 calls came in following the shooting, the University of Colorado Hospital, a level II trauma center, already had full emergency department — 49 out of 50 beds were filled.

“We’d been notified we were going to get three to five gun shot victims,” said Patrick Conroy, manager of support services and safety officer for the University of Colorado Hospital. “But we had this queasy feeling something was not quite right. We started notifying emergency services to get ready.”

Breast Cancer in Young Women May Be Up Slightly in Past Several Decades
Advanced breast cancer in women ages 25 to 39 may have increased since 1976, according to a new report in The Journal of the American Medical Association. In 2009 there were about 2.9 advanced cased per 100,000 younger women, up from 1.53 per 100,000 in 1976. The researchers say further study is needed to verify the numbers. In the mean time, they recommend that young women see a doctor if the notice lumps or other early indicators, and not simply assume they are too young to develop breast cancer. Read more on cancer.

Cohabitating Same-sex Couples Report Worse Health than Married Heterosexuals, Possibly Tied to Discrimination
Stress and discrimination may be the reason that cohabitating same-sex couples report generally worse health than do married heterosexuals, according to a new report in the Journal of Health and Social Behavior. The study looked at how the individuals describe their health, not at their health records. The same-sex male couples were 61 percent more likely to report poor or fair health and same-sex female couple were 46 percent more likely. "Research consistently suggests that 'out' sexual minorities experience heightened levels of stress and higher levels of discrimination, and these experiences may adversely affect the health of this population," said Hui Liu, lead author and an assistant professor of sociology at Michigan State University. "It may also be that same-sex cohabitation does not provide the same psychosocial, socioeconomic and institutional resources that come with legal marriage, factors that are theorized to be responsible for many of the health benefits of marriage." Read more on LGBT issues.

Poll: 1 in 5 Americans Know a Victim of Gun Violence
One in five Americans—and 4 in 10 black Americans—know a victim of gun violence, according to the latest Kaiser Health Tracking Survey. The poll measured personal experience and concerns about firearms. About 42 percent of Americans are worried about being the victim of gun violence, with racial and ethnic minority groups more likely to be concerned. About 75 percent of Hispanics, 62 percent of black Americans and 30 percent of white Americans say they are worried. Read more on violence.

AAP: Out-of-school Suspensions, Expulsions Harmful to Kids
Out-of-school suspensions and expulsions are generally counterproductive and can have profound long-term negative effects, according to the American Academy of Pediatrics (AAP). Data shows the youth are more likely to drop out of school, more likely to be involved in the juvenile justice system and will earn $400,000 less over a lifetime than a high school graduate. Such discipline also does not address potential underlying issues, such as drug abuse, racial tension, violence and bullying, according to AAP. AAP recommends early intervention programs to recognize and address behavioral and other problems. Recommendations also include a Positive Behavior Intervention and Support program to teach proper behavior at both the individual and school-wide levels. Read more on violence.

Study: 1 in 4 Admit to Bizarre Late-night Snacking
Approximately one in four students admit to creating and eating late-night crazy food concoctions, according to a new report in the International Journal of Eating Disorders. Researchers defined the relevant snacks as “strange food mixtures that you would be too embarrassed or ashamed to share with others” (e.g. sugar-covered scrambled eggs or mayo-smothered vegetables). While there is no inherent health danger in such mixing, health professionals recommend that people try to make healthy choices when selecting late-night snacks. About one-third of U.S. adults and nearly one in five youth ages 2-19 are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on nutrition.

Study: Mediterranean Diet Good for Heart Health
A Mediterranean diet—rich in olive oil, nuts, fresh fruits, fresh vegetables and even red wine—is more effective than a low-fat diet at helping at helping people at high risk for cardiovascular disease to ward off health problems, according to a new report in the New England Journal of Medicine. Researchers found a 30 percent greater reduction in relative risk of a heart attack, stroke or death, according to lead author Miguel Angel Martinez-Gonzalez, MD, MPH, PhD, chairman of preventive medicine and public health at the Universidad de Navarra in Spain. He said the findings are likely to due to the good-quality fats and wide array of nutrients. The findings give further support to the effectiveness of a Mediterranean diet at preventing heart disease. Read more on heart health.