Billie Weiss Q&A: Violence is Preventable

May 22, 2012, 2:20 PM, Posted by

file Billie Weiss, UCLA School of Public Health, Southern California Injury Prevention Research Program

A new report on the burden of injuries in the United States, The Facts Hurt: A State-By-State Injury Prevention Policy Report, was released today by Trust for America’s Health and the Robert Wood Johnson Foundation. The report concludes that millions of injuries could be prevented each year if more states adopted additional research-based injury prevention policies, and if programs were fully implemented and enforced.

According to the report, more than 18,000 Americans are murdered and more than 34,000 commit suicide each year. In addition, assaults are responsible for more than a million injuries annually.

  • Violence by intimate partners alone causes more than 2,000 deaths a year. Nearly three in 10 women and one in 10 men in the United States have experienced physical violence, rape or stalking by a partner.
  • More than 1,700 children die from abuse or neglect each year, and 80 percent of those are under four years old.
  • More than 15 people ages 10 to 24 die each day from some form of violence and more than 740,000 children and teens visit emergency rooms for injuries related to violence each year.

NewPublicHealth will be posting a series of injury prevention interviews with experts on issues such as motor vehicle safety and violence prevention. We recently spoke with Billie Weiss, MPH, associate director of the Southern California Injury Prevention Research Center at the UCLA School of Public Health about preventing injuries and deaths caused by violent acts including intimate partner abuse, gang violence child abuse, bullying and firearms.

NewPublicHealth: Is violence preventable?

Billie Weiss: Absolutely. Violence, like any other public health condition, can be measured and monitored and we can design interventions, but we can also devise strategies that prevent violence from happening in the first place. Some of the things that we talk about include providing good, nurturing environments for children and families. That is both a violence prevention strategy as well as a strategy for preventing other forms of public health crisis and public health emergencies. So, providing good, healthy, nurturing families for children and confident parenting for parents helps to prevent violence.

The other issue about preventing violence is teaching people how to deal with anger and how to deal with frustrations.

NPH: How is the nation doing on violence prevention right now?

Billie Weiss: Lethal violence is down, it’s reduced, but we are not spending the time and resources and doing the research that we need to be doing to assure that this gift of less lethal violence is maintained. Nor are we doing enough and committing enough research in terms of family violence and child maltreatment and youth violence.

NPH: How do make improvements?

Billie Weiss: We have a lot of good evidence on violence prevention strategy. Part of the problem, though, is that for some issues we still haven’t devoted the funding to research to really know what works. Issues where we need more evidence for what works include gang violence and preventing child maltreatment. We’ve been more focused on other issues and less focused on the issue of violence primarily because it’s been seen for many years as a law enforcement problem and not a public health problem.

NPH: How are we doing on getting people to focus on it from a public health perspective?

Billie Weiss: I think we’re doing a bit better in that people at least talk about it now. You hear it being discussed as a public health issue, but we still need funding for prevention strategies.

NPH: The report covers many different forms of violence, such as intimate partner violence and bullying. What links these various kinds of violence?

Billie Weiss: There are commonalities. I have yet to meet a gang member or a gang family where there isn’t also family violence, domestic violence and child abuse in the home, and child maltreatment. Those causes all are linked together. There’s no question in my mind. Part of the issue is actually having the documentation in the research. We need more research but we also need translation research so that programs that we have an evidence base for can be translated into different communities with different issues.

NPH: How early does violence prevention need to begin?

Billie Weiss: I would say violence prevention needs to begin in elementary school, maybe even in preschool. Children learn how to interact with each other, and bullying begins. Bullying is more prevalent and more visible as kids get older, but if you think about bullying, it’s one person trying to control another person. It’s no different when you look at child maltreatment or child abuse, which is about adults trying to control a child. If you look at intimate partner violence, it’s one partner trying to control another. So, it really has to begin at the very beginning when we learn how to treat each other.

NPH: With so many issues that need funding, how do you get policy-makers to focus on evidence-based violence prevention?

Billie Weiss: Obviously, we need to be doing a better job at that because we haven’t been terribly successful in getting commitments to the issue on the scope with which the problem exists in our society right now. It would be much more cost-effective to prevent it than to deal with the aftermath. It’s very costly when we have to incarcerate people or people come into our emergency departments and our hospitals and have to be treated.

We need to get research on a broader scale to demonstrate the cost benefits. Violence permeates everything we do. We can’t have healthy eating and active living if people are afraid to go out on the streets because they’re afraid of violence. We can’t have neighborhoods surviving if people won’t buy homes or support schools because of the violence.

NPH: The report noted a far higher rate of deaths through firearms than in other countries. Why is that?

Billie Weiss: The difference is generally that we have such easy access to firearms. They’re easily available to people that are having an argument and the easy access to a firearm can turn that argument into a lethal situation very quickly. There are many countries that have lots of guns, but the access isn’t as easily available as here. For example, people have to keep their guns locked up and they have to keep them in specific places and not just anybody can get a gun. In the U.S., almost anybody can get a gun.

NPH: The report recommends research on cross-cutting policy strategies such as de-concentration of public housing and development of business improvement districts. What sectors of the community do you think need to be at the table to create safe communities?

Billie Weiss: Almost everybody has a role to play in preventing violence in the neighborhood, so we certainly need public health departments at the table, law enforcement should be there as well, schools, and labor—because we need to be looking at jobs for young people and for families. We need mental health there. We need business. Businesses have difficulty thriving in communities in which violence permeates. We need the entertainment industry, which has a role to play in all of this as well, and then we need the people most affected by violence so certainly we need young people at the table as well to talk about it.

NPH: Are there specific actions you recommend?

Billie Weiss: Early childhood education, universal parenting classes for young people before they have children, improving our educational system, social and community equity, more research on underserved communities. And I do think we need to do a better job of linking violence prevention to the other health equity issues. Violence impacts everything that goes on in our daily lives.

>>Read more about the report.

>>Follow our series on injury prevention.

This commentary originally appeared on the RWJF New Public Health blog.