Preventing Youth Violence: Updates from the Field
Nov 5, 2012, 1:21 PM
Last week at the American Public Health Association (APHA) annual meeting, a number of presenters took on an important, but often overlooked topic in the public health world: violence. Violence is often primarily considered a criminal justice or public safety issue, but there is a growing movement of public health practitioners that recognize that the health of vulnerable communities cannot be improved without first stopping shootings and killings.
When violence is present in a community, it impacts the physical, mental and emotional health of all residents. Violence also often prevents other positive changes from taking place. According to Greta Massetti from the Centers for Disease Control and Prevention, the current economic impact of youth violence is an estimated $14.1 billion in combined costs from medical care and work loss.
Treating violence as a disease
For many vulnerable communities, violence is the most pressing health issue. For children growing up in violent communities, the health impact is more than just the physical threat. As Benita Tsao from Urban Networks to Increase Thriving Youth (UNITY) pointed out, growing up in a community plagued by violence can often feel like being in a war zone. That constant fear results in real health consequences, as evidenced by the increasing number of children who have grown up surrounded by violence and are now showing signs of chronic traumatic stress disorder. Experiencing ongoing trauma impacts young people’s physical, mental and emotional development, and has the ripple effect of making it harder to focus and succeed in school.
This evidence shows public health practitioners that to help communities thrive and be healthy, they will need to pay greater attention to violence prevention. Once violence has been prevented, making positive changes to schools, housing and other factors that can directly improve health, becomes more feasible. And while violence can often feel like an intractable problem, the good news is treating violence as a public health issue opens up a whole new world of possible solutions.
Interrupting and stopping violence
Currently, when violence is discussed, it is often portrayed as the work of gangs or a few “bad people.” Charlie Ransford from the organization Cure Violence explained how similar the way people currently talk about violence is to the way people used to talk about communities impacted by plagues and other infectious diseases. But the comparison doesn’t stop there. Violence presents all of the same characteristics as other infectious diseases – it is found in clusters, it spreads and can be transmitted from one person to another.
By treating violence as a disease, public health officials can utilize lessons learned from fighting infectious diseases like tuberculosis and cholera. Cure Violence has pioneered a model that uses a public health approach to stopping shootings and killings. Similar to how one would fight an infectious disease, the Cure Violence model has three key parts:
- Interrupt transmission
- Identify and change the thinking of the highest potential transmitters
- Change group norms
One of the key components of the Cure Violence model is to hire culturally appropriate workers to identify and interrupt violence. Cobe Williams, a long time violence interrupter (and featured in the award winning documentary, The Interrupters), explained that to stop the spread of violence in a community, interrupters first have to build relationships and trust with the people in their neighborhoods. Once interrupters build relationships in the community, they can play an important role in stopping violence and helping to change the thinking and norms of the community.
Focusing on what works
The Cure Violence model has been studied by the U.S. Department of Justice and Centers for Disease Control and Johns Hopkins Bloomberg School of Public Health. These institutions have found that when followed correctly, the Cure Violence model can dramatically reduce shootings and killings.
These type of evaluations fall in line with a new movement in the federal government to look at evidence-based models and cost-effective solutions for reducing violence. CrimeSolutions.gov and SafeYouth.gov are two prime examples of how the government is increasingly trying to provide resources and research on what is working to reduce crime and violence.
While the problem of violence in communities can feel large and insurmountable, one thing that all of the presenters emphasized is that when violence is treated like a public health problem, prevention is possible; and it’s happening every day in cities across the country.
This commentary originally appeared on the RWJF New Public Health blog.