Violence is an epidemic across the country. Although violent crime rates have significantly decreased overall since 1997, rates went up for the second year in a row in 2016. Suicide and homicide are the second and third leading causes of death for individuals ages 15-34, with suicide as the tenth leading cause of death in the United States overall. The Centers for Disease Control and Prevention (CDC) estimates the cost of death and injuries from violence in the United States amounts to $107 billion in medical care and lost productivity. Exposure to violence can have severe health consequences, including chronic diseases, mental trauma, and a decreased quality of life. Similar to a disease, violence is a health issue that infiltrates, spreads rapidly, and can devastate families and communities.
POLICIES & PRACTICES
More and more cities are treating violence as a public health issue, meaning a threat to the protection and promotion of health, and implementing policies to prevent, address, and respond to violence in their communities. Below are examples of best or promising practices and/or policies that show promising results in attempting to decrease violence and promoting healthy and peaceful conflict resolution.
CATEGORIES OF VIOLENCE
Youth Violence: Young people are most likely to be the offenders AND victims of violence. Peer pressure from other teens engaging in violent behaviors and a lack of opportunities for community involvement are two factors that can increase an adolescent’s likelihood of violence. Providing a safe and welcoming environment for activities that bring the community together during summertime and after-school hours can result in declining violence rates.
Domestic Violence: Almost half of the women killed by homicide each year are killed by an intimate partner. Intimate Partner Violence (IPV) can present as physical violence, psychological violence, sexual violence, or stalking. IPV victims often present to emergency rooms with signs of abuse, but have a difficult time connecting to concrete resources. Training physicians to recognize signs of abuse and foster a supportive relationship with their patients can encourage IPV victims to get the resources they need.
Gun Violence: Firearm mortality rates for suicides and homicides have increased in the United States. A large majority, 75%, of gun violence deaths are suicides. Firearms are the most common method of suicide for males and the second most common method for females. Easy access to firearms increases the likelihood of suicide, domestic violence homicide, and accidental death. Safe and secure storage of firearms, especially in homes with children, is vital in preventing these tragedies.
PRIMARY PREVENTION (UPSTREAM)
Primary prevention is an intervention before an event occurs that keeps it from happening. For example, banning automatic weapons or safe storage of firearms to keep them away from children.
Carefully designed community programs with an education focus can prevent incidents of violence. Empowering individuals to engage in civic activities while encouraging social cohesion can reinforce non-violent behaviors and increase the investments neighbors have in their communities. Educational initiatives such as defining different forms of violence (sexual assault, sexual harassment), changing social norms, and simplifying reporting processes can help make communities safer for everyone.
SECONDARY PREVENTION (EARLY IDENTIFICATION OF RISK FACTORS)
Secondary prevention is the screening or identification of risk factors. Conflict resolution and gang violence reduction are both types of secondary prevention.
Violence is transmitted like a disease. It tends to cluster and spread by motivations like owed debts, disrespect, or loyalty. Recognizing the risk factors for violence and cutting them off before they occur has shown promising results. The Cure Violence Model employs trained residents to peacefully resolve conflicts in neighborhoods with high violence rates. To date, the Cure Violence Model has reduced shootings in Baltimore, San Antonio, Philadelphia, Chicago, New York City, and other locations around the globe.
Gang Violence Reduction
Gang Violence Reduction is a multi-level approach to prevent gang violence through the identification of high-risk youths and collaboration between the health department, families, and law enforcement. Trained site coordinators work with youths who have had known contact with gang members and engage them in athletic leagues, social clubs, and community activities.
National Violent Death Reporting System
The National Violent Death Reporting System is a state-based surveillance system run by the CDC. Data containing information on violent deaths reported by medical examiners, police, coroners, toxicologists, and other anonymous state employees are collected regarding homicide, suicide, unintentional shootings, child abuse, killings by law enforcement, intimate partner homicides, and beyond. Data collected on location, military status, alcohol and drug use, homelessness, pregnancy, and other factors housed in one place are essential for researchers and policymakers to understand the scope of the problem. City health officials can help law enforcement and medical examiners sign up to contribute to the database.
TERTIARY PREVENTION (RESPONSE)
Tertiary Prevention is the response after an event has occurred. Trauma counseling and emergency department services are examples of tertiary prevention and exist in some cities. Crisis response and support for the families of homicide victims includes mental health services, financial guidance, counseling, and legal work. Trauma-informed practices can reduce the likelihood of a retaliatory shooting and manage post-traumatic events, such as health problems or social isolation, experienced by those close to the victim.
- National Violent Death Reporting System
- National Academies Press: Public Policy Approaches to Violence Prevention
- Cure Violence approach
- CDC STRYVE (Striving to Reduce Youth Violence Everywhere)
- CDC Violence Prevention Program
- CDC Hi-5 Initiative
- CDC Youth Violence Fact Sheet
- Prevention Institute: Unity
- 2016 Crime Statistics
- CDC: Mortality in the US Data Brief
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Note: These are highlights of selected activities going on in cities across the country, and are not meant to be comprehensive.