Too often, violence in general, and school violence in particular, is handled punitively. Law enforcement personnel are often involved in such cases, and harsh punishments may be doled out to offenders. While there are certainly some benefits to this approach, some advocate for a different focus. A public health approach sees juvenile violence as an epidemic that must be addressed in the same way that an infectious disease or injury would. A public health approach encompasses far more preventive work and entails community collaborations involving activists, educators, social services, mental health and medical professionals, and law enforcement.
It was not until the late 1970s that anyone discussed a public health approach to violence. Mark Rosenberg, director of public health services at the Centers for Disease Control and Prevention (CDC), advocated for the inclusion of community violence in the Surgeon General’s national public health agenda (in 1979). One year later, the Federal Alcohol, Drug Abuse and Mental Health Administration organized a symposium on violence as a public health issue. Physicians, psychiatrists, psychologists, and academicians all attended. Five years after the symposium, Surgeon General C. Everett Koop sponsored a conference on the issue, and the U.S. Department of Health and Human Services (HHS) began publishing reports using a public health lens to discuss youth violence.
This idea gained further popularity in 1991 with the publication of Deborah Prothrow-Stith’s Deadly Consequences: How Violence Is Destroying Our Teenage Population and a Plan to Begin Solving the Problem. Prothrow-Stith, a physician, saw prevention of disease as the highest calling in her field. Troubled by the young people she was seeing in the emergency who had been victims of violence, she was moved to initiate efforts to prevent youth violence. Prothrow-Stith advocates for health education in the classroom, community-based health education, and hospital screenings for risk factors. During the 1990s, she worked with child advocacy groups and community and political leaders to move these ideas into action. She also advised the Children’s Defense Fund, helping this organization create the Black Community Crusade for Children’s Task Force on violence.
The CDC recommends four steps to a public health approach: (1) define the problem; (2) identify risk and protective factors; (3) develop and test prevention strategies; and (4) assure widespread adoption. Public health professionals use a variety of approaches to help prevent violence. For example, multisystemic therapy (MST) involves closely monitoring the places where a youth spends most of his or her time, such as in the home, in the neighborhood, at school, and with peer groups. Students receive personal counseling, and parents are trained as well. Domestic violence advocates have implemented a public health approach through the DELTA (Domestic Violence Prevention and Leadership Through Alliances) program, which requires funded programs to build a collaborative community response to prevent dating and domestic violence. The California-based Prevention Institute sponsors a number of public health programs designed to prevent violence and reduce injury. Similarly, the Global Campaign for Violence Prevention is a good source of information about a public health approach to violence prevention.
A difficulty with these strategies is that they require tremendous organization and groups willing to collaborate. They are not short-term solutions, but rather require ongoing effort to succeed. Critics contend that they are suitable in urban communities, but not necessarily in rural areas that are less equipped with medical professionals and social services agencies. Politicians may not disapprove of these strategies, but often find it difficult to support a public health approach if it is perceived as being soft on crime.
- Finley, L. (Ed.). (2007). Encyclopedia of school crime and violence. Westport, CT: Praeger.
- Preventing violence and reducing injury. (n.d.). Prevention Institute. Retrieved from http://www.preventioninstitute.org/focus-areas/preventing-violence-and-reducing-injury.html
- Prothrow-Stith, D. (1991). Deadly consequences: How violence is destroying our teenage population and a plan to begin solving the problem. New York: HarperCollins.
- The public health approach. (n.d.). Global Campaign for Violence Prevention. Retrieved from http://www.who.int/violenceprevention/approach/public_health/en/index.html
- The public health approach to violence prevention. (2006, September 19). Centers for Disease Control and Prevention. Retrieved May 5, 2010, from http://www.cdc.gov/ViolencePrevention/index.html