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Abstract
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Control of stress and violent behavior is 1 of the 15 priority areas addressed in the 1990 health objectives for the nation. For control of stress, improved awareness of appropriate community service agencies and increased scientific knowledge of stress effects are the main objectives. For control of violent behavior, the objectives focus on three major problems: (a) deaths from homicide among young black males, (b) adolescent suicide, and (c) child abuse. Since the last progress report, published in 1984, more than 200 research projects directly related to these objectives have been funded, and a variety of implementation actions have been undertaken. During this period, baseline data on such critical concerns as homicides among blacks and Hispanics, suicide, family violence, and perceived stress have been obtained, thereby encouraging further study and facilitating achievement of the objectives. The mid-decade status report and recommendations that are presented in this article were initiated in a September 1985 review, by the Acting Assistant Secretary for Health, of progress toward achieving the 10 stress and violent behavior objectives selected for Federal implementation by the year 1990. The most recent available data have been used to update information on these 10 priority objectives.
VioLit summary:
OBJECTIVE:
This mid-decade (1980-1990) status and recommendations report for the Public Health Service was prepared by Silverman et al. after a September 1985 review by the Acting Assistant Secretary for Health to specify progress being made toward achieving the ten stress and violent behavior objectives selected for Federal implementation by the year 1990.
METHODOLOGY:
The ten priority objectives that were selected for Federal implementation were directed at improving the health conditions of certain populations, increasing awareness concerning the physical and mental hazards related to stress and violence, improving services and protection for individuals in need of aid, and increasing the means of surveillance and evaluation.
The mid-decade status and recommendations report was assembled using comparisons of baseline data and the situation, then current, in 1985.
FINDINGS/DISCUSSION:
The mid-decade (1985) status report of the ten specific priority objectives directed at measuring progress toward achieving reduction and control of violence and stress were summarized as follows:
1) By 1990, the homicide death rate among black males ages fifteen to twenty-four should be reduced to below sixty per one hundred thousand from a 1978 baseline of seventy-one per one hundred thousand. Then current statistics indicated there was a significant decline from a 1980 peak in such homicides, however the overall rate had not kept pace with the projected rate of decrease to obtain the 1990 health objective.
2) By 1990, injuries and deaths from child abuse should have been reduced by at least twenty-five percent, however no reliable baseline was available for comparison.
3) By 1990, the reliability of incidence and prevalence data regarding child abuse and other forms of family violence should be greatly increased. Available data supporting reductions was inconclusive and contradictory.
4) By 1990, the suicide rate among fifteen to twenty-four year-olds should fall below eleven per one hundred thousand population from a 1978 baseline of twelve per one hundred thousand. Suicide statistics suffered from inadequate information on death certificates, errors, and bias. To improve accuracy of suicide data, a set of operational criteria for classification of suicide was being undertaken.
5) By 1990, the proportion of the population over age fifteen years which would be able to identify a community agency to aid in stress management should increase to more than fifty percent. No baseline data was available, however available evidence suggested that the objective would probably be attained by 1990.
6) By 1990, the portion of the population between ages fifteen to twenty-four who can identify a suicide prevention "hotline" should be greater than sixty percent. No baseline data was available. Although some data was lacking, indications were that between forty-one percent and forty-three percent of the population could identify a suicide intervention service.
7) By 1990, the proportion of primary care physicians who take a careful history related to personal stress should be greater than sixty percent. No baseline data was available and no data was available for the mid-decade report to measure progress on attaining the objective.
8) By 1990, the number of persons reached by mutual support or self-help groups should double from a 1978 baseline of two and a half to five million Americans reached. The status report noted that 1990 objective goals had already been exceeded with between twelve to fourteen million Americans involved in mutual support and self-help groups.
9) By 1985, surveys should show what percentage of the population perceives stress as adversely affecting their health, and what proportion are trying to use appropriate control techniques. Available data in 1985 indicated that the first part of this objective had been met and the second would be achieved by the end of the decade.
10) By 1990, the existing knowledge base through scientific inquiry about stress should be greatly enlarged. The objective was noted as not being quantifiable, though clearly it was being achieved.
AUTHORS' RECOMMENDATIONS:
The authors noted that the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) had recommended that the highest priorities should focus on expanding the knowledge base, validating and refining key baseline data, assessing the efficacy of preventive interventions, and stimulating and expanding collaborative efforts to increase and sustain public and professional awareness.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
Public Health Approach
1980s
1990s
Homicide Rates
Homicide Incidence and Prevalence
Homicide Prevention
Child Abuse Incidence and Prevalence
Child Abuse Prevention
Child Abuse Rates
Victimization Incidence and Prevalence
Victimization Prevention
Victimization Rates
Domestic Violence Incidence and Prevalence
Domestic Violence Prevention
Domestic Violence Rates
Juvenile Suicide
Adult Suicide
Suicide Incidence and Prevalence
Suicide Prevention
Suicide Rates
Juvenile Stress
Adult Stress
Stress Management
Violence Prevention
Public Health Services
Public Health Personnel
Public Perceptions
Adult Health
Juvenile Health
Child Health |