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Abstract
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VioLit summary:
OBJECTIVE:
The purpose of this commentary by Rosenberg et al. was to discuss the issue of violence as a public health problem.
METHODOLOGY:
The authors employed a non-experimental explanatory design to examine why public health practitioners should address the problem of violence, what those people working in public health know about violence prevention, and whether a commitment has been made to address violence as a public health problem.
FINDINGS/DISCUSSION:
The authors began by defining violence as the intentional use of physical force against either another person or against oneself, resulting in, or highly likely to result in, injury or death. This definition includes suicidal actions and interpersonal violence such as rape, assault and child or elder abuse. Although the health consequences of violence are very serious, society has traditionally turned to the criminal justice system to protect it from such behavior. However, whilst the criminal justice sector does play an important role in the prevention of violence, its involvement in the problem is not enough, as injuries and deaths have continued to increase despite greater resources being devoted to criminal justice. Injuries resulting from violence have become one of the most important public health issues in the United States today, making the problem beyond the reach of the criminal justice system alone. In the reformulation of violence as a public health issue, the public health community can turn its attention to the notion of primary prevention, and can complement the work of the criminal justice system. Progress can be made in this quest for prevention by mobilizing the many resources available in medicine, mental health, social services and substance abuse services. The approach taken by the public health sector is one of health-event surveillance, epidemiologic analysis and intervention design and evaluation that is centered solely upon the prevention of this particular type of injury. This approach, whilst successful with the fight against diseases, will be more difficult with violence, as the problem is a multifaceted one with each face suggesting a different solution, and with the issues surrounding violence being so thoroughly intertwined with the larger social issues of poverty, unemployment, racism and the like. Attention must also be paid to each of these social problems on their own, as to ameliorate these problems would be to reduce the incidence of violence. Other problems facing prevention include some of the characteristics of American society itself, such as the emphasis upon violence in the media and the easy access to firearms. Exposure to media violence can lead to the acceptance of such behavior as normal, and firearms can elevate the severity of the consequences of violence. The ambivalence of society to these issues has prevented adequate research into these two issues. However, there is a firm commitment on the part of the public health sector to the prevention of violence. The Center for Disease Control has made violence prevention one of its highest priorities, and a National Plan for Injury Control, with a panel developed to provide recommendations for prevention of injuries from violence, is being established. This panel has recommended a national infrastructure for the prevention of violence, providing surveillance and direct resources for those at high risk, empowering communities to address the issue of violence at the community level, evaluating intervention activities and training workers in the skills required to accomplish the task of prevention. Federal, state and local government support will be needed, as well as backing from private- sector organizations. In relation to firearm injuries, the panel suggested that immediate access to lethal weapons was one of the most important factors in many homicides. At the very least, children should be prevented form access to weapons, by encouraging parents to assist in supervising their children and by empowering families to prevent firearm injuries. Guidelines are being developed to help those who want to prevent violence among youth in their own communities, with the input of minority leaders who have already developed programs in urban centers. Support is also being offered to the design, implementation and evaluation of community-based prevention programs that address the multifaceted nature of youth violence. Information about successful programs must be disseminated immediately in order to progress rapidly in the fight against violence. The authors concluded that the prevention of injuries and deaths due to violence is a necessary concern of public health professionals. While violence is a problem with no simple solution, the public health approach can make important contributions to the solving of this widespread phenomenon.
EVALUATION:
The authors present an informative discussion of the notion of violence as a public health issue. They make compelling arguments for the involvement of public health professionals in the effort to prevent violence, and demonstrate that the public health sector has made a strong commitment to finding a solution to the problem. This paper should be considered as an important message for policy and prevention planners. (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)
KW - Public Health Approach
KW - Public Health Personnel
KW - Violence Prevention
KW - Juvenile Violence
KW - Adult Violence
KW - Policy Recommendations
KW - Prevention Recommendations
KW - Professional Commentary |