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Using a Public Health Approach for Violence Prevention

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On December 14th, 2012, 20-year-old Adam Lanza fatally shot twenty children and six adult staff members at Sandy Hook Elementary School in Newtown, CT. It has been two years since that fateful and tragic day, and many parts of the country are still terrorized by the threat of violence.

Violence emerged as a public health problem in the late 1970s and early 1980s, prompting the Centers for Disease Control and Prevention (CDC) to establish the Violence Epidemiology Branch (later integrated into the Division of Injury Epidemiology). They recognized that violence could have numerous health effects, such as depression, anxiety, eating disorders, suicidal tendencies, and even death. With these health consequences in mind, CDC and public health officials began to think about treating violence much as they would treat other health issues.

Dr. Gary Slutkin, a public health specialist and violence control expert, founded Cure Violence. Cure Violence’s goal is to help control urban violence in cities across the globe using public health and disease control methods. One problem that Dr. Slutkin realized early on was that when it comes to violence, people often try to “fix everything.” However, there needs to be a strategic process before the problem can be solved. Just like any other disease or illness, interventionists need to do epidemiological research to monitor transmission. Using data from police reports, surveys, medical records and more, they can track where violence occurs, who are the perpetrators and who are the victims, what types of violent behaviors are present, when violence takes place, etc.

In addition to epidemiological research, Dr. Slutkin and workers at Cure Violence use a three pronged model for violence prevention:

  •  Detecting and Interrupting Potentially Violent Conflicts: When conflicts are occurring, Cure Violence workers step in and mediate so that the conflicts do not escalate to a violent level. They continue to follow up with those conflicts to ensure that they remain peaceful. If shootings do occur, workers immediately respond and work with victims, friends or family of the victims, or anyone else involved so that they can prevent retaliation.
  • Identify and Treat the Highest Risk: Cure Violence’s culturally-appropriate outreach workers build trust with people who are at high risk for committing violence. They discuss consequences of violence, teach non-violent responses for various situations, and help them obtain services like job training or drug treatment.
  • Change Cultural Norms: In addition to working with high-risk individuals, Cure Violence workers engage entire communities and convey to them that violence should not be viewed as normal but as a changeable behavior. They coordinate with existing community clubs or organizations and establish new ones where needed, and they distribute materials explaining that violence is unacceptable.

 

The Cure Violence model has been highly successful. Dr. Lloyd Sederer, Medical Director at the New York State Office of Mental Health, has seen that, “Reductions in violence of over 30 percent in year one of a program, and up to 70 percent in time, have been replicated 20 times and independently validated again and again. Dr. Slutkin likes to say the health approach to violence is ‘not a metaphor’ — that the treatment works, proving ipso facto, that indeed violence is a contagious process.” Due to Cure Violence’s successes, the organization is now working in 25 cities, as well as in Puerto Rico, Mexico, Honduras, Jamaica and South Africa.

To learn more about Cure Violence, visit http://cureviolence.org/.

To read about Dr. Gary Slutkin, visit http://www.huffingtonpost.com/lloyd-i-sederer-md/violence-as-a-public-heal_b_6288740.html.

To learn about the CDC’s public health treatment approach to violence, visit http://www.cdc.gov/violenceprevention/overview/publichealthapproach.html.

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