Why Prevention Must Be a Priority

What is youth violence prevention? | What is a public health approach to youth violence prevention? | Is there a need for youth violence prevention? | Does prevention really work?

Preventing youth violence is a vital part of promoting the health and safety of youth and communities, and here are some of the reasons why:

• Young people cannot learn and succeed in life if they are afraid to go to school or work because of fear of harm.

• Children cannot play if their neighborhoods and playgrounds are unsafe.

• Violence increases health care costs, decreases property values, disrupts social services, and threatens the success of businesses.

• When youth violence occurs, quality of life diminishes, and communities cannot thrive.

Making youth violence prevention a top priority is thus critical to the short- and long-term health, safety, and viability of a community.

What is youth violence prevention?

Youth violence is a complex problem that requires coordinated efforts at all points along a continuum of action. Along this continuum of action are:

• Prevention strategies that stop youth violence before it happens, and

• Intervention and treatment strategies that respond to youth violence after it happens.

We must respond to violence after it has already occurred to deter the increase of violence and address some of the physical and emotional consequences of violence. Intervention and treatment strategies include law enforcement and medical and mental health services.

But response to violence is only part of the solution. We must take steps to stop youth violence from happening in the first place. Youth violence prevention—actions taken to keep harm from happening—is the indispensible complement to response.

The goal of prevention is simple: to stop youth violence from happening in the first place. Similar to the way brushing and flossing aim to stop what can cause cavities and gum disease before there is a problem, youth violence prevention efforts focus on reducing the factors that put young people at risk for violence (risk factors), and increasing the factors that help protect them from violence (protective factors).

What is a public health approach to youth violence prevention?

Preventing violence before it occurs requires a balanced effort that addresses the complex factors underlying violence and builds on the assets of youth, families, and communities. A “public health approach to preventing violence” is comprehensive and multidisciplinary in nature, and aims to minimize the negative and maximize the positive.

The public health approach to youth violence is similar to the public health approach to all other injuries or health problems. It starts with finding the populations and locations at greatest risk, uncovering risk and protective factors, and developing and using evidence-based strategies and programs to address violence at the individual, family, community, and societal levels.

Fundamental tenets of the public health approach include:

• Primary prevention orientation: Efforts are designed to prevent violence before it occurs.

• Data-driven: Decisions and actions are based on data that describe the nature of the problem as well as contributing risk and protective factors (i.e., decisions made are based on data that answer basic questions such as who, what, why, where, when, for how long, etc.).

• Evidence-based: Strategies implemented to address the problem are based upon the best available research and evidence.

• Collaborative: Partners from all sectors of the community, including public health, law enforcement, education, recreation, economic development, mental health, social services, substance abuse, business, and others, work together to produce change.

• Population-based: Actions taken focus on community-wide or “environmental” solutions that benefit the entire community.

Is there a need for youth violence prevention?

Violence is a leading cause of injury, disability, and premature death among youth in the United States. It results in emotional, social, and behavioral problems that limit the development of youth and increase the likelihood that they will engage in violence in the future. Depression, anxiety, substance abuse, and other health problems are all associated with the effects of violence.

Youth violence knows no boundaries; it affects young people from all backgrounds and has a profound impact on the lives of young people and their families and friends, the communities where we live, and society in general.

To visualize the severity of this public health problem in the United States, consider these facts:

• More than 692,000 young people ages 10 to 24 are treated in emergency departments each year for injuries sustained due to violence.¹

• From 1999–2006, homicide was the second leading cause of death for young people ages 10 to 24 years old.²

• Violence disproportionately affects young people and people of color. For example, homicide is the leading cause of death among African Americans between the ages of 10 and 24.³

• Violence and safety concerns in some neighborhoods affect other determinants of health, such as whether or not parents will allow their children to be physically active outside or walk to school.^{4, 5}

• Violence is a factor in the development of chronic diseases, which account for a majority of premature U.S. deaths.^{6, 7}

• Youth violence affects communities by increasing the cost of health care, reducing productivity, decreasing property values, and disrupting social services.^{8, 9}

• Violence costs the United States an estimated $425 billion in direct and indirect costs each year. Of these costs, approximately $90 billion is spent on the criminal justice system, $65 billion on security, $5 billion on the treatment of victims, and $170 billion on lost productivity and quality of life.¹⁰

And this is just what we have space to share here. No community—affluent, poor, urban, suburban, or rural—is immune from the devastating effects of youth violence.¹¹ For more details, visit the Resources section of STRYVE Online.

Preventing youth violence in our communities is not just an option; it is a necessity. The seriousness of youth violence has drawn the attention of the U.S. Conference of Mayors, who have concluded that youth violence is a public health crisis and stated, “We can’t arrest our way out of this problem. Prevention is the key to long-term success.”

Does prevention really work?

Yes. The good news is that there are multiple approaches to prevent youth violence that are cost effective and that work. Communities across the country have proved it.

Many youth violence prevention approaches have been carefully evaluated and from these, the strategies that work have been identified. Before investing in unproven strategies or developing new ones, we encourage communities to select already-proven approaches supported by the best available evidence.

Here is a sample of key resources on strategies that work:

• The staff of Blueprints for Violence Prevention , a project of the Center for the Study and Prevention of Violence at the University of Colorado, has reviewed more than 800 violence and drug abuse prevention programs and identified the ones that meet a high scientific standard for effectiveness.

• The Guide to Community Preventive Services is a free resource to help communities choose programs and policies to improve health and prevent disease. CDC has reviewed more than 200 interventions and recommended how they should be used. The Guide includes a section on Violence Prevention Focused on Children and Youth .

• Chapter 2 of the World Report on Violence and Health , which is devoted to youth violence, includes a list of strategies that are effective in preventing youth violence or risk factors for youth violence.¹²

• Best Practices of Youth Violence Prevention: A Sourcebook for Community Action documents the best practices of four key youth violence prevention strategies and the science behind those best practices.¹³

• Youth Violence: A Report of the Surgeon General highlights 27 effective youth violence prevention programs. In many cases, the long-term financial benefits are substantially greater than the costs of the programs.¹⁴

This is just a sample of what is available. For more resources, visit the Resources section of STRYVE Online. Although there is no simple solution, there are strategies that are effective at stopping violence before it happens. Prevention works!

 

• 1. CDC, NCIPC. Youth violence: Consequences. [Online]. Accessed May 3, 2010 at: http://www.cdc.gov/ViolencePrevention/youthviolence/consequences.html .

• 2. CDC, NCIPC. 10 Leading causes of death, United States, 1999-2006, all races, both sexes. [Online]. Report generated May 3, 2010 through WISQARS at: http://webappa.cdc.gov/sasweb/ncipc/leadcaus10.html .

• 3. CDC, NCIPC. Youth violence facts at a glance summer 2009. [Online]. Accessed May 3, 2010 at: http://www.cdc.gov/violenceprevention/pdf/YV_DataSheet_Summer2009-a.pdf .

• 4. Mikkelsen L, Chehimi S, Cohen, L. Healthy eating and physical activity: Addressing inequities in urban environments. May 2007. Oakland, CA: Prevention Institute.

• 5. CDC. Recommended strategies and measurements to prevent obesity in the United States. MMWR 2009;58(No. RR-7).

• 6. Cost Benefit Analysis. [Online]. Memorandum from Megan Golden and Jena Siegel, Vera Institute of Justice, and Dall Forsythe, N.Y.U. Wagner School, consultant. [Online]. Accessed May 14, 2010 at: http://www.advancementprojectca.org/doc/p3_cost.pdf .

• 7. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998 May;14(4):245-58.

• 8. Mercy JA, Butchart A, Farrington D, Cerda´ M, Youth violence. In: Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World report on violence and health. Geneva: World Health Organization, 2002.

• 9. CDC, NCIPC. Youth violence: Consequences. [Online]. Accessed May 3, 2010 at: http://www.cdc.gov/ViolencePrevention/youthviolence/consequences.html .

• 10. DHHS. Youth violence: A report of the Surgeon General. Rockville, MD: DHHS, CDC, NCIPC; SAMHSA, CMHS; and NIH, NIMH, 2001.

• 11. DHHS. Youth violence: A report of the Surgeon General—Executive summary. Rockville, MD: DHHS, CDC, NCIPC; SAMHSA, CMHS; and NIH, NIMH, 2001.

• 12. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World report on violence and health. Geneva, World Health Organization, 2002.

• 13. Thornton TN, Craft CA, Dahlberg LL, Lynch BS, Baer K. Best practices of youth violence prevention: A sourcebook for community action (rev.). Atlanta: CDC, NCIPC, 2002.

• 14. DHHS. Youth violence: A report of the Surgeon General. Rockville, MD: DHHS, CDC, NCIPC; SAMHSA, CMHS; and NIH, NIMH, 2001.

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