Violence

VIOLENCE

The public health approach to the study and prevention of interpersonal violence was given formal recognition in 1984 when Surgeon General C. Everett Koop stated: "Violence is every bit as much a public health issue for me and my successors in this century as smallpox, tuberculosis, and syphilis were for my predecessors in the last century." As the injury and death toll from violent behavior have become increasingly evident, multidisciplinary scholarship in the study of violence has emerged and expanded at an unprecedented pace.

The most widely accepted definition of violence—sometimes termed "intentional interpersonal injury"—is: "behavior by persons against persons that intentionally threatens, attempts, or actually inflicts physical harm" (Reiss and Roth, 1993). The closely related terms "aggression" and "antisocial behavior" are generally applied to lesser forms of violence and include, but are not limited to, behaviors that are intended to inflict psychological harm as well as physical harm.

The public health approach to the study and prevention of violence entails a four-step process:(1) data collection of violence-related problems, assets, and resources; (2) assessment of the possible causes of violence through risk-factor identification; (3) the establishment and evaluation of violence prevention strategies; and (4) the dissemination and implementation of effective strategies. Public health, then, is inherently a research-driven and prevention-oriented science. This approach complements and overlaps with the narrower focus of criminology, which is primarily concerned with forms of violence that constitute crimes and with policies and practices that deter and punish perpetrators.

VIOLENT VICTIMIZATION

Epidemiological data on violence are derived from three primary sources: (1) hospital, emergency medical service, and medical examiner records;(2) police reports and arrest records (and other agency records, such as child protective services for reports of child abuse); and (3) self-report surveys and interviews. In addition, specialized studies that address the particular dynamics and contexts of violence have proven to be important to the understanding and prevention of violence.

The most complete and accurate violencerelated datasets are those on homicide victims. In the United States, the overall homicide victimization rate has fluctuated during the twentieth century from fewer than two homicides per 100,000 in 1900 to a high of nearly eleven homicides per 100,000 in 1980. In 1998, 17,893 individuals were murdered in the United States, which translates into an average daily death toll of forty-nine people. The worldwide 1998 homicide rate was 12.5 per 100,000, significantly higher than the U.S. homicide rate of 6.2 per 100,000. Nevertheless, data from the 1980s reveal that among the forty-one most developed countries, the United States has the third highest homicide rate.

Because violence is not evenly distributed throughout the population, these overall homicide rates provide only a partial picture of homicide's toll. Most notably, homicide victimization in the United States is most prevalent among youth. In 1998, homicide was the second leading cause of death among fifteen-to twenty-four-year-olds. Racial disparities in homicide rates are also disturbingly high. During the second half of the twentieth century, African Americans were murdered at five to eleven times the rate of their white counterparts. Gender differences are equally as dramatic, with males murdered at approximately ten times the rate of females. Finally, the risk of homicide is higher in urban than nonurban areas as well as within neighborhoods characterized by concentrated poverty. Neighborhood social disorganization also increases the probability of violence victimization as well as perpetration.

In comparative studies conducted in the 1990s, the homicide victimization rates in the United States, particularly among children and adolescents, were shown to be several times higher than those in any other industrialized country. In fact, the homicide rate for children under sixteen years old in the United States was five times higher than the corresponding homicide rate for the next twenty-five richest countries combined. The reasons for these elevated homicide rates in the United States are not fully understood; however, probable causes include easier access to firearms, more common and severe patterns of income disparities, and higher levels of racial and ethnic diversity in conjunction with racist and xenophobic attitudes and behaviors.

The question of mechanism, or the means by which people are murdered or injured, is another critical piece of information with respect to our understanding and prevention of violence. The examination of mechanism was particularly helpful in understanding the tremendous increase in homicide victimization rates of adolescents in the United States from 1987 to 1993, and the subsequent downturn through 1998. When the data are disaggregated by mechanism, a clear picture emerges: These trends over time can be accounted for by changes in the number and proportion of youth murdered with a firearm (see Figure 1). The changes in gun use during this period are generally attributed to three major factors: the crack epidemic—which had the effect of destabilizing local drug trafficking markets, rendering them more volatile and violent—and the subsequent petering out of this epidemic; changes in economic opportunity; and changes in policing policy for gun violations.

Most assaultive behavior, however, does not result in death. In 1997 more than 1.75 million people in the United States were treated for assaultive injuries in emergency departments, and more than 10 million individuals aged twelve and over reported that they had been victims of violent crimes. These and other data reveal that young people, African Americans, and males are disproportionately victimized by nonlethal forms of violence, though these disparities are less pronounced than for homicide victimization.

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Author Info: MICHAEL B. GREENE, The Gale Group Inc., Macmillan Reference USA, New York, Gale Encyclopedia of Public Health, 2002

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