Youth Violence is a Public Health Issue. Why Don't We Treat It that Way?

8 years ago

It has been several weeks since the nation recoiled in horror at the videotaped brutal beating death of 16-year-old Derrion Albert, the Chicago honor student who was caught in a melee between two factions of warring youth. Last week, President Obama dispatched Attorney General Eric Holder to the city to declare that he understood the urgency of the problem:

“The Department of Justice is releasing a new study today that measures the effects of youth violence in America, and the results are staggering. More than 60 percent of the children surveyed were exposed to violence in the past year, either directly or indirectly. Nearly half of children and adolescents were assaulted at least once, and more than one in ten were injured as a result. Nearly one-quarter were the victim of a robbery, vandalism or theft, and one in sixteen were victimized sexually.” (Emphasis mine.)

The Attorney General went on to discuss the need for coordinated solutions:

Our responses to this issue in the past have been fragmented. The federal government does one thing, states do another, and localities do a third. We need a comprehensive, coordinated approach to address youth violence, one that encompasses the latest research and the freshest approaches. Our administration is committed to implementing such strategies, which is why we've asked for $24 million in next year's budget for community-based crime prevention programs such as Ceasefire and Project Safe Neighborhood. And it's why our Office of Justice Programs is available 24 hours a day, 7 days a week to provide support and assistance to communities affected by violence.

Hear, hear! But I'm wondering -- where are the public health experts are in this discussion? 


Why a public health approach matters


A comprehensive study done under Clinton administration Surgeon General David Satcher argued forcefully that youth violence is not only a public safety issue; it's a public health issue. One key conclusion from that 2001 report suggests the road not taken:

The most important conclusion of this report is that youth violence is not an intractable problem. We now have the knowledge and tools needed to reduce or even prevent much of the most serious youth violence, with the added benefit of reducing less dangerous, but still serious problem behaviors and promoting healthy development. Scientists from many disciplines, working in a variety of settings with public and private agencies, are generating needed information and putting it to use in designing, testing, and evaluating intervention programs. ... Thus, the most urgent need is a national resolve to confront the problem of youth violence systematically, using research-based approaches, and to correct damaging myths and stereotypes that interfere with the task at hand

The Satcher report advocated a public health approach to the problem of youth violence that:

  • Defines the problem, using surveillance processes designed to gather data that establish the nature of the problem and the trends in its incidence and prevalence;
  • Identifies potential causes, through epidemiological analyses that identify risk and protective factors associated with the problem;
  • Designs, develops, and evaluates the effectiveness and generalizability of interventions; and
  • Disseminates successful models as part of a coordinated effort to educate and reach out to the public (Hamburg, 1998; Mercy et al., 1993).

I've taken the liberty of quoting the Satcher report extensively because it's worth asking whatever happened to its recommendations. A 2005 study by criminologist Brandon C. Welsh suggests that there were those in the criminal justice community who were still unaware of the value of this approach to the youth violence problem. From the abstract:

The increasingly punitive response to juvenile criminal violence is an unsustainable approach to reducing juvenile violence, according to the author. The sole reliance on a law-and-order approach is at the center of the problem. However, the public health perspective represents a promising approach to the reduction and prevention of juvenile violence and should be considered as a complement to the traditional law-and-order approach, rather than an alternative. 

Children in crisis

The sheer magnitude of post-traumatic stress being experienced by Chicago's children alone makes health policy an essential part of the solution to youth violence in that city. Listen to Trinity United Church of Christ's pastor, Rev. Otis Moss III, as he talks about what the children in his congregation are experiencing:

Rapper Killer Mike's XXL magazine blog post about his reactions to Albert's murder attests to the breadth and depth of the problem. Watching the video of the murder brought "20 ghosts" to his mind of victims and perpetrators of violence that he knew from his own youth, he said, adding:

Dozens of children have died this year in Chicago, and we did nothing. Atlanta, D.C, Detroit, Newark, Miami, N.O., Baton Rouge, Lil Rock, Oakland, thousands are dead and we did and do nothing! We watch the victims and families on local news, CNN and FOX and watch the offenders on 48hrs and American Gangster and Gangland and still we do nothing!

We feel a tinge of sadness for the children that die. We feel bone deep anguish and hurt for those black mamas. We look and feel lucky not to live “there.” We thank God our kid are ok and we resume life in this broken model of a village. We do nothing more! By doing nothing more we keep KILLING OUR CHILDREN!?!?!

"Mike's" cri de coeur elicited an impressive response, and we can only hope that his call to adult responsibility will be heeded.

Blogher CE Nordette Adams is watching the same tragedies unfold in her own city, New Orleans:

The level of stress on people here as we watch our own city, New Orleans, buckle under violence that often involves people under 25 is sometimes unbearable, which is why I address it in poetry and poem-prayers. Some days the bad news is so overwhelming I feel like we're drowning in blood, and I wonder how do they get their hands on so many guns. Why is it so many young people seem consumed with the need for revenge? 

What we can do

However, we more than cries of righteous indignation. We need to bring the same level of informed citizen activism to this problem that we bring to every other pressing issue we face. With that in mind, here are some tentative thoughts about questions we should be asking and solutions we should be considering:

1. We need to ask HHS Secretary Kathleen Sibelius what role her agency is playing in shaping policy on youth violence. I searched the HHS website with the term "youth violence" this evening and got no results. A search of the website of the Surgeon General brought up the Satcher report.

2. Speaking of Surgeon Generals, we don't have one. Pres. Obama's nominee, Dr. Regina Benjamin, only cleared the Senate Health Committee last week and reports are that Republican lawmakers are holding up a Senate floor vote because of an unrelated dispute with the Administration over Medicare contractors. The Surgeon General can play a valuable role in inter-agency policy coordination. What can be done to fill this key vacancy?

3. What's happening with the S.A.F.E.T.Y. (Securing America's Families by Educating and Training Youth Through Nonviolence) Act? Civil rights veteran John Lewis advanced this bill last May and so far, it has yet to receive consideration. It would create a grant program to train young people in non-violent conflict resolution. 


4. We need new approaches to breaking the school-to-prison pipeline. My colleague, Dr. Deborah Thompson, a professor of education at The College of New Jersey has often referred to the correlation between poor reading skills, the likelihood of school failure, and future incarceration. Indeed, a study reported just a few days ago in the New York Times, The Consequences of Dropping Out of High School (.pdf) makes it clear that we pay a high price for failing to keep kids in school. Not only do we see higher rates of unemployment and incarceration, we see greater expenses for taxpayers.

5. Let's delve more into what works. The Department of Justice has a links to case studies of successful programs. I wonder about the fact that only two of the studies cited were published after 2000. 

Here's one example of an approach that might be worth some formal study. I have a former student, Amy Stein, who is a social worker treating young people classified as emotionally and behaviorally disturbed. Using a combination of environmental education and arts therapy, Amy reports success in helping get kids back on track both psychologically and academically. As she chronicled in her 2002 book, Fragments: Coping With Attention Deficit Disorder, her creative approach to working with young people stems from a combination of personal and professional experience. Stein found that organic gardening and artistic expression helped her in her own battles with ADHD and other issues.

My interest in Stein's approach was buttressed by a speech that I covered last year for Blogher by activist and scholar Angela Davis spoke about a successful prison gardening project that she observed. She said the women participating in the project had learned new skills, improved their outlook on life and become healthier by changing their diets. They dreaded having to return to their communities, though, where the triggers remained that led to their incarceration, but constructive outlets such as community gardens were lacking. 

What kinds of creative approaches do you think communities and policymakers can enact to combat youth violence?


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