Linda L. Dahlberg

Original ArticlesYouth Violence in the United States: Major Trends, Risk Factors, and Prevention Approaches

Violence among youths is an important public health problem. Between 1985 and 1991, homicide rates among youths 15-19 years of age increased 154% and remain, today, at historically high levels. This paper reviews the major trends in homicide victimization and perpetration among youths over the last decade, the key risk factors associated with violence, and summarizes the many primary prevention efforts under way to reduce violence. Previous research points to a number of factors that increase the probability of violence during adolescence and young adulthood. Some of these factors include the early onset of aggressive behavior in childhood, social problem-solving skill deficits, exposure to violence, poor parenting practices and family functioning, negative peer influences, access to firearms, and neighborhoods characterized by high rates of poverty, transiency, family disruption, and social isolation. Efforts to address some of the primary risk factors for violence are under way across the United States, but evaluations to confirm program effectiveness are needed.Violence among youths is an important public health problem. Between 1985 and 1991, homicide rates among youths 15-19 years of age increased 154% and remain, today, at historically high levels. This paper reviews the major trends in homicide victimization and perpetration among youths over the last decade, the key risk factors associated with violence, and summarizes the many primary prevention efforts under way to reduce violence. Previous research points to a number of factors that increase the probability of violence during adolescence and young adulthood. Some of these factors include the early onset of aggressive behavior in childhood, social problem-solving skill deficits, exposure to violence, poor parenting practices and family functioning, negative peer influences, access to firearms, and neighborhoods characterized by high rates of poverty, transiency, family disruption, and social isolation. Efforts to address some of the primary risk factors for violence are under way across the United States, but evaluations to confirm program effectiveness are needed.

History of violence as a public health problem.

When and how violence was recognized as a matter for national—and then global—public health intervention. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.

Using Multimedia to Teach Conflict-Resolution Skills to Young Adolescents

SMART Talk is a multimedia, computer-based violence-prevention intervention that employs games, simulations, graphics, cartoons, and interactive interviews to engage young adolescents in learning new skills to resolve conflicts without violence. Eight modules cover anger management, dispute resolution, and perspective taking. SMART Talk was pilot-tested in a small-city middle school during a three-week period. After the pilot testing, SMART Talk was implemented in a middle school (sixth, seventh, and eighth grades) with a diverse socioeconomic population, located within 10 miles of a major Midwestern metropolis. The 16-week intervention began in January. Students had access to SMART Talk during the school day and could use the computer alone or with a partner. Subjects for whom parental permission (n = 558) was granted were given a preintervention and postintervention survey. The survey measured demographic, psychosocial, and environmental factors as well as aggressive and other violence-related behaviors. After the pretest, two teams from each grade were randomly assigned to the intervention group and one team to the control group. Only students in the intervention group had access to SMART Talk during the 16-week intervention period. After the posttest, control subjects had access to SMART Talk. Additional data for the evaluation were collected through archival records of grades and school disciplinary actions. All variables indicated comparability between intervention and control groups. As a population, 84% of the students were Caucasian and 9% were African American. Psychosocial variables indicated 30-day frequently angry (64%), 30-day depression (15%), and impulsivity (28%). Environmental variables indicated that 68% reported they could get a gun easily, 59% feel unsafe in their neighborhood, and 24% were personally affected by violence. Violence-related variables indicated 30-day threatened to hit (45%), 30-day hit someone (56%), bullying behavior (29%), and fighting (38%). Overall, a significant percentage of the sixth-, seventh-, and eighth-graders in this study have engaged in aggressive or risky behaviors such as fighting and bullying other students. Because many of these students frequently are angry, feel unsafe in their neighborhood, and have been personally affected by violence, violence-prevention programs are warranted in this school. SMART Talk gave the students an avenue to explore anger-management strategies and conflict-resolution and perspective-taking skills.

Global Status Report on Violence Prevention 2014.

INTRODUCTIONnInterpersonal violence affects millions of people worldwide, often has lifelong consequences, and is gaining recognition as an important global public health problem. There has been no assessment of measures countries are taking to address it. This report aims to assess such measures and provide a baseline against which to track future progress.nnnMETHODSnIn each country, with help from a government-appointed National Data Coordinator, representatives from six to ten sectors completed a questionnaire before convening in a consensus meeting to decide on final country data; 133 of 194 (69%) WHO Member States participated. The questionnaire covered data, plans, prevention measures, and victim services. Data were collected between November 2012 and June 2014, and analyzed between June and October 2014. Global and country-level homicides for 2000-2012 were also calculated for all 194 Members.nnnRESULTSnWorldwide, 475,000 people were homicide victims in 2012 and homicide rates declined by 16% from 2000 to 2012. Data on fatal and, in particular, non-fatal forms of violence are lacking in many countries. Each of the 18 types of surveyed prevention programs was reported to be implemented in a third of the 133 participating countries; each law was reported to exist in 80% of countries, but fully enforced in just 57%; and each victim service was reported to be in place in just more than half of the countries.nnnCONCLUSIONSnAlthough many countries have begun to tackle violence, serious gaps remain, and public health researchers have a critical role to play in addressing them.