PH10-4-Public Health Communications

HISTORY OF COMMUNITY VIOLENCE

Since 1965, homicides and suicides have been one of the top 15

leading causes of death in the United States (Dahlberg & Mercy, 2009).

Violence in communities continued as a public health indicator during the

s, and in 1991 homicide rates of younger males increased 154% (Centers

1980

of Disease Control and Prevention, 1994).

This trend became noticed in lower

income and vulnerable communities, and

continued to increase with the emerging

factors of child maltreatment and intimate

partner violence (Dahlberg & Mercy,

.

2009)

When reviewing trends of violent

crimes in communities, the U.S.

Department of Justice utilizes two

EDUCATION

•

Working together to

increase education aid

and resources is

essential, as well as

exploring ways to

enhance continuity

between schools and

families.

ECONOMICS AND

HOUSING

•

Investing in our economic

success creates growth,

by increasing our

workforce and

developments in our

community.

SAFETY

•

Community cohesion

with laws is important,

while increasing trust,

accountability, and public

safety improvements.

FEBRUARY 2021

PUBLIC HEALTH POLICY DESIGN

INCORPORATING KNOWLEDGE DRIVEN CONCEPTS

TO REDUCE VIOLENCE IN

COMMUNITIES

An Illustrated Newsletter Evaluating Community Violence and Health

Author: Chelsea Williams

PUBLIC HEALTH POLICY DESIGN FEBRUARY 2021

statistical programs to measure the magnitude, nature, and impact of crime (Crime characteristics and trends, 2019). The violent crime trends provide a comprehensive analysis of this public health indicator, as well as the graph below showing violent crime offenses from 2015-2019. Even though the level of crime has declined from 2017, approximately 1,202,500 violent crimes occur every year in the United States.

Pre	ventions
Primary	Efforts aim to prevent violence before occurrence.
Secondary	Focuses to treating the immediate injury and harm that results in a violent act.
Tertiary	There are a range of activities that can be accomplished to address the medium and long-term effects of violence and abuse. This includes therapy and other rehabilitation techniques.

Prevention of Violence

(“Violent Crime”, 2019). (Meade, 2009).

ROLES OF HEALTH PROFESSIONALS

Health professionals play a vital role in the intervention and prevention of violence, by ensuring proper evaluations and the use of proper health processes. Through the use of public health methods to interrupt violence and change neighborhood norms, health professionals are able to assist in prevention of community violence (“Violence is a Public Health Issue, 2018). Addressing violence with a health professional has been shown to be more socially accepted

(“What is health”, 2021).

PUBLIC HEALTH POLICY DESIGN FEBRUARY 2021

and non-offensive, compared to other methods (Usta, et. al., 2012). Below are three important roles that health professionals play in promoting health (Morrissey, 2016).

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NEIGHBORHOOD ASSISTANCE DEVELOPMENT OF HOUSING AND COMMUNITY OUTREACH TO ENHANCE SPACES FOR HEALTHY LIVING	1
TARGETING POPULATIONS PROVIDING CITY PROGRAMS AND COMMUNITY PARTNERSHIPS FOR DEVELOPING AGE GROUPS	2

FOCUSING ON CHILDREN 3

INCREASING RESILIENCY OF CHILDREN TO FAMILY AND COMMUNITY FACTORS

Investing in the community structure, organization, and development should be prioritized, as well as health care initiatives in the community. Teaching and offering education in health, as well as listening to the public perspective allows for a continuity between health professionals and the community they serve. Health professionals can increase their role by cross-functioning between other initiatives, including developments in education, infrastructure, and safety. This includes advocating for underserved individuals to receive services and resource that they need, ensuring cultural competence among the vulnerable population, and reducing social isolation within the community (“Roles of community”, 2021). Within the role of a health professional is the need to review all aspects of the individual, including the mental, social, and physical health of the community as a whole.

INCREASING THE

ROLE OF HEALTH

PROFESSIONALS

Health professionals should promote community engagement by doing more than health care.

GLOBAL BURDENS AND AFFECTS

Violence affects families, communities, nations, and permeates across generations. It has become one of the leading causes of death in many areas of the world and continues to affect many areas across the globe (Mercy et., al., 2017). The three primary forms of violence when reviewing global perspectives are interpersonal violence, collective violence, and state-

PUBLIC HEALTH POLICY DESIGN FEBRUARY 2021

perpetrated violence (Mercy et., al., 2017). When discussing community violence, this relates to interpersonal violence, as it is generally a product of an individual(s) in the community.

Interpersonal Violence Collective Violence State-perpetrated Violence

Self-directed violence	War	Genocide
Includes suicide	Terrorism	Torture
Family or partner violence	Gang Warfare
Community violence

(Mercy et., al., 2017)

The burdens of community violence are felt throughout the globe related to their magnitude, the nature of the crimes committed, as well as the consequences of the individuals, communities, and countries they involve. It is critical that programs and policies are put into place to address this leading health indicator. There are many consequences and affects of community violence, including risks of injury or death within the population, mental health problems, diseases and reproductive issues (Mercy et., al., 2017).

COMMUNITY ENVIRONMENTAL FACTORS

Environmental factors due to community violence enhance the overwhelming need to review strategies for assistance for this public health indicator. As seen on page 1 of this newsletter, education, economics and housing, as well as safety play key environmental roles within violent communities. Low neighborhood attachment and community disorganization, access to guns and other weapons, as well as few organized activities for youth are other environmental factors that influence the spread of community violence (“Office of mental health”, 2021).

In addition, environmental contaminants, which are present in lower-income communities and communities of violence, have been shown to lower IQ levels in the community, contributing to lower brain functions and heightened negative behavior. An example of this includes children exposed to lead early in life. These individuals suffer from a reduced IQ as well as negative impacts on cognitive function (Carpenter & Nevin, 2009). When reviewing the behavior of individuals with these

cognitive changes, there exists a shortened attention span, promotion of hyperactivity, and an increase in impulse, which can be determinants of violent behavior.

COMMUNITY STRATEGIES

For any public health indicator, to affect change and implementation of new initiatives, communication has to be present. When looking across the history of roles for health professionals, global concerns, and environmental factors, there needs to be a level of transparency and promotion for individuals in violent communities. This starts with open lines of communication across a range of departments, organizations, and governmental entities.

Like many of the indicators, including community violence, this is preventable. The struggles exist and major obstacles need to be overcome before real change can begin. This includes communication strategies and initiatives by local, state, and federal governments, as well as the community leaders prioritizing this indicator, looking at each area that affects violence and how it can be addressed.

Any communication outlets are important for the public perception of a topic. Media is one outlet that can expose violence and provide news coverage of events that occur, showing transparency with the public. It is important for media outlets to not only highlight cases of

violence, but also reinforce what is affecting violence and discouraging the behavior (“Changing the discourse”, 2018).

One first step is ensuring community safety is covered in media coverage. More often, cases of murders and crime are communicated, but very few stories related to violence prevention and health practitioner advocacy exist.

As technology is driving our communication pathways, it is essential to consider these forms of communication when determining the most effective approach. Considering a hybrid approach between social media outlets and group discussions may assist to benefit the communication gaps and overall productive conversation regarding this topic. Using media, local and state social networks, as well as state and federal policy discussions, ways of improvement could be recognized and ultimately, initiatives could be driven by an outreaching of public understanding and equity.

REFERENCES

Carpenter, D. O., & Nevin, R. (2009). Environmental causes of violence. Retrieved from https://election.princeton.edu/ wp-content/uploads/2013/01/violence_lead_Nevin.pdf

Centers for Disease Control and Prevention (CDC) (1994). Homicides among 15-19-year-old males--United States, 1963-1991. MMWR. Morbidity and mortality weekly report, 43(40), 725–727.

Changing the discourse about community violence: To prevent it, we have to talk about it. (2018). Retrieved from http:// www.bmsg.org/resources/publications/changing-the-discourse-about-community-violence-to-prevent-it-we-have to-talk-about-it/

Crime characteristics and trends. (2019). Retrieved from https://www.bjs.gov/index.cfm?ty=tp&tid=93

Dahlberg, L. L., & Mercy, J. A. (2009). History of violence as a public health problem. Retrieved from https:// journalofethics.ama-assn.org/article/history-violence-public-health-problem/2009-02

Hillis, S. D., Anda, R. F., Dube, S. R., Felitti, V. J., Marchbanks, P. A., & Marks, J. S. (2004). The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics, 113(2), 320–327. https://doi.org/10.1542/peds.113.2.320

Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A.M., Aguilar-Gaxiola, S., Alhamzawi, A. O., Alonso, J., Angermeyer, M., Benjet, C., Bromet, E., Chatterji, S., de Girolamo, G., Demyttenaere, K., Fayyad, J., Florescu, S., Gal, G., Gureje, O., Haro, J. M., … Williams, D. R. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British journal of psychiatry : the journal of mental science, 197(5), 378–385. https://doi.org/10.1192/bjp.bp.110.080499

Machtinger, E. L., Haberer, J. E., Wilson, T. C., & Weiss, D. S. (2012). Recent trauma is associated with antiretroviral failure and HIV transmission risk behavior among HIV-positive women and female-identified transgenders. AIDS and behavior, 16(8), 2160–2170. https://doi.org/10.1007/s10461-012-0158-5

Meade, F. (2009). Inside Out: An organisational map for primary violence prevention. Retrieved from https:// www.who.int/violenceprevention/inside_out.pdf

Mercy, J. A., Hillis, S. D., Butchart, A., Bellis, M. A., Ward, C. L., Fang, X., & Rosenberg, M. L. (2017). Interpersonal violence: Global impact and paths to prevention. Retrieved from https://www.ncbi.nlm.nih.gov/books/ NBK525208/

Morrissy, J. (2016). Violence: A Community Health Approach. Retrieved from https://www.chausa.org/publications/ health-progress/article/july-august-2016/violence-a-community-health-approach

Norton, R., & Kobusingye, O. (2013). Injuries. The New England journal of medicine, 368(18), 1723–1730. https://

doi.org/10.1056/NEJMra1109343

Office of mental health. (2021). Retrieved from https://omh.ny.gov/omhweb/sv/risk.htm

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Roles of community health workers - RHIHUB TOOLKIT. (2021). Retrieved from https://www.ruralhealthinfo.org/ toolkits/community-health-workers/1/roles

Usta, J., Antoun, J., Ambuel, B., & Khawaja, M. (2012). Involving the health care system in domestic violence: what women want. Annals of family medicine, 10(3), 213–220. https://doi.org/10.1370/afm.1336

Violence is a public health issue: Public health is essential to understanding and treating violence in the U.S. (2018).

Retrieved from https://apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/ 2019/01/28/violence-is-a-public-health-issue

Violent crime. (2019). Retrieved from https://ucr.fbi.gov/crime-in-the-u.s/2019/crime-in-the-u.s.-2019/topic-pages/ violent-crime

What is health? (2021). Retrieved from https://www.countyhealthrankings.org/what-is-health

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