Since the subject of violence as a public health issue is near and dear to my heart, and since I haven't seen it dealt with on a significant scale, or addressed adequately in programs and policies, I've decided to approach the subject with a blog page. It's my hope that the blog will spur some interest in others to consider the significance of violence issues in the public health arena, and perhaps even lead some to the understanding that violence is one of the primary sources (if not the main primary source) of all disease in the world. The following excerpt comes from a paper I wrote earlier in the year, and is placed here as an "Introduction" to addressing violence as a Public Health issue.
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The Centers of Disease Control and Prevention (CDC) has only recently recognized the problem of violence as a significant Public Health issue. From criminal incidents such as sexual assault, domestic violence, homicide and suicide; medical providers, and other members within the healthcare system sometimes find themselves caught in between the two worlds of medicine and law. Medical providers who address cases related to violence frequently devote long hours of medical service towards these patients because of the complexity of the care they become involved in, however there are few resources available for them to turn to. Although medical providers frequently encounter aspects of violence in their daily patient care routines, issues related to violence remain inadequately addressed within national and state Public Health policy, and therefore efficiency and efficacy of violence prevention programs are suboptimal.
In 1979, the Carter Administration’s U.S. Surgeon General Julius B. Richmond identified violent behavior as a key public health priority . In the year 1980, the CDC made a particular effort to study the patterns of violence, and their efforts grew into a national program aimed at reducing the death and disability of violence associated injuries in the workplace. In 1992, the CDC established the National Center for Injury Prevention and Control (NCIPC) with the purpose of having it serve as the lead federal organization for violence prevention. Currently, the Division of Violence Prevention (DVP) serves as one of three divisions within NCIPC.
The main mission of the Division of Violence Prevention is to prevent both injuries and deaths that result from violence, and its goal is to do this by stopping violence before it begins. The DVP feels this can be done by: utilizing database systems to monitor all violence-related injuries; researching factors that put individuals and communities at risk and/or factors that protect them from violence; and assessing, planning, implementing violence programs as well as evaluating the effectiveness of those programs.
While the CDC has begun to develop programs and policy that link violence programs together, and has begun pooling its resources; individual U.S. states, other federal programs and the Department of Defense (DoD) have yet to recognize the benefits redesigning the structure of their violence prevention programs. Independent silos of violence prevention exist in the health care arena, and many of these silos of prevention are structured around the social services/psychology programs instead of Public Health programs. By developing state and federal programs that address violence overall, and by utilizing shared education and training, staffing, policy, and database resources, there can be maximum efficiency and efficacy within the system.
Violence issues most frequently encountered in the medical system include the following: Sexual Assault; Domestic Violence; Adult Assault; Child Sexual and/or; Physical Abuse; Trafficking of Persons; Workplace Violence; Gang Violence; Hate Crimes; Stalking; Suicide and Homicide.
Each one of the issues listed has an independently financed state and/or federal program dedicated to it, and each of these programs is housed in its own independent public health office.
The existence of violence within the United States is a significant health problem that affects people in all stages of life, from infants to the elderly. As an example, in 2005, there were 18,124 deaths from homicide as well as 32,637 from incidents of suicide. It is important to understand that violence unravels and deteriorates communities as well as individuals, by reducing productivity, disrupting social services and decreasing the value of local property. In addition, survivors of violence suffer permanent physical and emotional scars, and many have a greater need of counseling services, as well suffer as an increased risk of future violence, homicide and suicide incidents.
In developing an understanding of these issues, it is up to Public Health to address the problem of violence, to gather data, to assess its origins and impacts, and to consider appropriate responses via programs and interventions related to violence. Until Public Health begins to lead the way in violence prevention and response in communities, efforts to combat violence and to reduce its effects will remain largely inefficient and ineffective.
References
Centers for Disease Control (CDC) (2008) Public Health Approach to Violence Prevention. Retrieved on 16 January, 2009 from: http://www.cdc.gov/ncipc/dvp/PublicHealthApproachTo_ViolencePrevention.htm
Centers for Disease Control (CDC) (2008) Violence Prevention at CDC. Retrieved on 16 January, 2009 from: http://www.cdc.gov/ncipc/dvp/prevention_at_CDC.htm
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