Understanding and Controlling Violence

VioLit summary: OBJECTIVE: This paper was presented by Felton Earls, M.D., Professor of Child Psychiatry, Harvard Medical School, at the Third National Conference: Health care for the poor and undeserved "children at risk." Dr. Earls, reported on interpersonal violence and its increasing rates, he reviewed the current organizational and scientific approaches for controlling it, and he proposed new strategies to help advance the knowledge of its causes. METHODOLOGY: This presentation followed a nonexperimental discussion of violence. FINDINGS/DISCUSSION: Dr. Earls began his discussion by suggesting that the circumstances enticing children towards victimization or perpetration are no different from those experiences that are linked to violence among young adults. He argued that child abuse, domestic violence, assaultive behavior and homicide are reported to interact within communities and families. A major road block in the study of violence is that we have created different systems which appear to fragment the way we define and deal with it. He suggested that such fragmentation has on one side, the Criminal Justice System which is concerned with apprehending and incarcerating violent offenders, yet on the other side there are public health and social service systems which are oriented towards human welfare and address violence within the home. With respect to our current ability to track the magnitude of violence, Dr. Earls discussed mortality data, survey data identifying victimization, and criminal and juvenile data reporting arrest and incarceration rates. Also, some hospital rates and physical abuse rates were made available. However, these were not uniformly reported and cannot be used in the public health data collection. He stated that even though the morality rates were important, there is no system available to track nonfatal injuries adequately, and that only recently has violence become a public health priority. Available data from the FBI showed that the rate of violence rose in 1970, fell in the early 1980s, and has subsequently risen sharply in the last few years. This data demonstrates that men were victims of homicide at 10 times the rate of women, and that homicide was the leading cause of death for male and female African-Americans under the age of 35. Correctional facilities report that the inmate populations of jails, state and federal prisons rose from 274,563 in 1974 to 450,416, in 1986. The number of violent offenders remained high with 58% in 1979 and 55% in 1986. Dr. Earls reported that over the past decade, the number of children and adolescents within the criminal justice system has increased while the proportion of adolescents in the population has decreased. The author further stated that the United States has the distinction of leading the industrialized nations with the most prisons, most homicides, and highest costs due to injury. Dr. Earls pointed out that the U.S. legal, juvenile, and criminal justice systems are mostly reactive, though the public health agencies try to work preventatively through gathering rates of violence, and constructing preventative interventions. AUTHOR'S RECOMMENDATIONS: Dr. Earls recommended that all services involved with the management of violence, policy makers, professionals and those involved in research work together in a more integrated fashion. He placed priority on public policy and professional practice needs before research needs because he believed that a restructuring of the values of society are needed before a cure designed by research could possibly be effective. Specifically, he recommended that many areas be addressed to face the current level of violence in our society. With respect to fire arms, he recommended the elimination of assault rifles, mandatory waiting periods, and more effective federal regulations controlling the manufacturer, safety and distribution of firearms. He also stated that we need to address racial bias and discrimination within the system. In the area of education, he said that those individuals who were trained in behavioral sciences and health care, who will work with and treat children, need to also be trained to work across criminal justice and social welfare systems. Dr. Earls stated that violence severely impacts the lives of children who then require help from professionals in medicine, psychology, education, and social work. These providers lack an awareness of the value of a coordinated and sustained approach to violence prevention. He offered the following targets of change: educational preparation of the poor and disadvantaged; programs which enhance IQ; the encouragement of cooperation; help motivate and integrate children into the school system; and reduce the number of teen pregnancies as well as school dropout rates. He believed that more males are needed as prosocial models to help compensate for children growing up without "father figures". These children also need to develop the foundations necessary for controlling their aggressive impulses. Finally, he felt increased attention needed to be paid to those involved in violence; victims and perpetrators alike. He suggested that discrimination and avoidance may be playing a role in health care when psychiatric care is given to a person who attempts suicide rather than to a child who is a victim of violent injury. Dr. Earls reported that past research has been segmented into separate schools of philosophy without considering the variables from other disciplines. Many levels of information are now needed within a single research design. Also, future research should address how males and females respond to the risk factors identified in delinquent males. He stated that the role that neurotransmitters play, specifically serotonin, needs to be explored in terms of its relationship to male aggression. New studies could help identify clues which may distinguish behavior types in children which make them vulnerable to violent behavior in the future. Also, he stated that the effects of single parent families living in poverty, specifically African American, and the risks for deviant and violent behavior should be addressed and causal factors identified. Future research should also sample fathers when looking to the causes of violence. While previous research addressed mothers' and teachers' contributions regarding the nature of family life and risk of delinquency, the fathers perspective was noted as sorely lacking. Dr. Earls thought that there should be a way to measure variations between communities and the link that community change has with individual development as it relates to violence. Finally, he said that future research needs to contrast primary prevention with secondary prevention of antisocial and violent behavior. Efficacy of interventions could then be examined when observing primary prevention, prior to the age a child manifests behavior problems, and secondary prevention, during the elementary school period. In conclusion, Dr. Earls thought that structural changes within society may need to change in order to help control violence in our society. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Violence Causes KW - Public Health Services KW - Prevention KW - Child KW - Juvenile KW - At Risk KW - Socioeconomic Factors KW - Research Recommendations KW - Policy Recommendations KW - Intervention Language: en