|
Abstract
|
OBJECTIVE:
The aim of this report by CDC was to present a summary of the proceedings of the Forum on Youth Violence in Minority Communities.
METHODOLOGY:
The paper represents a summary of the forum which was held in Atlanta, on December 10-12, 1990. The forum was co-sponsored by the Centers for Disease Control and by the Minority Health Professions Foundation. 110 participants and observers were involved in the forum, and these papers, reports and abstracts represent their thoughts and deliberations about youth violence in minority communities.
FINDINGS/DISCUSSION:
Foreword to the Proceedings: The paper began with the observation that ethnic and minority populations bear much of the burden of illness and death in society, primarily due to their overrepresentation in the incidence of fatal and nonfatal injuries associated with interpersonal violence. These groups should be targeted in the fight against injuries resulting from violence, at the same time as addressing issues such as poverty, racism, unemployment and lack of educational opportunities. A scientific perspective is needed in the fight against violence, particularly in relation to the role of firearms, which account for over 30,000 deaths, especially in minority populations, in the United States each year. Violence is now a public health problem, and actions must now be taken to prevent youth violence in minority communities. These actions include the provision of financial support to violence prevention efforts, and the evaluation and modification of existing programs. Guidelines must be developed for the implementation and evaluation of prevention programs, partnerships between local, state and federal communities should be established, results of evaluations of interventions should be applied to community programs, and a public health infrastructure must be built to deliver violence prevention services to those most in need, by establishing training programs to develop a body of people who can lead prevention efforts.
Background of the Forum: Despite the omnipresent threat of violence in society today, little guidance is available to communities to establish prevention programs. The Forum, focusing on minority communities, was designed to summarize current knowledge about violence prevention so that this knowledge can be applied to these communities, and to develop priorities for evaluating prevention programs so that future research can be targeted at areas of immediate concern.
The Necessity of Social Change in Preventing Violence: Not only should public health efforts at violence prevention be expanded, but the larger social context in which violence occurs must also be recognized. Economic and social disparities among subgroups of society are fundamental in the etiology of violence. Poverty, unemployment and racism contribute to violence, by generating frustration, low self-esteem, hopelessness and anger about lack of opportunities for equality and success. A parallel approach of immediate actions to prevent violence and addressing the larger social issues represents the best opportunity for a successful reduction of violence in America today.
The Prevention of Minority Youth Violence Must Begin Despite Risks and Imperfect Understanding: While youth homicide rates in the United States are unacceptably high, homicide rates in minority communities are even higher and more unacceptable. Homicide is the leading cause of death among black youth, taking 6,000 lives each year; rates are also extremely high, and rising, among Hispanic and Native American youth. More than 95% of the increase in homicide rates for young black males has been attributed to firearms, which now account for 82% of homicide deaths of black males, aged 15 to 24. Prevention resources should be focused upon the states of New York, Florida, Michigan, Missouri, California and the District of Columbia, which together account for more than half of all homicides of young black males in the United States. Three themes which are addressed in the Forum are the improvement of children's health and reduction of the impact of violence upon children, the development of a public health infrastructure, including community organizations and voluntary health groups, directed toward transforming the nation's health, and making violence prevention a practical reality and primary emphasis in health care via use of program evaluations to identify promising interventions.
Violence is a Greater Killer of Children than Disease: Whilst efforts to eradicate disease in children have progressed substantially, society has not responded to the threat that violence presents to our children. Injuries are now the primary killer of children, and many young people are at a high risk for violence. Associated with such risk are access to firearms, alcohol and drug use, drug trafficking, poverty, racial discrimination and a cultural acceptance of violent behaviors. Children are born into violence, and are never exposed to different methods of expression, but are constantly exposed to violence and injury. Many women are victims of intimate violence, as lethal combinations of drugs, alcohol and guns become more and more available. Society should sensitize itself to violence, rather than continue to accept it as inevitable. Programs should be designed for each particular culture and subgroup of society, in order to be have a chance at being effective.
Charge to the Participants: From Analysis to Action: Now that the seriousness of the problems of violence is recognized, action must be taken to find a solution. Six steps are the key to progress in the fight against violence: scientific knowledge must be continually expanded to provide evaluations and examine risk factors; information and education must be disseminated to the public, to decision makers and to targeted risk groups; the team of social workers, health care professionals and law enforcement officials working on this problem must join in coordinated prevention efforts; action cannot wait for perfect knowledge; communities must be empowered to understand that they can make a difference in violence prevention; and finally, action must be taken now, and society must start to make a difference today. Violence rates are increasing, and the problem is becoming one of children shooting children. Society cannot ignore the problem of guns, and scientifically based prevention programs must target the phenomenon of children with firearms and must develop early childhood interventions to alter the attitude that accepts violence as normal.
Panel Discussion 1: Lessons Learned - The Community Experience: Successes and setback of ongoing community violence prevention programs were examined, to provide a discussion about lessons learned from these trials. Raising community and agency awareness of homicide is important, as is the provision of suggestions on reducing personal and community risk of victimization. The right system of intervention is critical, as are the agents of change who need to provide training and alter attitudes to violence. The public must learn, perhaps via media- and peer-based education, that violence as a health issue is neither inevitable nor unpreventable. Communities must be empowered via knowledge and sharing of resources, and prevention planners should work with the support of, and in conjunction with, the community. Violence prevention requires a comprehensive approach, involving large coalitions and systematic efforts. The relationship among alcohol, drugs and violence must be seen as critical, and youth and their families should be included in any prevention program. Conflict resolution training should be age- and culture-specific, and evaluations of programs should guide further program development.
Panel Discussion 2: Funding of Community Interventions to Prevent Violence: In order to implement successful community violence prevention programs and to continue important research into prevention strategies, a public-private partnership should be developed to allow for a planned and long-term funding effort for violence prevention. Underlying these efforts should be the focusing of public attention on the problem of violence, and the treatment of violence as a public health issue by expanding the role of medicine to include addressing issues of the environment, poverty and quality of life as causes of violence. In a public-private partnership, the government must listen to people's concerns, must provide leadership in prevention efforts, and must sustain these roles over a long time period in order to effectively alter the phenomenon of community violence.
Reports of the Working Groups: The working groups were designed to provide information upon prevention programs that could be implemented immediately in minority communities to prevent youth violence, to identify areas needing critical evaluation in order to direct future research, and to identify specific principles of community intervention that could be applied to the prevention of youth violence.
Application of Principles of Community Intervention: Working within the view that violence is a public health problem that is also community- based, community approaches to prevention represent a critical factor in the fight against violence. A number of assumptions underlying this behavior must be understood: that violence is a learned behavior that can be changed and prevented; that there is no single or simple solution, but rather multifaceted solutions are needed; that a community-based framework for action must include coordinated efforts and provide support for behavioral change; that a commitment to the principles of participation is needed; and that meaningful change will take time. Successful community-based programs must involve the formation of partnerships among various organizations, agencies and individuals, carefully planned intervention programs relevant to the needs of the target population, financial resources and the expertise and time of people within the community, participant involvement, well-defined goals and specific objectives, data describing the nature of the problem of violence in a given community, multiple methods of prevention and intervention, qualified and well-trained personnel and finally, practical evaluations to identify and correct problems in the program.
Violence Prevention Strategies Targeted at the General Population of Minority Youth: Intervention strategies that have been applied to minority youth, whilst few and far between, have involved educational interventions to change people's knowledge and attitudes, environmental technological interventions to discourage the possibility of violence, recreational interventions to provide an outlet for stress and anger, and legal interventions that employ police to deter violent behaviors. A number of underlying assumptions were thought to be important in successful community prevention programs: the concept of ownership, to allow for community individuals to identify their problems and to develop their solutions; the use of a broad range of people, including parents, involved in the programs to help teach youth; and the dissemination of violence prevention strategies to all communities, not just minority populations. Interventions could include school-based programs that emphasize conflict resolution training, plans for safe schools, mentoring and role model programs, positive peer influence programs, development of self- esteem, and culturally appropriate curricula. Community-based programs should include links and cooperation among various agencies, media campaigns to promote violence prevention, technical assistance and training to support violence reduction, mentor programs to teach conflict resolution and life skills, recreational, social and cultural training programs to explore socially acceptable options to violence, and employment opportunities to build knowledge and skills. National strategies should include the development of a national plan to coordinate violence prevention efforts and to reduce the media's portrayal of violence as glamorous. Longitudinal evaluations of educational interventions should be conducted, using improved tools, designs and methodologies, and studies should be developed to discover why some youth cope without turning to violence.
Violence Prevention Strategies Directed Toward High-Risk Minority Youths: Factors that have been associated with violence, such as unemployment, poverty, lack of educational opportunity, drugs and alcohol and weapon use, are all more prevalent in poor, urban, minority environments. Targeting a specific population can be vital in the search for effective intervention. High-risk groups include youths who live in areas with high rates of violence, gang members, youths from families with a history of violence, violent youths and victims, relatives of victims, and witnesses of violence. Underlying the identification and targeting of high-risk groups are a number of assumptions: each high-risk youth must be evaluated individually to determine his or her needs; interventions should address the family and social environment as well as the individual; outcome expectations should be realistic; individual failures in programs should be evaluated to provide information about modifying the program; programs should include a variety of services and agencies; interventions must be culturally relevant; several levels of government might need to be involved and coordinated; violence prevention services should be readily accessible to all youths. For intervention in high-risk areas, community needs should be identifies, interventions should be multifaceted and sustained, community members should reclaim areas taken over by violent youths, homicide rates must be reduced, the community should become active and eventually take over the interventions, training and leadership should be provided, evaluations should be conducted and community resources should be identified and coordinated. For youth from dysfunctional families, strategies should include training on management of feelings, programs offering physically stimulating activities, development programs to foster self-esteem, mentoring programs, academies for individuals who show leadership, artistic, athletic or intellectual promise, and programs that encourage the performance of public services. For victims of violence and witnesses of violence, strategies should include survival skills training, the identification of witnesses and provision of psychological counseling by trained counselors, mentoring programs and support groups. Strategies for violent youth include conflict resolution training, peer counseling and mediation, employment training programs, physically challenging activity programs, mentoring, programs to encourage public service, and psychological counseling. For youth who live in high-risk areas, problem sites should be targeted for intervention, street-level interventions should be established, community members should be mobilized and school programs established, job placement programs and recreational programs should be set up, and mental health, drug counseling and other social service programs should be coordinated. Evaluations of these programs were also highly recommended.
Weapons and Minority Youth Violence: Weapons such as guns and knives are used in over 80% of youth homicides. Weapon use and ownership is deeply rooted in social, economic and racial issues, so that intervention must address these issues where possible. A clear understanding of the impact of these issues is necessary for successful intervention, as is community awareness about the problem of weapon use. Improved security should be implemented in communities, including neighborhood watch programs, technological devices, and legal measures. Firearm safety courses should be required when obtaining a gun license, certain types of highly powerful weapons should be banned, and efforts to restrict illegal gun trafficking should be increased. A federal agency should be developed to deal specifically with firearms, and design and performance standards should be established. All gun owners should be licensed, and a waiting period after purchase should be introduced. Evaluations of prevention programs should be conducted, and information from these should be widely disseminated. Interventions in Early Childhood: The basic values and attitudes that one learns early in life are crucial in the later development of violent behavior patterns. Violence prevention strategies should include the promotion of nonviolent values, should attempt to mitigate the effects of exposure to violence, and should target young children and their families to reduce risk factors for violence. Prevention efforts should address the ways in which children experience and learn violent behavior, and should be culturally sensitive and considerate of the family unit in which the child has learned. Interventions should be delivered in the home to provide support to the family, in schools via education about nonviolent interpersonal relationships and social skills, in treatment settings in the form of therapeutic services for victims of abuse and neglect, and in the community, with family support centers providing parenting education, crisis intervention, mentoring programs and traditions that can strengthen one's sense of family and community. Public education must inform people of the existence of such interventions, using forms of communication and media that are indigenous to each community. Support for longitudinal evaluation research must be expanded, and other evaluation of early childhood interventions can include the development of increased surveillance for child maltreatment and the provision of training materials and curricula for intervention providers. Continued research should be directed at examining the effects of childhood placement experiences, the success of cognitive and social training, the effectiveness of therapeutic interventions and training of intervention workers, and the effectiveness of mentoring programs in early childhood.
Closing Remarks - Prevention of Violence: a Public Health Commitment: Since violence has become accepted as a public health problem, workers in the field of violence prevention have learned that better data are needed, as are more comprehensive surveillance systems to identify at-risk populations, and better evaluations of prevention programs. The solution to violence can only be achieved with a coordinated effort on the parts of communities, churches, researchers, educators, volunteers, social workers and families. Youth have to be accepted, to feel as if they belong and are doing the right thing. They have to be shown what to do, not told what not to do. Nonviolent conflict resolution must be taught, and alternatives to gangs must be offered. Self-esteem must be built, by providing opportunities for constructive activities and interesting programs.
Evaluation of Community-Based Violence Prevention Programs: One of the vital links in the successful prevention of violence is the evaluation of programs and the dissemination of information about which types of programs are effective and which are not. Such evaluations can direct future intervention efforts, can provide solid evidence of a particular program's effectiveness, can ensure the collection and sharing of information and can identify areas of research needed to support further program and evaluation efforts. By employing formative evaluations of the development of programs and their specific interventions, process evaluations of the services delivered, and outcome evaluations comparing the situation before and after the intervention was implemented, prevention and intervention planners can rely upon a convincing body of knowledge to direct their future work.
EVALUATION:
The Forum on Youth Violence in Minority Communities represents a vital and much needed examination of some of the issues surrounding the prevention of violence. In the summary of the proceedings, crucial topics have been thoroughly and thoughtfully discussed, and implications and recommendations have provided planners and researchers alike with important information about where to proceed in the fight against violence. This Forum should be seen as an excellent source of ideas and information, in which experts from a variety of fields have come together to discuss current knowledge and beliefs about the issue of prevention of violence. (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)
Language: en |