Youth Violence Prevention at CDC

Youth Violence Is a Significant Public Health Problem• Homicideisthesecondleadingcauseofdeathforyoung

peoplebetweentheagesof15and24.

• In2010,morethan738,000youngpeopleages10to24weretreatedinemergencydepartmentsforassault-relatedinjuries;over30%ofhighschoolstudentsreportedbeinginatleastonephysicalfight;andnearly20%reportedbeingbulliedonschoolproperty.

• Homicidesandassault-relatedinjuriesamongyouthages10to24injustoneyearcostAmericansanestimated$16.2billioninlifetimecombinedmedicalandworklosscosts.

Public Health is Making a Difference• We know that youth violence can be prevented. TheTask

ForceforCommunityPreventiveServiceshasidentifiedstrate-giesthatwork(e.g.,universalschool-basedviolencepreventionprograms),andtheBlueprintsProjecthasidentified11specificmodelprogramsandanother19promisingprograms.

• CDC is unique among federal agencies inthatitworkstopreventyouthviolencebeforeitoccurs.CDCpromotesacom-prehensiveandcoordinatedapproachbycontributingevidencetoinformpreventionandworkingacrosssectors(includingschools,lawenforcement,andcommunitybasedorganiza-tions).In2011,CDCspent$19.7milliononyouthviolencepreventionefforts.

• CDC provides public health leadership andCDCfundinghashelpedtoprovidedatausedtodescribethemagnitudeandburdenofyouthviolence,identifypromisingandeffectivepre-ventionstrategies,andbuildcommunities’capacitytopreventyouthviolence.

CDC’s AccomplishmentsThe Division of Violence Prevention (DVP) at CDC is committed to stopping violence before it begins. Wedothisbyusingthepublichealthapproach,whichincludesdescribingthemagnitude,characteristics,andconsequencesofviolentbehaviorsandtrackingtrendsovertime,identifyingriskandprotectivefactors,developingandtestingpreventionstrategies,andensuringwidespreadadop-tionofevidence-basedstrategies.

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National Center for Injury Prevention and ControlDivision of Violence Prevention

Strong Data to Track the Problem and Identify Populations at Risk:

• InMay2011,CDCreleasedViolence-Related Firearm Deaths Among Residents of Metropolitan Areas and Cities --- United States, 2006—2007.Thisreportdocumentedfirearmhomicidesandfirearmsuicidesformajormet-ropolitanareasandcities(MSAs),withanemphasisonyouthaged10-19years.Comparedwiththenationalrateof4.2per100,000personsperyear,thisstudyfoundthatfirearmhomiciderateswerehigherforlargemetropolitanareas,witharateof5.2overall;thehighestrateswereincentralcities.Specifically,foryouthages10-19,residentsofthe50largestMSAsaccountedfor73%offirearmhomicidesand39%offirearmsui-cidesnationally.Inaddition,theyouthfirearmhomiciderateexceededtheall-agesratein80%oftheMSAsandin88%ofthecities.

• School-Associated Violent Deaths Study (SAVD)isapartnershipbetweenCDCandtheDepartmentsofEducationandJusticeandhascollecteddatafromJuly1,1992,throughthepresent.SAVDdescribestheepidemiologyofschool-associatedviolentdeaths,identifiescommonfeaturesofthesedeaths,estimatesthefrequencyandrateofschool-associatedviolentdeathintheUnitedStates,andidentifiespotentialriskfactorsforthesedeaths.PreliminarydatafromJuly2011ondeathsofyouthages5-18fromSAVDpublishedintheDepartmentofEducation’s“IndicatorsofSchoolCrimeandSafetyReport:2011”showthatfromJuly1,2009,throughJune30,2010therewere33school-associatedviolentdeathsinelementaryandsecondaryschoolsintheUnitedStates.Twenty-fiveofthesewerehomicides,fiveweresuicides,andthreewerelegalinterventions.

• National Violent Death Reporting System(NVDRS)isastate-basedsurveillancesystemthatusesinforma-tionfromavarietyofstateandlocalagenciesandsources—medicalexaminers,coroners,police,crimelabs,anddeathcertificates—toformamorecompletepictureofthecircumstancesthatsurroundviolentdeaths.Forexample,inNewJersey,becauseNVDRSdatadocumentedthatfarmorehomicideswererelatedtogangviolencethanpreviouslyknown,thestatewasabletoinformpolicedepartmentsofabroadergangviolenceprofile.Nowthegangviolenceproblemistrackedmoreaccurately,andviolencereductioneffortsareapriority.

Research to Understand the Problem and Identify Effective Interventions:

• Linkages across various forms of violence,CDCfundedtheStudentHealthandSafetySurveytostudytheinter-relationshipsamongpeer,date,andself-directedviolence.Theresultsindicatestrongassociationsbetweenriskforvictimizationandperpetrationandsubstantialoverlapacrossdifferenttypesofviolence.Forexample,riskforsuicideattemptswasovertwotimeshigheramongyouthwhohadbeenviolentagainstotherscomparedtothosewhohadnotbeenviolent.

• Media and Violence,CDCfundedresearchthatdem-onstratedyouthwhoreportedthatmany,most,orallofthewebsitestheyvisiteddepictedrealpeoplefighting,shooting,orkillingwere5timesmorelikelyalsotoreportseriouslyviolentbehavior,comparedwiththosewhoreportedthatnoneofthewebsitestheyvisitedhadthesedepictions.

• The Academic Centers for Excellence in Youth Violence Prevention(ACEs)fosterrelationshipswithlocalcom-munitypartnerstohelpdevelop,implement,andevaluatepromisingpreventionefforts.

• TheJohnsHopkinsUniversityCentercoordinatedthecommunity-basedimplementationandevaluationoftheSafeStreetsprogram,areplicationoftheChicagoCeaseFireprogram.Thisevaluationshowsthattheprogramworkstointerruptviolence,particularlyshootings,andchangenormsabouttheaccept-abilityandinevitabilityofviolence.Inmostimplementationcommunities,shootingsandkillingsre-ducedandtheysawfewerretaliatorykillings.

• TheVirginiaCommonwealthUniversityACEdocumentedtheimpactofunrestrictedalcoholbeveragelicensesonviolence.Duringthetimewhentherestrictionwasineffect,theaveragerateofambulancepickupsforintentionalinjuriesdeclinedfrom13.1per1,000residentsaged15to24yearsoldtozero.Whentherestrictionswereoverturned,ambulancepickupsincreasedto5.3per1,000residents.

• Evaluations of policy and structural approaches to prevent youth violenceidentifiedtheimpactofBusinessImprovementDistricts(BIDs)inLosAngelesonyouthviolenceandviolentcrime.AnanalysisofofficialcrimereportsfoundpositiveeffectsofBIDsonloweringtherateofinterpersonalcrimesofviolence.BIDareashada12%dropinrobberyrates,an8%dropinviolentcrimeoverall,and32%fewerpolicearrestsovertimecomparedwithnon-BIDareas.AcostanalysisfoundthatBIDsalsoresultedincostsavingsduetoreducedcrimerates,reducedarrests,andlowerprosecution-relatedexpenditures.

• Preventing perpetration among middle-schoolers.Alarge-scalemulti-siterandomizedcontroltrialwasfundedbyCDCtoimplementtheGREAT(GuidingResponsibilityandExpectationsinAdolescentsTodayandTomorrow)interventionwithatotalof37middleschoolsacrossfoursites.TheGREATinterventionincludedseparatecomponentsforparents,teachers,andstudents.Theresultsindicatethatwecanhavesignificantposi-tiveeffectswiththeGREATinterventionformiddleschoolyouth.Inparticular,schoolswheretheGREATparentprogramwasundertakenhadasignificantdropintherelativelevelsofviolenceperpetration.Thesefindingssuggestthatpreventioneffortsdirectedtowardasubsetofstudentswhodisplayhighlevelsofaggressionandsocialinfluencehavethepotentialtoproduceschool-levelchangesinratesofphysicalaggression.

• Shaping and filling gaps in the research field asevidencedbydevelopinganddisseminatingover400CDC-authoredpublicationsandjournalarticles.In2011,CDCreleased,“MeasuringBullyingVictimization,Perpetration,andBystanderExperiences:ACompendiumofAssessmentTools,”whichprovidesresearchers,preventionspecialists,andhealtheducatorswithtoolstomeasurearangeofbullyingexperiences:bullyperpetration,bullyvictimization,bully-victimexperiences,andbystanderexperiences.

Programmatic Work to Build Capacity and Increase Implementation of Prevention Activities:

• Striving To Reduce Youth Violence Everywhere(STRYVE)isanationalinitiativetoenablecommunitiestoimprovetheirabilitytouseevidence-basedstrategiestopreventyouthviolenceby1)increasingawarenessthatyouthviolencecanandshouldbeprevented;and2)providingguidancetocommunitiesonhowtopre-ventyouthviolence.Thepreventionofyouthviolencerequiresunifiedactionbymultiplesectorsanddisci-plines.Accordingly,CDCisforgingpartnershipstoachieveSTRYVEgoals.TheSTRYVEActionCouncil,whichincludes13nationalorganizations,wasformedinSeptember2010.In2011thispartnershipexpandedwiththeformationoftheSTRYVEPartnershipNetwork.Inaddition,STYRVEincludesanonlinecomponent,www.safeyouth.gov,whichprovidestraining,tools,andresourcesforcommunityleaderstostrategicallyplan,implement,andevaluateanevidence-basedyouthviolencepreventionapproach.

• Urban Networks to Increase Thriving Youth through Violence Prevention(UNITY)isapartnershipbe-tweenthePreventionInstitute,theHarvardSchoolofPublicHealth,andtheUCLASchoolofPublicHealthtoassistlargeurbanUScitiestobuildeffective,sustainableeffortstopreventviolence.UNITYhasdevelopedtheUNITYRoadmap,whichisatechnicaltoolspecificallydevelopedforlargecities,describingthecoreele-mentsnecessarytopreventyouthviolencebeforeitoccurs.AUNITYsupportedstudyfoundthatalthoughcitieswiththegreatestcoordinatedmultisectoralapproachhadthelowestratesofyouthviolence,mostcitiescitedalackofacomprehensiveyouthviolencepreventionstrategy.

Youth Violence Prevention at CDC

Selected Products

Measuring Bullying Victimization, Perpetration, and Bystander Experiences: A Compendium of Assessment ToolsThispublicationprovidesresearchers,preventionspecialists,andhealtheducatorswithtoolstomeasurearangeofbullyingexperiences:bullyperpetration,bullyvictimization,bully-victimexperiences,andbystanderexperiences.

Youth Violence: Measuring Violence-Related Attitudes, Behaviors, and Influences Among Youths: A Compendium of Assessment ToolsThiscompendiumprovidesresearchersandpreventionspecialistswithasetoftoolstoassessviolence-relatedbeliefs,behaviors,andinfluences,aswellastoevaluateprogramstopreventyouthviolence.

The World Report on Violence and HealthThisisthefirstcomprehensivereviewoftheproblemofviolenceonaglobalscale–whatitis,whomitaffects,andwhatcanbedoneaboutit.Threeyearsinthemaking,thereportbenefitedfromtheparticipationofover160expertsfromaroundtheworld,receivingbothpeer-reviewfromscientistsandcontributionsfromrepresentativesofalltheworld’sregions.

Electronic Aggression DocumentsInSeptember2006,CDCconvenedanexpertpaneltodiscussthelatestinformationonhowtechnologyisusedbyyoungpeopletobehaveaggressively.Thepanelaffirmedtheneedforapurposefulapproachtopreventingyouthviolenceandaggressionperpetratedthroughtheuseofelectronicmedia.AspecialissueoftheJournalofAdolescentHealthandseveralcompanionpiecesweredeveloped(http://www.jahonline.org/content/suppl07).

Youth Violence: A Report of the Surgeon GeneralThisreport—thefirstSurgeonGeneral’sreportonyouthviolence—isaproductofextensivecollaboration.Dr.DavidSatcherconvenedseveralfederalagencies,includingCDC,nonprofitorganizations,aswellasindividualyoungpeopletoplan,writeandreviewthereport.Thisreportreviewsamassivebodyofresearchonwhere,when,andhowmuchyouthviolenceoccurs,whatcausesit,andwhichpreventivestrategiesareeffective.

For more information:www.cdc.gov/violenceprevention/youthviolence

1-800-CDC-INFO(232-4636)•cdcinfo@cdc.gov•www.cdc.gov/violenceprevention