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It has been several weeks since the nation recoiled in horror at the videotaped brutal beating death of 16-year-old Derrion Albert, the Chicago honor student who was caught in a melee between two factions of warring youth. Last week, President Obama dispatched Attorney General Eric Holder to the city to declare that he understood the urgency of the problem:
“The Department of Justice is releasing a new study today that measures the effects of youth violence in America, and the results are staggering. More than 60 percent of the children surveyed were exposed to violence in the past year, either directly or indirectly. Nearly half of children and adolescents were assaulted at least once, and more than one in ten were injured as a result. Nearly one-quarter were the victim of a robbery, vandalism or theft, and one in sixteen were victimized sexually.” (Emphasis mine.)
The Attorney General went on to discuss the need for coordinated solutions:
Our responses to this issue in the past have been fragmented. The federal government does one thing, states do another, and localities do a third. We need a comprehensive, coordinated approach to address youth violence, one that encompasses the latest research and the freshest approaches. Our administration is committed to implementing such strategies, which is why we've asked for $24 million in next year's budget for community-based crime prevention programs such as Ceasefire and Project Safe Neighborhood. And it's why our Office of Justice Programs is available 24 hours a day, 7 days a week to provide support and assistance to communities affected by violence.
Hear, hear! But I'm wondering -- where are the public health experts are in this discussion?
Why a public health approach matters
A comprehensive study done under Clinton administration Surgeon General David Satcher argued forcefully that youth violence is not only a public safety issue; it's a public health issue. One key conclusion from that 2001 report suggests the road not taken:
The most important conclusion of this report is that youth violence is not an intractable problem. We now have the knowledge and tools needed to reduce or even prevent much of the most serious youth violence, with the added benefit of reducing less dangerous, but still serious problem behaviors and promoting healthy development. Scientists from many disciplines, working in a variety of settings with public and private agencies, are generating needed information and putting it to use in designing, testing, and evaluating intervention programs. ... Thus, the most urgent need is a national resolve to confront the problem of youth violence systematically, using research-based approaches, and to correct damaging myths and stereotypes that interfere with the task at hand
The Satcher report advocated a public health approach to the problem of youth violence that:
- Defines the problem, using surveillance processes designed to gather data that establish the nature of the problem and the trends in its incidence and prevalence;
- Identifies potential causes, through epidemiological analyses that identify risk and protective factors associated with the problem;
- Designs, develops, and evaluates the effectiveness and generalizability of interventions; and
- Disseminates successful models as part of a coordinated effort to educate and reach out to the public (Hamburg, 1998; Mercy et al., 1993).
I've taken the liberty of quoting the Satcher report extensively because it's worth asking whatever happened to its recommendations. A 2005 study by criminologist Brandon C. Welsh suggests that there were those in the criminal justice community who were still unaware of the value of this approach to the youth violence problem. From the abstract:
The increasingly punitive response to juvenile criminal violence is an unsustainable approach to reducing juvenile violence, according to the author. The sole reliance on a law-and-order approach is at the center of the problem. However, the public health perspective represents a promising approach to the reduction and prevention of juvenile violence and should be considered as a complement to the traditional law-and-order approach, rather than an alternative.
Children in crisis
The sheer magnitude of post-traumatic stress being experienced by Chicago's children alone makes health policy an essential part of the solution to youth violence in that city. Listen to Trinity United Church of Christ's pastor, Rev. Otis Moss III, as he talks about what the children in his congregation are experiencing:
Rapper Killer Mike's XXL magazine blog post about his reactions to Albert's murder attests to the breadth and depth of the problem. Watching the video of the murder brought "20 ghosts" to his mind of victims and perpetrators of violence
