Addressing Violence by Advancing Equity

Violence is a public health issue and requires that a variety of systems and sectors work together to address it. This includes public health departments, health care systems, and behavioral health providers, but media, faith-based organizations, and community information systems can play roles as well. No matter where you work or how you interact with your community, you can play a role in violence prevention. This framework provides information and recommendations by area for a cross-sector approach to violence prevention.

Government officials and agencies must value the input, experience, and capacity of community members and organizations. Connecting these sectors helps to align health department functions with equity goals. Instead of disregarding or working against them, health departments can support the advocacy power and voice of communities, making the health departments more accountable to those communities in their mutual goals of advancing equitable health and safety outcomes. This allows for health departments and residents to identify root causes of inequities – including unequal distribution of power and historical trauma – to build trust and foster long term relationships.

Sims, J., Viera, S., & Aboelata, M. J. (2018). Partnering for Health Equity: Grassroots Organizations on Collaborating with Public Health Agencies. Prevention Institute. https://www.preventioninstitute.org/publications/partnering-health-equity-grassroots-organizations-collaborating-public-health-agencies.

With issues like housing access, food insecurity, and education inequality as risk factors for exposure to violence, addressing these issues also addresses safety. While their mission may not be violence prevention, nonprofits that support communities access basic needs can engage in equity-based approaches that provide short-term support to mitigate structural and systemic barriers and advocate for long-term social change. Research has quantified the relationship between nonprofit organizations and violence, finding that organizations focusing on crime and community life lead to reductions in homicides, violent crime, and property crime.

Sharkey, P., Torrats-Espinosa, G., & Takyar, D. (2017). Community and the Crime Decline: The Causal Effect of Local Nonprofits on Violent Crime. American Sociological Review, 82(6), 1214-1240. https://doi.org/10.1177/0003122417736289.

Nonprofit organizations and agencies provide support to families in a variety of ways, including financial assistance, parenting classes, workforce development, and educational resources. In the same way that healthcare systems can be used to screen for and provide intervention in intimate partner violence, preventionists have sought to integrate approaches to address IPV in service delivery. Researchers have developed a readiness assessment tool to identify those existing programs and organizations well-suited for an IPV intervention. It can be used by other researchers, service providers, and prevention specialists to discover strategic partnerships and further support families within communities.

Andrews, N., Motz, M., & Pepler, D. J. (2020). Developing and testing a readiness tool for interpersonal violence prevention partnerships with community‐based projects. Journal of Community Psychology, 48(6), 1715–1731. https://doi.org/10.1002/jcop.22361.

Individuals who experience intimate partner violence may be fearful or distrusting of police involvement. The reasons why they may not report their experience are complicated, and the process they go through when they do is even more complicated and biased. To address this, a nonprofit organization that works to prevent gender-based violence and the police department in Cincinnati have partnered on a program to support survivors of IPV, and researchers were invited to evaluate the program. DVERT™ (Domestic Violence Enhanced Response Team) is a trauma focused crisis response team that provides an on-call, on-scene safety planning, access to resources, empowerment, and engagement in on-going support services. The program intends to decrease incidents of repeat IPV, improve IPV survivor experiences and outcomes, educate IPV survivors of their potential for involvement in continued violence, assist with decisions regarding their safety and needs, and strengthen responses to IPV survivors in crisis during crucial opportunities for intervention.

Other studies exist around these responder-practitioner-researcher partnerships regarding the criminal legal system and perpetrators. DVERT enables self-determination and empowerment for survivors within the larger context of creating social change.

Wojcik, M., Rubenstein, B. Y., Petkus, A. A., Racadio, M., Anderson, V. R., Fisher, B. S., Wilcox, P., & Bleser, A. (2021). Coming Together in the Fight Against Intimate Partner Violence: Lessons Learned From a Researcher–Practitioner Collaboration Evaluating Cincinnati’s Domestic Violence Enhanced Response Team (DVERT). Journal of Contemporary Criminal Justice, 37(2), 221-243. https://doi.org/10.1177/1043986221999861.

Community-led initiatives do not just improve connectedness. They also engage approaches that expand ideas about what can keep individuals and neighborhoods safe. The One Million Experiments website includes stories about community projects, a podcast, and ‘zines. Visitors can also share activities that have worked in their community.

Training and employing residents to mediate conflicts in their neighborhoods is a violence prevention model called street outreach. Technology can play a vital role in supporting the organizations to coordinate these responses, which is why a group in Chicago collaborated with software developers and academics to co-design, build, and deploy a mobile application to give them more agency over their communication with one another and build a counter-structure to traditional policing.

Dickinson, J., Arthur, J., Shiparski, M., Bianca, A., Gonzalez, A., & Erete, S. (2021). Amplifying Community-led Violence Prevention as a Counter to Structural Oppression. Proceedings of the ACM on Human-Computer Interaction, 5 (CSCW1, 180). https://doi.org/10.1145/3449279.

Violence prevention and interventions are often participatory in nature and implemented through face-to-face interactions. While connecting online is more widely accepted and often functions as a substitute for in-person interaction, some concerns remain about how “safe” and “secure” the virtual world can be for creating community, developing trust, interpreting non-verbal communication, and ensuring privacy and confidentiality. Through the pandemic, increased use of videoconferencing and telehealth have not only provided a continuum of connection and care but also increased access for those who have mobility needs, are immunocompromised, live in remote locations, or have care-giving responsibilities. Continuing to examine how and under what circumstances a virtual safe social space can be created can expand the reach of violence prevention programs and intervention approaches.

Ndungu, J., Ngcobo-Sithole, M., & Gibbs, A. (2022). Researchers or practitioners’ opinion of the possibilities for creating virtual safe social spaces for violence prevention interventions for young people. Health Education Research, 37(3), 155-166. https://doi.org/10.1093/her/cyac008.

Being intentional and proactive about developing and supporting grassroots efforts can convert one person’s passion into local, long-term change. Whether you are interested in solving a problem in your community or involving more of your neighbors in your cause, you’ll find something of value to your work in findings about grassroots leadership from the W.K. Kellogg Foundation.

When individuals access the healthcare system, all of their needs can and should be assessed so that they can be met and that they are safe in their living environments and communities. Routine visits for primary or pediatric care provide an opportunity to connect individuals with resources and intervene with additional mental health or case management supports. Additional research is needed to expand this area of violence prevention.

Roche, J.S., Philyaw-Kotov, M.L., Sigel, E., et al. (2022). Implementation of a youth violence prevention programme in primary care. Injury Prevention, 28. https://injuryprevention.bmj.com/content/28/3/231.

Healthcare providers are well-positioned to help people address a variety of negative impacts on their well-being. IPV causes adverse effects for individuals and their families and assessing for that in primary care, pediatric, gynecological, and other wellness visits can identify needs and resources to prevent or end violence. The Centers for Disease Control and Prevention (CDC) has compiled a document of clinical and healthcare assessment tools for IPV and sexual violence. It serves as a guide to help identify victims requiring additional services and can help practitioners make appropriate referrals for both victims and perpetrators.

Community Health Workers (CHW) serve in a frontline public health capacity within communities, becoming trusted connections between the community and health and social services. CHWs facilitate access to services, improve the quality and cultural competence of service delivery, and increase health knowledge and self-sufficiency through outreach, community education, informal counseling, social support, and advocacy. CHW’s community-focused roles can be applied to address structural determinants of health inequities, which also positions CHWs to support violence prevention. In preventing community violence, youth violence, and family violence specifically, use of CHWs within comprehensive approaches helps to reframe violence as a public health issue, change community norms around violence, help communities to heal collectively from violence, and develop community leadership and capacity to initiate change in structural conditions.

Barbero, C., Hafeedh Bin Abdullah, A., Wiggins, N., Garrettson, M., Jones, D., S. Guinn, A., Girod, C., Bradford, J., & Wennerstrom, A. (2022). Community Health Worker Activities in Public Health Programs to Prevent Violence: Coding Roles and Scope. American Journal of Public Health (1971), 112(8), 1191-1201. https://doi.org/10.2105/AJPH.2022.306865.

The National Action Alliance identified seven key elements for the successful implementation of comprehensive community-based suicide prevention. They include Unity, Planning, Integration, Fit, Communication, Data, and Sustainability. Community-based programs play a critical role in supporting the development of positive social connections, identifying those who may be at risk, and getting them the resources they need.

Responsible gun ownership and safe storage can prevent firearm injury and death, especially with regards to suicide. The Gun Shop Project through the Harvard T.H. Chan School of Public Health connected public health and mental health practitioners with firearm retailers and gun range operators to educate them on the role they can play in suicide prevention and to provide materials that can be displayed and distributed.