Addressing Violence by Advancing Equity

A public health approach can address structural factors linked to susceptibility to violence. Research in this area indicates that increasing investment in the following can advance protective factors across the lifespan:

• Access to health care and treatment
• Community violence intervention
• Civilian crisis response

The Brookings Institute has published “A New Community Safety Blueprint: How the Federal Government Can Address Violence & Harm Through a Public Health Approach.” These recommendations of investment aren’t just for federal policymakers. States and municipalities also have the authority and capacity to make similar investments.

People and communities experience violence in overlapping ways, and certain conditions give rise to many forms of violence, including intimate partner violence, sexual violence, child maltreatment, bullying, suicidal behavior, and elder abuse and neglect. This may take place in the home, in school, at work, or within neighborhoods, and they can happen at the same time or at different stages of life. The forms of violence are interconnected and often share the same root causes. Understanding the overlapping causes of violence and the factors that can protect people and communities is important to better address violence in all its forms. To clarify the relationships among eight forms of violence, Prevention Institute developed Connecting the Dots with the U.S. Centers for Disease Control and Prevention. Those interested in violence prevention in one form can use this guide to coordinate their efforts, increase their impact, and work toward preventing multiple forms of violence at once.

Wilkins, N., Tsao, B., Hertz, M., Davis, R., Klevens, J. (2014). Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention Oakland, CA: Prevention Institute.

Negative emotions can be challenging, but being able to identify and label them supports healthy coping mechanisms. This can prevent someone from harming themself or others. The American Psychological Association has a helpful guide on how to deal with anger and whether you or someone you know are at risk for violent behavior, recognize warning signs of violence in others, and discover what can help.

Harm to older adults can take many forms, including neglect or physical, sexual, emotional, or financial abuse. Everyone within a community can play a role in preventing elder abuse by checking on their neighbors, listening to their concerns, and offering support to them and their caregivers, and noticing the signs of elder abuse.

Bystander training raises awareness about sexual violence and equips individuals with ways to intervene. Through attitude and behavior change, everyone can learn how to recognize harmful behavior and take responsibility to address it. Various forms of bystander training exist, and researchers have studied approaches to and the efficacy at preventing sexual violence. One systematic review examines the evidence base around bystander training and suggests applications beyond preventing sexual violence. Schools, organizations, and business owners can offer bystander training to keep staff and those they serve and their communities safe.

Mujal, G.N., Taylor, M. E., Fry, J. L., Gochez-Kerr, T. H., & Weaver, N. L. (2021). A Systematic Review of Bystander Interventions for the Prevention of Sexual Violence. Trauma, Violence, & Abuse, 22(2), 381-396. https://doi.org/10.1177/1524838019849587.

Programs like Cure Violence and Safe Streets connect trained outreach staff with residents to mediate conflicts, promote nonviolence norms, and connect youth to community supports to reduce risks and build buffers against violence. These programs go beyond intervening in violence to provide positive mentors to young people and link them to educational opportunities, employment training and assistance, and mental health services. They also engage the community with public education and neighborhood events to foster beliefs that violence in any form is not acceptable.

This doesn’t just apply to community violence. It applies to interpersonal violence as well, including intimate partner violence. Society often treats IPV as being private and only addressable at the individual and personal levels. A public health approach to IPV includes change at the community and societal levels as well, which means everyone can play a role in ending IPV. The Centers for Disease Control and Prevention have developed resources and technical packages that include cross-cutting prevention efforts, community-level prevention, strategies and approaches to prevent intimate partner and sexual violence, information on race, class, gender and social determinants of health, and a vision for the future of the prevention field.

Access to health care provides much needed well-being support for individual’s mental and physical health. This social determinant of health is also a protective factor for exposure to violence. Researchers have studied the relationship between access to health care and criminal behaviors and found that increased access, including an expansion to Medicaid, has the potential to reduce crime. Several cost-benefit analyses show that this is a cost-effective policy change to reduce crime, especially when compared to carceral solutions, and reduce recidivism among offenders convicted of violent crimes. One study found that the estimated decrease in reported crime amounts to an annual cost savings of $13 billion.

Aslim, E. Mungan, M. C., Navarro, C. I., & Yu, H. (2022). The Effect of Public Health Insurance on Criminal Recidivism. Journal of Policy Analysis and Management, 41(1), 45-91. https://doi.org/10.1002/pam.22345.

Vogler, J. (2020). Access to Healthcare and Criminal Behavior: Evidence from the ACA Medicaid Expansions. Journal of Policy Analysis and Management, 39(4), 1166-1213. https://doi.org/10.1002/pam.22239.

As part of the public health approach to gun violence prevention, research can guide organizations, communities, cities, states, and the country as a whole implement effective programs and policies. A Research Roundup from the Giffords Law Center offers an analysis of gun violence publication trends in 2021 and identifies several areas that should be addressed within the field of gun violence research.

Procedural justice refers to the idea of fair processes and how an individual’s perception of fairness relates to the quality and result of their experiences within various systems. It includes four pillars – voice, respect, neutrality, and trustworthiness – which enable individuals involved in various processes to express their concerns, give and receive dignity and respect, have confidence that all those involved care about the outcomes, and participate in unbiased and transparent decision-making processes. Research demonstrates that procedural justice is critical for law enforcement authorities, emphasizing transparency, explaining policing actions, responding to community concerns, and decreases harmful policing practices, and prevents violence. As a study in Chicago shows, procedural justice is an effective alternative to the force-based command and control model used in most law enforcement agencies.

Wood, G., Tyler, T. R., & Papachristos, A. V. (2020). Procedural justice training reduces police use of force and complaints against officers. Proceedings of the National Academy of Sciences – PNAS, 117(18), 9815-9821. https://doi.org/10.1073/pnas.1920671117.

Cities can use a community responder model to send the right support to calls related to behavioral health crises, wellness checks, or intoxication as well as calls related to quality of life. The Crisis Assistance Helping Out On The Streets (CAHOOTS) program in Eugene, Oregon is one example.

Use of de-escalation tactics during encounters with citizens is one way being examined to prevent police violence. Training officers on how to achieve a calm or neutral state for all participants in a conflict can resolve highly confrontational situations without the use of force. To understand the potential advantages of this training, researchers partnered with a local police department and examined the relationships between receipt of the training and police interactions. De-escalation training resulted in reductions in use of force incidents, citizen injuries, and officer injuries, which demonstrates the potential for this training to make police encounters with the public safer for all.

Engel, R.S., Corsaro, N., Isaza, G. T., & McManus, H. D. (2022). Assessing the impact of de‐escalation training on police behavior: Reducing police use of force in the Louisville, KY Metro Police Department. Criminology & Public Policy, 21(2), 199-233. https://doi.org/10.1111/1745-9133.12574.

Researchers have frequently studied the relationship between self-control and violence and the way parenting impacts a child’s development of self-control. Failure to develop sufficient self-control can increase an individual’s risk for negative health, mental health, and societal outcomes far into the future. As a means of addressing and preventing violence, schools, agencies, and nonprofit organizations can offer children and parents programs that proactively support self-control development or intervene in behavioral issues. One such program is SNAP® (Stop Now And Plan), an evidence-based cognitive behavioral model that provides a framework for teaching children struggling with behavior issues, and their parents, effective emotional regulation, self-control, and problem-solving skills. Its goal is to help children stop and think before they act.

So many gun injuries and deaths, including those that are due accidents or suicidality, can be prevented through safe gun storage. Theft also decreases with the proper storage of firearms. Gun shops can support gun owners by educating them on safe storage options, and use of safe storage in homes can keep firearms out of reach of children, young adults, and those who may have suicidal ideation.

Rowhani-Rahbar, A., Simonetti, J. A., & Rivara, F. P. (2016). Effectiveness of Interventions to Promote Safe Firearm Storage. Epidemiologic Reviews, 38(1), 111-124. https://doi.org/10.1093/epirev/mxv006.

Gun safety doesn’t have to be a taboo topic. In fact, talking about gun safety can save lives. Resources from End Family Fire encourage these conversations and have tips on how doctors can talk with patients, how parents can talk with other parents, and how family members and friends can talk with one another. Asking someone about their safe storage practices can prevent unintentional firearm injuries and suicides.

Individuals, their loved ones, and their friends can engage in an intentional, voluntary practice to reduce suicide risk by limiting access to lethal means like firearms, medications, alcohol, or any item that can be used to self-harm. Increasing the time and distance between an individual and their access to lethal means can reduce risk and save lives. The Veterans Administration provides several resources for both individuals and communities on lethal means safety. This VA resource lists actions and information for individuals. Additionally, the VA, the National Shooting Sports Foundation (NSSF), and the American Foundation for Suicide Prevention (AFSP) have compiled tips for safely storing firearms as well as best practices for engaging the community about safe firearm storage.

A special issue of the Journal of the American Medical Association (JAMA) dedicated to firearms and violence explores a new era for prevention through policy. An increase in previously nonexistent funding to research gun violence can provide insight into decision-making at multiple levels. In the past, an evidence base around the dangers of smoking changed public opinion and policy. Now, the same can and should be done around firearms to guide individuals and policymakers.

Morral, A.R. & Smart, R. (2022). A New Era for Firearm Violence Prevention Research. Journal of the American Medical Association, 328(12):1197-1198. https://jamanetwork.com/journals/jama/fullarticle/2796679.

Research shows that legislation is effective at reducing gun violence, and that most gun laws are compatible with Second Amendment interpretations. You can be informed about the gun laws in your state and learn more about the intention behind each policy by visiting the Giffords Law Center.

Several evidence-based and data-driven ways to prevent violence focus on equity, investing in communities, supporting families, and improving the built environment to give people access and opportunity so that they can thrive. We all deserve a future free from violence, and elected officials can help make that happen. Voting in each election can hold policymakers accountable and put those in office who align with violence prevention strategies that work without creating additional harm.

If you find something useful on this page, send it to or talk about it with someone you know or a group you lead.

Centers for Disease Control & Prevention: https://www.cdc.gov/violenceprevention/index.html

Safe States Alliance: https://www.safestates.org/

Prevention Institute: https://www.preventioninstitute.org/

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