By Potter, Roberto Hugh; Saltzman, Linda E.
Corrections Today , Vol. 61, No. 1
Professionals in the fields of corrections, criminal justice, criminology, social work and sociology are often surprised to learn that a public health agency such as the Centers for Disease Control and Prevention (CDC) is involved in violence prevention. When one of the authors recently left a corrections-related research position at a regional state university, several corrections professionals asked him why CDC was involved in the area of violence, and what CDC did that was different from the justice system approach. In this article, these questions will be addressed through an overview of why CDC addresses violence as a public health issue. This article also will outline some of the violence-related activities of CDC and explore areas in which criminal justice, corrections and public health organizations might collaborate to achieve mutual goals.
A Public Health Approach
Within the public health approach, violence is "the intentional use of physical force, against another person or against oneself, which either results in or has a high likelihood of resulting in injury or death."(1) Because violence often leads to injury, sexual abuse, emotional and psychological injury, or death, CDC is naturally interested in learning about violence and how to prevent it. However, our focus concentrates primarily on preventing violence. The traditional role of the justice and correction professions has been to punish or rehabilitate those who have already committed a violent act. This contrast provides us with one of our first areas of overlap and possible collaboration: violence prevention work.
Another area of overlap is the way in which CDC conceptualizes violence. We do not use a "disease model" for explaining violence. Thus, we do not believe that there is necessarily anything organically wrong with an individual who acts violently, although there may be in some instances. The public health approach to violence is more akin to the public health approaches to chronic diseases. For example, to prevent lung cancer, the public health approach would be to reduce or eliminate cigarette-smoking behavior, an established risk factor. This approach seeks to determine what contributes to the likelihood of a person either engaging in the target behavior, or being a victim of that behavior, and then developing preventive measures to help that person avoid being in the at-risk category.
The public health approach to problem-solving, whether it be infectious diseases or violence, involves a four-step process of applied science. First, identify the size of the problem. Second, determine the risk and protective factors (protective factors reduce the risk of involvement with violence) for the population being studied. This step of the public health approach is to understand why violent behaviors occur. Through public health surveillance activities, characteristics of victims and perpetrators can be identified. Factors that tend to cluster around probability of victimization (e.g., poverty), or those that appear to be protective (e.g., educational attainment, employment) can be cataloged. Once this risk and protective factor exploration has been accomplished, such information can be employed to develop programs that address risk reduction or protection enhancement.
Both of these tasks are accomplished through the use of epidemiology, the underlying science of public health. "Public health surveillance" is the term used to describe the collection of information to determine the size of a health problem, describe the characteristics and circumstances associated with the problem, and to monitor trends in the problem behavior or condition. In the case of violence, CDC uses a variety of data sources, including the Uniform Crime Reports, National Crime Victimization Surveys, hospital admissions, and the recently completed National Violence Against Women Survey.(2) Many in the justice field might categorize this as data collection, monitoring or needs assessment to differentiate from "surveillance" as the term is used by law-enforcement and corrections professionals. …