Magazine article Black Issues in Higher Education

Is Violence a Public Health Issue? Question Provokes Fierce Debate

Magazine article Black Issues in Higher Education

Is Violence a Public Health Issue? Question Provokes Fierce Debate

Article excerpt

Is Violence a Public Health Issue? Question Provokes Fierce Debate.

by Linda Douglas

Louis W. Sullivan's mention in a 1989 speech that violence is the leading cause of death among Black males ages 15 to 24 was the beginning of a sometimes contentious campaign that is only now beginning to pick up steam.

Sullivan, who served as former President George Bush's secretary of Health and Human Services from 1989 to 1993 and now heads the Morehouse School of Medicine in Atlanta, gave the speech at the annual conference of the National Coalition of 100 Black Men. It planted the seed for treating violence as a public health issue across the country.

Pre-dating the Sullivan speech, the Atlanta, GA-based Centers for Disease Control and Prevention (CDC) had been working on the issue, according to Mary Ann Fenley, a CDC communications officer. It has probed the causes of violence for about 12 years, she said, although programs to address the issue are still about a year away from implementation.

Said Fenley: "This is an issue because of its impact on the quality of life and on public health agencies. We monitor death certificates and it became real apparent, 12 years ago, that the number of deaths [of] young people [from] suicides and homicides was high, and it has increasingly gotten worse.

More than 20,000 people die from homicides every year, and more than ten million people suffer from injuries received in violent conflicts, according to the U.S. Department of Health and Human Services.

But in most cases, people aren't randomly singled out for violence. Often it is the result of friends fighting over trivial matters. More than 40 percent of all homicides occur between friends and acquaintances, the department said in its 1993 report: "The Prevention of Youth Violence, A Framework for Community Action."

"The CDC is a prevention agency, so we are interested in primary prevention. We would like to intervene before things ever start."

Criticism and Controversy

Efforts by Sullivan and the CDC have resulted in studies on violence and subsequent recommendations to communities on preventing violence by reaching a child early in life.

"Most homicides occur among people who are related to each other," said Sullivan recently. "We proposed a model that was a public-health model to address violence in the same way that we took up AIDS or pneumonia, the bottom line being finding ways that we can prevent violence and finding ways to address the underlying cause."

Sullivan's findings named the prime causes as joblessness, homelessness and abuse of alcohol and drugs. HHS looked at programs it was already operating, such as those dealing with alcohol or drug abuse, or those that addressed teens in an attempt to consolidate the programs and give them a bigger thrust into the affected communities.

But this approach prompted fierce debates and racist retorts. Shortly after Sullivan had taken on the project, Fred Goodwin, who was then the administrator for the Alcohol Abuse and Public Health Administration, made a comment that upset observers studying the issue. During a gathering of the National Advisory Council for the National Institute of Mental Health, Goodwin discussed a study on monkeys in captivity and aggressive behavior, including a reference to the inner cities as jungles. Goodwin was reprimanded and demoted, but that did not quell a storm of criticism and charges that Sullivan was handling the issue of violence the wrong way. …

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