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The Public Health Approach to Enhancing Resilience and Preventing Violence in Schools and Communities
The impressive increases in lifespan, declining rates of many diseases, and improvements in health status over the past century are more attributable to the use of public health prevention measures than to direct medical treatment or biomedical advances.
-- Elliott, Hamburg, and Williams, 1998
The public health approach, with its emphasis on primary prevention, has had an extremely positive impact on the health status of Americans during the past century. For example, the public health campaign against cigarette smoking has led to the elimination of thousands of cases of lung cancer, and the public health campaign encouraging the wearing of seat belts has greatly reduced the number of deaths from automobile accidents. It is reasonable, therefore, to use the public health approach to enhance resilience and reduce injuries and deaths due to violence because the "approach allows one to think about violence not as an inevitable fact of life but as a problem that can be prevented" (Hamburg, 1998, pp. 39-40).
The core elements of the public health approach include:
- Community-based methods for identifying the sources of the problem -- taking a population-based perspective, in contrast to the individual intervention approach of the physician’s office
- Epidemiological data and analyses for identifying and delineating patterns of risk and protective factors associated with the problem
- Ongoing surveillance and tracking of the problem and the identified risk and/or protective factors to establish trends in their prevalence and incidence -- telling who suffers from specific problems and why
- Designing community-based interventions based on a scientific analysis of the problem to reduce or eliminate risk factors and enhance or introduce protective factors
- Evaluating and monitoring interventions to establish and improve their effectiveness
- Public education to share information about the problem and effective and ineffective interventions (Elliott, Hamburg, and Williams, 1998, pp. 20-42).
The public health approach is an optimistic approach that provides tools for individuals and communities to proceed in a positive direction. The hopefulness in this approach is echoed by the American Psychological Association’s Commission on Youth and Violence:
Psychology’s message...is one of hope. The Commission overwhelmingly concluded, on the basis of the body of psychological research on violence, that violence is not a random, uncontrollable or inevitable occurrence. Many factors, both individual and social, contribute to an individual's propensity to use violence, and many of these factors are within our power to change. Although we acknowledge that the problem of violence involving youth is staggering and that there are complex macrosocial, biomedical, and other considerations that must be addressed in a comprehensive response to the problem, there is overwhelming evidence that we can intervene effectively in the lives of young people to reduce or prevent their involvement in violence (American Psychological Association, 1993, p. 14)
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