The field of Violence Prevention has come a long way since its infancy in the 1980's when gang and youth violence was first considered a public health issue. The complexity of an issue like violence mandates a matching comprehensive approach for solutions. There are four key components to the public health model: 1) Defining the problem and utilizing surveillance to understand trends,2) Identification of potential causes through a thorough analysis of risk and protective factors, 3) Designing, developing and evaluating intervention strategies, and 4) Exportation of successful and generalizable programs. The following are risk factors that contribute to violent behavior, criminal and gang activity, and injury:
- Substance Abuse
- Injury Recidivism
- Physical aggression/School fights
- Low socioeconomic status/Poverty
- Mental illness/Post traumatic stress
- Antisocial parents
- Ties to antisocial peers or gangs
- Involvement in criminal acts
- Poor education
Risk factors rarely occur in isolation. The more risk factors present, the greater the likelihood of involvement in violence. Individuals exposed to the risks also do not live in isolation. For this reason, it is critical that any attempt at violence prevention should target at-risk individuals by reaching into the greater community in which they reside in order to appropriately address the cadre of contributing environmental factors. Most of the violence prevention programs that have shown greatest success have recognized the importance of incorporating the community into strategies of risk reduction.
Violent injury is, to a large extent, a societal disease. As a result, the link that a trauma center develops with its surrounding communities and its resources should be seamless if risk and protective factors are to be understood and addressed.
The Teachable Moment
The basic premise of the teachable moment in the context of health care is that a sudden change in health status tends to create a state of self reflection and a tangible sense of an individual's mortality and vulnerability. This "cue" may signify an open window during which time the individual may be more likely than before to change high-risk behaviors in an effort to lift them from future vulnerability and compromise.