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Community Health Equity & Promotion

Violence Prevention Efforts 1998-2008

“Violence is the use of physical force or power, threatened or actual, by an individual, group or institution that either results in or has a high likelihood of resulting in injury, death or psychological harm. The threat or act can be against oneself, another person, or against a group or community. A variety of factors at the family, community and societal level combine to create an environment that contributes to violence and violent behavior.”

Violence is a Public Health Issue

When acts of violence occur and physical injuries ensue, emergency and trauma health care services are responsible for transporting and treating individuals. Many of the intentional injuries attended to in health facilities are a result of weapon use, physical assault or poisoning/overdose. These acts of violence primarily occur between family members (intimate partner violence, elder abuse and child abuse,) acquaintances (arguments, “beefs,” turf issues that escalate,) or are self-inflicted. Very few acts of violence resulting in injuries occur between strangers. Violent injuries may require counseling, treatment and advocacy for both the victim/survivor and the perpetrator. Public health departments provided much of these services. In the 1990’s, the United States Surgeon General produced a report on violence as a public health issue, noting that violent acts and behaviors were at an epidemic proportion. In a seminal thesis written by Susan Swift and Larry Cohen, the underlying causes and risk factors of violence at once compelled local public health practitioners to become more involved in addressing violence, and called us to a mission beyond patching up people.

In 1998, the San Francisco Department of Public Health’s Health Education Section took the lead in developing prevention-focused work to address violence as a public health issue. Initially, the Health Education Section organized a community-wide network of stakeholders (the Violence Prevention Network) to develop a violence prevention framework and roadmap. As well, the Section collected, analyzed and disseminated violent injury and mortality data, relevant to understanding violence and perhaps to reveal “prevention” points. Finally, the Section provided expert workshops and panels to promote a greater understanding among stakeholders on violence prevention as a public health issue.

Over time, the Violence Prevention Network and the Health Education Section’s Violence Prevention Programs funded grassroots mini-projects, supported citywide conferences and provided ongoing support and consultation to a regional youth violence prevention planning group and other networks. While the RoadMap to Violence Prevention has been completed for some time, it still represents a solid framework for developing promising practices and programs to prevent violence and promote safe and peaceful neighborhoods. Much of the work completed in the 1990s and early 2000s was encapsulated and built upon for the Mayor’s Violence Prevention Plan released in 2008. CHEP does not currently have funding to implement violence prevention planning or programs that work is now being led by the Mayor’s Office. Much of the work of DPH Population Health Division focuses on building strong, healthy communities, a violence prevention strategy in and of itself.