New directions in violence prediction: the public health arena

Injury resulting from interpersonal violence is now recognized as an important public health problem. Consequently, the public health community is applying its perspectives and strategies to the goal of preventing violence. The public health approach emphasizes preventing injuries due to interpersonal violence from occurring or recurring, rather than treating the health consequences of these injuries. Four interrelated steps are used to develop information to guide the development of prevention strategies: public health surveillance, risk group identification, risk factor exploration, and program implementation/evaluation. The ability to predict which people are at greatest risk of injury (or producing injury) and the relative effectiveness and costs of alternative prevention strategies are central to decisions influencing the nature and focus of public health prevention strategies. In order to improve the information base on which decisions concerning violence prevention strategies are founded, the following activities should be given priority: (a) developing surveillance systems for morbidity associated with interpersonal violence; (b) precisely identifying risk groups for nonfatal violent events; (c) applying case-control methods to the exploration of potentially modifiable risk factors for injuries and violent behaviors; and (d) rigorously evaluating extant programs that are intended to prevent interpersonal violence or modify a suspected risk factor for violence.