Understanding and Preventing Violence, Volume 4 Consequences and Control (1994) / Chapter Skim
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Violence and Intentional Injuries: Criminal Justice and Public Health Perspectives on an Urgent National Problem
Violence and Intentional Injuries: Criminal Justice and Public Health Perspectives on an Urgent National Problem
Pages 167-216
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From page 167... ...
In this view, justice demands judgment and punishment for such acts, regardless of the practical effect of punishment on future criminal offending ;von Hirsch, 19761. Yet reliance on the criminal justice system also reflects a practical Mark Moore is at the Kennedy School of Government, Harvard University; Deborah Prothrow-Stith and Howard Spivak are at the School of Public Health, Harvard University; and Bernard Guyer is at the Department of Maternal and Child Health, Johns Hopkins University.
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From page 168... ...
Criminal violence exacts a particularly large toll from the health of those who are least advantaged in the society. These simple facts make violence a concern for the public health community as well as the criminal justice community.
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From page 169... ...
In short, criminal violence may usefully be seen as a public health problem not only because the consequences of violent attacks constitute an important health problem, but also because public health methods may expand society's current capacities for dealing with the problem. That is the primary purpose of this paper: to show how the criminal justice system's traditional vision and response to violent crime may be usefully complemented by the public health community's approach to the problem.
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From page 170... ...
2. In reckoning the social consequences of criminal attacks resulting in injury, it is important to consider not only the magnitude of the physical injury, but also the psychological damage and fear that are stimulated by criminal violence.
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From page 171... ...
Before presenting our analysis, however, two cautionary notes are in order. First, the analysis uses the literary device of referring to perspectives and views held by the "criminal justice community" and the "public health community." We understand that individuals in these "communities" do not all hold the same views.
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From page 172... ...
Second, we make a sharp distinction between the views of the "criminal justice practitioner community" and the "criminal justice research community." One could make a similar distinction for the public health community, but making this distinction seems less important for the latter. The intellectual and professional gulf between practitioners and researchers seems much less in the public health community than in the criminal justice community.
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From page 173... ...
The public health community must be concerned about such events because they damage the health status of the least advantaged in society. SIGNIFICANT ASPECTS OF INTERPERSONAL VIOLENCE Both public health and criminal justice communities initially concern themselves with the nature and magnitude of the injury that results from interpersonal violence.
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From page 174... ...
In these respects, then, the criminal justice community gives attention to the seriousness of the injury to the victim. Criminal Justice Emphasis on the Offender What is surprising to public health professionals, however, is how quickly the attention of criminal justice officials shifts from the victim and his injuries, on the one hand, to concerns about the offender, on the other.
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From page 175... ...
Public Health Focus on the Victim In contrast, in looking at instances of criminal violence, members of the public health community initially focused more attention on the victim. Because they were interested in health consequences, it mattered whether a knife wound was deeply penetrating and life threatening, or bloody but easily sutured.
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From page 176... ...
The reasons for this are the follow~ng. Violence and "Nonviolent" Crimes The concerns of the criminal justice community embrace all criminal offenses including those offenses that do not necessar
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From page 177... ...
Yet, in an important sense, the criminal justice community's concerns about these "property offenses" can be seen as deriving from concerns about controlling violence and its consequences as much as from concerns about protecting property. To the extent that this is true, the public health community might be interested in these offenses as well as the more obviously violent crimes.
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From page 178... ...
Violence and Relationships As noted above, what initially draws the public health community to the problem of intentional violence is concern for the health consequences of criminal violence. Once in this domain, however, the concerns of the public health community naturally widen to include other offenses National Committee for Injury Prevention and Control, 1989:192-2671.
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From page 179... ...
There is nothing wrong with this, of course. The interesting question is what particular concerns prompt the public health community's interest in these crimes and what the criminal justice community might learn from these perspectives.
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From page 180... ...
The criminal justice community's vision of violent crimes committed by dangerous offenders is enlarged by concern for the victim, for psychological damage, and for the special problems created by crimes that occur in the context of ongoing relationships. The public health community's vision is enlarged by
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From page 181... ...
It also becomes apparent that the two communities cannot simply carve up the domain of interpersonal violence into separate spheres and then operate independently within them. The criminal justice community owes a great deal to the public health community for spotting the problem of crimes in ongoing relationships, and for being an important part of the response to such offenses, but it cannot simply cede these cases to the public health or social service community.
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From page 182... ...
"INTENTIONS OF OFFENDERS" AND "RISK FACTORS FOR VIOLENCE": TWO DIFFERENT CAUSAL PARADIGMS Just as the criminal justice and public health communities have usefully contrasting views on what is socially significant about interpersonal violence, they also have similar but slightly different ideas about where to look for the causes of the problem. The differences are sharper, here, between the views of criminal justice practitioners on the one hand, and those of criminal justice researchers and the public health community on the other, for it is in this domain that the precepts of "behavioral science" make their strongest claims.
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From page 183... ...
PUBLIC HEALTH: AN EPIDEMIOLOGIC APPROACH The public health community acknowledges the role of the offender's intentions in causing violence: that is implicit in categorizing assaultive behavior as "intentional injuries." However, the public health community tends to see criminal violence as emerging from a more complex causal system than one dominated solely by the settler! intentions of the offender.
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From page 184... ...
William Haddon, for example, has proposed the matrix presented in Table 1 as a way of identifying potentially modifiable risk factors in the control of automobile accidents National Committee for Injury Prevention and Control, 1989:~. It is useful to see how these methods might be applied to the analysis of interpersonal violence.
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From page 186... ...
In approaches to injury prevention, for example, safety engineers and public health analysts gradually came to conceive of mechanical energy as the vector of injury. Epidemiologists of violence might begin to conceive of feelings of anger, frustration, or aggression as the relevant agent for interpersonal violence.
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From page 187... ...
Previolence Teaching parenting skills Teach nonviolent dispute resolving skills Early psychiatric interventions During violent event After violent event Using nonviolent means of control Teaching selfdefense to victims Emergency medical treatment Incapacitation Rehabilitation Marital counseling in domestic assault Family therapy in child abuse and neglect Regulating weapons Regulating alcohol Regulating public drunkenness Reducing poverty Reducing disorder of cities Using architecture to promote a sense of community Eliminating weapons Police rapid at scene response Mobilizing police Community alertness Providing jobs and counseling to poor families Adding street lighting in dangerous areas SOURCE: National Committee for Injury Prevention and Control {1989:8~.
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From page 188... ...
Indeed, in this conception, the public health analysis of violence comes into almost perfect alignment with criminological and sociological views of the problem. SOCIOLOGICAL AND CRIMINOLOGICAL ANALYSES Although it is true that the criminal justice practitioner community tends to focus on the character and intention of offenders as the most important causal factor determining incidents of victimization, the criminal justice research community has Tong engaged in analyses of interpersonal violence, and criminal offending more generally, that are in the same spirit as epidemiological analyses carried out by the public health community.
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From page 189... ...
Situational Analyses of Crime Causation Both researchers and practitioners in the criminal justice community have also become increasingly interested in the idea that many crimes emerge not simply from the evil intentions of criminal offenders but also from criminogenic features of particular situations ;CIarke, 19901. An unlighted area around a subway stop may be an invitation for street muggings.
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From page 190... ...
There is an argument that guns in the hands of police officers or law-abiding citizens might reduce crime and violence through general deterrence of criminal offenders Fleck, 19881. However, what is more readily observable is that the widespread availability of guns seems to facilitate violence by providing criminal offenders with a plentiful supply of weaponry; by making it possible for spouses, in a moment of fury, to become murderesses; or by providing the means for protective homeowners to transform a household burglary into a violent encounter in which the burglar, the homeowner, or the late arriving teenage son, mistakenly taken for a burglar, might be killed {Cook, 19831.
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From page 191... ...
Both have perspectives on the causes of violence that are to some degree unique and complementary, and to some degree similar and overlapping. DANGEROUS OFFENDERS AS VECTORS OF VIOLENCE It is also interesting to note that one could easily incorporate the criminal justice community's focus on criminal offenders in the analytic framework of the public health community.
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From page 192... ...
For example, the values and traditions of the law infuse the perceptions of the criminal justice community in a much more powerfuT way than they do the public health community. On the other hand, the values and traditions of science exercise a far creaser influence on the public health community than on the O criminal justice practitioner community.
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From page 193... ...
To help identify preventive opportunities, the public health community distinguishes among three kinds of preventions Primary prevention seeks to prevent the occurrence of disease or Injury entirely usually by operating on broad features of the environment that make the disease or injury possible or likely to occur. Secondary prevention is concerned with identifying cases or situations relatively early in some developmental process that will lead to serious problems if not altered.
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From page 194... ...
Its proponents believe that the way they handle individual cases has effects on levels of criminal violence that stretch out over time and across social life. In short, the criminal justice community both practitioners and researchers believes that the reactive, case-oriented approach also prevents crime.
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From page 195... ...
juvenile Delinquency Prevention There is still more to the criminal justice community's preventive efforts. In the early decades of the twentieth centurythe same period in which the public health community was gathering strength and making great contributions to the control of infectious diseases through improved municipal sanitation an innovation in criminal justice institutions swept across the country.
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From page 196... ...
Among these commodities, drugs have been the most consistently favored target of the criminal justice community. Indeed, it is the conviction that drugs are closely tied to criminal violence that has propelled drug control to the forefront of the nation's
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From page 197... ...
Some police departments, despairing of the competence of educational institutions to communicate the proper message, have established their own efforts in schools to educate children about the use of drugs [Bureau of Justice Assistance, 1988; Kennedy School of Government, 1990J. This major effort to reduce drug use is thus not simply a moral crusade by the criminal justice community but also, in its eyes, a straightforward way of preventing criminal violence by controlling an important risk factor.
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From page 198... ...
Insofar as the criminal justice community is focusing on policies to control the availability and use of weapons, it is engaged in an effort that the public health community would recognize as a classic strategy of secondary prevention. Situational Approaches to Crime Control In addition to a focus on criminogenic commodities, the criminal justice community has also begun to see the environment of cit
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From page 199... ...
This method encourages officers and police departments not to treat crime calls simply as incidents to be searched for violations of law, but instead to look behind the incident to determine what factors are causing the violence and to search for methods including, but not limited to, arrest of offenders for altering the situation so that it is less criminogenic. ~ · 1- · ~1 ~ Mere are, by now, many 1na~vlaua~ examples or successes in problem solving, and the anaTytic methods and organizational arrangements necessary to support problem solving are becoming more refined, but there is not yet evidence indicating that this approach applied generally across a police department will have a substantial aggregate effect on levels of criminal violence isee Moore, 19921.
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From page 200... ...
PUBLIC HEALTH APPROACHES TO VIOLENCE PREVENTION Still, however interested the criminal justice community might be in preventive efforts, its commitment to prevention is not quite like the commitment that the public health community brings. At best, prevention is an additional thought in criminal justice.
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From page 201... ...
From the perspective of the criminal justice community the two most important ways in which the public health community's zeal for prevention departs from its approach is in the emphasis on finding technoTogical "fixes" for problems and the effort to determine the broadest social and cultural factors influencing levels of violence. Some of the public health community's most dramatic successes have been in areas in which technology provided a broad, permanent solution to a problem.
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From page 202... ...
The public health community seems to think that this principle is being applied when it examines the control of criminogenic commodities such as guns and alcohol. These Took like consumer products that are unsafe and that might be redesigned or regulated to produce fewer acts of interpersonal violence.
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From page 203... ...
When the public health community reports that criminal violence is disproportionately located among the nation's poor minority communities, and concludes that crime must be caused by poverty and racial discrimination and that the only Tong-term solution is to alleviate these "risk factors," it is merely echoing the conclusions of those in the criminal justice community who have Tong emphasized the "root causes" of crime {Silberman, 1978; Curtis, 19851. To some degree, in recent years, many in the criminal justice research and practitioner community have turned away from these concerns, not so much because these observations were judged to be wrong or inaccurate but because they seemed irrelevant to
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From page 204... ...
To have these issues come back before the criminal justice practitioner community as a new approach to crime prevention is not necessarily unwelcome, but it is hardly a new contribution. The question that remains to be answered by the public health community {along with the criminal justice community and society in general)
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From page 205... ...
The combination is supposed to produce important changes in behavior. Many in the public health community are more hesitant about using criminal law to try to affect broad changes in attitudes and behavior.
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From page 206... ...
The criminal justice community brings a preference for a largely reactive, individual case-based focus, whereas the public health community brines a broader Preventive approach to the problem. Although there are some preventive aspects to the ordinary criminal justice system processing of cases, these are not the primary concern of the criminal justice community.
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From page 207... ...
However, this is a quite myopic view for the criminal justice community to take. The public health community is quite clear that it is dependent on the operational capacity of the police and
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From page 208... ...
PUBEIC HEALTH CONTRIBUTIONS TO THE FIGHT The answer to this question is that the public health community brings two key resources to the criminal justice community's attack on violence. The first resource is improved analytical capabilities.
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From page 209... ...
It also changes who pays attention to the problem, which is the second great political contribution that the public health community's interest in violence makes to the criminal justice community. Once violence is seen as a health problem, a different group of people begins paying attention.
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From page 210... ...
In these broad ways, the public health community may make its largest and most important contribution to society's understanding of, and attack on, the intertwining problems of criminal violence and intentional .
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From page 211... ...
Department of Justice. Bureau of Justice Statistics and Federal Bureau of Investigation 1985 Blueprint for the Future of the Uniform Crime Reporting Program: Final Report of the UCR Study.
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From page 212... ...
Annals of the American Academy of Political and Social Sciences 455. 1983 The influence of gun availability on violent crime patterns.
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From page 213... ...
Jacobs, J.B. 1988 Drunk Driving: An American Dilemma.
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From page 214... ...
Department of Justice and the Program in Criminal Justice Policy and Management, Kennedy School of Government, Harvard University. Moore, M.H., S.R.
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From page 215... ...
:923. National Committee for Injury Prevention and Control 1989 In jury Prevention: Meeting the Challenge.
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From page 216... ...
1978 Criminalfustice7 Criminal Violence. New York: Random House.
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