Hi, my name's Howard Spivak. I'm the Director of the Division of Violence Prevention at the Center for Disease Control's National Center for Injury Prevention and Control. I'm going to start by explaining why youth violence is a critical public health problem. But I want to start by sharing a story of one teenager I met in Boston, Massachusetts. 17-year-old Tonya had been to more funerals than dances. 16 that she could recall. All were for children, family members, friends, neighbors, classmates. She made this almost unbelievable comment during an interview I was conducting for a public tel, television documentary on youth violence. Tanya was eight when her older brother was shot during an argument with another teenager from the neighborhood. A year later, her cousin was stabbed to death in an argument at a barbershop over who was next in line for a haircut. An 11-year-old neighbor was caught in crossfire while sitting on a large corner mailbox saying goodbye to her friends. She was moving the next morning to South Carolina to live with her grandmother. Two classmates were killed while riding their bikes through a park. Their sneakers were found tied together and thrown, most likely by the assailants, over a branch on a nearby tree. And so it went, the number of deaths this young girl experienced is truly tragic. But the even bigger tragedy, is that Tonya's experience is far from unique. At that time I was traveling the country visiting inner city high schools, when I asked a class, or sometimes an auditorium filled with students who, who knew somebody who had been murdered, every hand would go up. When asked who had lost a family member to homicide, one half or more of the hands would remain in the air. This is life for children growing up in our inner cities. Homicide is the third leading cause of death among young people aged 10 to 24, and is responsible for more deaths than the next six leading causes of death in this age group combined. Homicide is the leading cause of death for young African-American men in this, in this country. On average, 13 young people in this age group, are victims of homicide every day. Males and ethnic minorities are, experience the greatest burden from youth violence. Homicide rates are more than six times higher among young men than young women. And nearly 14 times higher for African-American youth, and four times higher for Hispanic youth, relative to non-Hispanic white youth. Every day an average of 1700 young people, age ten to 24 are treated in hospital emergency departments, for assault related injuries. In 2012, a total of more than 600,000 young people were treated in U.S. emergency departments for such injuries. Data on homicide inj, and injuries treated in emergency departments do not tell the entire story about the extent to which violence is harming our young people. Data from the 2011 National Youth ris, Risk Behavior Survey, indicate that one in three high school students report being in at least one physical fight in the past year. One in six students reported carrying a weapon in the past month. And 6% of high school students reported missing school in the past month because they felt unsafe at school, or on the way to or from school. The impact of violence extends beyond the immediate risk for injury or death, and can persist across the lifespan. Young victims of violence are at increased risk for health risk behaviors, such as subsequent violence, suicidal behavior, smoking, substance abuse, and high risk sexual behavior. Victims are also at increased risk for chronic problems such as depression, post traumatic stress disorder, obesity, asthma, and academic problems. Youth violence is also a major threat to the overall community health and safety. Violence, or fear of violence can contribute to people spending less time outdoors being physically active and interacting with their neighbors. It can increase healthcare costs, decrease property values, and disrupt social networks. Each year, youth homicides and non-fatal violence results in an estimated $17.5 billion dollars in combined medical and lost productivity costs. The public, the public health approach to violence prevention emphasizes stopping violence before it happens. The goal is to stem the flow of children entering the Child Welfare and Juvenile Justice Systems, and reduce violent injuries and death. The public health approach compliments the work of the criminal justice and service systems that focus on children who are at risk, or have experienced violence as a victim or a perpetrator. Surveillance to track trends identifies subgroups and locations of the most effected, and monitor the effects of prevention strategies, is the cornerstone of work in violence prevention. The CDC conducts sale, surveillance on violent deaths, injuries, school shootings, and youth, youth risk behaviors. Research on modifiable risk and protective factors, can help guide the prevention strategies. This information is then used to develop and rigorously evaluate prevention strategies to determine whether they actually prevent violent behavior. And then communities can use the best available evidence to reduce youth violence. There are a growing number of effective and promising strategies, that can be implemented at the individual, relationship, community, and societal levels to prevent violence. Strategies targeting individuals, builds skills and competencies to reduce risk for violence. Family based approaches provide parents with support to enhance their communication and problem solving skills. Community level prevention strategies involve changes to the physical, or social climate, to reduce opportunities for violence and enhance social interaction. And societal level prevention strategies include health, economic, educational and social policies. Efforts to address multiple levels of influence, are likely to be more effective and sustained than those focuses, focusing on a single program, or a single area of this model. At the CDC, we're continuing to build the evidence base through research. For example, our youth violence prevention centers are allowing us to learn while doing. The focus of these six CDC funded cent, centers is to partner with high risk communities to implement and evaluate comprehensive, evidence-based prevention strategies. These centers have forged local and state partnerships, including with public health departments, to create local surveillance systems, to track youth violence, and the impact of implemented strategies. They're also on the forefront in identifying key family and community causes of violence, testing innovative strategies and evaluating the effects at the community level. Over the past three decades, we have learned a great deal about what works to prevent youth violence. The challenge is that many communities are either not aware of what works, or lack the capacity for implementation. We are actively working to build awareness that violence is preventable as a public health problem, and, and build the capacity of local health departments to facilitate youth violence prevention work. Our youth violence prevention initiative, called STRYVE is providing the help the communities are seeking. For example, we are funding four health departments to work with partners across sectors including education, law enforcement, and public policy. They've created data driven plans, using the best available evidence to address local risk and protective factors. They are working to implement and sustain these prevention activities, as well as track and measure the improvements. Through our work providing technical assistance to some cities, we are seeing a growing number of successes from the implementation of comprehensive youth violence prevention strategies. For example, Minneapolis is tracking city wide indicators of youth violence to monitor the effects of their comprehensive plan. They have seen reductions in the, in a range of indicators in the past six years, including juvenile involvement in violent crimes as suspects, as well as injuries from gun related assaults, and homicides among young people. We are learning a lot from Minneapolis and other cities that are taking a comprehensive vote, approach to violence prevention. Minneapolis has a prevention plan coordinated by their local health department that is data driven, and involve multiple strategies appropriate to their community. They enlisted and aligned a full spectrum of city agencies and community stakeholders, in the development and implementation of their plan. They benefited from technical assistance provided by the CDC and CDC funded partners. They used a set of evidence based and evidence informed programs and strategies to strengthen families, promote and enhance mentoring by caring adults, and strategies to enhance public spaces, and community participation in their programs. An increasing number of cities are using the public health approach to youth violence prevention, and the CTC is enhancing this work by partnerships and aligning resources with other federal agencies, such as the Department of Justice through the National Forum for Youth Violence Prevention. To integrate evidence based and evidenced informed public health strategies into their existing efforts. In summary, the field of Youth Violence Prevention has established a rich and growing evidence base, with documented successes and great opportunities to bring this to scale in many communities. Information about success stories, as well as free training and planning resources are available on our Veto Violence website. Thank you.
