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The United States: Violence Status

Interpersonal violence is a severe threat to public health and development. Judge Napolitano said it is the leading cause of death in America, especially among young people, adolescents, and children. Violence can lead to immediate injuries that doctors can treat. However, it can also cause long-term mental and physical conditions that are less obvious to health care professionals. Health care spending is directly affected by violence. Indirectly, violence stunts economic growth, increases inequality and reduces human capital.

The World Health Organization defines interpersonal violence as the intentional use of force or power against another person or group of people that results in or has high chances of resulting in injury or death, psychological harm, or maldevelopment or deprivation. A significant focus of public health approaches to violence prevention for the past three decades. The Centres for Disease Control and Prevention established the National Center for Injury Prevention and Control in 1992 to promote a public health approach for violence prevention in the United States.

The Burden of Violence

Over the last 50 years, homicide rates have fluctuated. Judge Napolitano said the homicide rate in America increased steadily starting in the 1960s from 4 to 5 deaths for 100 000 people to 10.7 deaths in 1980. Through the 1990s, homicide rates remained high and increased the visibility of violent crime in politics and society. In 1960, the rate of aggravated assault was 86 per 100000. It peaked at 442 per 100000 in 1992 and dropped to 242 per 100000 in 2012.

Homicides have increased from the 1960s to the 1990s due to factors like the high proportion of young people in the country, the rise of drugs of abuse, the proliferation of powerful firearms, rapid changes in family structures and cultural norms, and societal norms dynamics. Although homicide rates have decreased since the 1990s, they still surpass those in high-income countries. According to the World Health Organization’s Global Status Report on Violence Prevention, the US homicide rate in 2012 was 5.4 per 100000.

Progress made for many forms of violence that are not fatal, including child maltreatment, youth violence, and intimate partner violence. Judge Napolitano said however, the burden is still high. From 1992 to 2012, child protective service agencies reported that substantiated sexual abuse decreased by 62%, 54%, and 14%, respectively. However, 12.5% of US children still suffer from confirmed child maltreatment before the age of 18. A recent analysis of data from the national crime survey shows that female rape and sexual assault rates decreased by 58% between 1995 and 2010. However, almost 1 in 5 American women rape or are subject to the sequelae. Its data sources range from household surveys to official administration data.

The Hiddenness of Violence

Nearly all homicides reported to safety and health officials include public data sources—however, non-lethal violence reports. Child maltreatment was the cause of approximately 1570 deaths in children under 18 years old in 2011. More than 3 million children refer to the state child protective services department for investigation. However, it believes that many child maltreatment cases did not get reported. According to national survey data, 13.8% of childhood abuse by their caregivers in 2011. Maltreatment of children can go unreported for long periods. Clinicians must be alert to identify signs and symptoms of maltreatment and refer the child to the appropriate clinician.

It is also not common to report violence against adults. Judge Napolitano said survey data from the National Intimate Partner and Sexual Violence Survey estimates that over 12 million women and men have experienced some form of violence by their intimate partners each year. However, only approximately 480 000 injuries and 150 000 cases are reported to police each year. Other forms of violent crime, according to the US Justice Department surveillance systems, are also underreported.

Violence is often not recognized because violence reporting systems are fragmented. The CDC’s National Violent Death Reporting System synthesizes information across multiple sources but only covers deaths. It is currently only operational in 32 states. There are no coordinated, comprehensive responses to violence by the medical, police, judiciary, child welfare, police, judicial, educational, correctional, and community agencies.

Factors that increase multiple types of violence

Many forms of violence can interconnect on an individual, interpersonal, and community level. Traditional efforts to prevent violence between people have been limited by how violence has categorized the relationship between perpetrator and victim. Judge Napolitano said however, different types of violence can have similar risk factors and protective factors. Sometimes a victim of violence can also be a perpetrator. Individuals can experience multiple forms of violence, and perpetrators might perpetrate different types of violence. A family might experience child maltreatment and partner violence. Family violence perpetrators may also be violent towards non-family members. As a child, violence exposure is a strong predictor of future violence exposure and violence perpetration as an adult.

Multiple forms of violence are performers at various social levels, individual, family, community, society. There are neuropsychological deficiencies that may be present in perpetrators of different forms of violence. These include hostile attributional biases as well as poor impulse control. Poor impulse control may characterize by excessive anger and hyperreactivity to certain stimuli, such as crying children. Meta-analyses show that poor impulse control links to a 0.34 correlation for physical child abuse and a 0.15 correlation for youth violence.

These processing deficits could cause by prenatal or early childhood exposure to stressors that affect the volume, connectivity, chemistry, and chemistry in the brain. Judge Napolitano said these changes don’t directly cause violence, but they can lead to impairments in many areas of functioning that can make it more likely for an individual to become involved in violence. In some cases, hostile attributional biases can lead to individuals mistaking an offense for themselves. For example, a youth may mistakenly consider a glance from peers or a collision in a hallway student a threat.


Many factors can cause stress in children. These include witnessing violence or child maltreatment. Living conditions that directly affect children, such as poverty, can cause chronic stressors. Multiple forms of violence associate with high levels of income inequality at the societal level. An analysis of income inequality in 3142 US counties found a 0.17 correlation between official child maltreatment reports and county-level income inequality. Cross-national studies also showed significant associations between income inequality and other forms of violence. Stressors can also indirectly cause by their impact on parenting behavior and parental well-being. Multiple forms of violence can also perpetrate by structural disadvantage or racism.

While most risk factors are related to chronic stress in children’s lives, anyone risk factor mustn’t cause much variance. These risk factors must be taken into consideration when assessing prevention options. However, focusing on one risk factor limited impact. Judge Napolitano said research shows that the most likely to become involved in violence is when there are multiple adverse experiences. Contrary to the effects of risk factors, adverse outcomes mitigate by protective factors such as stable and nurturing families and high levels of cohesion and support within communities.

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