Overview and Summary: Societal Violence: What is Our Response?

  • Sarah Kelly, PhD, RN
    Sarah Kelly, PhD, RN

    Sarah Kelly is an Assistant Professor in the College of Nursing at Rutgers, The State University of New Jersey in Newark, NJ. Dr. Kelly focuses on vulnerable youth and the issues that influence their healthcare needs. Specifically, her program of research addresses youth exposure to community and gang violence and the impact exposure to violence has on their health. Since completion of her PhD (2008), she has also expanded her research trajectory to exploring how violence affects vulnerable youths’ health related quality of life.

In recent years, we have focused an enormous amount of attention on societal violence, in particular violence that affects the nation’s youth.  Violent acts, such as the shootings at Columbine (1999), Virginia Tech (2007), Aurora Movie Theater (2012), and more recently at the Sandy Hook Elementary school (2013) have had a profound effect on today’s youth and adults. These shootings are examples of societal violent acts; however, other forms of societal violence occur every day throughout the United States.

So what is violence? What is societal violence? How does societal violence affect us? These seem like simple questions that are easy to answer, but understanding violence is complicated. First, many researchers have differing conceptualizations of what violence is, thus leading to a plethora of definitions. The World Health Organization (WHO, 2002) provides the most comprehensive definition of violence. WHO defines violence as:

The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation (pg. 5).

In addition to defining violence, WHO (2002) differentiates violence into three categories: self-directed violence (e.g., suicide), interpersonal violence (e.g., intimate partner violence or community violence), and collective violence (e.g., social or political violence). Although, WHO does not specifically define societal violence, I suggest that societal violence is a blending of community and social violence. Societal violence can range from an interpersonal act of violence between two people on the playground to a mass shooting by one person. These examples of violence can have a profound effect on families, local communities, and society as a whole.

Violence in society can range from a simple assault to homicide (Bureau of Justice Statistics, 2013). According to the Bureau of Justice Statistics (2013) from 1992 to 2011, there was a 49% decrease in homicides. In addition, from 1994 to 2011, there was a decrease in intimate partner violence (IPV) for females (72%) and for males (64%). Homicides among youth declined by 22%; however, this age group still had the highest homicide rate.  Despite the declination of homicides, there was actually an increase in violent victimizations (rape, sexual assault, robbery, simple and aggravated assault) for those 12 years and older from 2011-2012.

Researchers have explored the influence societal violence has on the victims. For example, Graham-Bermann and Seng (2005) and Kelly (2010) found that exposure to this violence has an immediate direct negative impact on youths’ physical and mental health. Further, there is evidence showing that the consequences of violence can continue to have a lasting impact on their adult lives (Scarpa, 2001). The lasting effect of exposure to violence on youth in our society warrants and deserves attention from healthcare professionals, such as nurses.

Nurses are in a distinct position to facilitate preventive methods geared toward decreasing societal violence. Nurses practice in a variety of settings that enable them to interact with those who have experienced or are experiencing some form of violence. In this OJIN topic, different forms of societal violence are presented, along with preventive strategies that nurses may incorporate in to their practice. Please join me in exploring the various forms of societal violence discussed and learn about how nurses can have a positive influence on those most at risk.

The introductory article, “Healthy People 2020 Objectives for Violence Prevention and the Role of Nursing,” by Simon and Hurvitz, offers an overview of violence in todays’ society, a public health approach to preventing violence, and discusses how nurses are an integral part of violence prevention. The authors describe objectives related to violence prevention, one of the targeted goals for Healthy People 2020. Using the goals in Healthy People 2020 and a public health approach to preventing violence, Simon and Hurvitz describe a four step method for violence prevention. They provide nursing specific resources and recommendations for violence prevention. More importantly, through examples of successful programs, such as the Cardiff Violence Prevention Program, the authors show the important contribution that nurses make toward violence prevention.

Child Maltreatment (CM) is a major public health concern affecting children. One of the main problems with exploring CM is the various ways the term is defined and operationalized. In the article “Child Maltreatment: A Public Health Overview and Prevention Considerations,” Merrick and Latzman present a valid argument, that the inability to have a consensus definition and method to capture the phenomenon leads to barriers in identifying the incidence and prevalence of CM. This inconsistency can lead to obstacles in preventing and treating CM. Further, the sequelae of CM can have a lasting impression on children, leading to problems in their adult lives. Certain factors that children are exposed to can potentiate or moderate the effects of CM. Nurses are vital to identifying those children at risk for and helping to prevent CM. Nurses assess and implement interventions aimed at protecting patients. The authors describe three types of programs (universal, selected, and indicated) that nurses and other healthcare providers can use for prevention and treatment of CM.

Gang violence is a serious public health issue that threatens society. Youth are at risk for gang membership. Engaging in gangs and gang violence can result in the need for healthcare. McDaniel, Logan, and Schneiderman’s article, “Supporting Gang Violence Prevention Efforts: A Public Health Approach for Nurses,” focuses on preventing gang violence and providing nurses with information they need to decrease incidences of gang violence.  In this article, the authors lay out a public health approach nurses can use to understand and prevent gang violence. The four step public health approach focuses on describing and monitoring the problem; identifying the risk and protective factors; the development and evaluation of prevention programs; and the implementation and dissemination of these programs. Prevention programs are geared toward universal education about gangs; educating those at risk for gang involvement; and youth already involved in gang activity. There are opportunities for nurses to engage in each phase of gang prevention and in each type of prevention program. Nurses should have an understanding of gangs and gang violence. To help nurses facilitate their education about youth risk for gang activities and prevention initiatives, the authors provide web resources to access information about gangs and gang violence.

Nurses also play an important part in decreasing and preventing school violence. The various forms of violence affecting children in schools can influence their physical and mental health. In the article “Violence in the School Setting: A School Nurse Perspective,” King discusses different forms of violence and the school nurse response. The statistics on school violence presented in this article are staggering. King suggests that children use violence at school to deal with problems; this is one method of problem solving. Real life experiences from school nurses show that children have differing reactions to their exposure of violence at school. School nurses have the opportunity to develop a trusting relationship with children. Children frequently confide in and share personal experiences with school nurses. The information that the school nurses gather during interactions with children is valuable because it may be useful to help deescalate or intervene in the violence. This article provides a wealth of information on school violence and how nurses can provide a safe learning environment for all children.

The journal editors invite you to share your response to this OJIN topic addressing Societal Violence either by writing a Letter to the Editor or by submitting a manuscript which will further the discussion of this topic which has been initiated by these introductory articles.

Sarah Kelly, PhD, RN
Email: sarah.kelly@rutgers.edu


© 2014 OJIN: The Online Journal of Issues in Nursing
Article published January 31, 2014

References

Bureau of Justice Statistics. (2013). Violent crimes. Retrieved from www.bjs.gov/index.cfm?ty=tp&tid=31

Graham-Bermann, S. A., & Seng, J. (2005). Violence exposure and traumatic stress symptoms as additional predictors of health problems in high-risk children. The Journal of Pediatrics, 146(3), 349-354.

Kelly, S. (2010) The psychological consequences to adolescents of exposure to gang violence: An integrated review of the literature. Journal of Child and Adolescent Psychiatric Nursing, 23(2), 61-73.

Scarpa, A. (2001).  Community violence exposure in a young adult sample: lifetime prevalence and socioemotional effects. Journal of Interpersonal Violence, 16(1), 136-153.

World Health Organization. (2002). World report on violence and health. Retrieved from www.who.int/violence_injury_prevention/violence/world_report/en/summary_en.pdf.

Citation: Kelly, S., (January 31, 2014) "Overview and Summary: Societal Violence: What is Our Response?" OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 1, Overview & Summary.