Introduction

In adopting the 2030 Agenda for Sustainable Development in 2015, the United Nations (UN) sought to bring the world community together to focus on wide-ranging, long-term goals.1 This builds on and significantly expands the breadth, depth, and scope that the UN had presented in 2000 with the Millennium Development Goals (MDG’s).2 Importantly, the 2030 Agenda highlights violence prevention as a key component for development and for improving quality of life in all parts of the world. The hope is that these ambitious goals will drive transformative collaborations and a generation of new ideas for addressing devastating local realities in areas of need.

The UN’s launch of Millennium Development Goals has had remarkable impact, helping to reduce extreme poverty by half and setting new standards of ambition for the 2030 Agenda’s Sustainable Development Goals (SDG’s). In addition, the World Health Organization’s (WHO’s) World Report on Violence and Health 3 serves as a compendium of knowledge on violence and also crucially helps reshape world discourse on violence—focusing efforts on a public health model for preventing violence that moves beyond the prevailing law and order paradigm. Uniting around a common vision of effective violence prevention, the WHO Violence Prevention Alliance (VPA)4 is a network of WHO Member States, international agencies, civil society organizations, and academic institutions that formed almost thirteen years ago to implement the recommendations of the influential World Report. 3 VPA members work together to generate evidence for, and to implement, effective violence prevention strategies and actions.

The 2030 Agenda calls for member states to “significantly reduce all forms of violence and related death rates everywhere”,5 and places violence as the top priority within an overarching goal to “promote peaceful and inclusive societies for sustainable development” (Goal 16). Violence, or more accurately its absence, is thus cast as a measure of societal health. For perhaps the first time, there seems to be clear acceptance that violence destroys health in both the narrow sense of causing death and disability—but also more broadly in holding back creativity, economic growth, and generation of well-being. Successful responses to this call for action will depend on new forms of scholarship and collaboration.

This Sponsored Special Issue of the Journal of Public Health Policy focuses on those new forms of research and action. They are based on a dialogue between scholars and practitioners, and our joint imagining and implementation of a next generation of violence prevention strategies. To prepare this Issue, the Guest Editors have assembled representative works of VPA members. These include the World Bank, the United States Centers for Disease Control and Prevention, Prevention Institute, the Danish Institute Against Torture, the University of Cambridge Institute of Criminology, the London School of Hygiene and Tropical Medicine Gender Violence and Health Centre, and the Yale University Law and Psychiatry Division. We first conceived the Special Issue at a VPA meeting in 2014, and it began to take definitive shape at the 7th WHO Milestones of a Global Campaign for Violence Prevention (GCVP) Meeting, entitled “Violence Prevention and the 2030 Agenda for Sustainable Development,” in September 2015 at the WHO Headquarters in Geneva, Switzerland. The Meeting took place during the week before the UN General Assembly’s adoption of the 2030 Agenda in New York City and represented a golden opportunity for the violence prevention community to mobilize action under the agreement of all UN Member States.

Themes and Scope of the Special Journal Issue

This Special Issue deliberately draws on a wide variety of academic and practical disciplines and seeks to make a case for bringing together the perspectives of researchers, policymakers, and practitioners. It seeks to bring attention to the imbalance of the burden of violence around the world and to highlight remaining challenges. Above all, we hope that this collection of engaging and thought-provoking articles from the VPA will encourage and help guide the global community’s ongoing endeavor to reduce violence.

The VPA adopts the WHO’s broad definition of violence:

The intentional use of physical force or power, threatened or actual, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.3 (p. 5).

The VPA also adopts the scope of the World Report. Recognizing that there is much to gain from considering the different forms of violence together or in relation to one another, the VPA examines self-directed, interpersonal, and collective violence under one rubric; so too does this Special Issue. Thus, we address here power and not just physical force; intention and not just action; and maldevelopment or deprivation and not just injury or death. In addition, the VPA advances the mandates of the 2030 Agenda: to confront spiraling conflict, crime, violence, terrorism, and humanitarian crises that forcedly displace entire peoples and to “strengthen universal peace”, by creating conditions to sustain peace. These include reducing interpersonal violence and reducing the enormous disparities of opportunity, wealth, and power by ending exploitation, empowering women and children, and creating more inclusive societies where “no one will be left behind”.1

Worldwide, violence also affects health and expands demands on healthcare more broadly than simply via the initial trauma.6 Evidence of this exacerbation includes the Adverse Childhood Experiences (ACE) studies,7 which reveal that, in addition to violence and trauma being major risk factors for further violence, they also exacerbate the likelihood of other leading causes of illness and death.8 The ACE framework demonstrates a link between (a) specific related stressors in childhood, including child abuse, neglect, witnessing violence among family members, and repeated exposure to intimate partner violence; and (b) resulting risky behaviors and health problems in adulthood including alcohol abuse, chronic obstructive pulmonary disease, depression, illicit drug use, heart disease, and liver disease. Furthermore, childhood experience of war or conflict can lead to developmental trajectories that can determine the violence or peace of a society at large.9

Across the world, safety affects not only where people live, work, travel, go to school, and recreate but also the level of economic development the country is able to achieve—and whether that society will have a thriving culture, generative workplaces, safe transportation, and areas where one can play, obtain essential goods, and be active.10 Strong local and national connections protect against violence 11 , 12 and correspond with significantly lower rates of homicide and self-destructive behaviors such as substance abuse.13 According to some research, having policies and practices in place that support community cohesion, intergenerational connections, and a collective willingness to intervene on behalf of the common good, accounts for more than 70 per cent of the variation between communities in levels of violence.12

Furthermore, people and communities everywhere experience violence in overlapping ways, and certain conditions 14 give rise to many forms of violence, including violence in the home, community violence, gang violence, and intergroup conflict.15 Exposure to community violence and conflict increases the likelihood of interpersonal violence, instability of families, and difficulties achieving peace.9 Similarly, a culture of family violence contributes to making a community less safe. However, when children grow up in safe, 16 – 18 stable,19 and nurturing relationships and environments, they learn empathy, impulse control, anger management, and problem-solving—all skills that protect against interpersonal, self-directed, and collective violence20 and allow for learning, play, and healthy development.21,22 Therefore, violence prevention helps generate viable ecologies that lead to economic growth and general well-being.

Successfully addressing the interplay between community environments and safety and advancing effective violence prevention strategies across the world requires close collaboration between practitioners and researchers. The field of violence studies has contributed greatly to bridging the gap between evidence and implementation, but more work remains. We have sound knowledge about ‘what works’ in violence prevention and are beginning to see glimmers of political will: at least the 2030 Agenda calls it forth. The Guest Editors gather here the latest work of several ‘global players’ of violence prevention:

  • Lee and colleagues lead off, presenting results of consultations with the UN for establishing key indicators for the SDG’s of the 2030 Agenda to mark and measure progress. The SDG’s offer a valuable opportunity to build partnerships across global and local institutions, which are necessary for sustainable violence prevention. [doi: 10.1057/s41271-016-0002-7]

  • Kumar and Willman of the World Bank explore the difficulty of healing and rebuilding lives in fragile and conflict-affected settings. A growing number of programs that combine psychological with livelihood support reveal that these two together improve psychosocial as well as economic well-being under conditions of critical need. [doi: 10.1057/s41271-016-0009-0]

  • Hillis and colleagues of the US Centers for Disease Control and Prevention (CDC) focus our attention on children as a group that is disproportionately vulnerable to the adverse effects of violence, while more than one billion experience violence every year. The authors explain and advocate for use of a particular framework, called THRIVES, to guide countries of all income levels in light of the emphasis of the 2030 Agenda. [doi: 10.1057/s41271-016-0003-6]

  • Observations of Eisner and colleagues of Cambridge and Utrecht Universities, in the UK and the Netherlands respectively, present a promising way to connect the academic disciplines of criminology and public health. Comparative data for trends in interpersonal violence across a large number of countries support their argument that recent major declines in violence, especially in high-income countries, can help guide violence reduction policies. [doi: 10.1057/s41271-016-0004-5]

  • Cohen and colleagues of the Prevention Institute in the US examine how systems and institutions contribute to trauma and violence, particularly for young minority groups. Although risk factors for violence are present in many communities, they maintain that violence is preventable and offer tools and frameworks for developing comprehensive, collaborative strategies for use in cities worldwide. [doi: 10.1057/s41271-016-0005-4]

  • Zimmerman and colleagues of the London School of Hygiene and Tropical Medicine in the UK, Raising Voices in Uganda, and the International Organization for Migration provide a compelling case for involving practitioners in research design and project evaluation. Although research partnerships between scientists and nongovernmental or international organizations may be challenging, they contend that these are essential for addressing complex social problems including violence against women and girls. [doi: 10.1057/s41271-016-0006-3]

  • Marino and colleagues from the state of Oregon in the US explain why engaging with affected communities is crucial for understanding cultural context and more effective prevention. Limiting access to firearms among those at risk of suicide, they conclude, is successful only when the message about firearm safety is culturally compelling within local communities. [doi: 10.1057/s41271-016-0007-2]

  • Focusing on one of the areas of the world most adversely affected, Janzen of the University of Kansas in the US studies the means to break the cycle of violence. Ethnography and anthropology, he finds, provide essential tools for policymakers, therapists, and leaders to help communities reckon with their memories of violence, redress past grievances, and restore civil society in a way that prevents future violence. [doi: 10.1057/s41271-016-0008-1]

  • Gilligan and colleagues of New York and Yale Universities in the US complete our collection with a Viewpoint that uses the public health model to look at how governmental regimes may assist violence prevention. Given the emphasis on violence reduction in the 2030 Agenda to develop a secure and healthy society, the authors call for further research on how the level of democracy of a regime can affect violent death rates of not only civil and interstate wars, but also homicide and suicide. [doi: 10.1057/s41271-016-0027-y]

Approach and Process

In October 2014, at the VPA’s annual meeting in Washington, DC, US, several among us decided that, in anticipation of the 2030 Agenda, and knowing the prominence that the violence prevention theme would take, the VPA as leaders in the field should publish a special journal issue in response. Drawing on its unique forum of practitioners, policymakers, and scholars, the Guest Editors put forth a call for abstracts in a similar manner as previous journal special issues 23 and received forty-four. Conversations with the Journal of Public Health Policy (JPHP) began in November 2014, leading to a personal meeting in October 2015 and mutual enthusiasm for the topic. The Guest Editors formed an abstract selection committee from among VPA volunteers to score the abstracts, ranked them, and selected the top eleven for peer review. In a manner slightly different from standard Issues of JPHP, the Guest Editors formed an article review committee, again consisting of volunteers from the VPA but representing a wide geographic area as well as a large range of expertise. The committee arranged for each article submission to undergo two reviews, and each reviewer completed one or two reviews. The top eight articles, apart from the introduction and the first invited article are what we present here.

Authors revised the papers between November 2015 and May 2016, following receipt of reviewers’ comments. The Guest Editors edited the papers during April and May 2016 for quality assurance and compliance with JPHP guidelines, with the enormous help of the Editors-in-Chief. This Special Issue is also companion to a VPA special issue with the International Journal of Public Health,24 published simultaneously but which covers more scientifically oriented articles with an emphasis on the Global South.

Merging Evidence and Implementation in Violence Prevention

Many public organizations and fields of scholarship are increasingly recognizing that violence is a complex human problem that requires complex solutions, not just individual programs. It also requires a conversation across disciplines as well as collaboration between many fields beyond just the health or justice sector. However, as in many areas of contemporary inquiry, we face the fundamental problem of a divide between theory and practice, between evidence and implementation. We must bridge this divide to advance violence prevention beyond the confines of our own circles of specialists. Otherwise, practitioners may consider theory to be distant from practice, and researchers lose sight of what needs urgent evaluation, while community members' needs go unmet. In addition, developing this needed collaborative intellectual and practical landscape can become muddled if journal reviewers, academic researchers, and funding institutions adhere to narrow concepts of study design with limited utility in application to complex interventions and multifaceted problems. Unless we overcome these challenges, there is a danger that the growing understanding about the critical need for violence prevention will stay within insular circles, and we will never effectively translate both scholarly evidence and community wisdom into practice. Although these challenges are not unique to the study of violence prevention, the urgency of the problem requires that we tackle them now.

Halting the destruction of violence and advancing people’s ability to thrive on this planet requires ensuring that academic theory and research are relevant to the kind of work and change that is needed on the ground. As much as the violence prevention field has emphasized evidence-based practice, the pursuit of evidence has largely missed input from practitioners and community members, leading to less than optimal real-world applicability. In addition, while practitioners and policymakers have deemed urgent the need for research that is relevant to low- and middle-income countries, where 90 per cent of global violence happens, only 10 per cent of violence scholarship arises out of these settings, where there are fewer resources and experimentation is difficult. This must change in light of the UN goals of peaceful and inclusive societies. The academic community, now a major player, needs to reach beyond fragmented and isolated professional networks to engage across spheres in collaboration with practitioners. As Deborah Prothrow-Stith puts it,

Violence is not the problem of one neighborhood or group and the response and solution are not the responsibility of one agency or one sector…. Professionally we have silos, and we operate in these silos…. People working to prevent child abuse are right across the hall from people working on violence against women, and they don’t work together. As we go into communities to bring everybody to the table, don’t let people say, ‘I work on child abuse, but this is about gang violence.’ Don’t let people say, ‘I work on violence against women, and this is about child abuse.’ This thing, all this violence, is connected.25

Conclusion

Using the multisectorial (governmental, nongovernmental, private, and academic) and multilevel (community, national, regional, and international) forum of the VPA, we make use of this Special Issue to demonstrate ways to advance and deepen the conversation on operative global strategies and best local practices for preventing violence. Merging evidence and implementation emerges as a way to elevate and evaluate effective solutions. The diverse audience of the Journal of Public Health Policy will no doubt add another dimension to this dialogue. Only through such wide-ranging exchanges and collaborations will we be able to achieve the radical transformation that the 2030 Agenda inspires. In the process, we hope to advance a healthier, more just, and happier world for subsequent generations to inhabit.

Editors’ Note

This article is one of the ten papers in a Special-Sponsored Issue of the Journal of Public Health Policy in 2016, Violence and Health: Merging Evidence and Implementation .