and to the transmission of violence. There are important contextual factors within communities, such as who are marginalized or culturally isolated and who have normalized violence, and certain risk factors that accompany violence, such as alcohol and drugs. The speakers used contextual factors to frame the discussion of violence within the contagion framework.

Place

Many speakers noted that place can have adverse impacts on health. The context in which violence occurs determines proximity to exposure, and how often a person is exposed (similar to dose). The place in which violence occurs also influences whether an individual sees violence as a “normal” response, whether they have resources that could counter violence, and whether they have opportunities to respond without violence.

Speaker Barry Krisberg of the University of California, Berkeley, School of Law spoke about place in terms of the experience of prison that “produces a whole series of dysfunctional, psychological developments.” He showed two photographs of a California treatment facility, stating, “The youth who stays in this facility has committed a violent crime, and he spends 21 hours a day in this room, getting all kinds of cognitive behavioral therapy, but this is his life. When he is fortunate enough to get out, for an hour or so, he gets to exercise in this, which is described euphemistically as his program area. . . . This is fairly typical. In fact, unless you live in the state of Missouri, your facilities look pretty much this way.”

Dr. Krisberg noted that many believe that if we make prison so horrible, people will avoid committing violence to stay out of these places. In addition, taking offenders “out of circulation,” or incapacitation, means that they are not “on the street” committing crime. On the contrary, Dr. Krisberg stated, prisons and juvenile facilities exacerbate and spread violence. They are much more violent than the general community, and the perpetrators of violence in prison are both staff and inmates. Much of the violence in prison is related to gangs, and the experience of being a victim increases the risk of joining a gang, which further cements these gang structures (Wolff and Shi, 2009). Dr. Krisberg went on to comment that who actually commits violence in prison is not clear. It is not necessarily true that those who commit violence outside prison are those who are most violent in prison. However, those with histories of assault and robbery (though not homicide) are at increased risk of perpetration of violence while incarcerated.

In terms of the psychological effects of incarceration, Dr. Krisberg brought up the previously hypothesized idea of “prisonization” or institutionalization, in which one adapts or develops an inmate culture or ideal. This has changed slightly, Dr. Krisberg stated, but in general, “prisons



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