through arrests and incarceration, which act to deter, incapacitate, and rehabilitate criminals (Moore, 1993). Deterrence is seen as working either on potential offenders in the community or on incarcerated offenders in relation to the commission of future crimes. More recently, there has been an increased emphasis on crime prevention via community policing and other means to prevent crime and violence. A major impetus was the passage of the federal Violent Crime Control and Law Enforcement Act of 1994, which provided funds to state and local governments for new prevention programs.

The recognition of the growing health consequences of violence propelled the public health community, beginning in the 1970s, to consider violence as a public health problem (National Committee, 1989). In 1985, the Surgeon General's Workshop on Violence and Public Health signaled the entry of public health into what traditionally had been the domain of the criminal justice system (U.S. DHHS, 1986; Mercy et al., 1993). Viewing violence prevention as a public health goal calls attention to the measurable health consequences of assaultive injuries, highlights the role of the health sector in identifying and reducing the violence embedded in situations and relationships, and highlights the potential utility of epidemiologic tools in identifying risk factors and designing interventions that lie outside the usual sphere of crime prevention and control. In this way the perspective and methods of public health usefully complement the perspective and methods of criminal justice in understanding and responding to violence.

Recognizing the validity and benefits of both public health and criminal justice perspectives, Moore and colleagues (1993) argued for a synthesis. In their view, "to deal effectively with what can now be seen as a far more complex problem of violence and its consequences, there is urgent need for an effective collaboration between the two communities." The committee agrees with this assessment and urges continued and expanded collaboration to bring the resources and creative approaches of the criminal justice and public health communities to violence prevention.

Although numerous factors enhance the risk of violence, research has determined that some of these factors appear to be salient as proximate causes of potentially lethal violence (i.e., the subset of violent events that present a risk of serious injury or death). These include the use of firearms, the use of alcohol and illicit drugs, the interaction of mental disorders and substance abuse, and the developmental and contextual features of adolescence in urban America that accentuate all other risk factors for violence (NRC, 1993, 1994; IOM, 1996; Zimring and Hawkins, 1997).

A number of NRC reports have summarized the accumulating body of knowledge on the causes of violence (NRC, 1993, 1994, 1996, 1998). Progress has been less pronounced in developing and evaluating prevention programs, in large part, because of the time lag between understanding causation and translating this understanding into programs, the complexity of the problem, and the imperfections of current surveillance systems.



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