I commend the convening of the new Together for Children coalition to use data to target violence prevention interventions for individual children and youth identified as at high risk for involvement in the cycle of violence as perpetrators or victims. Still, I warn the well-intentioned stakeholders to consider a few realities that will challenge the success of this approach.
Identifying “who” might be vulnerable is different from identifying “what” creates vulnerability. Few if any children are born bad or troubled. The conditions and circumstances that shape their emotional, social and cognitive development are the forces and factors that make certain children susceptible to violence. And it is, therefore, by addressing those influential conditions that we will succeed in rooting out the causes and improving the outcomes for any and every child.
There is no magical or unalterable reason why children living in some neighborhoods suffer more or less violence than do kids in other communities.
Zip code is a proxy for the basic and primary environmental influences on children’s healthy development — safety, economic stability, supportive family, freedom from hunger and discrimination, clean and inviting places to live and play and lots of caring interactions with neighbors who know and care to help each other.
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Children who lack these basic needs will surely be “blacklisted” with labels whose prophecy they will likely fulfill even if they receive the extra attention that their data-based risk status recommends.
Furthermore, the coalition already acknowledges that supports and resources to internalize positive conflict resolution strategies and use cooperative learning methods must begin during the early childhood years.
By the time children enter Kindergarten, most have a consistent self-concept for success or failure that they will take into every encounter with peers and adult authority figures.
Let’s learn from the lessons of other threats to the public’s health. People infected with tuberculosis only develop symptoms of the disease when their resistance to infection is weakened by other factors such as poor nutrition and chronic stress.
Zika will no longer threaten us when we eliminate the mosquitoes that carry the virus (akin to removing the weapons that attack our kids). Applying repellent to at risk individuals cannot prevent those already infected from carrying and transmitting the disease.
True prevention starts from the beginning of life, is offered to everyone in a community without stigma as a positive and necessary resource for healthy development, expects good outcomes for all and is far cheaper than the cost of minimizing or reversing a disease process.
If neighborhoods all across the city and county looked more alike with respect to their safety, beauty, employment, transportation, parks and recreation facilities, school, child care and healthcare quality, we’d have little absenteeism, higher academic performance, economic productivity and self-sufficiency and communities that care rather than kill.
The new violence prevention coalition deserves our support. At the same time, we must anticipate that for some, the endangered label may add burden. For others, trying with all their might to live above our statistical cut offs, they may miss the extra help they need and deserve in order to thrive.
Perpetrators and victims are indistinguishable as babies. They just lose hope long before they ever find death.
Dr. Peter A. Gorski is professor of public health at the University of Miami Miller School of Medicine, as well as professor of pediatrics and humanities, health & society at the Herbert Wertheim College of Medicine, Florida International University.