Massachusetts Medical Society: Recognizing and Preventing Youth Violence

Recognizing and Preventing Youth Violence

Following is the introduction to the the guidebook "Recognizing and Preventing Youth Violence". The full guide is available for download in PDF format (Download Youth Violence Guidebook, 292 KB). Hard copies can be obtained for $7.00 each by calling 1-800-843-6356.

Violence is a leading cause of injury, death, and mental health problems for America's youth. Although physicians and other health care professionals have always been involved in treating the results of violence, recent research and practice suggest that we can also play a critical role in its prevention.

We have two opportunities for intervention and prevention: during a routine health care visit and when caring for a youth who has been injured. On these occasions we can provide preventive education, screening for risk, and linkages to intervention and follow-up services.

This guide was written to:

  • provide basic information about youth violence
  • describe risk factors and appropriate screening tools
  • suggest approaches to violence prevention and intervention
  • present ideas and resources for advocacy and research

This guide does not focus on determining who is a victim and who is a perpetrator, as these distinctions are often blurred when dealing with youth violence. Instead, this guide will focus on identifying known risk factors and predictors for violent behavior, in order to reduce injury for all youths at risk.

Each patient contact is an opportunity for us to listen, counsel, and teach. As health care professionals, we can make a significant impact in the prevention of youth violence.

Ylisabyth S. Bradshaw, D.O., M.S., Chair of MMS Committee on Violence

Robert D. Sege, M.D., Ph.D., Vice Chair of MMS Committee on Violence

Some Sobering Facts

  • On average, in 1997, there were 17 Americans between the ages of 15 and 24 murdered each day.1,2
  • Teens are 21/2 times more likely than adults to be victims of violence.3
  • Firearms represent the third leading cause of death among Americans 10 to 14 years old and are the second leading cause of death among those 15 to 24 years old.
  • In a national survey of high school students 4,5, 36 percent had been in a physical fight more than once during the past year, with 4 percent requiring medical attention.
  • Of all the head injuries reported to the National Pediatric Trauma Registry between September 1988 and January 1996, 49 percent were the result of assault, while many of the remaining head injuries were due to child abuse. 6
  • Children who are witnesses and victims of violence are at significantly higher risk for developmental and mental health problems including depression, conduct and anxiety disorders, and post-traumatic stress disorder. These same children are more likely to become aggressive and violent than children not exposed to violence.


Best Practices of Youth Violence Prevention, A Sourcebook for Community Action. Thornton TN, Craft CA, Dahlberg LL, Lynch BS, Baer K. One free copy can be obtained by calling (888) 252-7751 or from This can also be downloaded via the Internet at


1 Youth Violence in the United States. National Center for Injury Prevention and Control.

2 National Summary of Injury Mortality Data, 1981-1997. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (Unpublished).

3 Facts and Myths About Youth Violence. National Center for Injury Prevention and Control.

4 Kann L et al. Youth Risk Behavior Surveillance, United States, 1999. Morbidity and Mortality Weekly Report, June 9, 2000; (49):SS-5.

5 Brener ND et al. Recent trends in violence-related behaviors among high school students in the United States. JAMA, Aug 4, 1999; 282(5):440-446.

6 Firearm Injuries. FACTS from The National Pediatric Trauma Registry. February 1995. Fact Sheet #7.

7 Margolin G et al. The effects of family and community violence on children. Annual Review of Psychology, 2000; 51:445-479.

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