To tackle any problem, we must begin by being aware of why the problem exists. Once we have that awareness, then we can look at solutions. The scientists that give us some of the earliest indications of causes of social conditions are epidemiologists. They study groups of people and examine how problems are related to their lifestyle, their environment, and other factors. However, in the case of violence, it can be difficult to determine which things are really causes and which things are merely coincidentally associated. For example, if we look closely at American trends, we would find that in the last century violence has increased dramatically; so has the purchase of nylon stockings. Just because these two characteristics have risen in frequency together does not mean that buying nylons causes violence or vice versa. Careful analysis is therefore needed once we identify associated factors to draw conclusions that truly are reasonable and thus worthy of the time and energy it takes to address them.
What then do the epidemiologic studies suggest are really the causes of violence? Before we can even answer the question, we need to recognize that violence is a problem with many different faces. Some factors cause one type of violence, but not others, while other factors are common causes for many or even all types of violent acts. Some of the forms of violence that need to be considered are listed in Figure 1: Forms of Violence in America.9
As you could guess, each of these different forms of violence has different causes or "risk factors" that increase the likelihood that such an event will occur. Let us compare some of the risk factors for suicide and homicide to provide an indication of how factors that contribute to different types of violence can be both strikingly similar and remarkably different.10,11 Figure 2: Comparison of Risk Factor for Homicide and Suicide lists these factors.
One of the themes of this entire book is that you can, to a large extent, play a role in determining your own health and the health of our nation. From this perspective, I believe that there are certain key tasks that I should engage in personally, and do my utmost to encourage others to undertake. These tasks should not be misconstrued as offering a total solution to the problem of violence in our nation. They are, however, a series of personal commitments that can make a profound difference regardless of what external factors look like. Whether or not gun control laws are implemented; regardless of who your neighbors are; in spite of any deficiencies in our nation's mental health services; no matter how we deal politically, educationally, or legally with child abuse and spousal abuse; the tasks presented here can and will make a difference. As a society we do need to address as many of violence's risk factors as possible, but as individuals we can begin now to promote several factors that individually and collectively will dramatically decrease the toll of violence in our land.
What then are these key individual tasks that I believe every American should personally address? First, avoid all illicit drugs and all mind-altering medications-unless absolutely necessary. Second, espouse sound values and be secure with those values. Third, spend your recreational time in activities that build your character, rather than undermine your values. These few succinct suggestions may seem simplistic, but I believe they hold the keys to many of the deepest roots of the problems we face regarding violence.
Task Number One: Avoid Mind-altering Drugs
The U.S. Department of Health and Human services has determined that an important factor associated with homicide is the use, manufacture, and distribution of illicit drugs.12 They cite three reasons for violence occurring in this context. First, the mind-altering affects of drugs can increase the likelihood that violent activities will occur as a result of being under the influence. Second, to secure funds for drugs, addicts engage in crimes that sometimes put lives at risk. Third, the "drug business" carries multibillion dollar stakes: violent deaths can result from confrontations regarding the manufacture, sale, or distribution of drugs. No national statistics are available that give us a feel for the percentage of homicides related to the illegal drug industry. However, studies in New York City and Miami indicate that at least 25 percent of all the homicides in those cities are related to drug use.13
Alcohol is a key player among the causes of violent deaths. Many studies have shown that roughly 50 percent of the victims and perpetrators of assaultive violence are under the influence of alcohol.14 Alcoholism is ranked as the second most commonly reported mental illness associated with suicide (only depression outstrips it).15 Concerning child sexual abuse, alcohol use occurred in conjunction with anywhere from 19 to 70 percent of the offenses.16 Statistics like these provide a strong argument for total abstinence from alcohol and illicit drugs if a person is concerned about being either a victim or perpetrator of violent acts. I explore the broad range of issues dealing with alcohol more thoroughly in Chapter 17, "Want a Drink?"
Many prescription drugs also have mind-altering effects. Whether it be Valium, Ativan, Xanax, Codeine, Lortab, Percocet, or a host of other less familiar drugs, many of the agents that we resort to for pain, anxiety, or discomfort can impair our mental clarity. We should look at such drugs as the cause of problems rather than the solution. There may be a legitimate short-term use for some of these agents. However, if you are using any mind-altering drugs on a regular basis, you should view that as an indication that you need further help.
Task Number Two: Espouse Sound Values
Even standard medical textbooks focus on issues relating to values and spirituality when they discuss violent crimes. For example, Dr. Donald Balaban, when describing risk factors for either committing or being a victim of homicide, sites three particular areas of psychosocial deficiency. Specifically he lists "lack of traditional support systems (such as family and religious institutions)," lack of "moral consciousness" and lack of a "sense of identity."17
The concern for a lack of moral consciousness strikes a resonating chord with many Americans. Many feel that our nation is experiencing a steady moral decline, and this sets the stage for violent acts. Is such an assessment justified?
George Barna and his Barna Research Group have conducted extensive interviews, particularly of the young Americans who are sometimes referred to as "Generation Xers." He has drawn some striking conclusions that provide insight into our nation's future generation of leaders.18 Some of these conclusions are listed in Figure 3: Generation X, Moral Issues, and Violence.
Furthermore, young people throughout urban-and rural-America are displaying a callused disregard for human life. In many cases, their ignominious deeds are "crimes of fashion" according to Jack Levin, a well-known criminologist at Northwestern University. Some of the crimes and Jack Levin's quotes are listed in Figure 4: Youth Crimes of Fashion.
Many cite evidence like that presented by Barna and Levin as justification for reasoning that the moral underpinnings of our society are coming loose, and that the rise in violence is one of the consequences.
Task Number Three: Choose Character-Building Recreational Activities
Whether we talk about drug use or values in general, it is necessary to look at the inputs that impact on these areas. Many believe that one of the prime contributors to our values is who we spend our leisure hours with and what we do during that time. There are many recreational activities that we could profitably discuss in this chapter. Some would be powerful motivators for good, and others would have significant deleterious consequences.
Let us focus on two of the most pervasive leisure activities in our society. I agree with the researchers who believe that these two activities share no small part of the blame for the American violence epidemic. They may even be the most dangerous, but they look so respectable and are so well accepted that it renders them more capable of enticing people to fall under their influence. The first of these influences is television.
