Introduction

The epidemic of youth violence in our nation is both the result of and a major contributor to serious developmental damage to many American children. The crisis is a clarion call, requiring one to rethink the ways in which educational, mental health, and law enforcement services are delivered, in order to achieve a primary focus on the mental health of the family and child.

A public health model for understanding and enhancing the relationship between children, families, and basic community services is presented in Chapter 2 of this volume. The public health perspective adds needed new dimensions to the understanding of the nature and scope of the youth violence epidemic, as well as bringing new concepts, tools, and measures for intervention.

This chapter considers the impact of violence and related risk factors on child and youth development and reviews some of the efforts that have been made to improve neighborhood safety and promote prosocial behavior. It examines three major systems that serve the developing child: school, mental health services, and neighborhood police. Our case studies illustrate how a coordination of these three systems can better serve children and families. An integrated approach can best foster early intervention and prevention, applying what is known about children's developmental needs.

Poverty, marital disruption, domestic violence, family breakdown, parental unemployment, substance abuse, unsafe housing, poor physical health, and an overburdened educational system are just a few of the circumstances that take a huge toll on the development of children in urban centers. For these children, the world is a dangerous and threatening place in which to grow up. Their world is crime-ridden streets, where schools and playgrounds belong to gangs and drug dealers. It is dilapidated homes with broken windows, poor heating, peeling lead paint, rats, and garbage. It is a world in which children grow up afraid and ashamed of the way they live, where they learn basic survival skills before they learn to read. Some of these disadvantaged children succeed and prosper despite adversity, but too many face limited futures outside the economic, social, and political mainstream.

Most poor children in America are in double jeopardy. Whether in the inner city or in desolate rural areas, they experience the most health problems but have the least access to medical care. They are at the highest risk of academic failure but often attend the worst schools.