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Funds Go to Battle Epidemic of Violence : Research: Wellness Foundation's first major grant boosts fight against violence using public health approach to disease as a model.

December 30, 1993|JILL LEOVY | SPECIAL TO THE TIMES

WOODLAND HILLS — Last year, the board of directors of the newly formed California Wellness Foundation set out to find a health-related cause worthy of $30 million.

They passed over prenatal care. They rejected vaccination. Instead, startling the research community, the board announced its first major grant program for a subject that the public only recently began to link to public health: violence prevention.

The program, launched by the foundation created by Health Net as part of a state-brokered deal that allowed the HMO to drop its nonprofit status, was by far the largest private contribution ever made to the public heath approach to violence prevention.

The foundation is funding violence research by nine fellows into topics such as why some people are repeat victims of violence, and which programs best curb aggression in children. But rather than wait for results, the foundation is also funding dozens of grass-roots violence prevention programs, and has created an organization to lobby for less violence in movies and television.

Its approach mirrors new research being done across the country in the area of violence prevention. Investigators say their research is distinct from medical research into what some think may be genetic explanations for violent behavior--criticized as overly deterministic by some public health experts.

Instead, Wellness Foundation researchers and other public health investigators are focusing on social causes, and education programs and government policies to prevent violence.

Researchers seek to prevent violence in the same ways they would seek to prevent any epidemic--by applying the standard tools of the disease scientist's trade. The method is no different whether the disease in question is violence, yellow fever or dysentery, researchers say. Only the solutions vary--what washing hands and building sewers are to digestive parasites, job programs and anger-management training may be to violence.

Using this model, epidemiologists map the progress of the so-called violence epidemic, identify vulnerable "host populations" and risk factors, and seek vectors or transmitters that help it spread. Then they identify policy changes that might prevent it, and educate people about behaviors that promote the disease.

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Public health researchers first began attempting to frame shootings, stabbings and assaults as manifestations of disease more than a decade ago. Today, it appears that efforts to instill this approach in the public consciousness have gone a long way toward success. Newspapers casually refer to the "epidemic of violence." Aspects of the public health approach are found everywhere, from presidential speeches to television sitcoms.

And money has followed. Where violence, the social problem, was long too political for mainstream foundations, violence, the public health problem, is a magnet for corporate grants.

Not just the Wellness Foundation, but the Carnegie Corp. of New York, the Joyce Foundation and the Ford Foundation in recent years have announced new grant programs for violence prevention.

Advocates say the change is a result, in part, of a concerted campaign to reframe age-old arguments about gun control and media violence in terms of public health.

"Once it becomes a public health problem, people from all ends of the political spectrum can own the issue," explained Howard Kahn, Wellness Foundation president.

"Before, it was just 'Build more prisons,' " said Susan B. Sorenson, an associate research epidemiologist at UCLA's School of Public Health, who has received a Wellness Foundation grant. Now, she said, public health researchers have succeeded in getting physicians, and even police, to look at the economic and social context in which violence occurs.

The Wellness Foundation's research grants will further advance incursions of epidemiology--the study of disease--into the area of violent crime.

"Instead of a virus, think of a bullet," said Andrew McGuire, executive director of the San Francisco-based Pacific Center for Violence Prevention, which is funded by the Wellness Foundation.

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Not all supporters take the disease model so literally. But they see clear benefits in defining violence in terms of disease rather than criminality.

They point to widespread changes in national attitudes and policies brought about by public health campaigns to limit smoking and drunk driving, and argue that the same changes can occur in the area of violence once it comes to be seen as a matter of public health.

The Wellness Foundation will provide about $5 million in grants over six years. This year's initial awards total nearly $1 million to five California universities and the state Department of Health Services to pay for research by nine academic fellows, including psychologists, epidemiologists and surgeons.

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