The Impact of Violence

Imagine violence as a stone dropped into a still pond. The initial impact, representing the immediate effects of violence—such as physical injury, psychological trauma, or death—creates the first wave. This first wave is disruptive and visible, but the ripples do not stop there. 

They spread outward, touching other areas of life, such as physical and mental health, family stability, and economic security.¹ These are the lasting effects of violence, often more subtle but far-reaching—physical disabilities, disrupted education, job loss, or involvement with the criminal justice system. 

As the ripples continue, they reach even further into the future, affecting not just individuals but entire communities and future generations.1 There are multigenerational effects—patterns of violence, reduced opportunities, and trauma that persist over time, long after the initial violent event. 

These effects are most acutely felt in historically marginalized communities, where they are driven by systemic and institutionalized racism and disinvestment, creating conditions that continue to restrict opportunity and exacerbate harm across generations.^1​

In June 2024, the U.S. Surgeon General released a landmark report (PDF, 4.4 MB) detailing the far-reaching ripple effects of community violence, with a particular focus on firearm violence.2 

The report illustrates how the impact of violence extends well beyond direct victims, highlighting the stress and harm caused by hearing gunshots, knowing someone who was shot, witnessing violence, or being threatened with a firearm.² 

These experiences ripple through individuals and communities, accumulating to create a significant disease burden through reduced physical activity, increased mental health concerns, and a decline in social cohesion and community trust.² 

By showing how even indirect exposure to violence degrades the health and quality of life for everyone in affected communities, the report serves as a critical resource for understanding these interconnected effects.² 

It underscores that preventing and reducing violence is an urgent public health issue that improves well-being for all people.²

​​Figure 1. Ripple Effect Impacts of Violence on Health. Holly Valero @HollyWorks^3,4,5,6,7

Disclaimer: The effects of violence expand farther beyond what is listed here; the image highlights some of the immediate, lasting, multigenerational effects of violence.

Public Health Approach to Violence

Public health offers a framework to counteract and prevent these ripples of harm. Recognizing that violence is preventable, public health works to reduce factors that increase the risk of violence and amplify protective factors that safeguard individuals and communities. This approach focuses on addressing underlying root causes—what is often described as working "upstream"—to prevent violence before it occurs.¹

By promoting the health of people and communities where they live, learn, work, and play, preventing violence is a crucial element of improving population health, achieving health equity, and creating resilient communities.

The public health approach to violence prevention involves four key steps:

1. Define and monitor the problem: 
• Analyze data to understand violence-related behaviors, injuries, and deaths. This helps pinpoint areas of greatest need.
2. Identify risk and protective factors: 
• Determine what increases or decreases the likelihood of violence, helping to target prevention efforts effectively.
3. Develop and test prevention strategies:
• Use data and evaluation to inform evidence-based program planning.
4. Assure widespread dissemination of effective practices:
• Share best practices of effective strategies and approaches through awareness, training, networking, and technical assistance.¹

Preventing violence using the public health approach also requires cross-sector partnerships with schools, social services agencies, and public works to create meaningful change. Preventing violence also necessitates a public health analysis of systems, policy, and governmental structures that either improve or deteriorate community conditions. Public health practitioners can play a key role in convening cross sector partnerships and educating policy makers to promote collective action for violence prevention.1​

Addressing Disparities and Inequities 

The ripples of violence do not affect everyone equally. Factors such as gender, race, income, and age shape the intensity and reach of its effects.¹ Marginalized communities often face compounded barriers due to systemic inequities, which makes it more difficult to recover from exposures to violence. These compounding barriers can lead to worsened health outcomes and negative impacts on socio-economic status throughout the life course.¹  Repeated exposure to violence, especially early in life, can contribute to toxic stress, which overwhelms a person's ability to cope with stress and deteriorates life-long mental and behavioral health.¹ Public health solutions tackle root causes while leveraging these strengths to foster healing and recovery.​

For example:

• Gender: One in three women experience intimate partner violence in their lifetime^1​, while older men living in rural areas have the highest rates of suicide.¹
• Race: Young Black men (ages 15-29), compared to other racial groups, are more than six times more likely to die from firearm violence.⁸
• Age: Youth ages 10-14 are more likely to die from suicide than motor vehicle crashes.⁹

Explore the data more at CDPH's EpiCenter interactive data tool or the California Violent Death Reporting System dashboard.

By addressing these disparities and focusing on root causes, public health interventions can transform the ripple effects of violence into waves of opportunity and resilience.

Sources

​ 1. Preventing Violence in California. Volume I: The Role of Public Health (PDF, 3.7 MB)

2. Firearm Violence: A Public Health Crisis in America. The U.S. Surgen Generals Advisory 2024 (PDF, 4.4 MB)

3.The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis​

4. Crime and Violence, Healthy People 2030

5. ​Violence as a Threatening Factor to Public Health

6. Prevention Resources for Action

​7.Connection the Dots: An Overview of the Links Among Multiple Forms of Violence (PDF, 2.7 MB)

8. The Impact of Gun Violence on Children and Adolescents

9. CDC National Cetner for Health Statistics. WISQARS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. ​​​​​​​​​​​