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"Violence and the threat of violence can hinder children’s ability to learn, and can lead to chronic disease later in life.”
BILLIE WEISS (MPH ’81) was a new epidemiologist analyzing death records at the L.A. County Department of Public Health in the early 1980s when she realized that her position’s traditional focus on infectious disease was missing a big part of the story.
“In the younger population, injuries and violence were causing more death and disability than anything else,” Weiss recalls. “I went to my bosses and said we should be doing something about this. So we got funding, but we also realized we had no idea what we should be doing.”
More than 30 years later, violence is widely recognized as a problem that can be prevented through public health approaches, and Weiss is renowned in Los Angeles and beyond for research and leadership efforts that have pointed the way toward effective strategies. In November, she received the prestigious 2015 Victor Sidel and Barry Levy Award for Peace at the American Public Health Association annual meeting.
Weiss’ efforts to increase L.A. County’s attention to the issue led to her becoming director of the department’s Injury & Violence Prevention Program, a position she held until 2004, when she moved to the Fielding School to serve as associate director of the school’s Southern California Injury Prevention Research Program. Throughout her career, Weiss has led public health research aimed at assisting community-based organizations in effectively preventing violence. Her impact has been felt across the country. Weiss co-chairs Urban Networks to Increase Thriving Youth (UNITY), a national initiative to strengthen and support local efforts to prevent violence in the nation’s largest cities. She has consulted with public health leaders in metropolitan areas of several states who were interested in adopting the grassroots approach to preventing violence by building coalitions and partnerships that Weiss helped to spearhead in Los Angeles. Weiss has also been involved in efforts to address domestic violence and violence against women in Scotland and the United Kingdom, and participated in drafting the World Health Organization’s Melbourne declaration, which calls on nations and organizations to reduce preventable injury rates.
Upon realizing how little was known in the 1980s about strategies to prevent violence, Weiss and other public health leaders began talking about the need to bring in the perspectives of people in multiple fields who were involved with the issue. Those discussions led to the establishment in 1991 of the Violence Prevention Coalition of Greater Los Angeles (VPC), which has become a model for similar coalitions around the world. Co-founded by Weiss, then-Fielding School professor Susan Sorenson, and Paul Juarez, then at Charles R. Drew University School of Medicine, the VPC’s wide-ranging membership encompasses leaders and organizations from public health, law enforcement, the legal community, youth development, and victim support services, as well as those working to prevent gun violence, domestic violence, gang violence, and child abuse, among others. Weiss now serves as the organization’s executive director emeritus.
Through the VPC, Weiss has been a leader in efforts to educate gang intervention workers and law enforcement officers in public health concepts and strategies, including education about domestic violence.
“We have seen a nexus between gang violence and intimate-partner violence that is not well investigated or documented,” Weiss says. “I see this as a major issue. Most of the gang members I have worked with were either victims of, or witnesses to, intimate-partner or family violence. Among the girls involved in gangs, we see a great deal of domestic or intimate-partner violence. If you look at homicides in the 15-24 age group, the majority of them are gang-related, and if we are trying to prevent these without addressing intimate-partner violence, it limits how successful we might be.”
The VPC and other public health entities are increasingly training community-based workers in providing services that recognize the mental distress violence inflicts. “Violence is a public health issue that affects mental as well as physical wellbeing,” Weiss says. “We have entire communities where people are affected daily by the trauma of living in violent environments. Violence and the threat of violence can hinder children’s ability to learn, and can lead to chronic disease later in life. The people who work with these individuals need to be informed about what that means and how it can be addressed.”
After spending much of her career focused on the issue of violence, Weiss is more convinced than ever about what it takes to address it. “The public health model is critical in addressing violence, because it focuses on the community,” she says. “We can continue trying to change individuals from now until forever, but if we then send them back into the same communities with the same problems, we haven’t really fixed anything.”
Weiss laments cutbacks in support for public health research in violence prevention. In particular, she says, limits on funding for studies related to gun violence should be of serious concern to public health professionals.
“We haven’t been able to evaluate what’s working and what’s not, or which strategies are better than others,” Weiss notes. “Meanwhile, we have more and more gun violence – mass shootings, domestic shootings, and suicides. We have to get a handle on this, and one thing we do know from the limited research is that states with looser gun laws have more shootings and more gun deaths.”
On the positive side, she has seen a significant shift among law enforcement agencies, policy makers and others in their willingness to view violence as a public health issue and embrace public health strategies to prevent it. “I’m proudest of the fact that I’ve been able to get people to look at this in a different way,” Weiss says. “Without a collaborative, coordinated effort focused on prevention, little will change. But we can do it – we’ve shown it with tobacco, we’re showing it now with diet and exercise. Prevention works, there is no question in my mind about that.”