VP Prelim Plan Recs_May2012

1
Santa Clara County
Public Health
Department
Violence
Prevention
Assessment
Findings
and Preliminary
Recommendations
Prepared by:
Aimee Reedy,
Division Director-Programs
Angie Aguirre,
Consultant-Creative Mundo
May 2, 2012
County of Santa Clara
Public Health Department
Public Health Administration
976 Lenzen Avenue, 2nd Floor
San José, CA 95126
408.792.5040 voice
408.792.5041 fax
www.phd.org

2
Santa Clara County Public Health Department
Violence Prevention Findings and Preliminary Recommendations
Background
In alignment with the national health agenda, the Santa Clara County Public Health
Department has set its strategic focus on three local winnable battles: 1) Obesity
Prevention, 2) Tobacco Prevention, and 3) Injury and Violence Prevention. In October
of 2011, the Department launched a Community Violence Assessment to inform
internal strategic planning in the area of violence prevention. The Assessment
consisted of two primary facets: 1) an analysis of local violence data, and 2) interviews
with community leaders and groups about existing violence prevention efforts and
possible roles for the Department to support those efforts as well as opportunities for
leadership and collaboration.
This document presents recommendations for the Santa Clara County Public Health
Department to establish broad goals and key activities to prevent violence. The
recommendations were informed by the assessment findings and interviews with staff
from other local health departments and national violence prevention experts
representing the National Association of County and City Health Officials (NACCHO),
the Centers for Disease Control and Prevention, Futures Without Violence, and the
Prevention Institute. An extensive review of violence prevention literature was also
conducted. The list of stakeholders who informed this planning process can be found
in the Appendix.
Scope of Violence Nationally and Locally
Violence is a growing public health crisis in the United States and youth, low-income
populations, and people of color are disproportionately affected. In the United States,
violence accounts for approximately 51,000 deaths annually.1 Homicide is the leading
cause of death for young black men.2 Alongside the deaths violence causes are the
significant consequences of non-fatal violence: injuries and disabilities, mental health
and behavioral consequences, reproductive health consequences, other health
consequences, and the impact of violence on the social fabric.3 The economic burden of
violence in 2005 totaled to $47.2 billion ($47 billion in work loss costs and $215
million in medical treatment).4
1 Centers for Disease Control and Prevention, Injury Prevention and Control, available at:
http://www.cdc.gov/ViolencePrevention/violentdeaths/index.html. Accessed on March 21,2012.
2 Centers for Disease Control and Prevention, Leading Causes of Death in Males United States, 2007, available at:
http://www.cdc.gov/men/lcod/index.htm. Accessed on March 21, 2012.
3 Violence Prevention Alliance and Education Development Center, Why Invest in Violence Prevention?, 2011.
4 Centers for Disease Control and Prevention, Injury Prevention and Control, available at:
http://www.cdc.gov/ViolencePrevention/violentdeaths/index.html. Accessed on March 21,2012.

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In Santa Clara County, there have been some improvement in numerous violence-
related indicators over the past decade, however, the disparities among population
subgroups are stark and call for priority action. School and cyberspace safety also
necessitate heightened attention and action.
The analysis of local violence data conducted as part of the Violence Community
Assessment showed that:
• Women are more likely to be abused.
o 11% of adult women reported physical abuse by an intimate partner as
compared to 2% of adult men.
• Men are much more likely to perpetrate violence and experience a
violence-related death.
o 83% of homicide deaths and 91% of firearm related deaths were males.
o 80% of bookings and charges filed for domestic violence related assault
and battery were males.
• African Americans, Hispanics, and youth/young adults are
disproportionately impacted by violence. Moreover, African Americans
and Hispanics face a deficit of resiliency factors necessary to prevent
violence.
o African Americans have a higher: child maltreatment substantiation rate
(12 per 1,000 children); percentage of adults who report physical abuse
(11%); and rate of adult felony arrests for assault (81 per 10,000 people).
o Hispanics have a higher: percent of recurrence of child maltreatment
within six months (12%); firearm related age adjusted death rate (6 per
100,000 people); and domestic violence related death rate (11 per 100,000
people).
o Hispanic students were the least likely to report the highest level of
developmental assets (6%).
o The age groups with the highest rates of nonfatal hospitalized assault
injuries were youth ages 15-19 (67 per 100,000 people) and young adults
ages 20-24 (78 per 100,000 people).
• Bullying remains a concern for Santa Clara County schools.
o 21% to 44% of students reported experiencing some form of bullying on
the school property in the past 12 months.
• San Jose, Morgan Hill, Gilroy, Campbell, Santa Clara, and the county’s
unincorporated area are most heavily impacted by violence in the county.
• Students at East Side Union High School District are more likely to be
affected by violence than students from other school districts.5
The full profile on violence in Santa Clara County can be found at www.sccphd.org.
5 Caution should be taken in making conclusions from school district level analysis because data were limited at this
level.

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Preventability of Violence
Violence can be prevented, and its impact reduced. The factors that contribute to
violent responses – whether they are factors of attitude and behavior or related to
larger social, economic, political and cultural conditions – can be changed.6 The World
Health Organization (WHO) has identified strategies for evidence-based interventions
to prevent interpersonal and self-directed violence: developing safe, stable, and
nurturing relationships between children and their parents and caregivers; developing
life skills in children and adolescents; reducing availability and harmful use of alcohol;
reducing access to guns, knives and pesticides; promoting gender equality; changing
cultural norms that support violence; and ensuring victim identification, care, and
support.7
Role of Public Health in Preventing Violence
“As long as there has been violence, there have also been systems – religious, philosophical, legal
and communal – that have grown up to prevent or limit it. None has been completely successful,
but all have made their contribution to this defining mark of civilization. Since the early 1980s,
the field of public health has been a growing asset in this response. A wide range of public health
practitioners, researchers and systems have set themselves the tasks of understanding the roots of
violence and preventing its occurrence”.8
Although there has been a growing recognition of the unique skills and solutions the
public health community can offer to prevent violence, this role is often overlooked.9
Consequently, there has been a renewed effort to identify and promote the specific
roles of the public health community to prevent violence. According to the National
Association of County and City Health Officials (NACCHO), local health departments are
well suited to unite community partners to address the causes of violence and related
inequities through policy, environment, and system change.
Policy, environmental and system change implies that there are social and
environmental conditions that influence violence behavior and that we can
deliberately change or design these conditions such to create environments that are far
more conducive to health and safety. This approach is similar to the strategies that
have yielded significant accomplishments in tobacco and chronic disease prevention.
6 World Health Organization, Violence Prevention the Evidence: Series of Briefings on Violence Prevention, 2010.
7 Violence Prevention Alliance and Education Development Center, Why Invest in Violence Prevention?, 2011.
8 World Health Organization, Violence Prevention the Evidence: Series of Briefings on Violence Prevention, 2010.
9 Safe States Alliance, Preventing Violence: Roles for Public Health Agencies, 2011.

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Recommended Goals and Activities for the Santa Clara County Public Health
Department to Prevent Violence
The recommended goals outlined on the following page will position the Santa Clara
County Public Health Department to make a meaningful and lasting impact in the
prevention of violence. Efforts will be maximized if they are approached in a manner
that is:
• Collaborative/cross-sector;
• Trauma-informed;
• Evidence-based;
• Community-informed/engaged;
• Culturally competent; and
• Geared towards populations most affected by violence
Based on the data findings, the following populations were prioritized.
• African American and Latino youth and young adults
• Girls and young women
• Parents of children and teens
In the long-term, the violence prevention goals and activities outlined in this planning
document are expected to:
• Decrease teen dating violence;
• Decrease incidents of bullying;
• Increase protective factors; and
• Increase effective parenting practices.
In addition to the outcomes listed above, additional neighborhood-level outcomes will
be established in collaboration with community members, which could include
reductions in youth and gang violence.

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Overarching Goals
1) Frame violence as a public health issue, raise awareness that violence is
preventable, and strengthen support for upstream violence prevention efforts.
2) Increase the adoption and utilization of evidence-based practice to prevent
violence across the lifespan.
3) Integrate violence prevention into programs and services of the Santa Clara
County Public Health Department.
4) Change social norms about the acceptability of violence, the importance of
prevention, and the stigma associated with seeking help.
5) Convene partners in multi-sector strategies to breakdown silos, leverage
resources, and ensure a prevention component in anti-violence efforts.
6) Advance neighborhood-level strategies to prevent violence in areas within the
county that are highly impacted by violence, while recognizing and leveraging
community assets in those areas. Strategies will target populations most
affected by violence in priority neighborhoods.
7) Change policies and systems to prevent violence, including addressing the
social, environmental, and economic conditions that often give rise to violence.
Table 1 on the following page presents key violence prevention activities that are
aligned with the overarching goals described above. The table includes the Social-
Ecological Model (SEM) level10 that these activities address, as well as key partners,
cost gauge, the extent to which the activities are supported by evidence, and priority
activities for FY 2013.
Next Steps
These recommendations represent a starting point for re-establishing violence
prevention efforts within the Santa Clara County Public Health Department. The
Department will continue to prioritize the recommendations and map internal
resources to those priorities in collaboration with stakeholders. Many of the goals and
activities described herein can be achieved through enhancing existing efforts and
partnering with others, with little new resources. Other goals and strategies will
require new resources, which will be sought from national, state, and local sources,
including foundations and government agencies. The Department has already
embarked on collaborative grant seeking to address effective parenting practices and
healthy teen relationships.
Implementation of this planning effort will depend on the availability of resources, and
will be achieved incrementally. This planning document will be updated on a regular
basis in consideration of evolving needs and resources.
10 The four-level social-ecological model considers the complex interplay between individual, relationship,
community, and societal factors. The model could be used to better understand violence and the effect of potential
prevention strategies. Centers for Disease Control and Prevention, The Social-Ecological Model: A Framework for
Prevention, available at http://www.cdc.gov/ViolencePrevention/overview/social-ecologicalmodel.html. Accessed
on March 21,2012.

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Table 1. Public Health Department Proposed Violence Prevention Goals and Activities
Goals Activities SEM Level
Type of
Violence
Key Partners Cost
Evidence-
Based Practice
FY 2013
Priority
1) Frame violence as a
public health issue,
raise awareness that
violence is
preventable, and
strengthen support
for upstream violence
prevention efforts.
Conduct a campaign to raise awareness and
change the way people think about violence.
For example, raise awareness about:
• Risk factors that can lead to violence.
• Protective factors necessary for preventing
violence.
• Impacts of violence on physical and mental
health.
• Connections between violence and other
areas of public health concern (e.g.,
violence and active living and healthy
eating).
• Linkages between the different types of
violence.
• Disparities and the role of social
determinants, including racism and poverty.
• Society • Multiple • Political, community, and
faith leaders
• Violence prevention
experts (e.g., CDC,
NAACHO, Prevention
Institute)
• Media
• Local CBOs
Medium
to High
Model Practice
Routinely compile and release violence data
across the lifespan.
• Society • Multiple • County agencies
• Law enforcement
• Local Councils (e.g., DV &
Child Abuse councils)
• Foundations
High Model Practice
Develop a webpage on the Public Health
Department’s website that provides local
injury and violence data and information
about education and resources related to
injury, violence and trauma.
• Society • Multiple • Violence prevention
experts
• Local CBOs
• County/City agencies
• United Way 211
Low Model Practice
Serve on violence prevention related
committees, such as the City of San Jose’s
Mayor’s Gang Prevention Task Force, SCC
Reentry Network, Suicide Prevention Task
Force and the COE Bullying Prevention
Committee.
• Community
• Society
• Multiple • SCCPHD Leadership
Low Committees
are
implementing
best practices
Partner with the Trauma Informed
Collaborative to increase community
awareness about the effects of trauma from
exposure to violence and how to address it.
• Individual
• Relationship
• Community
• Multiple • Mental health field
• Local CBOs
• Trauma Informed
Collaborative
Medium Model Practice

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2) Increase the
adoption and
utilization of
evidence-based
practice to prevent
violence across the
lifespan.
Hold a Violence Prevention Conference on the
evidence-base for violence prevention
programs, policies and systems change
efforts.
• Community • Multiple • Violence prevention
experts
• Local CBOs
• Office of Women’s Policy
• SCC Office of Education
• Foundations
• Domestic Violence
Council
• Child Abuse Council
High Model Practice
Lead Level 1 (Primary Prevention) of Triple P,
a multi-level, evidence-based parenting
education program that reduces child
maltreatment.
• Individual
• Relationship
• Community
• Society
• Child
abuse
• First 5 SCC
• Mental Health Dept.
• United Way 211
• Foundations
• Local CBOs
• Model organizations
• Business sector
Medium Well supported
by evidence
Promote Bully Prevention Programs and
Policies such as the Olweus model, and
expand the “non-school” or community
component of the Olweus Bullying Prevention
Program.
• Individual
• Relationship
• Community
• Bullying • SCC Office of Education
• Local CBOs
• Faith Community
• Foundations
by evidence
Promote evidence-based teen dating violence
prevention programs in Santa Clara County
(e.g., Safe Dates and Start Strong).
• Individual
• Relationship
• Teen
dating
violence
• Local schools
• Local CBOs
• Faith Community
• Foundations
Low Well supported
by evidence
Leverage expertise and resources from state
and national organizations that are striving to
prevent violence.
• Community • Multiple • CA Public Health Dept.
• CDC and other federal
government agencies
• NACCHO
• Safe States Alliance
• National violence
prevention organizations
Low Recommended
Practice
3) Integrate violence
prevention into
programs and services
of the Santa Clara
County Public Health
Department (PHD).
Continue and enhance PHD programs that
include a violence prevention component
including the Nurse-Family Partnership (NFP),
Black Infant Health, and Adolescent Family
Life Program (child abuse and domestic
violence prevention); HIV/STD services; and
others as identified.
• Individual
• Relationship
• Community
• Multiple • SCCPHD Staff & Partners
• Political and community
leaders
Low NFP and
domestic
violence
screening are
well supported
by evidence

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Utilize EMS data to analyze serious injury
causes and patterns in Santa Clara County and
develop EMS-based preventative measures to
reduce those injuries.
• Community • Multiple • EMS Agency
• Public Health Assessment
Division
Medium TBD
Integrate violence prevention strategies in the
PHD’s Safe Routes to School efforts, Active
Transportation strategies, and the WIC
program.
• Community • Multiple • SCCPHD CDIP Staff
• School Districts
• Residents
Develop a department wide team to move
violence prevention strategies forward,
identify additional points of programmatic
intersection with violence prevention, and
expand internal capacity to address violence.
• Community • Multiple • SCCPHD Staff (e.g., EPI,
PHN, HIV/AIDS)
Low TBD
4) Change social
norms about the
acceptability of
violence, the
importance of
prevention, and the
stigma associated
with seeking help.
Launch countywide campaigns to raise
awareness, provide education, and influence
policies related to specific forms of violence,
such as bullying (especially cyber bullying),
teen dating violence, and domestic violence.
Campaigns will prioritize populations most
affected by violence (e.g., change norms
among men to prevent violence against
women).
• Individual
• Relationship
• Community
• Society
• Bullying
• Teen
dating
violence
• Domestic
violence
• Political, community,
business, and faith leaders
• Health care providers
• Violence prevention
experts
• Media
• Youth, parents, survivors
• Local CBOs
• Domestic violence
community
• County/city agencies
• Futures Without Violence
Medium
to High
Model Practice
5) Convene partners
in multi-sector
strategies to
breakdown silos,
leverage resources,
and ensure a
prevention
component in anti-
violence efforts.
Hold a series of “violence prevention
alignment” meetings with other county
agencies to: 1) understand departments’
roles/strategies to prevent violence, 2)
identify opportunities for collaboration on
existing efforts, and 3) discuss possibilities for
new joint efforts.
• Community • Multiple • Political leaders
• County agencies
• Community leaders
• Local CBOs
• Faith Community
• Business sector
Low to
Medium
Model Practice
Provide leadership in identifying sustainable
sources of funding for violence prevention.
• Community • Multiple • Political leaders
• Government agencies
• Foundations
• Networks
Low Recommended
Practice

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6) Advance
neighborhood-level
strategies to prevent
violence in areas
within the county
that are highly
impacted by violence,
while recognizing and
leveraging community
assets in those areas.
Strategies will target
populations most
affected by violence
in priority
neighborhoods.
Identify violence prevention risk factors and
protective factors/community assets by zip
code and census tract in Santa Clara County.
• Community • Multiple • Local leaders
• Local CBOs
• Community institutions
and associations
• Business sector
High Model Practice
Engage community and faith leaders in
neighborhood violence prevention efforts,
and build capacity for place-based strategies
to prevent violence.
• Relationship
• Community
• Multiple • Local leaders
• Local CBOs
• Community institutions
and associations
• Business sector
Identify policy/environmental strategies and
initiatives to prevent violence in priority areas
(e.g., clean up vacant spaces to prevent crime,
and promote physical activity and social
cohesion)
• Community • Multiple • Local leaders
• Local CBOs
• Neighborhood groups
• County/city agencies
• Business sector
7) Change policies and
systems to prevent
violence, including
addressing the social,
environmental, and
economic conditions
that often give rise to
violence.
Advocate for the expansion and improvement
of education and screening related to sexual
and domestic violence.
• Community • Domestic
violence
• Heath care providers
• Local chapters of medical
associations
• Political/community/faith
leaders
• Family Resource Centers
• Media
• Futures Without Violence
• DV Community
by evidence
Participate in the SCC Domestic Violence
Death Review Committee and continue
participation in the SCC Child Death Review
Team.
• Community • Domestic
violence
• Child
Abuse
• SCC DV Council
• Child Abuse Council SCC
• County agencies
Low Well supported
by evidence

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Appendix: List of External and Internal Stakeholders
The table below lists the stakeholders who provided their insights and guidance
regarding the possible roles for the Santa Clara County Public Health Department to
prevent violence. External stakeholders represented a diverse array of sectors
including government, the nonprofit sector, education, philanthropy, criminal
justice, and the faith community. A number of stakeholders represented the Santa
Clara County Public Health Department, as well as other local public health
departments across the nation.
Name Title Organization
Local External Stakeholders
Jaime Alvarado Executive Director Somos Mayfair
Kathy Andrade Community Program Director First 5 Santa Clara County
Art Barron Program Coordinator MACSA/South County
Collaborative
Bess Bendet Director California Blue Shield Foundation
Cheryl Berman Division Director of Adult Treatment Santa Clara County Department of
Alcohol and Drug Services
Stephen Betts Division Director of Adolescent Treatment Santa Clara County Department of
Alcohol and Drug Services
David Brody Chief Program Officer First 5 Santa Clara County
Marc Buller Assistant District Attorney Santa Clara County Office of the
District Attorney
Laura Buzo Associate Director First 5 Santa Clara County
Eve Castellanos Executive Analyst/Domestic Violence
Prevention Coordinator
City of San Jose, Office of the City
Manager
Brenda Carrillo Health and Safety Coordinator Santa Clara County Office of
Education
Andre Chapman President and CEO Unity Care
Maria de Leon Director City of Gilroy, Parks and Recreation
Department
Amanda Freeman Director of Education Silicon Valley FACES
Darcie Green Community & Government Relations
Manager
Kaiser Permanente
Matt Hammer Executive Director PACT
Raj Jayadev Founder Silicon Valley De-Bug
Wendy Kinnear Program Manager-Administration Santa Clara County Social Services
Agency
Michele Lew President and CEO AACI
Hon. Katherine Lucero Judge Santa Clara County Superior Court
Mario Maciel Superintendent City of San Jose’s Mayor’s Gang
Prevention Task Force
Julio Marciel Program Director California Wellness Foundation
Pat Mitchell Executive Director Silicon Valley FACES
Adam Moreno Program Coordinator MACSA

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Erin O’Brien Executive Director Community Solutions
John Porter Superintendent Franklin-McKinley School District
Angel Rios Assistant Director City of San Jose, Parks, Recreation
and Neighborhood Services
Elizabeth Sills Community Benefit Manager Kaiser Permanente
Jolene Smith Chief Executive Office First 5 Santa Clara County
Christina Soto Director of Youth & Family Services MACSA
Sherri Terao Family and Children’s Services Division
Director
Santa Clara County Department of
Mental Health
David Tran Director of Victim Witness Assistance Silicon Valley FACES
Denise Turner Chief of Police City of Gilroy
Dr. Tony Williams Pastor Maranatha Christian Center
Teresa Yu Domestic Violence Program Manager AACI
Stakeholders from the Santa Clara County Public Health Department
Mandeep Baath Epidemiologist II, Epidemiology Program Santa Clara County Public Health
Department
Sarah Barragan Health Care Program Manager I Santa Clara County Public Health
Department
Bonnie Broderick Senior Health Care Program Manager,
Chronic Disease and Injury Prevention
Programs
Santa Clara County Public Health
Department
Laura Brunetto Public Health Nurse Manager II (acting
Interim Director of Nursing), PHN
Regional Services, First 5, NFP Programs
Department
Alma Burrell Health Care Program Manager II, BIH
Program
Department
Lilian Castillo Health Program Specialist, Chronic
Disease & Injury Prevention
Department
Dr. Martin Fenstersheib Health Officer Santa Clara County Public Health
Department
Louis Girling Assistant Public Health Officer (retired),
CCS Program
Department
Charles Jackson Health Education Associate, BIH Program Santa Clara County Public Health
Department
Alice Kawaguchi Health Education Specialist, Chronic
Disease and Injury Prevention Programs
Department
Susan Lowery Health Education Specialist, Chronic
Disease and Injury Prevention Programs
Department
Rocio Luna Division Director-Assess, Planning, &
Health Policy
Jim McPherson Senior Health Care Program Manager,
HIV/AIDS Program
Department
Grace Meregillano Public Health Nurse Manager Santa Clara County Public Health
Department
Richard Nichols Health Program Specialist (retired),
HIV/AIDS Program
Department

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Daniel Peddycord Director, Public Health Department Santa Clara County Public Health
Department
Michael Petrie Emergency Medical Services
Administrator, EMS
Department
Dr. Aimee Reedy Division Director-Programs Santa Clara County Public Health
Department
Maritza Rodriguez Health Planner, Assess, Planning & Health
Policy
Department
Susan Silveira Public Health Nurse Manager I,
MCAH/CHDP Programs
Department
Pam Stoddard Senior Epidemiologist, Epidemiology
Program
Department
Beverly White Health Education Specialist, BIH Program Santa Clara County Public Health
Department
Violence Prevention Experts
Rachel A. Davis Managing Director Prevention Institute
Marci Hertz Health Scientist Centers for Disease Control and
Prevention
Anna Marjavi Program Manager Futures Without Violence
Xavier Morales Program Manager Prevention Institute
Laura Runnels Senior Program Analyst National Association of County and
City Health Officials (NACCHO)
Neil Rainford Public Health Advisor Centers for Disease Control and
Prevention
Billie P. Weiss Associate Director, Southern California
Injury Prevention Research Center
UCLA School of Public Health
Stakeholders from Local Public Health Departments
Alyssa Banks Research Associate Minneapolis Department of Health
and Family Support
Chesley Blevins Community Health Promotion Specialist San Diego County Public Health
Services
Tony Gomez Project/Program Manager Public Health − Seattle & King
County
Dr. Liz Maker Evaluation Specialist Alameda County Public Health
Department
Linda McGlone Senior Health Educator Monterey County Health
Department
Tania Mireles Director, Violence Intervention &
Prevention (VIP)
Boston Public Health Commission
Gretchen Musicant Commissioner of Health Minneapolis Department of Health
and Family Support
Dr. Paul Simon Director of Chronic Disease and Injury
Prevention
Los Angeles County
Department of Public Health
Amelia Barile Simon Community Health Promotion Specialist II San Diego County Public Health
Services

VP Prelim Plan Recs_May2012

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