Adolescent interpersonal violence victimization is an adverse childhood experience and a serious public health problem for youths, their families, and communities. Violence victimization includes dating violence, sexual violence, and bullying. Youth Risk Behavior Survey data for 2019 were used to examine physical and sexual dating violence; sexual violence by anyone; and bullying victimization, whether on school property or electronic, of U.S. high school students by sex, race/ethnicity, and sexual identity. In addition, this report explores frequency of dating violence and frequency of sexual violence among students who reported these forms of victimization and presents composites of dating violence and bullying. Findings reveal that 8.2% of students reported physical dating violence; 8.2% reported sexual dating violence; 10.8% reported sexual violence by anyone, of which 50% of cases were by a perpetrator other than a dating partner; 19.5% reported bullying on school property; and 15.7% reported electronic bullying victimization during the previous 12 months. Approximately one in eight students reported any dating violence, and one in four reported any bullying victimization. Female students; lesbian, gay, and bisexual students; and students not sure of their sexual identity reported the highest prevalence estimates across all five violence victimization types, any and both forms of dating violence, and any bullying victimization. Non-Hispanic white students reported the highest prevalence of bullying victimization. Among students experiencing physical or sexual dating violence or sexual violence by anyone, the most common frequency reported was one time during the previous year; higher frequency was more prevalent among male students compared with female students. These findings provide a contextual understanding of the prevalence of interpersonal violence of U.S. high school students, highlighting those with highest prevalence. Findings can be used by public health professionals to guide prevention efforts with youths in schools and communities.

Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018-2020 National Survey of Children's Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6-17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9-11 years compared to 15-17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

BACKGROUND: Research shows associations between bullying victimization and substance use for teens. However, more research about this relationship for younger adolescents and across race/ethnicity is needed. METHODS: Prevalence and pooled logistic regression analyses of 2019 Middle School Youth Risk Behavior Survey data from 13 states (N = 74,059 students) examined associations between self-reported bulling victimization (at school, electronically, and both) and having ever tried cigarette smoking, alcohol, or marijuana; used an electronic vapor product; or misused prescription pain medicine. Regression analyses were adjusted by age and sex/race/ethnicity. RESULTS: All 3 measures of bullying victimization were significantly associated (p < .05) with the 5 substance use behaviors examined (adjusted prevalence ratios ranged from 1.29 to 2.32). These associations held across sexes. Significant associations were found within all 7 race/ethnicity categories, with the most associations reported for the non-Hispanic (NH) white, NH black or African American, Hispanic/Latino, and NH Asian groups. CONCLUSION: The association between bullying and substance use by middle school is a highly relevant issue to consider as students return to classrooms.

Researchers have documented that vacant lot greening can reduce community-level crime and violence. Busy Streets Theory (BST) suggests that residents who are involved in the greening process can help to improve physical environments and build social connections that deter crime and violence. Yet few researchers have explored how community engagement in the greening process may affect crime and violence outcomes. We applied BST to test the effects of community-engaged vacant lot greening compared to vacant lots that received either professional mowing or no treatment, on the density of violent crime around study lots. Using mixed effects regression models, we analyzed trends in violent crime density over the summer months from 2016 to 2018 at 2102 street segments in Youngstown, OH. These street segments fell within 150meters of an intervention parcel that was classified as one of three conditions: community-engaged maintenance, professional mowing, or no treatment (control). We found that street segments in areas receiving community-engaged maintenance or professional mowing experienced greater declines in violent crime density than street segments in areas receiving no treatment, and more decline occurred in the community-engaged condition compared to the professional mow condition. Our findings support BST and suggest that community-engaged greening of vacant lots in postindustrial cities with a concentrated vacancy can reduce crime and violence.

Although research advocates for comprehensive cross sector youth violence prevention efforts, mobilizing across sectors to translate scientific recommendations into practice has proven challenging. A unifying framework may provide a foundational step towards building a shared understanding of the risk and protective factors that impact youth violence. We conducted two empirical tests of the nurturing environment framework on youth violence across ethnic and geographically diverse rural and urban adolescent samples. Results show that overall the characteristics of nurturing environments are associated with lower levels of aggression and violence. In addition, minimizing exposure to socially toxic conditions had the strongest associations with lower aggression and violence. Findings were supported across both samples, suggesting that this framework may apply in urban and rural, economically disadvantaged contexts.

Violence, a leading cause of death in the United States (https://bit.ly/3esvTLM), leaves lasting scars among victims and communities. A recent study of 15- and 17-year-old youths living in high-burden Chicago, Illinois, neighborhoods indicated that almost 87% had been exposed to a serious form of violence, 32% had lost a close friend or family member to murder, and 18% had witnessed a fatal shooting (Gorman-Smith et al., unpublished data). Although these are staggering statistics, reducing and preventing youth violence is possible. We have a growing list of effective, evidence-based interventions, but why does implementation remain low?1

The Centers for Disease Control and Prevention (CDC)–funded Youth Violence Prevention Centers (YVPCs) apply different models to reduce youth violence that are applicable to firearm violence because they are comprehensive, cut across ecological levels, and involve multisector partners that inform firearm injury prevention strategies. In addition, all YVPCs engage youths and communities in reducing violence, which may also be a useful approach to the prevention of firearm violence. YVPCs’ role in helping to address firearm violence is vital for public health because in 2019 firearms were the leading mechanism of death among youths aged 10 to 24 years in the United States.1 Of the 7779 firearm-related deaths among youths in this age group in 2019, 4483 (57.6%) were attributable to homicide; 2972 (38.2%) to suicide; and 324 (4.2%) to unintentional, undetermined intent, or legal intervention.1 In addition, firearms accounted for 4483 (90.3%) of the 4965 youth homicide deaths and 2972 (45.8%) of the 6488 youth suicide deaths in 2019.1 In 2019, the youth firearm homicide rate was 7.06 per 100 000 and the youth firearm suicide rate was 4.68 per 100 000. Non-Hispanic Black youths experienced firearm homicide rates (31.02 per 100 000) that were 17.5 times higher than those of non-Hispanic White youths (1.77 per 100 000), and firearm homicides among non-Hispanic Black youths accounted for 66.2% of all youth firearm homicides in 2019.1 In total, 7455 youths aged 10 to 24 years died by firearm homicide or suicide in 2019, which translates to more than 20 youths dying every day from these firearm-related injuries.1 Overall, youth firearm mortality rates in 2019 were higher in rural areas (13.25 per 100 000) than in urban areas (12.00 per 100 000). Youth firearm suicide rates were higher in rural areas than urban areas (7.64 vs 3.48 per 100 000), and youth firearm homicide rates were higher in urban areas than rural area (8.14 vs 4.84 per 100 000).2 Firearm-related mortality rates for youths have surpassed rates of motor vehicle (MV)–related deaths in the United States since 2016.1 The fact is that between 2008 and 2017, the federal government spent on average $1 million annually on research addressing firearm-related deaths among those aged 1 to 18 years, compared with $88 million annually on research for MV-related deaths among youths.3

Lack of maintenance on vacant neighborhood lots is associated with higher levels of depression, anxiety, and stress for nearby residents. Overgrown grasses and dense brush provide hiding spots for criminals and space to conduct illicit activities. This study builds upon previous research by investigating greening programs that engage community members to conduct routine maintenance on vacant lots within their neighborhoods. The Clean & Green program is a community-based solution that facilitates resident-driven routine maintenance of vacant lots in a midsized, Midwestern city. We use mixed effects regression to compare assault and violent crime counts on streets where vacant lot(s) are maintained by community members (N = 216) versus streets where vacant lots were left alone (N = 446) over a 5-year timeframe (2009-2013). Street segments with vacant lots maintained through the Clean & Green program had nearly 40% fewer assaults and violent crimes than street segments with vacant, abandoned lots, which held across 4 years with a large sample and efforts to test counterfactual explanations. Community-engaged greening programs may not only provide a solution to vacant lot maintenance, but also work as a crime prevention or reduction strategy. Engaging the community to maintain vacant lots in their neighborhood reduces costs and may increase the sustainability of the program.

BACKGROUND: This study used a new Crime Prevention Through Environmental Design (CPTED) assessment tool to test the associations between physical attributes of schools and violence-related behaviors and perceptions of students. METHODS: Data were collected from 4717 students from 50 middle schools. Student perceptions of risk and safety, and violence were assessed. Evaluators used the CPTED School Assessment (CSA) to quantify how well the physical elements of each school correspond to ideal CPTED principles. Generalized linear mixed models were used to adjust for school- and student-level characteristics. RESULTS: Higher CSA scores were generally associated with higher perceptions of safety and lower levels of violence perpetration and perceived risk in unadjusted models. Higher CSA scores were also associated with lower odds of missing school because of safety concerns in most adjusted models, with significant adjusted odds ratios (AORs) ranging from 0.32 to 0.63. CSA scores for parking and bus loading areas also remained associated with higher perceived safety (AORs = 1.28 and 1.32, respectively) and lower perceived risk (AORs = 0.73 and 0.66, respectively) in adjusted models. CONCLUSIONS: The CSA is useful for assessing school environments that are associated with violence-related behaviors and perceptions. The CSA might help guide school environmental modifications to reduce violence.

PURPOSE: Sexual violence (SV) perpetration on college campuses is a serious and prevalent public health issue in the U.S. In response, incoming male freshmen are mandated to receive SV prevention programming. To provide a more effective response, however, we need to understand the SV behaviors of male freshmen before they arrive on campus and the associated factors that contribute to risk and that afford protection, areas that have received limited attention. METHODS: Male freshmen (N = 1,133) across 30 selected 4-year colleges and universities throughout the state of Georgia were recruited for a longitudinal study on SV perpetration. Levels of precollege SV as well as a range of covariates were assessed at baseline. Self-reported SV perpetrators were compared with nonperpetrators on demographic and hypothesized covariates deemed either risk or protective; then risk and protective models were analyzed using binary logistic regression. RESULTS: Weighted analyses revealed that 19.3% self-reported perpetrating SV before college. Before starting college, young men who reported more sexual media consumption, heavy episodic drinking, hypermasculine beliefs, and peers who endorsed SV were more likely to have a history of SV perpetration at college matriculation. Alternatively, men with more knowledge of effective sexual consent and stronger family functioning were less likely to arrive to college with an SV perpetration history. CONCLUSIONS: A significant proportion of incoming male freshmen have perpetrated SV previously. Colleges and universities need to assess incoming freshmen for risk behaviors and negative beliefs and to offer both primary and secondary preventions to more effectively reduce further perpetration.

BACKGROUND: Youth reporting combined histories of nonfatal violence, suicidal ideation/behavior, and gun-carrying (VSG) are at risk for perpetrating fatal interpersonal violence and self-harm. AIMS: We characterized these youth to inform prevention efforts. METHOD: We analyzed 2004 data from 3,931 seventh-, ninth-, and 11-12th-grade youth and compared VSG youth (n = 66) with non-gun carrying youth who either had no histories of violence or suicidal thoughts/behavior (n = 1,839), histories of violence (n = 884), histories of suicidal thoughts/behaviors (n = 552), or both (n = 590). We compared groups based on demographic factors, risk factors (i.e., friends who engage in delinquency, peer-violence victimization, depressive symptoms, illicit substance use), and protective factors (i.e., school connectedness, parental care and supervision). Regression models identified factors associated with VSG youth. RESULTS: Illicit substance use and having friends who engage in delinquency were more common among VSG youth in all comparisons; almost all VSG youth had high levels of these factors. Depressive symptoms were positively associated with VSG youth versus youth without either violent or suicide-related histories and youth with violent histories alone. School connectedness and parental supervision were negatively associated with VSG youth in most comparisons. CONCLUSION: Family-focused and school-based interventions that increase connectedness while reducing delinquency and substance use might prevent these violent tendencies.

During a household survey in Tanzania, a nationally representative sample of females and males aged 13-24 years reported any experiences of sexual violence that occurred before the age of 18 years. The authors explore the prevalence, circumstances, and health outcomes associated with childhood sexual violence. The results suggest that violence against children in Tanzania is pervasive, with roughly three in 10 females and one in eight males experiencing some form of childhood sexual violence, and its health consequences are severe. Results are being used by the Tanzanian government to implement a National Plan of Action.

IMPORTANCE: National estimates of teen dating violence (TDV) reveal high rates of victimization among high school populations. The Centers for Disease Control and Prevention's national Youth Risk Behavior Survey has provided often-cited estimates of physical TDV since 1999. In 2013, revisions were made to the physical TDV question to capture more serious forms of physical TDV and to screen out students who did not date. An additional question was added to assess sexual TDV. OBJECTIVES: To describe the content of new physical and sexual TDV victimization questions first administered in the 2013 national Youth Risk Behavior Survey, to share data on the prevalence and frequency of TDV (including the first-ever published overall "both physical and sexual TDV" and "any TDV" national estimates using these new questions), and to assess associations of TDV experience with health-risk behaviors. DESIGN, SETTING, AND PARTICIPANTS: Secondary data analysis of a cross-sectional survey of 9900 students who dated, from a nationally representative sample of US high school students, using the 2013 national Youth Risk Behavior Survey. MAIN OUTCOMES AND MEASURES: Two survey questions separately assessed physical and sexual TDV; this analysis combined them to create a 4-level TDV measure and a 2-level TDV measure. The 4-level TDV measure includes "physical TDV only," "sexual TDV only," "both physical and sexual TDV," and "none." The 2-level TDV measure includes "any TDV" (either or both physical and sexual TDV) and "none." Sex-stratified bivariate and multivariable analyses assessed associations between TDV and health-risk behaviors. Results: In 2013, among students who dated, 20.9% of female students (95% CI, 19.0%-23.0%) and 10.4% of male students (95% CI, 9.0%-11.7%) experienced some form of TDV during the 12 months before the survey. Female students had a higher prevalence than male students of physical TDV only, sexual TDV only, both physical and sexual TDV, and any TDV. All health-risk behaviors were most prevalent among students who experienced both forms of TDV and were least prevalent among students who experienced none (all P < .001). CONCLUSIONS AND RELEVANCE: The 2013 TDV questions allowed for new prevalence estimates of TDV to be established that represent a more complete measure of TDV and are useful in determining associations with health-risk behaviors among youth exposed to these different forms of TDV.

OBJECTIVES: We aimed to determine the frequency, characteristics, and precipitating circumstances of eviction- and foreclosure-related suicides during the US housing crisis, which resulted in historically high foreclosures and increased evictions beginning in 2006. METHODS: We examined all eviction- and foreclosure-related suicides in the years 2005 to 2010 in 16 states in the National Violent Death Reporting System, a surveillance system for all violent deaths within participating states that abstracts information across multiple investigative sources (e.g., law enforcement, coroners, medical examiners). RESULTS: We identified 929 eviction- or foreclosure-related suicides. Eviction- and foreclosure-related suicides doubled from 2005 to 2010 (n = 88 in 2005; n = 176 in 2010), mostly because of foreclosure-related suicides, which increased 253% from 2005 (n = 30) to 2010 (n = 106). Most suicides occurred before the actual housing loss (79%), and 37% of decedents experienced acute eviction or foreclosure crises within 2 weeks of the suicide. CONCLUSIONS: Housing loss is a significant crisis that can precipitate suicide. Prevention strategies include support for those projected to lose homes, intervention before move-out date, training financial professionals to recognize warning signs, and strengthening population-wide suicide prevention measures during economic crises.

We examined the circumstances that precipitated suicide among 1,046 youth aged 10-17 years in 16 U.S. states from 2005 to 2008. The majority of deaths were among male subjects (75.2%), non-Hispanic whites (69.3%), those aged 16-17 years (58.1%), those who died by hanging/strangulation/suffocation (50.2%) and those who died in a house or an apartment (82.5%). Relationship problems, recent crises, mental health problems, and intimate partner and school problems were the most common precipitating factors and many differed by sex. School problems were reported for 25% of decedents, of which 30.3% were a drop in grades and 12.4% were bullying related. Prevention strategies directed toward relationship-building, problem-solving, and increasing access to treatment may be beneficial for this population.

Dating violence is a serious public health problem. In recent years, the U.S. Centers for Disease Control and Prevention and other entities have made funding available to community based agencies for dating violence prevention. Practitioners who are tasked with developing dating violence prevention strategies should pay particular attention to risk and protective factors for dating violence perpetration that have been established in longitudinal studies. This has been challenging to date because the scientific literature on the etiology of dating violence is somewhat limited, and because there have been no comprehensive reviews of the literature that clearly distinguish correlates of dating violence perpetration from risk or protective factors that have been established through longitudinal research. This is problematic because prevention programs may then target factors that are merely correlated with dating violence perpetration, and have no causal influence, which could potentially limit the effectiveness of the programs. In this article, we review the literature on risk and protective factors for adolescent dating violence perpetration and highlight those factors for which temporal precedence has been established by one or more studies. This review is intended as a guide for researchers and practitioners as they formulate prevention programs. We reviewed articles published between 2000 and 2010 that reported on adolescent dating violence perpetration using samples from the United States or Canada. In total, 53 risk factors and six protective factors were identified from 20 studies. Next steps for etiological research in adolescent dating violence are discussed, as well as future directions for prevention program developers.

Teen dating violence (TDV) is a preventable public health problem that has negative consequences for youth. Despite evidence that youth in urban communities with high crime and economic disadvantage may be at particularly high risk for TDV, little work has specifically addressed TDV in these communities. The Centers for Disease Control and Prevention (CDC) has developed a comprehensive approach to prevent TDV-Dating Matters: Strategies to Promote Healthy Teen Relationships-that addresses gaps in research and practice. This Report from CDC describes the programmatic activities, implementation support, evaluation, and surveillance of the Dating Matters initiative, which will be implemented in four urban communities.