In September 1996, the French-American Foundation organized a bilateral exchange on youth violence research at United Nations’ Headquarters in New York City, with generous support from UNICEF and the Sol Goldman Charitable Trust. The Foundation’s “Maternal and Child Health” project was the genesis for this program. Due to the increase of violent behavior and its impact on the young, we felt that a comparative approach based on principles of public health would help provide a clearer definition of the problem. Such an approach is also well suited to evaluate the policy framework of both countries in terms of both prevention and treatment.
The meeting brought together French and American researchers, policymakers, journalists, and other experts on youth violence. Participants included Jeffrey Fagan, the Director of Columbia University’s Center for Violence Research and Prevention, Deborah Prothrow-Stith, Assistant Dean of Government and Community Programs at Harvard University School of Public Health, Claude Romer, Chief of the World Health Organization’s Promotion of Security and Prevention of Trauma program, and Michel Wieviorka, professor of sociology at the École des Hautes Etudes en Sciences Sociales.
      The focus of the meeting was to address youth violence in the context of "public health," but as many participants noted, the term "public health" carries a different meaning in France than it does in the United States. Due to the double meaning of the term and its potential for manipulation, to speak of violence in terms of "public health" in France warrants a negative response. The fact that, in the past, the medical institution, ranging from psychiatric wards to hospitals, has been employed in jailing dissidents – in certain authoritarian countries madness has been sufficient grounds for expulsion – prejudices its usage. “Health,” therefore, is understood as a linguistic device manipulated by individuals and institutions alike to legitimize their intervention. The question is yet further complicated by the fact only particular forms of violence meet with disapproval. That there exist certain types of violence which are understood as “legitimate,” to use Weber's expression, and which shape the “official” normative structure is, in France, associated with a form of domination, to adopt Marxist terminology. It is precisely this dual character of violence that has been exposed through analysis of the phenomena.
      In the United States, the specific character of violence, and its denomination under the term “public health,” relates to the way in which the medical community and some public policy experts have dealt with the problem. The testimony of Dr. Deborah Prothrow-Stith, serving as moderator of the conference, is extremely relevant in this regard. She recounts, “As a young doctor during the 1980's, I treated an alarming number of victims of violence, and at times even their aggressors, and I was forced to reassess my role when it became apparent that patients required, in addition to medical care, psychological treatment in order to address their fears of becoming a victim once again.” Violence, like disease, thus acquires a dual component and needs to be understood in terms of treatment and prevention alike.
      The characteristics of the American system and its institutional and regulatory make-up are fundamentally foreign to the French experience. The role played by the State in public health policy in the United States has prompted medical schools, not faculties as exist in France, but rather university departments with a greater level of autonomy in managing and establishing their affairs, to fill the void. Consequently, these schools have had to assume a larger role than just the medical training of future doctors. They have had to provide training for hospital and care center administrators, lobbyists, health office managers and all those, both local and federal, who deal with medical-related questions. This expanded role has prompted "Public Health Schools" to broaden their programs into teaching other disciplines, and has responded not only to disciplinary pressures but also to societal pressures which are impossible to ignore.
     Beyond the debate over terminology and methodology, the principal objectives of the conference were to investigate the phenomena of violence, its impact on the young, the reasons for its emergence and possible programs for mitigating its harmful effects. The comparativist and multidisciplinary approach of the conference – sociologists, jurists, epidemiologists, political scientists, representatives from local districts and public powers, teachers, police officers, journalists, psychologists and doctors all gathered at the United Nations – helped confirm, if this was not already clear in spirit, that the question is not understood uniformly, but is instead seen through a complex set of configurations. The separation between the experiences of the field-worker and the analysis of the scholar will only be bridged in the event that: first, the problem itself is clearly formulated; second, answers to the problem share a common language so that the divide between scholar and field-worker is reduced. Only through critical examination of a discipline's approach as well as its comparison with other disciplines (legal, psychological, socio-economical, epidemiological) is a full accounting of the complexities of violence possible.
     Often the impression is that Americans and French are each in their own right advocating an “indigenous” methodology and analysis for others. But a step in the right direction was taken through this exchange, not so much towards resolving the battle to prevent violence – the first step is always just a beginning – but rather towards better appreciation of these phenomena and the constructs it produces. In effect, violent behavior does not respond to a homogeneous classification. This is true for violence of a psychological nature which is connected to the intellectual constructs of certain groups, privileging them over others, but also for physical violence which is by no means uniformly elaborated. For example, one's cultural grouping may be oriented towards pacification while another, to the contrary, searches to extend violence through its institutionalization. As such, one's position in society and the type of society that one belongs to – where reflection on the problem is already a product of one's point of view – are important factors in determining the framework from which violence is identified as well as the images associated with it. Thus, to think of violence from outside the framework in which it is produced and interpreted requires access to the objective and subjective contents which explain it. Intimate knowledge of our environment, from our family and friends to society (state, schools) to the images acquired (television, police) of certain acts (some forms of drug use) and groups (minorities, poor), is a prerequisite for defining better methods of prevention.