The incidence of youth violence approached epidemic proportions in the early- to mid-1990s in many urban, poor areas, where the rates of violence doubled and tripled. For example, according to the Office of Juvenile Justice and Delinquency Prevention (OJJDP), the number of murder offenders in each age group between 14 and 17 increased both substantially and proportionately from 1984 through 1993. In addition, the rate of robberies and aggravated assaults by juveniles rose dramatically from 1981 to 1993, the peak year of serious violent crime committed by youth.

This increase in urban youth violence is referred to by many in the prevention field as the "first wave" of youth violence. After a few years, it seemed to plateau and was then followed by a rise in the number of school shootings in suburban and rural areas—locations previously thought to be safe havens. This "second wave" of youth violence gained national media attention and mobilized school and community groups across the country to take a closer look at why some young people were turning to more serious violent crimes.

Currently, America is experiencing an increase in violence among girls, a group that was formerly considered a relatively nonviolent population. Despite an overall decrease in juvenile crime since the mid-1990s, girls' involvement in delinquency and crime has increased significantly. According to OJJDP, between 1992 and 1996 the number of juvenile females arrested for violent crimes increased by 25 percent, with no increase in arrests of male juveniles for the same offenses. Girls' murder arrest rate, while still low, is up 64 percent from where it was 10 years ago. This "third wave" of youth violence merits close attention by schools, mental health professionals, and others concerned with the health and safety of young people who may be able to prevent the growth of violence among girls before it becomes even more widespread.

Recently, The Challenge had the opportunity to talk with Dr. Deborah Prothrow-Stith, a nationally recognized public health leader. Director of the Division of Public Health Practice and a professor at Harvard University, Dr. Prothrow-Stith is known for her work in adolescent health and prevention of youth violence, particularly among girls. We asked her about the increase in violence among girls in the United States.

The Challenge: Why has this "third wave" of youth violence made us uncomfortable and moved us beyond our professional comfort zone?

Dr. Prothrow-Stith: During the first wave of youth violence, many Americans comforted themselves with the perception that those involved were the "bad" kids who had something "wrong"with them. Services and interventions came from the criminal justice system. The second wave forced us to do a little more soul-searching because it was closer to home for many of us, and we began calling in mental health workers, in addition to the services from the courts. We still, however, continued to focus on the individual, not the environment. This third wave makes us uncomfortable, however, because we can't blame it on the "y" chromosome or poverty. This change is an outright shattering of our social and cultural perception that girls would never do these things. This has forced us to look at ourselves and our perceptions—to move beyond the school climate to taking a deeper look at who we are and what our environment is.

The Challenge: Why are girls now engaging in violence? What has changed?

Dr. Prothrow-Stith: We live in a society in which power equals violence and violence is glorified and admired. We live in a culture of violence. Genetics and biochemistry have not changed. Guns are not more accessible to girls than they used to be. But our environment has changed. Who we are has changed. The mediaÕs portrayal of females has changed. In recent years, we have seen the "feminization" of super-heroes. On television, in movies, and on video games, women and girls frequently play the roles of avengers who use violence to achieve their goals—roles previously played only by men. Girls have been socialized to use violence—they have added violence to their problem-solving repertoire. Until recently, their typical responses to problems included running away, using drugs, or prostituting themselves. Now their options also include violence.

The Challenge: How do we begin to address these changes?

Dr. Prothrow-Stith: We must begin by looking at our environment, at who we are—our movies, TV, sports, politics, and public policy. We must look at our professional practices and protocols. As a society, we do a lot of finger-pointing and blaming—parents blame schools, schools blame parents, we all blame the media. But, we need to remember: in an avalanche, no one snowflake is responsible. Similarly, many different factors have contributed to the increase in violence among girls.

We need to add "culture of violence" to our list of risk factors, and to acknowledge that other risk factors such as family violence, availability of guns, poverty, and alcohol and other drug use may determine which young people turn to violence. Remember, "hurt children hurt children." We must make an effort to integrate the known risk factors into our prevention and intervention strategies and programming focusing on girls. These are not new risks our young women are facing, but the risks need to be addressed in the context of the social and cultural changes that have taken place. One of our challenges is about responding differently—our ways of disciplining young people often add to the hurt instead of helping. Unless we start to address our toxic environment, we will not begin to make a difference.

The Challenge: What else do we need to do?

Dr. Prothrow-Stith: First, we need to continue our primary prevention efforts that are directed at all children, girls and boys alike. We must continue to focus on improving the school climate and reinforcing the importance of listening, forgiveness, and compassion. Schools must support these things. And in these primary prevention efforts, we must remember to include girls, despite the perception that they are less vulnerable than boys.

Then, when addressing our secondary prevention efforts—those efforts that target our more vulnerable youth and populations—we must recognize that a more intense set of strategies is needed. There are some children, some young women, who have already experienced grief, pain, and loss, who have already witnessed violence. They have experienced gender-related problems such as sexual abuse, male violence, and early motherhood. With these girls, we need to take an approach that acknowledges their special set of issues, especially when they are entering adolescence and particularly when they have already been victimized. Too often, hurt children come to our schools and get re-traumatized. Again, unless we start to address their toxic environment and respond differently, we will not get to "who we are," and "who we are" is the heart of the problem. It is time to make sure that our curricula, our strategies, and our programming specifically target the issues and the hurt that our young women are facing. Real success will take place when the third wave is thwarted. Girls need to be taught not to use violence as a coping strategy. They must also be taught not to be victims.