Editor’s Note: Targeted violence can be prevented before it starts by applying the same four‑step public health approach that CDC’s Division of Violence Prevention used for decades to reduce community violence, sexual violence, intimate partner violence, child maltreatment, and suicide. In this article, focused on primary prevention, the author summarizes a longer article making the case for applying the public health violence prevention model to targeted violence, along with recommendations for how to do so effectively.
You’ve probably heard this old prevention parable: A fisherman sees someone drowning in the river and rescues them— and then another one, and another. Eventually, he wanders upstream to see why so many people are falling into the river in the first place. He finds a broken bridge, repairs it, and goes back to fishing in peace.
If your job involves stopping and responding to targeted violence and terrorism plots, you’re paid to work downstream: monitor threats, triage tips, intervene when someone leaks intent, and help communities recover. That work is essential. But it does not shrink the pipeline of people moving toward violence. A complementary track—long-established in other violence prevention domains—focuses upstream on the conditions that make targeted violence more (or less) likely to begin with and reduces the number of plots that require disruption and response.
A new paper by DeGue et al. (2025) in Psychology of Violence describes the same four‑step public health approach that CDC’s Division of Violence Prevention has used for over forty years to reduce community violence, sexual violence, intimate partner violence, child maltreatment, and suicide, translating this model into a practical roadmap for preventing targeted violence faster. Using shared definitions, comparable data, attention to modifiable risk and protective factors across the social ecology, evidence‑based strategies adapted for context, and implementation supports that turn programs into durable systems, this work has demonstrated that prevention is not “soft” on security; it is the missing half of it.
Several key lessons learned from the general violence field can help us accelerate progress and innovation in targeted violence prevention to reduce pressure on law enforcement resources and keep communities safer:
Treat targeted violence as a public health (and public safety) problem
Targeted violence is not only a threat to public safety and national security. It is threat to the health and well-being of individuals and entire communities. Seeing targeted violence through a public health lens simply means asking, “How do we reduce how many people head down this path in the first place?” Public safety tools focus on the immediate threat—investigations, arrests, prosecutions, and crisis response. Public health adds an earlier layer—called primary prevention—in which we use data to spot patterns (who, where, and under what conditions harm tends to occur), strengthen the conditions that keep people safe, and weaken the conditions that make violence more likely.
This approach sets clear goals: cut the number of incidents (“incidence”) and the proportion of the population affected (“prevalence”), lessen how harmful they are when they occur (“severity”), and reduce disparities—the fact that some communities are hit harder than others. It also enables measurement at the population level (schools, workplaces, neighborhoods), so leaders can see whether prevention is working. CDC’s Division of Violence Prevention has used this playbook for decades in other areas— clearly defining the problem, identifying the risk factors that raise the odds of harm and the protective factors that lower it, testing practical strategies (from mentoring and school-connectedness to safer environments and economic supports), and building the training and data systems that help communities keep what works. Applied to targeted violence, this doesn’t replace law enforcement; it shrinks the pipeline that reaches them.
Use shared definitions and comparable data to see the problem clearly
Clear, specific definitions are the foundation for good measurement. When researchers and data systems use the same definition of “targeted violence” and the same inclusion and exclusion criteria, they can count incidents the same way, compare trends across places and years, and more easily evaluate whether prevention is working. Without that consistency, we risk double-counting some events, missing others, and drawing conclusions from apples-to-oranges data. At a minimum, the field should agree on what qualifies as targeted violence, how it overlaps (or doesn’t) with related constructs (e.g., violent extremism, terrorism, hate crimes), how to code motive and context, and which data elements to collect across jurisdictions. Existing resources—open-source compilations of public mass shootings (e.g., The Violence Project), school-focused datasets (K–12 School Shooting Database), and retrospective studies such as the U.S. Secret Service’s Mass Attacks in Public Spaces series (MAPS 2016–2020)—are useful, but they apply different case definitions and inclusion rules making it difficult to see the full picture of trends and patterns in targeted violence risk.
Public health addresses this problem with multi-source surveillance anchored in shared definitions. CDC’s National Violent Death Reporting System (NVDRS) links information from medical examiners, law enforcement, and vital records to create a comprehensive picture of violent deaths—who was involved, what happened, and under what circumstances. Adapting the same logic for nonfatal targeted violence events could improve prevention planning and evaluation efforts immediately.
Leverage shared, modifiable risk and protective factors to focus upstream
Decades of research across community violence, sexual violence, intimate partner violence, child maltreatment, and suicide have identified overlapping, modifiable conditions that raise or lower risk across the social ecology (Connecting the Dots). Many of these same factors have also been associated with an increased or decreased risk for targeted violence, for example:
- social isolation versus connection to caring adults
- conflictual or unsupportive family relationships versus stable, supportive ones
- delinquent peer networks versus prosocial ties
- exposure to violence (including online) versus safer, prosocial environments
- economic stress or unemployment versus greater economic security
These constructs are not predictive checklists for individuals; they are population‑level levers that can be moved with policy, programs, and norms. Understanding these shared factors is critical to the development of cross-cutting prevention approaches that are more likely to be effective, not only for one form of violence but multiple.
Start with what works; adapt and evaluate for targeted violence outcomes
Because many levers are shared across violence types, we do not need to start from scratch when identifying promising prevention approaches for targeted violence. CDC’s Prevention Resources for Action summarize strategies with evidence of reducing violence and suicide: skills for emotional regulation, problem‑solving, and healthy relationships; positive social norms (including active bystander behavior and norms against dehumanization); strengthened economic security; improved access to mental‑health and substance‑use services; and safer physical and social environments in schools, workplaces, and communities.
The near‑term task is to align existing programs with targeted violence pathways and evaluate intermediate outcomes related to mobilization—connection to a trusted adult, grievance processing, tolerance for violence, dehumanization, identity fusion, and help‑seeking intent. We already know what works to prevent other forms of violence, and by impacting shared risk and protective factors, those approaches might already be effective for targeted violence as well.
Build and sustain the infrastructure that turns programs into systems
Implementation quality determines real‑world impact. Evidence‑based strategies require user‑friendly guidance, workforce training, technical assistance, and data feedback loops to sustain fidelity and improvement. Public health has invested in this infrastructure for decades. For example, CDC’s VetoViolence platform includes free tools and training for violence prevention practitioners to build the skills and capacity needed to adopt, adapt, implement, and evaluate effective strategies. Investment in training, coaching, technical assistance, and cross‑sector coordination is critical to moving effective strategies into the field and supporting sustainability.
Recognize the changing landscape and keep the work moving
Many of the projects we reported on in DeGue et al. (2025)— and the experts that led and supported them— have been eliminated or are at risk of elimination due to funding and staffing cuts in CDC’s Division of Violence Prevention and DHS’s Center for Prevention Programs and Partnerships in 2025. Despite this, the prevention need remains. We can carry the work forward across sectors and jurisdictions using the established public health approach, through state and local coalitions, academic-community technical‑assistance centers, practitioner training networks, and digital hubs for implementation tools and evaluation support. Researchers and experts in other forms of violence and suicide prevention can help accelerate progress by addressing the potential applications of their ongoing work to targeted violence prevention, with small steps like adding outcome measures that extend the value of their work to this field with minimal additional resources.
Conclusion
Preventing targeted violence is not a new problem in need of a new playbook. It is a public health and public safety challenge that can be addressed with tools already proven in other areas of violence prevention. By agreeing on shared definitions and comparable data, focusing on modifiable risk and protective factors, adapting evidence-based strategies already in use, and funding the infrastructure that turns programs into systems, we can reduce how many people begin to mobilize toward violence—and lessen the harm when incidents occur. This is not a substitute for law enforcement; it is the upstream work that makes their downstream job smaller. In short, fix the bridge so fewer people end up in the river.