Fundamental to the approach is a shift of emphasis, from reacting to acts of violence, to preventing violence-- that is, acting upon the social, behavioral, and environmental factors that cause violence. To be effective, proactive policies must be firmly grounded in science, and require that communities to participate fully to engender a sense of ownership of the problem and its solutions. The authors present epidemiologic data in explaining the impact of violence on different subgroups. The 1980s was arguably the most violent decade this century, perhaps in U.S. history--more than 215,000 dead and 20 million injured. The epidemic of violence not only threatens physical health, but erodes the integrity of basic social institutions such as the family, the community, and the health care system. 5 tables, 66 endnotes