The Gun Violence Epidemic

Violence breaks down communities. But, often, these communities are already broken down by poverty, joblessness, and inequality. When violence breaks out, people – and businesses – don’t want to move in. That means there are more school closings, more foreclosures, and fewer options for lower-income youth. Violence creates the conditions that make it thrive. Or maybe it’s the other way around. It’s hard to tell where it started. But some people have been trying to figure out how to make it stop.

“Violence is a crime issue, it is a social problem, it is a human rights problem, it is also a public health problem,” said James Mercy, the Special Advisor for Global Activities in the Division of Violence Protection at the CDC.

Now it’s obvious why violence is a public health problem. But it hasn’t always been this way. Mercy and Linda Dahlberg give us the play-by-play in a 2009 report for the CDC. There are two main reasons. First, there was a dramatic burst in homicide and suicide rates in the 1980s. Second, we started to accept behavioral factors as targets in disease prevention.

“There’s no one solution,” Mercy said. “These types of problems, like heart disease, require interventions on multiple levels. In general, what seems to be most effective, are early-type interventions. Interventions around parenting, and the environments that children are in.”

There are also interventions that try to stop violence as it starts. This has become known as violence interruption, which came out of Gary Slutkin’s anti-violence initiative, CeaseFire (now known as Cure Violence). Founded in the West Garfield neighborhood of Chicago in 1995, the project uses outreach workers, often former gang members, to conduct mediation. In 2011, Steve James filmed a documentary on the program, The Interrupters.

“Gun violence in particular acts very much like a social contagion. It spreads like a virus,” said Daniel Webster, Director of the Center for Gun Policy and Research at Johns Hopkins. “It spreads over time and place and among social networks, just as a virus might. So Slutkin thought about what was effective in controlling HIV and TB and other infectious diseases. A lot of times it boils down to what is the most proximate key behavior.”

Violence interruption hasn’t only been used in Chicago. By 2012, the Robert Wood Johnson Foundation set up 15 more sites to implement violence interruption. Webster and Jennifer Whitehill brought the program to Baltimore’s violent neighborhoods as Safe Streets. They reported much success: “5.4 fewer homicide incidents and 34.6 fewer nonfatal shooting incidents, on average, across all program sites during 112 months of observation.” They also seemed to break the social support for violence as a solution.

“What these violence interrupters do is help people realize that the social norms have not been serving them or their communities particularly well. They give people an excuse to walk away from situations they might otherwise feel like the social code is ‘I have to respond with violence’,” Webster said.

"Thou Shall Not Kill - Stop Killing - Stop Violence - Limousine.” Seth Anderson. CC BY 2.0, 2011.

“Thou Shall Not Kill – Stop Killing – Stop Violence – Limousine.” Seth Anderson. CC BY 2.0, 2011.

But where is the violence coming from? I spoke with Rebecca Levin, the Director of Strengthening Chicago’s Youth (SCY), to try to understand. Created by Lurie Children’s Hospital of Chicago, SCY brings together public and private stakeholders to tackle youth violence. They created a “Focus on Five” actions that everyone can take to prevent gun violence.

“One of the items on there is about access to firearms and gun violence prevention policy,” Levin said. “But you could get rid of every gun in Chicago, that would get rid of our gun violence problem. But that wouldn’t get rid of all our underlying issues and all the other pieces related to the gun violence issue.”

For Levin, the root cause of gun violence is related to structural violence.

“If you look at the cities that are experiencing more success with violence prevention, with cities with less success, slower declines are more segregated,” Levin explained. A recent New York Times report (“A Chicago Divided by Killings”) backs Levin up: “residents living near homicides in the last 12 years were much more likely to be black, earn less money and lack a college degree.”

Previously on this blog, I wrote about the health impact of racial residential segregation. Consider Chicago. We know Chicago remains one of the most segregated cities in the United States. We also know that we see dramatic differences in life expectancy, when we move from a predominantly white to a predominantly black neighborhood.

Segregation causes, as the sociologist William Julius Wilson might call it, an “accumulation of disadvantages.” Segregate a population and they get decreased access to resources, increased poverty and joblessness, and more constraints on their life chances. Concentrated poverty creates an environment for violence. But violence, also, creates more poverty: fewer businesses want to invest in an area, which depresses property values and decreases civil services, and keeps people disconnected from job networks. Gun violence is a public health problem that causes more public health problems.

“It is noteworthy how these conditions overlap. Substance abuse, violence, those are the particularly key ones that are quite concentrated in social disadvantage,” Webster said. “If you can reverse those determinants, you could stand to benefit not only with respect to violence but other health outcomes as well.”

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9 Responses to The Gun Violence Epidemic

  1. nfb290 says:

    Oftentimes, we think of crimes involving firearms as a chain of isolated events. But it indeed reflects the current state of our society. In a perfect world where parents spend adequate time with their offspring instead of working two or three jobs to provide for the family, and single mothers are non-existent, violence would be rare. The main focus would be to raise a well-rounded individuals and to help them reach their potential. But we do not live in a perfect worls. It is a vicious cycle: poverty gives rise to desperation that, in its turn, brings out the worst in people and creates more violence. We look at public health statistics as a combination of numbers and do not make connection between the quality of parenting and mentoring we provide to our kids and homicide rates. We are capable of changing the current state of things by encouraging our children to do their best at school and to get better education to ensure better future

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  3. Yvonne McGinnis says:

    If we truly want to eradicate gun violence in America, why don’t we adopt the Japanese gun model assessment program? This gun violence model would still protect the Second Amendment rights of all Americans. Most of the debate surrounding Second Amendment rights focuses primarily upon the interpretation of the benefits and rights afforded Americans under the Bill of Rights, Second Amendment. Notwithstanding the fact that most of those rights afforded Americans are not clearly stated in the United States Constitution, Second Amendment. There is entirely too much speculation, interjection, and assumption. With America having one of the highest gun crime rates globally; with America having a gun crime rate 20 times higher than that of other countries in comparable size and economics, can we afford to speculate, interject, and make assumptions. If our gun crime rates didn’t cause a Punic health crisis; if our current gun laws didn’t place military style weapons in the hands of civilians, and if we had commonsense gun laws that required some form of expanded background checks on all gun purchases, there would be some room for speculation.

    Secondly those second amendment rights are progressively becoming abused by Americans, namely criminals. For example, “Stand Your Ground Laws” is literally a license to kill. It allows the perpetrator of the crime to pursue an individual; be the aggressor, stalk, shoot and kill the deceased victim, and then claiming self-defense. It also allows the shooter to manipulate and exploit both the victim and the crime scene. Another critical point on “Stand Your Ground” is the dilemma associated with the shooter setting up the stalked and deceased victim; having the opportunity to commit a self-defense gun crime. There are way too many flaws in the “stand Your Ground Laws”.

    • Joseph Schmidlap says:

      Are you kidding me. Have you even read a law on the books described as “Stand Your Ground”. You would be better served if you understood this law, it’s limitations and when it can be used, then to regurgitate sound bites from the media.

      Secondly there is nothing progressive about the Second Ammendment. It stands as it was written without any progressive thinking.

      We have a a lot of work to do as a society when it comes to violence. Disregarding all the other issues that lead up to violence and focussing on only one of the many tools used to perpetuate this violence is extremely miopic.

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  6. Texas TopCat says:

    Some good points in the article. I still not sure that organizations like CDC should be involved. There is much more work needes to be done about law enforcement. Things that help the economy in general will help this problem. The poorest people always get hurt the hardest and longest during bad economy. Step one for the government is to enforce laws against violent crimes in ALL CASES.

  7. Thanks for the research and the links. There are a lot of good resources on this post for anyone wanting to delve more deeply into the issue of violence prevention. As someone who has been trained to think about the connection between cities and health outcomes I am encouraged that the public health community and the medical community have been paying more attention to broader sets of social factors in the last couple of decades. In addition to programs that rely on interventions by local authority figures and mentors, my intuition is that the next step in the turnaround process will have to do with enlisting young men’s loyalty to their neighborhoods and their love of place. We all have deep affiliations to our homes and this is a positive that can be reworked so that “protection” takes on new and more constructive meanings. These “soft” areas of research are not as easy to quantify as segregation and income inequality etc., but the frontier in social change, I believe, will be to learn how to work with our loyalties and other positive social aspects more effectively.