What if gun violence is a public health issue?

Memphis ended 2016 with 228 homicides…most of them were shootings. While that number is both shocking and a record for the city, the story it doesn’t tell is the amount of gun violence that didn’t result in death. It also doesn’t give Memphians or policy makers any real strategy for tackling gun violence in the city.

CA Homicide Tracker - Click to view
CA Homicide Tracker – Click to view

Traditionally, the response to gun violence has been to double down on policing strategies. Both the current and former Memphis Police Directors admit this strategy is only a response to violence, not prevention.

City leaders have described gun violence in the City as an “epidemic”. While that language is mostly a rhetorical flourish, they may be on to something. A new study published in the Journal of the American Medical Association looks at gun violence from a “contagion model” to both predict and intervene to prevent gun violence.

Gun Violence as a contagion

Researchers from Yale University wanted to understand how gun violence manifests itself in social networks. Previous research has shown a link between demographics and gun violence. However, demographic models alone are too diffuse to be adequate predictors of where a spikes might appear.

The Yale researchers used that demography along with a social network model based on contagion patterns. Specifically, they sought to find out if gun violence followed outbreak models like HIV.

To do this, researchers used data provided by the Chicago Police Department for the years 2006 to 2014. The study evaluated instances of gun violence over that time to determine if that violence spreads like a “social contagion”.

One of the researchers, Andrew Papachistos, PhD of Yale University, spoke with NPR about the study Tuesday. In the interview, Papachristos says that using a contagion model is a better way of identifying future victims. Just like exposure to flu increases chances of contracting the flu, exposure to gun violence is a higher predictor of becoming a victim.

Not only is it an epidemic. We can actually show in our study how it’s transmitted and actually specific individuals who may be at risk. – Andrew Papachristos, PhD. via NPR

Researchers found that the social contagion and demographic factors best predicted who would be victims of gun violence.

This research calls into question the strategy of putting more police “boots on the ground” to address gun violence.

Treat it like an epidemic

So if more police isn’t the answer, what is? The study concludes that using a public health model of targeted interventions might be the best medicine.

In the conclusion, the authors note that tracking gun violence through social networks (not social media networks) could provide information for targeted interventions. Expanding outreach to people in the social network of the victim is a better way to reduce future violence.

What this means is more resources must be provided to the victims and their social networks to reduce gun violence.

This isn’t a new idea. For the better part of a decade there have been programs that treated gun violence as a public health issue. This is just the first time its been studied using nearly a decade of data.

This model that has been tried in several cities, with some success. One program called Cure Violence has been in place in New York City for several years. An independent evaluation of the program found a 20% reduction in shootings in targeted neighborhoods.

The New York City model includes money for issues not directly related to gun violence. These issues include teen reproductive health and nutrition. These supports help reduce the probability of gun violence by reducing stressors on target populations.

New York City spends around $20 million a year on programs in the Cure Violence network. The program is administered by Office of Public Health, and involves several local hospitals and direct service organizations.

While $20 million sounds like a lot of money, the NYPD budget is over $4.5b annually. That puts the cost of this program at less that .5% of the police budget. To put that into perspective, a similar approach would cost Memphis about $1.1 million, or the equivalent of 27 cops.

The Failure of Carrots and Sticks

Violent Crime in Memphis
Violent Crime in Memphis

In November, the Memphis-Shelby County Crime Commission released its most recent crime reduction plan.

I’ve been fairly critical of the Crime Commission in the past.  That criticism revolves around a lack of transparency, and the curious manner in which they send out press releases only when violent crime is down for a period of time (usually a month) and always measured against a high water mark rather than a running average (which indicates a political rather than policy purpose).  All that said, I read through the plan with an open mind, and looking for something new.

One section of the report (B5: Group Violence Intervention) mentions intervention programs similar to the Cure Violence model. However, it does not specifically mention key groups (particularly public health leaders) to implement these ideas. The OSC plan relies on the efforts of law enforcement, prosecutors, and unnamed “stakeholders”.

While the plan mentions Boston’s “Operation Ceasefire” and programs in New York City, it doesn’t speak to program implementation. The Cure Violence model has a specific plan. Does the OSC program include this, and if so, why isn’t it detailed?

I can excuse the Commission for not knowing about the most recent study. However, it is mind boggling that no funding request or outside supports are included in the plan.

Taken in total, the Operation Safe Community V3 plan looks like more of the same. Unfortunately, more of the same hasn’t actually reduced gun violence or violent crime in the city at all over the past 10 years. It has stayed in the same range (between 15 and 20 instances per 1000 people) the entire time.

That’s simply unacceptable.

Conclusion

The rate of violent crime has ebbed and flowed over the past decade. The Crime Commission periodically tells us “crime is down”. It isn’t.

None of the strategies put forward by the Crime Commission have resulted in a real, long-term reduction in violent crime.  All the while, cities across the country have seen durable drops in violent crime by employing strategies that seek to treat the underlying causes like a public health problem rather than rely solely (or primarily) on law enforcement strategies.

Its encouraging that the Crime Commission included this kind of comprehensive model in its plan, even if it only looks like lip service.  If anything, this new study gives them ammunition to go to State and Local leaders to ask for more resources that deal with these underlying problems.  But the Crime Commission also needs to expound on the actual implementation of such a plan, beyond the couple hundred words they slipped in their most recent crime plan.

Without new tactics, strategies, and outside expertise, the Commission plan isn’t worth the paper its written on.

The Crime Commission either needs to come heavy with a real plan, or admit that they are really only an organization that provides propaganda and political cover in the guise of “planning”.

Memphis deserves better. I hope that our leaders come together to craft a plan like Cure Violence funded and operational here.

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