Violence is an infection and New Orleans has a raging case.
New Orleans has a violence problem. We residents are reminded of it nearly every day when we check the local news or check-in with our families, friends, and neighbors. Every now and then, the world is reminded of our city’s violence problem, too. The Mother’s Day shooting put New Orleans back into the international spotlight for all the wrong reasons.
Why am I bringing this up in my public health column? Because in recent years there has been a growing interest in treating violence as a public health issue. It makes sense when you think about it; experiencing violence certainly harms a person’s health, mentally and physically. Therefore, reducing violence would improve the overall health of a population. Homicide is the #1 leading cause of death in black men between the ages of 15 and 34. Reducing violence among this population is likely to have an impact on common public health measures such as mortality rate and life-expectancy.
In 2008, The New York Times published a profile on an epidemiologist named Gary Slutkin. Dr. Slutkin has spent the early part of his career in the developing world, fighting infections like tuberculosis and HIV. (Hello! My dream job!) When he returned to the US, he took a position in Chicago, another city with a high rate of violence. Upon studying the patterns of violence in that city, Slutkin recognized trends that were very familiar to him: geographical clusters of violent incidents, outbreaks of violent activity, and the ability use previous cases of violence to predict new cases. To Slutkin, Chicago’s urban violence was behaving like an infectious disease. Just as cases of an infection beget new cases of the infection, cases of violence beget new cases of violence (often in the form of retaliation).
Using this idea that violence spreads through a community in a manner similar to an infectious disease, Slutkin designed an intervention to stop transmission. He founded the organization Cure Violence, originally known as Cease Fire, to put his theories into practice. Cure Violence utilized former perpetrators of violence (often reformed gang members) to identify and diffuse potentially violent situations. The “interrupters”, as they’re known, draw on their experience and credibility to persuade members of their community not to commit violent retaliation after experiencing violence or otherwise being wronged/disrespected. The use of peers from the local community to promote behavior change is a technique that is often employed in public health. The thinking is that the target audience is more likely to heed advice given by someone they identify with, rather than an outsider.
So, does the infectious disease approach to violence reduction work? A growing body of evidence shows that it does. Independent evaluation of Cure Violence’s activity in Chicago shows that it has had a significant, direct impact on reducing violence in most of its target neighborhoods. The Cure Violence approach isn’t a panacea. Urban violence is a complex issue influenced by an array of factors. However, we can use all the help we can get in trying to reduce violence.
The City of New Orleans agrees. As part of Mayor Landrieu’s NOLA 4 Life homicide reduction plan unveiled last year, the city provided funds for Cease Fire New Orleans, which has been applying the Cure Violence model to the New Orleans community, specifically Central City. Cease Fire New Orleans recently completed its first year of operation, and hopefully we will soon have data on the effectiveness of the program in our own community. It is often difficult for programs with lofty aims, such as ending violence in a community, to show results in just one year, but at this point, I’ll take any glimmer of hope I can get for an end to the culture of violence in New Orleans.
This is not a New Orleans issue; it's an American problem. Americans are fond of electing "law and order" politicians who pander to fear, justifying the world's highest rates of incarceration with the false promise of making our society safer. Corporate greed feeds the cash-hungry political machine, paying prisoners mere cents per hour for modern-day slave "wages" while profiting in the hundreds of millions of dollars. Combine the resulting broken families, where fathers are missing, and children are preyed upon by the culture of gang violence with the criminal empires built upon the lie of drug prohibition, and the result is the horrific rates of violence experienced in American society today. The NRA plays no small role. Like the politicians, the NRA panders to, and preys upon fear to ensure an ample supply of weaponry onto our local streets and neighborhoods.