Gun Violence Is a Public Health Crisis that Demands Public Health Solutions

While most conversations about gun violence focus on criminal justice remedies — more police, more jails, and a “tough on crime” mentality — many violence prevention experts have long understood violence as an issue of public health. According to the CDC, for more than 20 years, homicide has been the first and second leading cause of death for Black and Latino males, ages 15-34, and the second leading cause of death for Black females from 15-24.

The correlation between poor public health and increased violence has played itself out over the last couple of years. The COVID pandemic has brought not only sickness and death, but social isolation, economic despair, emotional trauma, and depression — factors which have fueled the highest numbers of shootings in over two decades (which is why the massive federal COVID relief package included a provision for violence prevention services).

Key Findings

So, what have violence prevention experts learned about how to stem the tide of community violence?

First, studies repeatedly show that only a tiny fraction of any city’s population is truly at high risk for shooting someone — typically 0.2% or less. The goal then is to focus attention on this tiny fraction of individuals in order to address their physical, mental, and economic health needs before violence occurs. As when trying to stop the spread of infectious disease, this means intensive treatment for those who’ve been infected (most shooters have been victimized themselves) and ensuring that they do not infect others.

One example of this is through hospital-based violence intervention programs (HVIPs) which focus on preventing retaliatory violence. It is often in the highly emotional moments after a shooting victim is brought to the ER that siblings, cousins, and friends make the fateful decision to retaliate and, in health terms, further spread violence in the community. Whether they’re based in hospitals or on the streets, violence interventionists help individuals interrupt patterns of violence in their lives and plug them into a whole range of wraparound services to help them set a new path, including cognitive behavioral therapy, job training and placement, emergency housing, conflict mediation, and a range of survivor and victim services.

Invest in What Works

Successful community violence intervention (CVI) models have reduced shootings by 30-60% in a number of cities, but most efforts remain woefully underfunded. Effective initiatives which include a comprehensive set of wraparound services typically cost about $20,000 — 25,000 per year per program participant. This means that a city like Detroit with a population of about 675,000 should probably be spending at least $28 million a year on CVI. This may seem like a lot until one realizes that the taxpayer cost of a single nonfatal shooting in Detroit is over $1 million (and up to $3 million for a fatal shooting with two suspects). With 323 homicides and 1,065 nonfatal shootings in 2021, taxpayers are easily paying well over $1 billion for gun violence in Detroit. An investment of $28 million would pay for itself many times over.

In 2021, our organization worked with a broad coalition of over 150 organizations throughout the country to get the federal government to make proper investments in CVI throughout the country. While much of what we proposed has been stalled in Congress, one result is that the federal government made American Rescue Plan (ARP) funds — which included $350 billion in direct payments to cities, counties, and states — eligible for CVI. Some cities have made use of portions of this money to fund public health remedies like the ones described above to reduce gun violence, but most cities — even among the most violent — have not. In fact, recent reporting confirms that big cities around the country have spent large portions of their ARP funds on policing rather than on addressing the psychological, medical, and economic concerns of the low-income Black and Brown residents most impacted by the pandemic.

Maddening

For frontline violence interventionists, the families of the victims, and those who are in the line of fire every single day, the continued lack of investment in proven strategies — even when cities have millions of additional federal dollars on the table — is maddening.

Mayors, county administrators, and governors — Democrats and Republicans alike — are quick to stand at a podium and decry the scourge of gun violence after a shooting. But making pronouncements at a press conference is different from making investments. In his Pulitzer-winning book, “Locking Up Our Own,” James Forman, Jr. shares the history of how even Black politicians got swept up into the “tough on crime” ethos of the 1990s and helped fuel the mass incarceration of millions of Americans.

Since then, we have learned a tremendous amount about what does and does not work in reducing violence. However, despite widespread support for alternatives, many politicians continue to echo the destructive rhetoric and policies of the past. A poll of likely 2022 voters demonstrated widespread support for investments in community violence intervention across party lines (including two-thirds of gun owners and NRA members) which suggests that the public is ready to support substantive investments in public health approaches. At this point, it’s up to politicians to learn from the failures of the past and make real investments in bringing peace to our cities.

Pastor Michael McBride is the founder and executive director of LIVE FREE. Dr. Antonio Cediel is managing director of LIVE FREE. The organization works to end gun violence, mass incarceration and the death penalty.

For frontline violence interventionists, the families of the victims, and those who are in the line of fire every single day, the continued lack of investment in proven strategies — even when cities have millions of additional federal dollars on the table — is maddening.”