Quigley: Time to Treat Violence Like Public Health Issue It Is

On March 25, 2017 eight people were shot in the city of Chicago. The following day, twelve more people. Some were victims of retaliations and many more were left with new plans to retaliate, resulting in the continuation of a vicious and deadly cycle. As more shots are fired, more deaths occur, and more people are exposed to the trauma—and susceptible to the influence—of violence. While this sequence isn’t unique to Chicago, it is all too evident on the streets we call home. Violence of all forms is wreaking havoc in communities across the country, disproportionately impacting communities of color and shaving half a million years of life off our collective lifespan. But, it doesn’t have to be this way.

A reporter might cover this story with a headline that depicts a devastating 20 shootings in just two days. But to a public health official, this pattern looks a lot more like the spread of an epidemic. If we interrupt transmission at the first step by identifying and addressing the risk at hand, we have a much greater chance of preventing the cases that follow. It’s time to take it to scale, and health must be part of the equation.

In Chicago in 2000, the Cure Violence health approach saw a 67 percent decline in shootings and killings, which soon replicated to 70 communities nationwide with multiple independent evaluations from world-renowned institutions, such as the Johns Hopkins Bloomberg School of Public Health. The health approach is also working in hospitals in communities across the country like Oakland, which stemmed re-injury for 98 percent of participants involved in the hospital-based violence intervention program. It’s working in more rural settings as well, such as Elmira, NY where a nurse home visiting program reduced child abuse and neglect by 80 percent; and in North Carolina, which saw a 92 percent decrease in teen dating violence due to health interventions.

Since 1975, violence has been recognized as a public health problem, in large part to former Surgeon Generals Dr. Koop and Dr. Satcher’s pioneering efforts to make the health approach a national priority. Since then, we’ve seen that violence can be curbed—and stopped—if we treat it as we would any other epidemic health concern.

Unfortunately, these efforts are still too few and far between, as well as too inconsistently funded. The Violence as a Health Issue Collaborative led by Dr. Gary Slutkin, Founder/CEO Cure Violence; Dr. David Satcher, Former US Surgeon General and Director of the CDC; Dr. Al Sommer, Former Dean of the Johns Hopkins Bloomberg School of Public Health, and many other leaders representing over forty cities, forty national organizations, and totaling over 400 experts - have combined forces to elevate this approach, save lives, and protect future generations from unnecessary and preventable violence.

To start, there are four major investments that would protect millions from the trauma of experiencing or witnessing violence:

First, community-based violence intervention efforts with public health departments, universities, and community-based organizations implementing evidence-informed practices.

Second, hospital-based violence intervention initiatives that require hospitals to play a fundamental role in not only healing the wounds, but preventing people from being reinjured or injuring others.

Third, school interventions that focus on recognizing the signs of trauma, providing training to staff and parents to deescalate situations, and assessing the norms surrounding healthy conflict resolution strategies.

Fourth, academic institutions’—both medical and public health—curricula and research, which play an important role in inspiring the next generation leaders to focus on prevention and healing while promoting best practices.

I will soon be introducing legislation to accomplish these life-saving efforts. In addition to the lives that will be saved, hundreds of billions of taxpayer dollars will also be preserved by implementing this approach. We have seen the success it has had on various other potentially un-safe conditions from water sanitation and birth outcomes to disease prevention; just Imagine if we unleashed the power of health care and public health on violence as well. By working together to keep health at the center of our focus, as well as the national conversation, we can create the safe communities we all want and deserve.

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