Democratic presidential candidates have a new approach for tackling gun violence: Treat it as a public-health crisis

AP Photo/John Minchillo

For years, gun violence has been treated as a criminal issue, with law enforcement, punishment, and incarceration being the typical means of addressing the problem.
But with gun deaths on the rise in the US, traditional approaches have been far from effective, which has led to a policy shift among some contenders for the Democratic presidential nomination.
Sens. Elizabeth Warren, Kamala Harris, and Cory Booker are now calling gun violence a "public-health crisis."
Warren and Booker have outlined the need to fund public-health research to inform better policies to address gun violence, saying they will fund and use the tactics of community-based intervention.
These programs use data to locate high-risk areas for gun violence. Community members then intervene to mediate and de-escalate violence and refer people to social services.
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A significant policy shift on gun violence is taking place among contenders for the Democratic presidential nomination, with some now calling gun violence a "public-health crisis" that requires a public-health approach to tackle the issue.

When looking at gun violence as a criminal issue, the response has been to use law enforcement, criminal punishment, and incarceration. But those methods aren’t working, as deaths by firearms continue to increase in the US.

"Faced with a complex and entrenched public-health crisis, made worse by the ongoing inability of a corrupt government to do anything about it, it’s easy to despair," Sen. Elizabeth Warren, who’s competing for the 2020 Democratic presidential nomination, said in her proposal to fight gun violence. "But we are not incapable of solving big problems. We’ve done it before."

In 2017, 39,773 people died from gun-related injuries in the US, including homicides and suicides, according to data from the Centers for Disease Control and Prevention cited in a Pew Research Center analysis. The number of homicides involving guns rose by 32% between 2014 and 2017, according to the Pew study.

Presidential candidates are adopting a public-health approach

The rise in gun crime and continued mass shootings have led several 2020 Democratic presidential candidates to adopt a new approach that they say is evidence-based. The approach focuses on stopping violence and providing social services for people as a way of curbing shootings.

Democratic Sens. Kamala Harris, Cory Booker, and Warren have identified gun violence as a "public-health crisis" in their policy proposals.

After the recent back-to-back shootings in El Paso, Texas, and Dayton, Ohio, which killed 31 people and injured many more, Warren released her gun-policy proposal, which includes reforms that address gun violence in America.

Warren has called for more funding to update public-health research and to invest in "evidence-based community violence-intervention programs." Booker has taken a similar stance.

Republican President Donald Trump initially called to strengthen background checks after the shootings, but then quickly backed away from that proposal, reportedly under pressure from the National Rifle Association. Trump said on Twitter on Thursday that he was working on an effort to prevent mass shootings and that he was "hopeful Congress will engage with my Team to pass meaningful legislation that will make a real difference."

The Democratic senators emphasized the importance of conducting more public-health research to inform better policy decisions, even though funding this kind of gun-violence research has faced considerable setbacks.

Sen. Bernie Sanders, who’s also competing for the 2020 Democratic presidential nomination, also called for more funding to community-based organizations like Cure Violence and other "violence interruption models to stop violent incidents before they begin," in his "Justice and Safety for All" proposal.

Programs like Cure Violence, University of Chicago Crime Lab, Safe Streets, and Oakland Ceasefire are all using a public-health approach to curb gun violence in cities like Chicago, Baltimore, and Oakland, California. So far, the programs have reduced homicides and shootings in the areas in which they operate.

The public-health approach

"Most people have accepted the idea that gun violence is a public-health issue," Georges Benjamin, the executive director at the American Public Health Association, said. "Now it must be treated seriously."

A public-health approach to gun violence, according to Benjamin, is a multidisciplinary approach that needs to include research and data, social services, mental-health services, education, community intervention, policy change, and stricter regulations.

For Mike McLively, the community violence initiative director at the Giffords Law Center to Prevent Gun Violence, there are two main areas to address when discussing gun-violence reform. The first is changing laws around access to guns, and the second is intervening directly with people who are exposed to gun violence.

"When it comes to the national level, very little is done when it comes to scaling the demand for a public-health approach," McLively told Business Insider. "It’s been way underinvested."

For some time, local initiatives and organizations have implemented public-health approaches to combat gun violence. Evidence of their success can shed light on the outcomes if these approaches were expanded under the proposals from the 2020 Democratic candidates.

The programs using a public-health approach to solve gun violence

The organizations that have been on the front lines of gun violence for many years have been using a public-health approach by intervening in communities to mediate and prevent gun violence from breaking out. They connect "high-risk" individuals to support such as mental-health services, employment training, educational services, and substance-abuse treatment.

Scott Olson/Getty Images

In Chicago:

The Cure Violence program, launched in 1995, treated gun violence as a health epidemic.

The Cure Violence model was created to hire people from affected communities to de-escalate violence in "high-risk" areas by using police data in trying to prevent violence.

"Hiring people from the community is a basic public-health approach," Charles Ransford, senior director of science and policy at Cure Violence, told Business Insider. "We need to build meaningful trust, and we see success with this."

In 2000, West Garfield Park, a neighborhood that at the time had one of the highest rates of violence in the city, saw shootings decrease by 67% over the course of that year after Cure Violence came in, according to the organization.

By 2004, the program was in 16 communities and crime in the city dropped by 25%, with a 50% drop in the Cure Violence zones over the course of the year, according to Chicago Police Department data that the Cure Violence team evaluated.

The US Department of Justice sponsored an independent evaluation of the program in 2008 and found that Cure Violence had decreased shootings by 40% in its designated areas, two years after the program was implemented.

In 2015, when state funding was cut, Cure Violence could maintain only one program, and the city saw an increase in gun violence. Today, the program operates in 13 communities and four trauma centers in Chicago.

The model has been replicated in cities across the US, including Baltimore, New York, and Philadelphia.

Another program in Chicago called the University of Chicago Crime Lab has a different approach.

In 2017, the Chicago Police Department and Crime Lab built Strategic Decision Support Centers, allowing Crime Lab to embed data analysts in these centers. The data analysts evaluate crime rates and target local crime for police departments and community leaders to intervene.

"Chicago is really becoming a hub for this social type of policy and evaluation," Kim Smith, an associate director of criminal justice initiatives at Crime Lab, said. "The data analysis has proven to be helpful to measure the success and impact of certain projects."

Smith said that the public-health approach uses data to prevent crime and more effectively allocates resources to focus on reducing community violence. They can also better evaluate their strategy using data analysis to continually improve their tactics.

Since the implementation of these centers, Chicago had a 22% decrease in shooting incidents in 2017 compared to 2016. The Englewood neighborhood, one of the most violent in the city, experienced its lowest levels of shootings in 17 years, the Chicago Tribune reported in 2017.

In Baltimore:

In 2007, Baltimore implemented the program Safe Streets, which was the first Cure Violence replication site. The program partnered with the Baltimore City Health Department and had a hospital program at Johns Hopkins.

Baltimore has reported high rates of gun violence for years. This year alone, more than 150 people were killed as of June, a 17% increase in homicides over the same period last year. With nonfatal shootings, 500 people were shot, which was more than a 25% increase, The Baltimore Sun reported.

While Baltimore sees continued gun violence, three of the four neighborhoods that implemented Safe Streets saw a decrease in gun violence. According to the Journal of Urban Health, a neighborhood in South Baltimore and two neighborhoods in East Baltimore saw a reduction in homicides and nonfatal shootings. The reduction in shootings was linked with Safe Streets mediation tactics used by the outreach workers of the organization.

In 2016, the program mediated 196 conflicts that Safe Streets says would have likely resulted in gun violence. In March, the Baltimore Sun reported that Safe Streets would open three new sites in the city.

In Oakland:

The chart is courtesy of Giffords Law Center.

In 2012, the residents of Oakland launched a citywide violence-reduction strategy called Oakland Ceasefire with the help of experts from the California Partnership for Safe Communities.

The program has proved successful, with Oakland cutting its annual shootings and homicides nearly in half since 2012, according to a case study published by the Giffords Law Center.

The program discovered that 400 people, or just 0.1% of the city’s total population, were at the highest risk for engaging in violence at any time. It was this population that the program intervened with to mitigate violence.

To improve community and police relations, the program trains police officers and works to reform officers’ conduct.

There are regular meetings held between community leaders, the mayor, and the program coordinators to ensure goals are being met and improvements are made to the program.

The program also has sustained funding through an initiative launched in 2004, called Measure Y. The community voted to increase some city taxes and parking fees to raise $20 million annually for 10 years and was renewed in 2014.

"You really need robust and sustained funding for these programs to work," McLively said. "That is what distinguishes Oakland from the other cities who are trying to implement similar programs."

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