Cancer. Diabetes. AIDS. Lupus. Hypertension. Violence.
Most would think the last item mentioned above is unlike the others. Doctors, however, believe violence is a disease, too, and it should be amongst the rest addressed by the public health system.
During one of the presentations at this year’s American Public Health Association conference, researchers and activists gathered to discuss violence as a contagion. According to them, the patterns of criminal activities seen across the country are similar to those of the infectious illnesses that plague society.
So combat it, they say, violence requires the same public health approaches that are used to fight diseases.
“What’s needed is a system that can do something about this,” says Charles Ransford Jr., director of science and policy for Cure Violence, an organization that aims to reduce it globally by applying disease control methods.“We’re talking about departments, community leaders, universities and hospitals all becoming involved in finding out who’s been exposed to violence and identifying the medicine needed to remedy it.”
His group is an example of the work scientists say will decrease violence.
After carefully recruiting members of the community, the Chicago-based non-profit teaches “trusted insiders” how to anticipate violence and intervene before it erupts.
Leaders use three essential elements for treatment. They interrupt transmission to prevent violence from spreading, reduce the risk of citizen’s exposure to it and change the norms to educate and organize neighborhoods.
And it works.
More than 50 sites around the world, including in the Middle East, Latin America and U.S., have adopted the system. In Chicago, shootings dropped by 41 to 73 percent. Killings in a Baltimore neighbor fell by 56 percent, and New York City saw a 20 percent decline.
“We base our practice on science. It’s something that works across context. We’re not blaming people for their actions, but we’re trying to understand it so we can offer assistance,” Ransford explains.
His format isn’t the only one of its kind. Anne Marks runs Youth Alive. It’s a violence prevention program in Oakland, CA that began with its volunteers meeting victims of violence in the emergency rooms in an effort to prevent future occurrences of trauma.
Her program provides long-term solutions by supplying crisis response and support to families, organizing workshops and advocating for policies that reduce violence.
The National Network of Hospital-Based Violence Intervention Programs, which Marks co-founded, helps identify and develop other institutions such as hers. Why meet in medical centers?
According to the Journal of Adolescent Health, 44 percent of victims will return to hospitals as a result of another violent incident within five years, while 20 percent will die from it.
“It’s staggering. Prior victimization is the single most robust predictor of future victimization, so the goal is to promote positive alternatives for violence to halt retaliation, re-injury and arrest,” Marks says. “We know that hurt people hurt people but it’s also important to remember that healed people heal people.”
That’s why her system not only nurses the immediate physical needs but also the environmental and psychological ones such as posttraumatic stress disorder.
“PTSD is common. Victims come home to same home they were injured in with the same bullets holes in the door. There’s no treatment for them, so it’s a really different phenomenon,” she says.
Patients are broken as a result of the violence, which can negatively affect their reactions to it. Marks says sufferers can begin carrying weapons, joining gangs, missing school or work and sleeping less to feel safer.
John Rich, a professor at the Drexel University Dornsife School of Public Health, explains the harmful responses with biology.
“In traumatic situations, you’re going to feel your heart beat faster, you’re going to sweat, the hairs are going to stand up on your neck and you’re going to start breathing heavier…We know this as the fight or flight system, which prepares us to defend ourselves against real and perceived danger,” he says.
“Chronic stress can leave that system slightly on when it ought to be off. Therefore, all of the chemicals like cortisol remain in the body, somewhat invading the organs, which is not a good thing.”
Organizations such as Cure Violence and Youth Alive recognize this but does the government?
Antiviolence programs across the country have experienced funding issues.
The White House submitted a proposal this year to cut federal juvenile justice funds, which support local gang-prevention programs, by nearly 50 percent for the next fiscal year.
More locally, Gov. Bruce Rauner of Illinois wants to slash the funding for a group called CeaseFire almost 60 percent from $4.7 million to $1.9 million. As a consequence, the group’s state spending is currently frozen and could be lost altogether after the state budget is approved.
“Since March, when they stopped our funding, the shootings and homicides have really escalated. Programs where we had significant reductions have now all gone the opposite way,” says Jalon Arthur of CeaseFire.
Ransford thinks officials aren’t recognizing the need of health sector backing for violence, and it must be changed. While he and his colleagues don’t think health is the only answer, “it’s currently a missing piece of the puzzle,” he says.