Which group do you think has higher rates of post-traumatic stress disorder (PTSD): American soldiers deployed to combat in Iraq and Afghanistan, or American children living in high-crime urban neighborhoods who are exposed to community violence? At a Congressional briefing held a week ago, Dr. Howard Spivak, Director of the U.S. Centers for Disease Control and Prevention’s Division of Violence Prevention, discussed research showing higher prevalence of PTSD among the latter group, observing that many of our kids are essentially “living in combat zones.”
Dr. Spivak was one of five panelists at a briefing sponsored by the Congressional Tri-Caucus and the Prevention Institute’s Urban Networks to Increase Thriving Youth (UNITY). Among other troubling research findings shared at the briefing were:
- Children’s exposure to violence not only has serious mental health consequences, but is also linked with a range of chronic illnesses, including heart and lung diseases and diabetes. Neuroscientists have found that this type of trauma changes how chromosomes form, hinders brain development, and may shorten a person’s life expectancy by 7-10 years.
- The 2009 National Survey of Children Exposed to Violence – conducted as part of the U.S. Department of Justice’s Defending Childhood Initiative – found that 60 percent of children were exposed to violence within the previous year.
- Homicide is the second leading cause of death for youth ages 10-24. In many cities, it is the leading cause.
The good news is that some cities are making substantial progress in reducing youth violence – and they are doing so by redefining violence as an issue of public health. What does that mean in practice? In Minneapolis, this approach involves assessing the source of the problem; identifying risk and protective factors that affect the likelihood that youth will resort to violence as well as trends that influence those factors; developing and evaluating evidence-based interventions to reduce risk factors and enhance protective factors; scaling up what works; and using public education to raise awareness about effective solutions. In essence, local leaders are treating and combating violence as a preventable disease.
Under Mayor R.T. Rybak’s leadership, Minneapolis formed a multidisciplinary collaboration in 2007 to develop and implement a public health approach, resulting in the Blueprint for Action: Preventing Youth Violence in Minneapolis. NLC highlighted this as an innovation in its 2009 report on The State of City Leadership for Children and Families. At the briefing, Alyssa Banks, Youth Violence Prevention Coordinator in the Minneapolis Department of Health and Family Support, provided an update on the Blueprint’s progress.
Between 2006 and 2010, juvenile crime fell by 56 percent. Juvenile incidents involving guns were down 58 percent, and there was a 36 percent reduction in injuries from firearms among youth and young adults. At a more granular level, the city tracks 18 indicators related to four key Blueprint goals:
- Connect every youth with a trusted adult.
- Intervene at the first sign that youth are at risk for violence.
- Restore youth who have gone down the wrong path.
- Unlearn the culture of violence in our community.
Some of the projects unique to Minneapolis are Summer 612, in which several youth groups have received mini-grants to produce documentary films and PSAs featuring youth perspectives on how to counteract the culture of violence. A partnership with two hospitals establishes a protocol that any young person (age 10-24) who shows up at an emergency room with a violent injury be assessed by a social worker within 24 hours and referred to appropriate services. New opportunities for mentoring, summer employment, academic support, afterschool learning, early intervention, and family support are being extended to more youth in targeted neighborhoods.
Minneapolis’ emphasis on public health echoes other promising violence prevention efforts. At the briefing, Dr. Oxiris Barbot, Commissioner of Health for Baltimore City, discussed Safe Streets Baltimore, a replication of the well-known CeaseFire Chicago initiative that relies on outreach workers who are seen as “credible messengers” to intervene with high-risk youth and prevent shootings and retaliations. Barbot highlighted a correlation between the number of conflict mediations in East Baltimore and the Cherry Hill neighborhood and decreases in the number of homicides and nonfatal shootings.
The perception of violence as both a criminal justice issue and a public health epidemic appears to be spreading to an increasing number of cities. While calls to “crack down” are still prevalent, more local leaders are now speaking the language of “reducing risks,” “changing norms,” and “blocking transmission mechanisms.” Twenty cities belong to the UNITY City Network and are using the UNITY Road Map as a framework to guide their efforts. Thirteen cities in California have developed comprehensive gang prevention action plans as part of their participation in the California Cities Gang Prevention Network, an initiative sponsored by NLC and the National Council on Crime and Delinquency since 2007. Six cities are implementing multidisciplinary, balanced, and data-driven approaches in partnership with federal agencies through the National Forum on Youth Violence Prevention. In recent months, Philadelphia Mayor Michael Nutter and New Orleans Mayor Mitch Landrieu have launched the Cities United initiative to reduce violent deaths among young black males.
As Jack Calhoun, senior consultant to both the Forum and to NLC’s Institute for Youth, Education and Families, has written in NLC’s toolkit on preventing gang violence, “Law enforcement and social services must not be seen as antithetical concepts. They are wedded. As parents, we set limits and we nurture. To reduce gang violence, we must convey both certainty of consequences and certainty of help. Police must enforce the law, but most police leaders assert that ‘we cannot arrest our way out of this problem.’”
Thanks to the bold leadership of some municipal officials, more cities are taking a strategic approach to violence prevention rooted in public health principles – offering hope that fewer children will grow up with war zone-levels of stress, trauma, violence and victimization.