Health Care

The ‘Cure’ to Ending Violence in Baltimore

December 3, 2015  • Matan Zeimer, Guest Blogger

(Photo Credit: istockphoto)

Violence has heartbreakingly claimed more than 300 lives in Baltimore this year, far surpassing the 211 homicides in 2014. It also marks the highest rate the City has experienced since the 1990s. Since the tragic death of Freddie Gray and the subsequent uprising in April, there has been an unprecedented spike in violence, leaving everyone asking why it has so drastically increased in Baltimore.

In reality, we should be asking a different question.

We get closer to understanding the City’s devastating problem when we ask why violence has remained low in some of Baltimore’s historically most dangerous neighborhoods.

One evidence-based program, which has consistently succeeded in stemming violence in four Baltimore neighborhoods, is answering just that. Safe Streets, the longest running replication of the Cure Violence Health Model developed by University of Illinois-Chicago professor and epidemiologist Dr. Gary Slutkin, treats violence like an epidemic disease.

When viewed through a health lens, the increase in violence over the past several months makes a lot of sense. The logic is that the more a person is exposed to violence, the more likely they are to be involved in future incidents of violence — either as a victim or a perpetrator, spreading like a disease. In essence, violence has been fundamentally misdiagnosed and therefore the response across all sectors has not been sufficient to heal communities.

To put it into perspective, we can look to the high number of injuries and deaths that violence incurs: in the United States, homicide is the leading cause of death for African Americans ages 10 to 24 and is the second leading cause of death for all young people in that age group. Violence, including suicide and interpersonal violence, claims close to 60,000 lives annually and accounts for roughly $450 billion in health care costs.*

In addition, chronic diseases and mental health are negatively impacted by exposure to violence and the associated trauma, especially at a young age. Health approaches such as the Cure Violence Health Model provide alternative solutions to this epidemic and begin to address the underlying causes… stopping the spread.

Safe Streets’ framework highlights the importance of using health approaches focused on treatment. The program, housed out of the Baltimore City Health Department, uses strategies traditionally associated with disease control: interrupting exposure and transmission, identifying and working with those at highest risk,, and changing community norms.

Violence interrupters place themselves in the middle of altercations to ‘cool’ the situation and find alternatives to potential acts of violence. The key element of the Cure Violence Health Model is implementation by credible messengers. Their credibility arises from personal experience with crime and violence and connection to the communities they serve. According to James “JT” Timpson, the Safe Streets community liaison, “The success of the program is based on the ability of our guys to form relationships with those in the community who are most likely to promote the violence.”

The violence interrupters go far beyond mediating street-level conflicts; they provide critical follow-up with individuals and families and help them navigate relevant social services.

An independent evaluation of Baltimore’s Safe Streets program by the Johns Hopkins Center for the Prevention of Youth Violence reported that two-thirds of participants met with an outreach worker three or more times per week and that participants who requested assistance got help with: finding a job (88 percent); job interviewing skills (75 percent); job training (63 percent); getting into a school or GED program (95 percent); and resolving family conflicts (100 percent). The report also showed that the violence interrupters “helped the majority of program participants (52 percent) settle an average of two disputes. Twenty-eight percent of these disputes involved guns and 91 percent avoided violence.”

The two neighborhood sites currently experiencing the highest rates of success are Cherry Hill and Park Heights. Cherry Hill, once known for being one of the City’s most violent neighborhoods, has only had four shooting incidents this year and has gone 128 days without a firearm homicide. Prior to July, Cherry Hill had gone 440 days without a firearm homicide, along with two other sites that had gone well over a year without a firearm homicide.

George Hopkins, a pastor in southwest Baltimore who grew up in Cherry Hill, explained, “When these young people talk about violence, what seems extreme to outsiders is not extreme for them, it is their reality and it is part of surviving. We have to engage the people who don’t even realize there is something different out there.”

There is a critical narrative and approach to violence that we must change as a society, one that Safe Streets pushes against daily. Violence is not inevitable; there is a cure.

*Correction: This article originally stated that violence claims approximately 60,000 lives annually and accounts for roughly $450 billion in health care costs. We have clarified this sentence to note that the 60,000 deaths is as a result of violence as a whole and includes incidents of suicide and interpersonal violence.

Matan Zeimer is a Baltimore Corps Fellow working as the special assistant to the director of health policy at Cure Violence, a national strategy which approaches violences from a public health perspective. Baltimore Corps, which recruits talented millennials to join social enterprises, is in the 2015 class of the Aspen Institute Urban Innovation Acceleration Program. Learn more about the innovation program on our website.