A recent Time magazine article suggesting that we should treat “gun violence as a disease” rather than just as a crime got me thinking.
I vividly recall the debate several decades ago when alcoholism was suggested to be a disease and not just a behavior problem or character flaw. This approach helped people go into treatment and reshaped our thinking.
But the idea that gun violence is a disease is both provocative and compelling.
First, there is no doubt that we, as a nation, are experiencing an epidemic of gun violence and that it is a public health problem. There are more than 11,000 homicides in the U.S. each year from firearms. Tennessee is no exception. We rank third in the nation for shootings in or near schools, colleges or universities; additionally in 2014 more people were killed by gun-related causes in Tennessee than by motor vehicle accidents.
But if we look at who commits gun crimes and why they do it, a pattern appears. In Memphis, for example, one-third of gun homicides start with an argument.”Hurt people hurt people,” says Yvette Simpson who is piloting a program to curb gun violence in Cincinnati, not by increasing the number of cops, building prisons or increasing sentences but by employing social workers who are experienced in violence prevention.
If we labeled gun violence as a disease, it would be a “contagious disease.” Take children and adolescents who are exposed to violent behavior: They are 31.5 times more likely to engage in chronic violent behavior compared to those not exposed to violence. In fact, gun violence triggers a cycle of violence experienced by others at home, in the community and ultimately across the nation. We have the ability to stop this cycle of violence through counseling programs much like Alcoholics Anonymous.
There are models out there that are being tested right now. Cure Violence, known earlier as CeaseFire, is a nonprofit organization founded by Dr. Gary Slutkin, an infectious disease doctor and epidemiologist. “The Cure Violence Health Model uses the same three components that are used to reverse epidemic disease outbreaks. 1) Interrupting transmission of the disease. 2) Reducing the risk of the highest risk. 3) Changing community norms.” A Department of Justice report found that this program reduced shootings by 41 percent to 73 percent. And in five of the seven communities evaluated in the report, retaliatory shooting was reduced by 100 percent.
Today, 23 cities and 52 sites are implementing the Cure Violence program, but Memphis is not one of them.
Treating gun violence as a disease could leverage our assets in Memphis — including the strong hospital and medical infrastructure. More hospitals are being pressured to do outreach work in the community — known as “population health” in medical lingo. While this outreach effort currently is focusing on diseases such as diabetes and heart disease, it can also incorporate gun violence. The approach would call upon counselors and conversations, not just physicians and prescriptions.
Think of it this way: The recent measles outbreak in Memphis launched a flurry of public health activity. The solution required not just treating the measles cases, but also determining who else may have been in contact with the patients, counseling both patients and those contacts, and observing all of them.
We can treat gun violence in the same way. But the challenge with gun violence reduction is that counselors must work hand-in-hand with law enforcement officials, who often take a punitive rather than a curative approach to violence.
Another challenge for such programs is funding. The city cannot provide the funding, and outside grant funding cannot sustain the program over the long term. Here, the local hospitals can be part of the solution through their population health program.
This approach should not have any backlash from the National Rifle Association since it would be consistent with their view that “guns don’t kill people, people kill people” — in fact, they should be funding this pilot. If such an approach is able to reduce gun violence, there would be no need for a bitter legislative fight over gun control laws.
Memphis could benefit greatly. We have had 118 homicides this year. That is equivalent to one in 3,734 people killed, four times the homicide rate of New York City.
We need a novel approach to gun violence in our city, and possibly Cure Violence can help provide it.
Source: Commercial Appeal