It was an eventful July 4th weekend in the Land of Lincoln. The Illinois Senate over-rode Governor Bruce Rauner’s veto to pass its first state budget in over two years. This was the longest state budget impasse since the Great Depression.
Meanwhile, the mean streets of Chicago remained mean. The City recorded 15 homicides during the holiday weekend and over 100 shootings. Although down slightly, Chicago is on pace to record over 700 murders in 2017.
At first glance, the State’s budget war and the City’s surging gun violence appear to have nothing to do with one another. A closer examination reveals that slashing an effective violence prevention program in March 2015 triggered an epidemic of shootings and homicides.
For several years prior to the State’s budget crisis, the City’s annual homicide rate averaged in the low 400s. As the budget crisis took hold, homicides surged to 762 in 2016. This represented an horrific 78% increase from 2014, the last full year with an intact State budget.
As a long-time resident of Chicago, the upward spike in gun violence was both frustrating and baffling. Policy analysts blamed changing gang behaviors, readily-available guns, segregated neighborhoods, poverty and bad cops. These explanations were inadequate. Chicago had lived with these conditions for decades. There had to be another reason.
Then I listened to a remarkable interview with Dr. Gary Slutkin, founder and executive director of Cure Violence. Slutkin is an epidemiologist by training who asserts that gun violence is an infectious disease. Like tuberculosis, gun violence exhibits the following definitional signs and symptoms of an infectious disease:
- Contagion: one event leads to another which leads to another
- Predictive morbidity (injury) and mortality (death)
- Pattern distribution: it spreads in predictable ways
- Pattern disruption: targeted interventions can slow and reverse its spread
Cure Violence is a Chicago-based non-profit organization founded in 2000 by Slutkin in affiliation with the University of Illinois–Chicago School of Public Health. Cure Violence treats violence as an infectious disease. The organization goes to infected areas where it intervenes to stop the disease and limit its spread.
Cure Violence employs methodologies developed through the World Health Organization, operates in over 30 cities worldwide and has won numerous awards. It reduces violence by pursuing the following three well-defined strategies:
- Detecting and interrupting conflicts;
- Identifying and treating high-risk individuals; and by
- Changing social norms
Until March 2015, Cure Violence operated in 14 high-risk Chicago neighborhoods. They embedded trained “violence interrupters” and “behavioral change agents” within communities to identify signs of impending violence and intervene to cool tempers, buy time and shift perspectives. Their “signal” network includes local organizations (e.g. hospitals) to identify and interrupt brewing trouble.
For example, Cure Violence mapped gang relationships in high-risk Chicago neighborhoods. When an incident occurred, Curve Violence would dispatch its team to likely retaliation spots (not the crime scene) to diffuse tensions. The program worked exceptionally well by keeping violence from spiraling out of control in these high-risk neighborhoods.
In March 2015, Illinois’ Republican governor and Democratic legislative failed to agree on a State budget. Thus began Illinois’ long odyssey into fiscal uncertainty. With no budget, the State implemented broad-based program cuts. These cuts included the eliminating all State funding for Chicago’s Cure Violence programs. The Cure Violence program cuts lit the match that sparked a relentless surge in Chicago homicides (see chart below).
The observational linkage between Cure Violence funding cuts the Chicago’s spiking homicide rate is compelling. In essence, the State of Illinois conducted a negative “experiment” in the effectiveness of Cure Violence’s programming.
The consequences in lost human potential, damaged reputations, emergency funding and lost mojo are incalculable. This Chicago story should serve as a cautionary tale for any municipality addressing social contagions like gun violence. They have inherent potential to explode without appropriate monitoring and intervention.
Ironically, the Pullman neighborhood on Chicago’s Southside found independent funding to keep its Cure Violence program functioning. Pullman actually experienced a decline in homicides as gun violence in the City’s other high-risk neighborhoods caught fire.
The larger lesson is that multiple public health challenges resemble infectious diseases in how they originate and spread. These include chronic obesity, sexual violence, smoking, substance abuse, alcoholism and gambling.
Recognizing that these conditions and behaviors can trigger social contagion is essential in developing effective public health strategies for reducing their incidence. When infectious behaviors take hold, they can overwhelm individual powers of control with disastrous consequences.
In such circumstance, it takes cohesive communities with effective intervention tools to put the contagion genie back in the bottle. Chicago has learned that lesson the hard way.