By Laura DeKoven Waxman
July 2, 2012

Treating violence as an infectious disease is an approach proving effective in several U.S. cities. It is the basis for the CeaseFire Health model developed by Dr. Gary Slutkin, whose pioneering work in Chicago led to the application of public health principles to reduce shootings and killings. A June 15 forum sponsored by the Robert Wood Johnson Foundation provided an opportunity for mayors in Orlando for the Conference of Mayors annual meeting to learn about the CeaseFire Health model and consider implementing it in their own cities.

In Orlando for the session, Slutkin explained that violence spreads in waves, just as an epidemic does. As a result of social learning and expectations, "violence begets violence," Slutkin said, and just like an epidemic, it can be reversed if it is detected and identified, transmission is interrupted, and behavior and norms are changed. Key to CeaseFire's success are "interrupters," people with street "cred" from target communities who have influence and know who to talk to and how to de-escalate a situation before it results in bloodshed. Critical also are professionally trained outreach workers and community managers who work to change behaviors and community norms.

CeaseFire has been replicated as Safe Streets Baltimore, and that city's mayor, Stephanie Rawlings-Blake, reported on the effort's success. She explained that it is overseen by the Health Department, which has created an Office of Youth Violence Prevention and is combating violence using the same approach as with other diseases — identifying effective interventions, working with the community to implement them, and monitoring effectiveness. It is being implemented by a community-based organization in several neighborhoods with high levels of violence. She reported that Baltimore officials believe that the program has been successful because it was implemented consistently with the model, and said further that, "Conflict mediations were key to the reduction of violent incidents," and "having the right outreach staff with the right skills is the most critical element for conducting high-risk conflict mediations and is essential to the success of the initiative."

Further discussing the Baltimore replication was Dr. Jennifer Whitehill, who participated in the recently completed evaluation of Baltimore's CeaseFire replication by the Johns Hopkins Bloomberg School of Public Health. She reported that the evaluation found that homicides or non-fatal shootings were reduced in three out of four of the Safe Streets neighborhoods, and that a survey conducted in one of the neighborhoods showed that young men were four times more likely to express "little or no" support for using a gun to settle a dispute, thus demonstrating a change in norms about violence.

The session was moderated by Conference of Mayors Vice President Philadelphia Mayor Michael A. Nutter, whose city also is implementing the CeaseFire model. Citing his commitment to reducing violence, Nutter put the need into perspective, reminding participants that in 2010 there were nearly 13,000 murder victims; each day, an average of 16 young people between the ages of ten and 24 are murdered, 86 percent of whom are male. African Americans account for half of all homicide victims, and 85 percent of those victims are Black men. "We are watching an entire generation of African American men fall behind," he said. "We are watching the next generation of children grow up without fathers, uncles and male role models. We are watching our communities crumble under the weight of incarceration, drugs, illiteracy and, most of all, violence."

To reverse this situation, Nutter said that in addition to implementing the CeaseFire approach in Philadelphia, reducing violence is a priority for his work with the Conference of Mayors. He also is working with New Orleans Mayor Mitch Landrieu and others to establish Cities United, a diverse coalition of mayors working in partnership with aligned organizations to reduce violent deaths among Black men and boys.

Landrieu, whose city is also implementing the CeaseFire Health model, further discussed the magnitude of the violence problem in cities, especially in New Orleans where, he said, the capital murder rate is ten times the national average, although the city ranks 80th in violent crime. He decried the lack of attention that Black-on-Black crime gets and said that "not everybody is to blame, but we're all responsible." He described the impact that violence is having on individual New Orleans neighborhoods and especially on children exposed to violence, citing examples of young children who have known other young children who were killed. He called violence a national epidemic that should not be tolerated.

Also participating in the Forum was Fresno Mayor Ashley Swearingen, who described her city's efforts to reduce violence. Officials there have reached out to people responsible for violence and told them that if they stop committing crimes, resources will be available to them; if they continue, they will be locked up. Swearingen said that elements of the CeaseFire Health model would complement what they are doing in Fresno, specifically the use of "interrupters," which she said sounds great so long as they could find the right people to perform that role.

Robert Wood Johnson Foundation's Team Director of the Vulnerable Populations Portfolio Jane Lowe discussed the physical and mental toll that violence has on victims and entire neighborhoods, and the long lasting impact that it has on children exposed to it. She said that the Foundation supports CeaseFire because it works and that it is currently supporting technical assistance to encourage its replication across the country. "If we can stem violence, we can open the door to strengthen communities," she said. She urged mayors to be their partners in spreading the CeaseFire model.

Led by Denver Mayor Michael Hancock, several mayors attending the Forum indicated they felt the CeaseFire Health model makes sense and expressed interest in implementing it in their cities. Slutkin invited those wishing to learn more about CeaseFire to contact Chief Operating Officer Candice Kane at kanecm@uic.edu.