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Rather than viewing violence as tragic, yet inevitable, proposed legislation aims to bolster existing efforts to understand it as a preventable health crisis. Congressman Mike Quigley, (D-Ill.), a member of the House Appropriations Committee, has introduced the Public Health Violence Prevention Act (H.R. 2757). This bill would allocate $1 billion for the establishment of the National Center for Violence Prevention (NCVP) within the Centers for Disease Control and Prevention (CDC) and provide funding for scaling up prevention efforts across the country.
If the bill is approved, the NCVP would build upon ongoing efforts while creating new programs. According to Quigley’s press release, this would include the Public Health Violence Prevention Program (PHVP), “aimed at deploying health-focused responses to violence and the prevention of violence across all sectors.”
Violence claims nearly 60,000 lives every year in the United States. According to the CDC’s Fatal Injury Reports, violence is the leading cause of death for African Americans between the ages of 15 and 34 and it is among the top five causes of death for everyone between the ages of 1 and 44.
Beyond the direct loss of life, injuries, and years of life lost, violence also follows patterns that mirror other major health issues; the more someone is exposed to any form of violence, the greater likelihood they have of being involved in violence. The associated trauma results in negative health outcomes and is the largest of all health inequities.
The Public Health Violence Prevention Act is driven by the urgent and straightforward understanding that violence is preventable and that violence begets violence. Broadly described, direct health-based prevention strategies, such as Cure Violence and programs associated with the National Network of Hospital-based Violence Intervention Programs, work with victims of violence, their families, and those at highest risk to reduce the risk of injury, re-injury, and/or the potential for retaliation.
For example, Cure Violence employs trained “violence interrupters,” who are credible individuals in the communities where they work, to stop the spread of violence by detecting and interrupting potential and ongoing conflicts, identifying and working with the highest risk individuals to address their needs and change behaviors, and changing social norms through community mobilization.
These programs have been independently evaluated and garnered support from local and state leaders across the United States. In addition to supporting these programs, the Public Health Violence Prevention Act proposes a significant investment in evidence-informed practices for healing the physical, emotional, and social wounds of violence.
The bill builds on the Framework for Action developed by the Movement towards Violence as a Health Issue, co-chaired by Dr. David Satcher, former Surgeon General of the United States, Dr. Al Sommer, former Dean of the Johns Hopkins Bloomberg School of Public Health, and Dr. Gary Slutkin, founder and CEO of Cure Violence. This collaborative movement is comprised of more than 400 practitioners and community leaders representing more than 40 cities and 40 national organizations.
The Movement towards Violence as a Health Issue seeks to “fundamentally change the discourse on and approach to violence from the prevailing paradigm that understands violence as moral corruption or human failing that only applies punitive strategies to address the issue, to one that includes an understanding and addressing of violence as a health problem – an epidemic.”
While a source for the funding for the initiatives detailed in the proposal has not yet been announced, $1 billion is a fraction of the cost that violence incurs in the United States. Initial hospitalizations for gunshot wounds alone cost the U.S. more than $700 million every year. The Institute for Peace and Economics estimates that costs associated with violence in the U.S. total nearly $460 billion. This should be a clear bipartisan priority.
The funding, disseminated through the NCVP, would be predominantly directed to health departments, universities and community-based organizations seeking to develop or expand proven practices that address the underlying issues contributing to the perpetuation of violence, and provide individuals and communities with resources to heal from traumatic experiences. These efforts are more crucial than ever as we continue to see an increase in violence in many cities across the country.
With 152 homicides so far this year, Baltimore, where I live, is facing its deadliest year on record, up 32 percent from the same time a year ago. The Baltimore Sun reports, “In absolute numbers, Baltimore trailed only Chicago in homicides through May. Chicago had 240 — but it’s five times larger than Baltimore.” Baltimore, as with other major U.S. cities, has prevention efforts underway, but these programs face budget cuts and limited funding needed to have a city-wide impact.
The Trump administration, with leadership from Attorney General Jeff Sessions, has called for a focus to be placed on law and order responses to violence and crime, but city and state leaders (including law enforcement leaders) across the country have come to recognize that this is an issue we cannot arrest our way out of.
Progressive and bipartisan changes are happening at the state level across the country. One of the most recent examples was the decision by the Republican Attorney General of Ohio to invest $2.6 million in Victims of Crime Act (VOCA) grants to establish a statewide trauma recovery network modeled after California’s network of Trauma Recovery Centers. This comprehensive effort provides much needed support and advocacy services to survivors of violence and their relatives.
Oppressive and discriminatory sentencing and policing practices have only further increased the conditions that contribute to susceptibility to violence and persistent inequities. We need to be treating violence as the health crisis that it is.
Echoing leaders in the health field, including former surgeon general’s, city health commissioners, and organizations such as the American Medical Association and the American Public Health Association, Quigley wrote in an op-ed in April, “We have seen the success [the public health approach] has had on various other potentially unsafe conditions from water sanitation and birth outcomes to disease prevention; just Imagine if we unleashed the power of health care and public health on violence as well.”
Instead of criminalizing people, we need our systems across all sectors to be helping individuals and communities heal from all forms of historical and ongoing violence. If city, state, and national leaders want to end the spread of violence and help communities reach healthier and more equitable outcomes, they must prioritize violence as a health issue that can be prevented.