MC: Understanding gun violence as a public health issue, versus a criminal justice issue, has increased steadily since the 1980s and is now well-accepted. Like many public health issues, clean water, vaccinations, gun violence disproportionately affects children and the poor, and deep racial disparities exist with respect to risk and outcomes. Also, it’s pervasive; nearly 40,000 people per year die of firearm injuries every year in the United States; it is the leading cause of death of young African American men.
A public health approach to a problem first identifies the issue using epidemiologic methods, then define risk factors and protective factors, develop interventions, and finally implement and evaluate those interventions. These are interventions that are multi-tiered but ultimately have a population or community base. For gun violence, a combination of decreasing access to firearms, affording job and educational opportunities to disadvantaged communities, changing cultural norms regarding the acceptability of violence, and direct action and advocacy are needed to make a difference.
Q: What programs are in place at Northwestern Memorial to address violence and aid in prevention?
MC: Our central partnership is with Ceasefire Illinois/Cure Violence. We have partnered with CeaseFire to provide crisis intervention to all of our patients who have been injured by violence. Their outreach workers are trained community members whose work has been shown to decrease the likelihood of retaliatory shootings or reinjury. It is our version of beta-blockers after a heart attack or antibiotics after an admission for pneumonia; it prevents morbidity and mortality and is part of our care plan. Case management and referrals are handled by CeaseFire and our southeast side community partner, Claretian Associates. In addition, with other community groups, such as La Rabida, the YMCA, and the Black United Fund of Illinois, we have an ongoing service provision and research agenda to help create sustainable pathways that offer opportunities for change for our patients and their families.