Webinar 1:Understanding the Science of Violence

obviously impossible when

there is violence present!

Health

Preamble to the Constitution of the World Health Organization as adopted 19 June - 22 July 1946; signed by the representatives of 61 States, and entered into force on 7 April 1948.

“a complete state of physical, mental and

social well-being, and not merely the

absence of disease or infirmity.”

Violence is a

Contagion

Health Approach

1. Violence behaves like a

contagious disease

(epidemic)

2. Treating violence like an

epidemic gets results in

communities

Violence Meets the Definition of Epidemic

1. Violence clusters - like a disease

Cholera Violence

2. Violence spreads - like a disease

Influenza

Violence

3. Violence is transmitted -

through exposure, modeling,

social learning, and norms.

VIOLENCE

TRANSMISSION

Observing

Witnessing

Trauma

MEANS OF TRANSMISSION

Behaviors are formed and maintained

• Formed through:

Modeling

Trial and Error

• Maintained

through:

Culture

Social Norms

Copying

Susceptible

Media SchoolCommunity Family• Group/Gang Violence

• Collective

• Interpersonal Violence

• Civil War

• Riots

• Parental violence

• Child Abuse

• TV

• Movies

• Bullying

Methods of Exposure to Violence

Outcomes

• Perpetuate violence

(violent act, attempted violence, threat of violence)

• Additional victimization

• Police violence

• Institutional violence

State Sanctioned

MULTIPLE EXPOSURES

Exposures

COMMUNITY

Outcomes

MULTIPLE EVENTS

THE RESULT

SDOH

Education

Economic

Conditions

Health Care

System

Built

Environment

Community

Resources

Violence

HOW violence

affects other SDOH

Diminished performance, lower

attendance, decreased grad. rates

Reduced business investment,

reduced commercial activity

Higher costs from violent injuries

and increased chronic conditions

Unsafe public spaces leading to

reduced usage

More resources to public safety;

high demand due to trauma

MORE VIOLENCE

Community

Cohesion

Reduced cohesion and sense of

collective efficacy

Violence

Violence is a Social Determinant of Health(and violence negatively affects the other determinants)

Negative effects

of violence on SDOH,

including itself

Plus violence causes even more violence

Health Approaches

Key Elements:

1. Understanding, not blaming

2. Based on science

3. Neutral

4. Use of a team approach

Re-Understanding Violence

Moralism SCIENCE(not helpful)

Bad People

Bad Choice

Adverse

Circumstances(contribute)

TRANSMISSION

(exposure )

Reduces current inequity and promotes understanding

STOPPING CONTAGIONS

1. Interrupt transmission

2. Prevent future spread

3. Change group norms

Prevent Retaliations

Mediate Conflicts

Keep Conflicts ‘Cool’

Assess Highest Risk

Change Behaviors

Provide Treatment

Respond to Shootings

Organize Community

Spread Positive Norms

INTERRUPT

TRANSMISSION

REDUCE

HIGHEST RISK

CHANGE

COMMUNITY

NORMS

THE MODEL

1. INTERRUPT

TRANSMISSION

Credible

On your side

Validate

Reframe

Distract

New thoughts

Get emotion down

Ask (complex) questions

2. CHANGE

BEHAVIORS

Resource at critical

times

New role models

New rewards

Problem solving

New information

Skills, practice

Avoiding situations

Helping friends not do it

Getting/walking away

3. NORM

CHANGE

Multiple messengers

Response to shootings

Group effort

Tipping Point

CHANGE

NORMS

Using Data Strategically23

Violence Interruption and Reduction Training – Model 101

CANADA

MEXICO

BRAZIL

TRINIDAD

COLOMBIA

SOUTH AFRICA

KENYA

IRAQ

ENGLAND

JAMAICAPUERTO RICO

ISRAEL/WEST BANK

HONDURAS

SYRIAUNITED STATES

GUATEMALA

ADAPTATION PARTNERS

EXPLORING PARTNERSHIPS

PAST PROGRAMS

EL SALVADOR

EGYPT

CURE VIOLENCE: INTERNATIONAL PARTNERS

INDEPENDENT

EVALUATIONS

BALTIMORE

Up to 44% fewer shootings

Up to 56% fewer killings

>1 year with no shootings or killings in three communities

CHICAGO

41% - 73% fewer shootings and killings

100% reduction in retaliatory killings

48% fewer shootings during rapid reduction pilot program

LOIZA

(Puerto Rico)

50% decrease in killings in first year of implementation;

maintained for two years

NEW YORKUp to 63% fewer shootings

>1 year with no shootings or killings in multiple communities

EVIDENCE OF REDUCTIONS IN VIOLENCE

(U.S.)

Baltimore (Johns Hopkins)

Norms on violence were changed

o People in target area much less likely to accept

the use of a gun to settle a dispute;

o 4 times more likely to show little or no support for

gun use

Chicago (Northwestern)

Program participants were asked if there was an

adult in their life whom they trusted and on whom

they could rely

o 52% identified outreach workers as that person

o Second only to their parents (66%)

Behavior/Norm Change

In Auburn Gresham, 28.4% of the area was a hot spot, with 261 to 322

shootings per square mile. After CeaseFire, 13.5% of the area was a hot

spot (52.5% reduction)

Success in Chicago (Northwestern)

In Englewood, 73% of the area was a hot spot, with 261 to 322 shootings

per square mile. After CeaseFire, 0% of the area was a hot spot (100%

reduction)

Success in Chicago (Northwestern)

Africa

Cape Town, South Africa

Shootings 53%

Killings 31%

Kenya

Presidential election

violence with pub ed

campaign PeaceTxt

0

5

10

15

20

25

30

35

Zone 1 Zone 2 Zone 3 Zone 4 Zone 5

2014 2015

# o

f S

ho

otin

gs

17 month

streak with

0 shootings

100%

Drop

95%

Drop90%

Drop

90%

Drop

Cure Violence in San Pedro Sula HondurasJanuary – May (2014 vs. 2015)

Average shooting & killing reduction = 94%

Success in Trinidad (ASU)

Confidence in the police was found to improve

at a higher rate in Cure Violence areas

*Denotes statistical significance

Success in New York City (John Jay)

The Cost

of

Violence

Homicide

Non-fatal

Shooting

Medical & Lost Productivity

Costs / victim$1,300,000 $82,000

Victimization averted by SSB x 5.4 x 34.6

Costs averted due to Safe

Streets Baltimore$7,020,000 + $2,837,200 = $9,857,200

$4,725,000Approximate cost to operate SSB during evaluation period

Cost Savings = $5.1 million

Violence has become

more serious, more

frequent and driven by

use of knives

47% increase in knife-

related homicides

hospital admissions for

assaults with a sharp

object increased by

32%

A highly localised

approach – even down

to specific roads and

estates - is essential to

understanding and

responding to violence

Community and social

cohesion are important

tools in keeping

neighbourhoods safe

The Movement Towards

Violence as a Health Issue

GOALS

Develop common

understanding & language

Increase policies to

support health

approaches

Increase use of

health & community solutions

Advance racial & health equity

Develop multi-sector partnerships& coalitions

http://violenceepidemic.com/framework

Let’s Discuss

Next Steps

Webinar 2

Health-based Solutions to Violence

Do they really work?

Wednesday 9th December 3.30pm to 4.30pm

Webinar 3

Violence Interruption

How community-based violence intervention models

look in practice

Thursday 10th December 3.30pm to 4.30pm

One on One meetings

Email Lori at ltoscano@cvg.org

Thank you!Cure Violence

@CureViolence

For More Information Visit:

www.cvg.org