(Photo courtesy Drexel University by Tony Fischer)
Black Americans are 1.7 times more likely than white Americans to die of covid-19, according to the CDC. Bad. Black Philadelphians were 9 times more likely than their white neighbors to be killed by gun violence last year. Worse.
Across the country, gun violence has surged during the pandemic — even as other crimes continued decades of decline. Last year was the deadliest in Philadelphia’s history. This leads to a natural comparison: if gun violence is an epidemic inside a pandemic, what public health approaches from covid-19 could help?
“If violence is communicable, then the infectious agent is trauma,” Dr. John Rich told Generocity. “Trauma, chronic exposure to trauma, I believe feeds the cycle of violence.”
Rich, a 2006 MacArthur “Genius” Fellowship awardee, is the cofounder and director of the Center for Nonviolence and Justice at Drexel University, and a professor of health management and policy at the Dornsife School of Public Health. Focused on health inequities, particularly those of shooting victims and survivors and within communities of color, Rich is working to advance trauma-informed systems of health care. He is a national leader on the subject and has worked in Philadelphia neighborhoods for years.
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At its core, trauma-informed care, which has swept across nonprofit work in recent years, looks to incorporate a person’s full lived experience. Like the pandemic, gun violence, too, is best understood by evaluating the systems that put certain communities at greater risk.
Rich’s Center for Nonviolence and Justice was founded, with initial support from the Thomas Scattergood Foundation, in 2008, as gun violence continued to decline nationally. The 331 Philadelphians killed that year was the fewest in a decade, according to police statistics.
As covid-19 surged, so too has gun violence. In 2020, 499 Philadelphians were killed, a 40% increase from the year prior, according to city data. The 562 of our neighbors killed last year marked the highest total in city history. Almost a quarter as many Philadelphians were murdered with guns in the last two years as have died from the world’s worst pandemic in a century. January 2022 was less violent than the first month of last year, but still noticeably above 2020.
The comparison between an unchecked virus and gun violence, if imperfect, is increasingly used and straightforward: a lethal contagion that can spike unexpectedly. Likewise, divided politics have stymied efforts to follow successful policies from other countries. Yet, Omicron is on the decline. Can we marshal resources to address another uncontrolled epidemic?
Prevent, protect and promote
A fully-functioning public health infrastructure is meant to respond, not react, according to Rich, based on three foundational principles: prevent, protect and promote.
For the pandemic, prevention tools include masks to social distancing to vaccines; Protection concerns a focus on the most vulnerable among us, like the immunocompromised and the elderly, and promotion refers to data-gathering and information sharing, like updated guidance on staying safe. Local leaders have made their own recommendations but they’ve had access to considerable federally-funded research and guidance.
Those principles could work well in the context of gun violence. Yet for years legislation meaningfully limited how much the federal government could fund firearm research. A patchwork of community engagement efforts and nonprofits seek to contribute to prevention. Efforts on protection of and promotion to at-risk Philadelphians are equally limited in scope.
The problem, according to Dr. Rich, is the systematic dismantling of the public health care system over the past 10 years.
“Lots of money might go into healthcare, not enough money goes into public health,” Dr. Rich said. “We know there are communities that have greater vulnerability because of poverty, because of historic racial segregation and discrimination, structural racism, because of lack of access to health care.”
A lens of trauma
To advance the public health approach to the city’s gun violence issues, Rich would approach the problem through the lens of trauma — specifically racial trauma. As health care professionals and front line workers did with COVID-19, Dr. Rich would identify areas of mass trauma and look to implement effective strategies.
“How do we have interventions that address racial trauma that do not stigmatize the people in communities who are affected by this, but helps to mobilize the strength and powers of those communities while also, providing opportunities for healing to those who have been directly affected as well as others in the community,” Dr. Rich said.
Focus attention on the crisis
Though short-lived, the pandemic has had moments of solidarity. Early vaccination sites had a war-time feeling, in which residents were coming together for the greater good. Around the world, many people have tracked case counts and sought public health guidance to improve their safety, and for their neighbors.
In contrast, gun violence remains mired in a deeply segregated context. It is treated as an epidemic isolated to poor communities of color that other residents and their elected officials appear less willing to center. COVID-19 is a helpful reminder that epidemics do not follow artificial boundaries.
Pa. Gov. Tom Wolf and Philadelphia Mayor Jim Kenney have resisted labeling gun violence a public health emergency. Their teams have called it unnecessary, that such a declaration wouldn’t have its intended effect. That may be true, but without such a stance, we are suggesting this is not a citywide crisis.
Collaborations to combat poverty in Philadelphia confront a similar challenge: to solve our biggest, most urgent problems, we need the attention and the will of as many of us as possible.
From his perspective, Rich has reservations about the COVID-19 analogy.
“I understand why it’s framed that way,” Dr. Rich said. “The infectious disease metaphor is problematic. It implies that people are infected with violence.”
They’re not. Rich’s trauma lens suggests deeply entrenched systems ensnare many gun victims. The pandemic analogy does present gaps in our response to gun violence, but even if you doubt its usefulness, it does seem important to point one thing out. As a society, we seem far more willing to address one crisis than the other.-30-
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