A program called Ceasefire that began in a Chicago neighborhood has helped curb crime rates all across the country by treating violence like an infectious disease.
Epidemiologist Gary Slutkin, MD, founded the program in 2000 after noticing the high crime tendencies in his Chicago neighborhood of West Garfield Park. Slutkin had spent his early years battling epidemics in Africa, and he decided to put the same mindset towards ending violence as he did towards preventing infectious diseases. He noticed how violence only brought on more violence, similar to how one person with the flu can infect an entire office.
“This is similar to what happens with the flu, if you catch if from another person,” he said. “So in a way, violence is behaving like a contagious process.”
This rationale led Slutkin to re-examine the way people viewed crime. He likened his approach to the Black Plague that struck Europe in the 1300’s. He said the reason the plague had such deadly impact was because the science behind the disease was largely misunderstood. Once people learned how the disease was transmitted, then they could focus on preventing it from spreading. Slutkin said the same was true for violence in the 21st century.
“The problem of violence was stuck, and we needed a new strategy.”
Also similar to the plague, Slutkin noticed that violence tended to be clustered by location and occur in waves. He decided to throw out the old models for preventing violence and test his own theory.
“The sense I had was that there was a giant gap here and a strategy had to be rethought,” he said. “I had no idea what it would be, but I realized that we would have to do something with new categories of workers, something with behavior change, and something with public education.”
Implementing his Idea
Slutkin worked in Africa for over 10 years fighting infectious diseases the ravaged the nation, but during his time overseas he was able to understand some common trends about epidemics. He and his co-workers used a three-step process that included:
- Interrupting potential events
- Identifying the population at the highest risk
- Changing the behavior in the community related to the infection
Slutkin used the same process to prevent violence. He identified shootings as potential events, gang members as the population at the highest risk, and “treating violence as a way of life” as changing the community behavior.
In order to implement change, Slutkin focuses on finding a group of “violence interrupters” that held respect within the gang community. Oftentimes he focused on former gang members or convicts who had spent time in jail that had since committed to a life without crime. Slutkin said they were trained to prevent gun violence much like a doctor would train to prevent tuberculosis.
Encouraging Results
Preaching a system of non-violent conflict resolution and outreach programs, the pilot program help reduce area shootings by 67%. Some results by an independent study found the program was specifically responsible for a:
- 28% reduction in shootings and killings,
- 22% reduction in shootings and attempted shootings,
- 24% reduction in the concentration of shootings.
Since its inception in 2000, Slutkin has focused on bringing his ideas to other communities plagued by violence. Some of the other areas include Baltimore, New Orleans, New York City and Oakland. Slutkin said the expanded program has also been successful.
“We saw similar results in 17 other neighborhoods.”
Dr. Silverman comments
I love this kind of thinking. This solution was complex, yet so simple. It was a matter of pattern recognition and paradigm adaptation.
Dr. Slutkin saw clusters of violence. His experience with infectious diseases made him think that the violent behavior in a community acts like infection. But, he didn’t just stop with identification of the pattern. Learning from our experience with infection, violence disruptors (antimicrobials) were deployed to treat outbreaks.
It’s so simple, so elegant and yet it wasn’t visible until an already well developed treatment method from another field of medicine was applied. Results have been amazing.
In orthopedics we have a saying, “Be flexible with thinking and rigid in fixation.” While this obviously applies to doing surgery on broken bones, it also applies to how we approach any orthopedic problem. I routinely apply knowledge of the treatment of other bones and joints in the management of ankle and foot problems. Lessons learned on hips, knees, hands, wrists, elbows, shoulders, or even the cervical and lumbar spine can give me great insight when the pathway is unclear.
Hopefully, the work of Dr. Slutkin can be applied in large scale and with greater effect.
Related source: Medscape, TEDMED 2013
