Researchers Begin To Look At Gun Violence As Public Health Issue

MICHEL MARTIN, HOST:

Gun violence in Chicago is largely discussed as an issue of crime and punishment. But now we have two guests who say it should be looked at as a public health issue. Tracing outbreaks of diseases, say the flu or Ebola, can help predict where they strike next. Both of our guests say that that same kind of data tracking can help predict and ultimately prevent gun violence in places like Chicago. Gary Slutkin is a physician and epidemiologist. He's founder of the national organization Cure Violence. Andrew Papachristos is a sociology professor at Yale University who studies social networks and street gangs. And I started our conversation by asking Dr. Slutkin when he began to think of gun violence as a public health issue.

GARY SLUTKIN: Well, I may have been biased by the fact that I am a public health guy. I'm an infectious disease doctor and I had been working on other health epidemics at World Health Organization, epidemics like tuberculosis and cholera and AIDS. And when I came back to the U.S., not really intending to work on this problem but confronted by it, I got interested and began to look at graphs and maps and charts. And that's what epidemiologists do as boring as it is.

And it just looked to me like violence was behaving the same way as the other problems that I had been working on. Also, you know, I was asking people about what was the greatest predictor of violence? And the answer was a preceding violent event. And that's definitional of contagion is that it produces more of itself. I mean, what is the greatest predictor of a case of flu or of a cold is a preceding case of flu or a cold.

MARTIN: Professor Papachristos, let's go to you now. Your research is similar but focuses more on social networks as a common denominator in a lot of gun violence. Can you tell us more about that?

ANDREW PAPACHRISTOS: Yes. So I actually started approaching it in much the same way as Gary looking at it as an epidemic the way it concentrated. And when we talk about violence, we often talk about it as numbers, and that's part of what makes an epidemic, but it's actually an interaction. It's a behavior. And there are certain types of epidemics, whether we're talking about contagious diseases or other types of social epidemics, that are actually transmitted through behaviors. And so part of this early work actually found that gunshot violence and victimization is even more concentrated within social networks and actually has this way of being transmitted between individuals.

MARTIN: So Professor Papachristos, let me ask you this first, is that a philosophical issue that some decision-makers makers object to looking at it in this way?

PAPACHRISTOS: I do think that where gun violence is concerned one of the big challenges in dealing with data or violence prevention programs around this is how we frame the problem of gun violence. Because when we talk about gun violence, we always default to a criminal justice paradigm. And what we are actually talking about is victimization. And we need to change the discussion around sort of gun violence to focus on individuals as victims. Because in cities like Chicago and in most of our large cities, most of the victims of gun violence and gun homicides are young men with criminal records who we don't often like to think about as victims. We often think about them as perpetrators or suspects. So changing that narrative becomes key. That's one thing.

The other thing is when we think about gun violence and we default to this sort of offender or crime-based model, we are unable to enact a public health framework, which is broad and wide. And so in this context, if we think about something like obesity as a public health epidemic, if someone goes into the E.R. with a heart attack, we save their lives. And we don't look at their BMI. We save their lives. Hopefully, a primary care physician will later say, hey, you know what? Let's talk about diet or stop smoking. At the same time that cities are going to fight food insecurity and look at food deserts, at the same time that Michelle Obama's going to talk about getting fit - all of these things are combating an obesity epidemic that we believe is in the best interest of our citizens, but when it comes to things like gun violence, we don't have that same holistic approach.

MARTIN: Dr. Slutkin, before we let you go, building on what Professor Papachristos just said, do you see that you're making any headway?

SLUTKIN: There's great progress in violence being treated as a health issue now. There are some cities, for example in New York and Los Angeles, that have this in the city budget. Kansas City and Baltimore's Health Department are managing this. But the resources are short, and the need for public education so that people can begin to reinterpret this. People need to reinterpret when they hear the word criminal, they heard the word gang, that they're being scared by what we call the scary words. Whereas, really, this is a problem of behavior and norms and transmission and epidemic and social change and behavior change. I mean, this is a health issue.

MARTIN: That was Dr. Gary Slutkin. He is a physician and professor of epidemiology at the University of Illinois at Chicago School of Public Health. We also heard from Professor Andrew Papachristos. He is a professor of sociology at Yale University.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.