Can we decrease gun violence by treating it like an infectious disease? Signs point to yes

About a decade ago, the Chicago neighborhood where church leader and community activist Autry Phillips worked was consumed by gun violence.

“Looking at 40, upwards of 50 shootings a year,” Phillips says. “[The] community was in an uproar, and one of the things that clergy was trying to do was go out on corners and try to resolve problems that we knew nothing about, honestly. So when we met the doc, it was … eye-opening for most of us.”  

The "doc" that Phillips is referring to is Gary Slutkin, a physician and epidemiologist trained in infectious diseases. Slutkin fought cholera and tuberculosis in Somalia during the 1980s, and also led efforts to curb the spread of HIV in Uganda for the World Health Organization. After a decade abroad, he moved back home.  

“When I returned to the United States,” Slutkin says, “I began to see about kids shooting each other, and began asking people questions about ‘Okay, what are you guys doing about it?’ and nothing was making sense that they were saying. I then recognized this as what we at World Health would call a stuck problem. Because there were too many answers and none of them made sense and none of them were working.”

Slutkin started looking for patterns; he pulled out charts, graphs and maps. After a while, the epidemiologist saw something about gun violence in America that looked eerily familiar.

“This is the same kind of graph that I've been dealing with my whole life. This is the same kind of map, same kind of clustering, and I just said, ‘It's an infectious disease. This is behaving exactly like an infectious disease.’ ”

Slutkin says it helps if you look at gun violence as an infectious disease, rather than as a crime with a victim and perpetrator.

“If someone who has active tuberculosis … passes it on to his son, is there a perpetrator in there and a victim?” he asks.

Slutkin gives the example of someone who gets tuberculosis from a friend. “Objectively, that's what's happening in violence. Someone has picked this up from someone else, and they pass it on to someone else, and pass it on to someone else.”

To stop people from killing each other with guns, Slutkin would reach into the same toolkit he used combatting TB and AIDS — namely find local leaders, train them and have them teach others how to stop the deaths plaguing their neighborhoods. The program, which used to be called CeaseFire and is now called Cure Violence, has been featured in the documentary The Interrupters.

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Cure Violence has been active in 25 cities worldwide, including in Iraq and Honduras. And there’s evidence that the program works. According to a Johns Hopkins evaluation in 2012, gun homicides were reduced by 56 percent in one Baltimore neighborhood after the program stepped in. A 2009 Northwestern University evaluation showed the program reduced gun violence in high-crime neighborhoods in Chicago. 

“It wasn’t about trying to stop people from shooting, but it was more about changing the norms of individuals,” Phillips says.

Cure Violence brings together teams of people who go into neighborhoods after a gang-related shooting. Phillips' colleagues have gone out in the middle of the night to talk to an armed man bent on killing a rival. He describes how they might go about talking someone like that out of pulling the trigger.

“We ask him to think past right now, and it's two hours later. You've pulled the trigger. Someone else is dead. And now the police are looking for you. So what I want you to do is think about a mama right now. What would mama have you do? Would dad be pleased with you right now? Or more importantly, how is this going to affect you, two hours from now?” 

Sometimes, these kinds of negotiations can go on not just for hours or days, but months, says Slutkin. Kind of like any success in global health, real change occurs through hard work, not over days, but years.

Amy Costello's story came to us from the podcast Tiny Spark.