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Baltimore City is worth saving

My thing is public health, and there is an enormous public health problem in Baltimore, where I work and will be going to school in September. This past weekend, a total of 20 people were shot. Eight of them died.

Here is a story from the Baltimore Sun about the shootings. As of today, there have been 110 homicides in Baltimore (17.8 per 100,000 residents). This is troubling because, as the Baltimore Sun reporters put it:

“After the weekend, a total of 110 people had been slain in Baltimore this year, and homicides were up 10 percent compared with the same time last year. In Washington, by comparison, there have been 38 homicides in 2013.”

Washington, DC, has a population of about the same size, give or take a couple of thousand (and a few hundred thousand that go in and out of DC to work each day). So Baltimore is way ahead of DC when it comes to homicides.

Things seem even worse when you look at the map of homicides in the last week:

All shootings. Seven males.

Expand the map a little bit and see 2013, and you will see that homicides seem to be pretty well dispersed throughout the city:

But then zoom in to some neighborhoods and see the hell people are living in:

Who would want to live there? People who have to, that’s who.

The Sun article mentions a man who lives on a black where homicides seem to be a daily occurrence lately:

“As he picked up trash, Martin said the city doesn’t seem to want to invest in the area. Martin has lived in the neighborhood since 1968. Teens and young men have nothing to do, he said. There are no jobs. Budget woes have closed some of the city’s recreation centers. He said officers need to get out of their cars and get to know residents.”

It’s going to take more than that. Heck, it’s going to take more than rec centers. It’s going to take the whole city, and those of us who come in to work and study, to come up with a solution, and we need to do it fast. The city is on pace to 228 homicides by the end of the year, based on the current rate. That’s huge. That’s about 37 homicides per 100,000 residents.

Unfortunately, not everyone feels this way. That same article by the Baltimore Sun has some sad comments popping up:

Read it again.

That person who wrote that more White citizens in Baltimore would fix things is not a poe. She is an actual person. Not only that, she was not the only one with similar feelings of blaming the victims:

People with rap sheets deserve to be shot, I guess?

The tools of public health are systematic (and hopefully unbiased) gathering of data, analysis of those data by experts, and then dissemination of those data to people who will do something with it. Can public health rescue Baltimore? I think it can. We have data of where violence is happening, how it is happening (mostly guns), who is doing the killing (mostly males attracted to a life of crime because they have no other prospects), and we even know when because we know that there are “spikes” in violence during the summer months (like what Baltimore, Boston, and NYC are seeing right now).

I’ve told you before that we can treat violence as a virus. It’s not a difficult concept to grasp. Violence is infectious. A child who sees their parent(s) involved in violence is more likely to be violent themselves. Youths who hang around with violent youths are more likely to participate in violence. If it’s infectious, and we can identify the mode of contagion, then we can cut the chain of transmission.

To do all this requires a lot of work, and you can see how parents and teachers and others in the community can be un-involved when they have to work 16+ hours per day to make ends meet. It also requires stretching the budget of a city where about 10% of able workers are unemployed and where less than half of residents own their homes and where 1 out of 5 people live below the poverty level. In essence, Baltimore is a poor city, so it is hard to throw money at a problem where there is little money to throw.

We know what the problem is, where it is occurring, and who is doing the killing. There are proven strategies to curb violence in cities like Baltimore. It wouldn’t take a long time, but it would take great sacrifice. But we can’t seem to want to disable that pump handle, do we?

It’s time to remove the pump handles and save the city from the violence.

Featured image credit: Sam-Lehman / / CC BY-NC-SA

Categories: Blog

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René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

2 replies

  1. I lived for >20 years in SW Philadelphia. Even back in the ’70’s, it wasn’t uncommon to find someone OD’d in the park or someone with knife wounds.
    When I moved in, there was no sense of community, people didn’t sit out on their porches or steps in the summertime, they huddled inside of their homes in fear of the much higher crime rate in the neighborhood.
    I made it a practice to speak with each neighbor as I saw them, even those who I disliked, got to know them, they got to know me. They’d see me leave for duty in my military uniform. They’d see me return from duty in that uniform.
    Over a short time after moving in, some local thugs made the mistake of attempting to intimidate me, as they did with quite a few of the neighbors. They ended up departing intimidate, with various contusions and abrasions and missing their weapons, which mysteriously appeared at the local police station. Said police station was only 3 1/2 blocks away, but we had issues with our district, as the PD used it as a disciplinary district, the screw-ups ended up there.
    So, I started a town watch. No cooperation or assistance from the local PD, initially a one man operation. It was quite successful, the gunshots from the park at the head of our street halted. The drug dealing in the park halted. Didn’t care if one was there having a beer or having relations with one’s girlfriend, as long as one cleaned up after oneself-children do play there during the day.
    I did keep my zero targets in my front window, to clue in those miscreants who may be interested in a reprisal. Indeed, one local thug, a teen, mentioned my shot group and stated that he’d keep his SKS off of our street.
    During the initial phase of my town watch, there may or may not have been some extra-legal events that resulted in hospitalizations of some more dedicated miscreants attempted an ambush of my patrol. We’ll suffice it to say that criminals do learn quickly that there is effective resistance and move on toward easier game.
    Over time, the neighbors noticed the quietness in the neighborhood.
    They began to join me on my patrols. People began to sit out on their steps.
    The brighter ones received comments from me as an incidental matter, such as how difficult it was to drive around some parts of South Philly, due to all of the block parties. One took that comment to heart, sought election as block captain and got a block party permit.
    The block party was a huge success and a sense of community returned and spread quickly in our neighborhood.

    The funny thing is, that training that gave me insight into the problem and its community based resolution and exhibition of leadership was part of my military training. Indeed, it is the core of the “hearts and minds” effort that was dusted off in Afghanistan and Iraq. One builds a sense of community and commonality with those around you. One builds a sense of leadership, identifies a popular and effective leader and gives solid verbal support of the good things he/she has done and is doing, suggests new things to do to said leader and rarely be caught doing so, so that the idea is that leader’s idea until the populace notices that their suggests are also accepted.

    An epidemiological study and remediation plan is good, but tends to address the greater level problems, ignoring the smallest of subsets, the local community that has lost its sense of community. Solutions tend to be long term in nature, which is good. Quick fix mentality is a lousy trait in our nation, as most often, there are no true quick fixes, only long term efforts to correct the host of problems that cumulatively caused the problem to become an emergency.
    But, unless one addresses the problem on a micro-scale and the macro scale, one will find the effort to be Herculean in nature and highly resistant to remediation, as there is no community support, due to a lack of the sense of community.
    Something that was part and parcel behind the horrors of Katrina, as opposed to other hurricane disasters in other states that had a sense of community and all worked together to both survive and even thrive.


    1. You are very correct about the sense of community. Public health looks at populations, but we don’t particularly focus on the one or two people who have syphilis, or any other contagious disease, until they start spreading it around, then we call them “patient zero” and whatnot. What you did in Philly was “surveillance” followed by action. If you had just sat there and documented what happened, but did nothing about it, you’d be just as bad as all these people who took video and audio of the shootings last weekend and uploaded them to the web but never told the cops and refuse to be “snitches.”

      I haven’t yet made public one big piece of news about my DrPH. It involves work in Baltimore, but I don’t want to put all my cards on the table just yet… Not until the ink dries on the registration papers in August. Then these recent posts about violence will become clearer.

      If I haven’t done so yet, I’d like to thank you for your service. And I don’t just say that in an empty way like so many others do. I mean it. I went through lab school with a bunch of great guys at Beaumont Army Medical Center. They would eventually go on to Iraq and Afghanistan, and a couple of them didn’t come back alive. Those kinds of sacrifices are worthy of admiration, so thanks again and again and again.


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