Solutions

Community Violence Intervention

Community violence interventions (CVI) are programs that focus on those who are most at risk of being a victim of or committing an act of gun violence. CVI provides a public health approach to gun violence prevention, addressing the unique needs of the community where systemic racism, disinvestments, and trauma occur.   

Gun violence disproportionately impacts communities of color that have suffered from long-standing race-based redlining and disinvestment.1 Community gun violence is highly concentrated among a small number of people living in underserved communities. These individuals are often caught in cycles of victimization, trauma, and retaliatory violence. For generations, policing and incarceration have been the primary means to address gun violence in underserved communities and often these systems have perpetuated or exacerbated racial equities. Our center is actively working on understanding how and advocating for public health strategies that successfully engage with individuals at highest risk of violence or that alter the conditions that promote violence. CVI has the potential to reduce violence if adequately implemented and funded. These programs, often called community violence interventions (CVI), can significantly reduce gun violence in the most impacted communities.

Thematic illustration of hands raised in the air.

Cities, states, and the federal government should invest in promising community violence intervention strategies and dedicate funding to evaluate their impact.

Street Outreach and Violence Interruption Programs

Several types of community violence intervention program models have been used to reduce gun violence through outreach by credible messengers to individuals at highest risk, mediation of disputes that could potentially lead to shootings, promotion of nonviolent responses to conflicts, assistance with social services, and life coaching. 

Research

Studies have shown evidence that community violence interruption programs in Chicago,2,3 New York,4,5,6 and Philadelphia,7 have reduced gun violence. Our research on violence interruption programs in Baltimore have shown mixed success and highlights the importance of strong program implementation.8,9,10,11 Other street outreach programs, like Advance Peace in Richmond, California, use a fellowship model. This model supports those at highest risk by focusing on personal development and attainment of life goals without use of violence. Evaluations of Advance Peace provide evidence that this model can reduce community gun violence substantially.12

Hospital-based violence intervention programs (HVIPs) 

HVIPs intervene with individuals at high risk for involvement in gun violence, at a critical time in which risks can either increase without intervention or decrease with appropriate support. HVIPs often employ credible messengers to engage patients who have been shot or stabbed to discourage retaliation and connect survivors of gun violence to social services that can potentially reduce risks for future involvement in violence.

Research

Some studies have revealed significant reductions in risk of future involvement in both victimization and perpetration of violence for HVIP participants relative to controls;13 however, key weaknesses and mixed findings in evaluations of HVIPs14 underscore the importance of future research and development in this promising approach to reducing gun violence. 

Changing Environmental Conditions that Facilitate Community Violence

There is a robust body of research showing that changing the conditions that facilitate violence in communities can lead to significant reductions in gun violence. Examples include “cleaning and greening” vacant lots,15,16 fixing17 or demolishing18 abandoned buildings, improving street lighting,19 and reducing the density of alcohol outlets and restricting the hours alcohol can be sold20,21,22 have been shown to reduce gun violence in communities.

Public Investments in Community Violence Intervention

Oakland, California provides an excellent example of how investing in CVI, in partnership with law enforcement, can promote reforms in policing and reduce violence by placing a greater focus on the very small number of people involved in gun violence. Oakland adopted a special tax that provides significant and consistent funding for CVI programs. In 2012, the city implemented Ceasefire, a program that conducts in-depth problem analysis to identify individuals and groups involved in gun violence and engage these individuals with a clear message from law enforcement and the community that the violence must stop. Significant outreach and social support was offered in addition to a deterrence message. Additionally, the city invested in violence interruption and hospital-based violence intervention programs to provide a wide-range of support to those at highest risk for violence. 

Research showed that the Oakland program was associated with a city-wide 32 percent reduction in shootings through 2017 that was concentrated in the areas and groups that were engaged by the program.23 Importantly, the partnership between communities, CVI programs, and law enforcement also facilitated important reforms in policing. The large reduction in shootings were achieved while reducing arrests and excessive use of force by police.24 

Our Work

Center Co-Director Daniel Webster summarizes successful or promising public health approaches to reducing community gun violence25 and advocates for major investments in CVI infrastructure and frontline workers.26 Dr. Webster has led prior studies of the impacts of CVI programs in Baltimore and has current research projects on CVI impacts in Baltimore and New York City. He is also collaborating on a review of HVIP studies with Drs. Joseph Richardson, Jr (University of Maryland) and Chrisopher St. Vil (University of Buffalo) and doctoral students Nicholas Meyerson and Rachel Topazian to generate recommendations for strengthening future programs and research. Center faculty and staff have been involved in efforts to increase funding for CVI, helping to secure millions of dollars across the country for these efforts. 

“Despite the deep challenges faced by communities that have experienced high rates of gun violence, research has shown that investments in targeted and well-implemented public health solutions can save lives and reduce trauma from gun violence. Continued research, engagement, and advocacy will spur future innovations and bring to scale effective solutions.”

—Daniel Webster, ScD, MPH
Co-director, Johns Hopkins Center for Gun Violence Solutions

Select Journal Articles

  • Public Health Approaches to Preventing Gun Violence
  • Webster DW. Public Health Approaches to Reducing Community Gun Violence. Daedalus 2022; 151 (1): 38–48. https://doi.org/10.1162/daed_a_01886 
  • Decker MR, Wilcox HC, Holliday CN, Webster DW.  An integrated public health approach to interpersonal violence and suicide prevention and response.  Public Health Rep. 2018 Nov/Dec;133(1_suppl):65S-79S. doi: 10.1177/0033354918800019.  PMID: 30426878
  • Community Violence Intervention Programs
  • Webster DW, Whitehill JM, Vernick JS, Curriero FC. Effects of Baltimore’s Safe Streets Program on gun violence: a replication of Chicago’s CeaseFire program. J Urban Health 2013;90:27-40. doi:10.1007/s11524-012-9731-5. 
  • Buggs SAL, Webster DW, Crifasi CK.  Using synthetic control methodology to estimate effects of a Cure Violence intervention in Baltimore, Maryland. Injury Prevention Published Online First: 08 February 2021. http://dx.doi.org/10.1136/injuryprev-2020-044056. 
  • Milam AJ, Buggs S, Furr-Holden CD, Leaf P, Bradshaw CP, Webster D.  Changes in Attitudes towards Guns and Shootings following Implementation of the Baltimore Safe Streets Intervention. Journal of Urban Health 2016 Jun 13. 
  • Whitehill JM, Webster DW, Frattaroli S, Parker EM. Interrupting violence: How the CeaseFire program prevents imminent gun violence through conflict mediation. Journal of Urban Health 2014;91:84-95. doi: 10.1007/s11524-013-9796-9. 
  •  Whitehill JM, Webster DW, Vernick JS. Street conflict mediation to prevent youth violence: conflict characteristics and outcomes.  Injury Prevention 2013; 19:204-9. doi: 10.1136 /injuryprev-2012-040429. 
  • Alcohol Environment and Regulations Impacts on Gun Violence
  • Trangenstein P, Eck R, Lu Y, Webster D, Jennings JM, Latkin C, Milam AJ, Furr-Holden D, Jernigan DH.  The Violence Prevention Potential of Reducing Alcohol Outlet Access in Baltimore, MD.  Journal of Studies on Alcohol and Drugs 2020; 81:24-33. doi: 10.15288/jsad.2020.81.24. 
  • Trangenstein PJ, Curriero FC, Webster D, Jennings JM, Latkin C, Eck R, Jernigan DH.  Outlet type, access to alcohol, and violent crime. Alcoholism: Clinical and Experimental Research 2018 Nov;42(11):2234-2245. doi: 10.1111/acer.13880. Epub 2018 Sep 26. 
  • Milam AJ, Furr-Holden D, Bradshaw CP, Webster DW, Leaf PJ.  Alcohol environment, perceived safety, and exposure to alcohol, tobacco, and other drugs in early adolescence.  Journal of Community Psychology 2013;41:867-883. 

Center Reports

  1. Jacoby SF, Dong B, Beard JH, Wiebe DJ, Morrison CN. The enduring impact of historical and structural racism on urban violence in Philadelphia. Social Science & Medicine. 2018;199:87-95. doi: 10.1016/j.socscimed.2017.05.038.

  2.  Skogan WG, Hartnett SM, Bump N, Dubois J.  Evaluation of CeaseFire-Chicago.  Northwestern University report to the National Institute of Justice. March 2008. https://www.ojp.gov/pdffiles1/nij/grants/227181.pdf 

  3.  Henry DB, Knoblauch S, Sigurvinsdottir R. The Effect of Intensive CeaseFire Intervention on Crime in Four Chicago Police Beats: Quantitative Assessment. University of Chicago report to the McCormick Foundation, September 2014. https://cvg.org/wp-content/uploads/2019/09/McCormick_CreaseFire_Quantitative_Report_091114.pdf 

  4.  Delgado SA, Alsabahi L, Wolff K, Alexander N, Cobar P, Butts JA. Evaluation of Cure Violence in the South Bronx and East New York, Brooklyn. Research and Evaluation Center, John Jay School of Criminal Justice, City University of New York. October 2017.  https://johnjayrec.nyc/2017/10/02/cvinsobronxeastny/

  5.  Butts JA, Wolff KT, Misshula E, Delgado SA. Effectiveness of the Cure Violence Model in New York City. John Jay School of Criminal Justice, City University of New York. CUNY Academic Works. 2015.  https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1472&context=jj_pubs

  6.  Picard-Fritsche S, Cerniglia L. Testing a Public Health Approach to Gun Violence: An Evaluation of Crown Heights Save Our Streets, a Replication of the Cure Violence Model. NCJ Number 241019. Center for Court Innovation report to the Bureau of Justice Assistance, USDOJ. 2013. https://www.ojp.gov/ncjrs/virtual-library/abstracts/testing-public-health-approach-gun-violence-evaluation-crown

  7.  Roman CG, Klein H, Wolff KT, Bellamy MD, Reeves K. Philadelphia CeaseFire: Findings from the Impact Evaluation. Temple University, January 2017.   https://cvg.org/wp-content/uploads/2020/03/SummaryofPhilaCeaseFireFindingsFormatted_Jan2017.pdf

  8.  Webster DW, Whitehill JM, Vernick JS, Curriero FC. Effects of Baltimore’s Safe Streets Program on gun violence: a replication of Chicago’s CeaseFire program. J Urban Health 2013;90:27-40. doi:10.1007/s11524-012-9731-5.

  9.  Webster DW, Buggs SAL, Crifasi CK.  Estimating the Effects of Law Enforcement and Public Health Interventions to Reduce Gun Violence in Baltimore.  Johns Hopkins Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, January 2018.

  10.  Buggs SAL, Webster DW, Crifasi CK.  Using synthetic control methodology to estimate effects of a Cure Violence intervention in Baltimore, Maryland. Injury Prevention Published Online First: 08 February 2021. http://dx.doi.org/10.1136/injuryprev-2020-044056.

  11.  Milam AJ, Buggs S*, Furr-Holden CD, Leaf P, Bradshaw CP, Webster D.  Changes in Attitudes towards Guns and Shootings following Implementation of the Baltimore Safe Streets Intervention. J Urban Health 2016 Jun 13.

  12.  Matthay EC, Farkas K, Rudolph KE, Zimmerman S, Marragan M, Goin DE, Ahern J. Firearm and Nonfirearm Violence After Operation Peacemaker Fellowship in Richmond, California, 1996–2016.  American Journal of Public Health 2019; https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305288

  13.  Cooper C, Eslinger D, Stolley PD.  Hospital violence intervention programs work. Journal of Trauma 2006;61:534-540

  14.  Affinati, S., Patton, D., Hansen, L., Ranney, M., Christmas, A., Violano, P., . . . Crandall, M. (2016). Hospital-based violence intervention programs targeting adult populations: An eastern association for the surgery of trauma evidence-based review. Trauma Surgery & Acute Care Open, doi:10.1136/tsaco-2016-000024

  15.  Branas CC, South E, Kondo MC, Hohl BC, Bourgois P, Wiebe DJ, MacDonald J. Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear. Proceedings of the National Academy of Sciences, 2018;115(12), 2946-2951

  16.  Sadatsafavi H, Sachs NA, Shepley MM, Kondo MC, Barankevich RA. Vacant lot remediation and firearm violence – A meta-analysis and benefit-to-cost evaluation. Landscape and Urban Planning. 2022. https://doi.org/10.1016/j.landurbplan.2021.104281

  17.  Kondo, Michelle C., Danya Keene, Bernadette C. Hohl, John M. MacDonald and Charles C. Branas. A difference-in-differences study of the effects of a new abandoned building remediation strategy on safety. PloS One, 2015;10(7), e0129582

  18.  Jay, Jonathan, Luke W. Miratrix, Charles C. Branas, Marc A. Zimmerman and David Hemenway (2019). Urban building demolitions, firearm violence and drug crime. Journal of Behavioral Medicine, 2019;42(4):626-634

  19.  Becerril D, Tahamount S, Lerner J, Chaflin A. Can deterrence persist? Long-term evidence from a randomized experiment in street lighting. March 2022. My title (weebly.com)

  20.  Biderman C, De Mello JMP, Schneider A. Dry laws and homicides: Evidence from the São Paulo metropolitan area. The Economic Journal, 2010;120(543: 157-182

  21.  Twinam T.. Danger zone: Land use and the geography of neighborhood crime. Journal of Urban Economics, 2017:100:104-119

  22.  Trangenstein P, Eck R, Lu Y, Webster D, Jennings JM, Latkin C, Milam AJ, Furr-Holden D, Jernigan DH.  The Violence Prevention Potential of Reducing Alcohol Outlet Access in Baltimore, MD.  Journal of Studies on Alcohol and Drugs 2020; 81:24-33. doi: 10.15288/jsad.2020.81.24.

  23.  Braga AA et al. Oakland Ceasefire Evaluation. Report to the City of Oakland. May 2019. https://cao-94612.s3.amazonaws.com/documents/Oakland-Ceasefire-Evaluation-Final-Report-May-2019.pdf

  24.  Giffords Law Center to Prevent Gun Violence, Faith in Action, and Black and Brown Gun Violence Prevention Consortium. A Case Study in Hope: Lessons from Oakland’s Remarkable Reduction in Gun Violence. April 2019. https://policingequity.org/images/pdfs-doc/reports/A-Case-Study-in-Hope.pdf

  25.  Webster DW. Public Health Approaches to Reducing Community Gun Violence. Daedalus 2022; 151 (1): 38–48. https://doi.org/10.1162/daed_a_01886 https://www.amacad.org/publication/public-health-approaches-reducing-community-gun-violence

  26.  Papachristos AV, Webster DW.  Amid Infrastructure talks, Investment in Community Gun Violence Prevention is Crucial. US News & World Report. May 19, 2021.  https://www.usnews.com/news/health-news/articles/2021-05-19/investment-in-infrastructure-to-prevent-gun-violence-is-critical