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← Why violence clusters in cities -- and how to reduce it

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Showing Revision 6 created 07/14/2020 by Oliver Friedman.

  1. You are a trauma surgeon,
  2. working in the midnight shift
    in an inner city emergency room.
  3. A young man is wheeled in before you,
  4. lying unconscious on a gurney.
  5. He's been shot in the leg
    and is bleeding profusely.
  6. Judging from the entry and exit wounds,
  7. as well as the amount of hemorrhaging,
  8. the bullet most likely
    clipped the femoral artery,
  9. one of the largest
    blood vessels in the body.
  10. As the young man's doctor,
    what should you do?
  11. Or more precisely,
    what should you do first?
  12. You look at the young man's clothes,
    which seem old and worn.

  13. He may be jobless, homeless,
  14. lacking a decent education.
  15. Do you start treatment
    by finding him a job,
  16. getting him an apartment
  17. or helping him earn his GED?
  18. On the other hand,
  19. this young man has been involved
    in some sort of conflict
  20. and may be dangerous.
  21. Before he wakes up,
  22. do you place him in restraints,
  23. alert hospital security or call 911?
  24. Most of us wouldn't do
    any of these things.
  25. And instead, we would take
    the only sensible
  26. and humane course of action
    available at the time.
  27. First, we would stop the bleeding.
  28. Because unless we stop the bleeding,
  29. nothing else matters.
  30. What's true in the emergency room
    is true for cities all around the country.

  31. When it comes to urban violence,
    the first priority is to save lives.
  32. Treating that violence
    with the same urgency
  33. that we would treat
    a gunshot wound in the ER.
  34. What are we talking about
    when we say "urban violence"?
  35. Urban violence is the lethal
    or potentially lethal violence
  36. that happens on the streets of our cities.
  37. It goes by many names:
  38. street violence, youth violence,
  39. gang violence, gun violence.
  40. Urban violence happens
  41. among the most disadvantaged
    and disenfranchised among us.
  42. Mostly young men,
  43. without a lot of options or much hope.
  44. I have spent hundreds of hours
    with these young men.

  45. I've taught them at a high school
    in Washington DC,
  46. where one of my students was murdered.
  47. I've stood across form them
    in courtrooms in New York City,
  48. where I worked as a prosecutor.
  49. And finally,
  50. I've gone from city to city
    as a policymaker and as a researcher,
  51. meeting with these young men
  52. and exchanging ideas
    on how to make our communities safer.
  53. Why should we care about these young men?
  54. Why does urban violence matter?
  55. Urban violence matters,

  56. because it causes more deaths
    here in the United States
  57. than any other form of violence.
  58. Urban violence also matters
  59. because we can actually do
    something about it.
  60. Controlling it is not the impossible,
    intractable challenge
  61. that many believe it to be.
  62. In fact, there are a number
    of solutions available today
  63. that are proven to work.
  64. And what these solutions have in common
    is one key ingredient.
  65. They all recognize
    that urban violence is sticky,
  66. meaning that it clusters together
  67. among a surprisingly small number
    of people and places.
  68. In New Orleans, for instance,

  69. a network of fewer than 700 individuals
  70. accounts for the majority
    of the city's lethal violence.
  71. Some call these individuals "hot people."
  72. Here in Boston,
  73. 70 percent of shootings
  74. are concentrated on blocks and corners
    covering just five percent of the city.
  75. These locations
    are often known as "hot spots."
  76. In city after city,
  77. a small number of hot people and hot spots
  78. account for the clear majority
    of lethal violence.
  79. In fact, this finding
    has been replicated so many times
  80. that researchers now call this phenomenon
    the law of crime concentration.
  81. When we look at the science,
    we see that sticky solutions work best.

  82. To put it bluntly,
  83. you can't stop shootings
    if you won't deal with shooters.
  84. And you can't stop killings
    if you won't go where people get killed.
  85. Four years ago,

  86. my colleagues and I performed
    a systematic meta-review
  87. of antiviolence strategies,
  88. summarizing the results of over 1,400
    individual impact evaluations.
  89. What we found, again and again,
  90. was that the strategies
    that were the most focused,
  91. the most targeted,
  92. the stickiest strategies,
  93. were the most successful.
  94. We saw this in criminology,
  95. in studies of policing,
    gang prevention and reentry.
  96. But we also saw this in public health,
  97. where targeted tertiary
    and secondary prevention
  98. performed better than more generalized
    primary prevention.
  99. When policymakers focus
    on the most dangerous people and places,
  100. they get better results.
  101. What about replacement
    and displacement, you might ask.

  102. Research shows that when
    drug dealers are locked up,
  103. new dealers step right in,
    replacing those that came before.
  104. Some worry that when police focus
    on certain locations,
  105. crime will be displaced,
  106. moving down the street
    or around the corner.
  107. Fortunately, we know now
    that because of the stickiness phenomenon,
  108. the replacement and displacement effects
    associated with these sticky strategies
  109. are minimal.
  110. It takes a lifetime of trauma
    to create a shooter
  111. and decades of disinvestment
    to create a hot spot.
  112. So these people and places
    don't move around easily.
  113. What about root causes?

  114. Isn't addressing poverty or inequality
    or lack of opportunity
  115. the best way to prevent violence?
  116. Well, according to the science,
  117. yes and no.
  118. Yes, in that high rates of violence
    are clearly associated
  119. with various forms of social
    and economic disadvantage.
  120. But no, in that changes in these factors
  121. do not necessarily result
    in changes in violence,
  122. especially not in the short run.
  123. Take poverty, for instance.
  124. Meaningful progress on poverty
    will take decades to achieve,
  125. while poor people need and deserve
    relief from violence right now.
  126. Root causes also can't explain
    the stickiness phenomenon.
  127. If poverty always drove violence,
  128. then we would expect to see violence
    among all poor people.
  129. But we don't see that.
  130. Instead, we can empirically observe
    that poverty concentrates,

  131. crime concentrates further still
  132. and violence concentrates most of all.
  133. That is why sticky solutions work.
  134. They work, because they deal
    with first things first.
  135. And this is important,
  136. because while poverty
    may lead to violence,
  137. strong evidence shows that violence
    actually perpetuates poverty.
  138. Here's just one example of how.

  139. As documented by Patrick Sharkey,
  140. a sociologist --
  141. he showed that when poor children
    are exposed to violence,
  142. it traumatizes them.
  143. It impacts their ability to sleep,
  144. to pay attention, to behave and to learn.
  145. And if poor children can't learn,
  146. then they can't do well in school.
  147. And that ultimately impacts their ability
    to earn a paycheck later in life
  148. that is large enough to escape poverty.
  149. And unfortunately,
    in a series of landmark studies

  150. by economist Raj Chetty,
  151. that is exactly what we've seen.
  152. Poor children exposed to violence
    have lower income mobility
  153. than poor children who grow up peacefully.
  154. Violence literally traps
    poor kids in poverty.
  155. That is why it is so important
    to focus relentlessly on urban violence.
  156. Here are two examples of how.
  157. Here in Boston, in the 1990s,

  158. a partnership between cops
    and community members
  159. achieved a stunning 63 percent
    reduction in youth homicide.
  160. In Oakland, that same strategy
  161. recently reduced nonfatal
    gun assaults by 55 percent.
  162. In Cincinnati, Indianapolis
    and New Haven,
  163. it cut gun violence by more than a third.
  164. At its simplest,
  165. this strategy simply identifies
    those who are most likely to shoot
  166. or be shot,
  167. and then confronts them
    with a double message
  168. of empathy and accountability.
  169. "We know it's you
    that's doing the shooting.
  170. It must stop.
  171. If you let us, we will help you.
  172. If you make us, we will stop you."
  173. Those willing to change
    are offered services and support.
  174. Those who persist
    in their violent behavior
  175. are brought to justice
    via targeted law enforcement action.
  176. In Chicago, another program
    uses cognitive behavioral therapy

  177. to help teenage boys
  178. manage difficult thoughts and emotions,
  179. by teaching them how to avoid
    or mitigate conflicts.
  180. This program reduced violent
    crime arrests among participants
  181. by half.
  182. Similar strategies have reduced
    criminal reoffending
  183. by 25 to 50 percent.
  184. Now Chicago has launched a new effort,
  185. using these same techniques,
  186. but with those at the highest risk
    for gun violence.
  187. And the program is showing
    promising results.
  188. What's more,
  189. because these strategies
    are so focused, so targeted,
  190. they tend not to cost much
    in absolute terms.
  191. And they work with the laws
    already on the books today.
  192. So that's the good news.

  193. We can have peace in our cities,
  194. right now,
  195. without big budgets
  196. and without new laws.
  197. So why hasn't this happened yet?
  198. Why are these solutions still limited
    to a small number of cities,
  199. and why do they struggle,
    even when successful,
  200. to maintain support?
  201. Well, that's the bad news.
  202. The truth is, we have not been very good
    at organizing our efforts
  203. around this phenomenon of stickiness.
  204. There are at least three reasons
    why we don't follow the evidence

  205. when it comes to urban violence reduction.
  206. And the first, as you might expect,
  207. is politics.
  208. Most sticky solutions don't conform
    to one political platform or another.
  209. Instead, they offer
    both carrots and sticks,
  210. balancing the promise of treatment
    with the threat of arrest,
  211. combining place-based investment
    with hot-spots policing.
  212. In other words,
  213. these solutions are both soft and tough
  214. at the same time.
  215. Because they don't line up neatly
  216. with the typical talking points
    of either the Left or the Right,
  217. politicians won't gravitate to these ideas
    without some education,
  218. and maybe even a little pressure.
  219. It won't be easy,
  220. but we can change the politics
    around these issues
  221. by reframing violence
    as a problem to be solved,
  222. not an argument to be won.
  223. We should emphasize evidence
    over ideology
  224. and what works versus what sounds good.
  225. The second reason why we don't
    always follow the evidence

  226. is the somewhat complicated nature
    of these solutions.
  227. There is an irony here.
  228. What are the simplest ways
    to reduce violence?
  229. More cops.
  230. More jobs.
  231. Fewer guns.
  232. These are easy to spell out,
  233. but they tend not to work
    as well in practice.
  234. While on the other hand,
  235. research-based solutions
    are harder to explain,
  236. but get better results.
  237. Right now, we have a lot of professors
  238. writing about violence
    in academic journals.
  239. And we have a lot of people
    keeping us safe out on the street.
  240. But what we don't have
  241. is a lot of communication
    between these two groups.
  242. We don't have a strong bridge
    between research and practice.
  243. And when research
    actually does inform practice,
  244. that bridge is not built by accident.
  245. It happens when someone takes the time
  246. to carefully explain
    what the research means,
  247. why it's important
  248. and how it can actually
    make a difference in the field.
  249. We spend plenty of time creating research,
  250. but not enough breaking it down
    into bite-sized bits
  251. that a busy cop or social worker
    can easily digest.
  252. It may be difficult
    to acknowledge or accept,

  253. but race is the third and final reason
  254. why more has not been done
    to reduce violence.
  255. Urban violence concentrates
    among poor communities of color.
  256. That makes it easy for those of us
    who don't live in those communities
  257. to ignore the problem
    or pretend it's not ours to solve.
  258. That is wrong, of course.
  259. Urban violence is everyone's problem.
  260. Directly or indirectly,
  261. we all pay a price
    for the shootings and killings
  262. that happen on the streets of our cities.
  263. That is why we need to find new ways
    to motivate more people
  264. to cross class and color lines
    to join this struggle.
  265. Because these strategies
    are not resource-intensive,
  266. we don't need to motivate
    many new allies --
  267. we just need a few.
  268. And we just need them to be loud.
  269. If we can overcome these challenges

  270. and spread these sticky solutions
    to the neighborhoods that need them,
  271. we could save thousands of lives.
  272. If the strategies
    I've discussed here today
  273. were implemented right now
    in the nation's 40 most violent cities,
  274. we could save over 12,000 souls
  275. over the next eight years.
  276. How much would it cost?

  277. About 100 million per year.
  278. That might sound like a lot,
  279. but in fact, that figure represents
    less than one percent
  280. of one percent
    of the annual federal budget.
  281. The Defense Department
    spends about that much
  282. for a single F-35 fighter jet.
  283. Metaphorically, the treatment is the same,

  284. whether it's a young man
    suffering from a gunshot wound,
  285. a community riddled with such wounds,
  286. or a nation filled with such communities.
  287. In each case, the treatment,
    first and foremost,
  288. is to stop the bleeding.
  289. I know this can work.
  290. I know it, because I've seen it.
  291. I've seen shooters put down their guns
  292. and devote their lives
    to getting others to do the same.
  293. I've walked through housing projects
    that were notorious for gunfire
  294. and witnessed children playing outside.
  295. I've sat with cops and community members
  296. who used to hate one another,
    but now work together.
  297. And I've seen people
    from all walks of life,
  298. people like you,
  299. finally decide to get involved
    in this struggle.
  300. And that's why I know that together,
  301. we can and we will
    end this senseless slaughter.
  302. Thank you.

  303. (Applause)