The workshop’s second panel session featured two examples of programs building resilience and safety at the community level. Roberto Rodríguez, outreach worker supervisor for Stand Up to Violence (SUV) at Jacobi Medical Center, described the public health model he and his colleagues are using to address violence in the community. DeVone Boggan, founder and chief executive officer of Advance Peace, then discussed a program he created in Richmond, California, to address gun violence by working directly with the individuals most responsible for gun violence in that community. After the presentations, Lourdes Rodríguez, program officer at the New York State Health Foundation, moderated an open discussion. Highlights and main points made by individual speakers are in Box 4-1.
The Cure Violence Health Model, developed by Gary Slutkin of the University of Illinois at Chicago (Ransford et al., 2013),2 recognizes violence as a contagious disease and a public health crisis, said Roberto
1 This section is the rapporteurs’ synopsis of the presentation made by Roberto Rodríguez, outreach worker supervisor for Stand Up to Violence (SUV) at Jacobi Medical Center. The statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
2 For more information on the Cure Violence Health Model, see http://cureviolence.org/the-model/essential-elements (accessed November 2, 2016).
Rodríguez. Slutkin noticed that similar to disease, gun violence in Chicago occurred in clusters.
Slutkin based Cure Violence on the premise that violence is a solvable contagious disease. Studies by independent external evaluators of Cure Violence programs in Chicago, Baltimore, and New York show that this idea has merit. After implementing the program, in Chicago, for example, shootings fell by 75 percent, and in Baltimore murders fell by 56 percent. Today, Cure Violence is ranked as 1 of the top 10 nongovernmental organizations in the world by the Global Journal, and it has been deployed in more than 23 U.S. cities and more than 50 neighborhoods in 8 countries on 5 continents, said Rodríguez.
The Cure Violence disease model has three major components. The first component aims to interrupt transmission to stop violent events before they happen, primarily by interrupting conflict to prevent retalia-
tion. The second component involves identifying and changing the thinking of the highest potential transmitters of violence, largely those involved in the gang lifestyle, to reduce the number of violent individuals in the community. The third component works to change community norms to create social pressure to stop violence, which Rodríguez explained requires engaging community leaders, residents, business owners, and faith leaders to bring awareness to the devastation gun violence has on communities and to change attitudes so that community members reject violence in the community. Too often, he added, community members become desensitized to violence and accept it as the way things are. Overcoming that acceptance is an important step to changing community norms.
The Cure Violence program at the Jacobi Medical Center3 covers three precincts in the northern section of the Bronx where the prevalence of gun violence has been high, and it deploys teams of credible messengers to work in the community and target those individuals who are at highest risk of committing violence. The most effective credible messengers at Jacobi are health outreach workers who live in the neighborhood and often share the same background as the highest risk individuals whom they engage, Rodríguez explained. “Outreach workers already have the trust of those high-risk individuals and therefore are more able to influence and change behavior,” he said. One important role for these outreach workers is to not only get violent individuals to change their behaviors and quit the lifestyle that exposes them to violence, but also change the mindset of individuals who want to join the violent gang subculture.
The primary targets of the program are individuals who are active in a street gang, have a history of violence, are engaged in high-risk activity, and carry a weapon. Many have been shot recently or released from prison, and while the program’s primary concern is to target youths between 14 and 25 years old, there are individuals older than that in the program who Rodríguez characterized as still behaving like adolescents by causing destruction in their neighborhoods, he said.
Participation in Cure Violence is completely voluntary, which is an important point, said Rodríguez, because it makes it easier for the targeted individuals to be receptive to and engage in the program. Each outreach worker has a caseload of up to 15 participants, and their role is similar to that of a social worker in that they screen, assess, and create a treatment plan designed to meet each client’s needs. Perhaps 90 percent of the participants do not have jobs and are not enrolled in school, so the outreach workers help the participants find jobs, get their general edu-
cational development degree, and in some cases, even help participants enroll in college. Outreach workers and other program staff even take the participants on field trips.
Rodríguez, who said he loves engaging with his clients, recounted an incident where one of his clients, out of the blue, contacted him via Facetime. His client held out his hand and showed him bullets. Instead of trying to counsel him via phone or put him down, Rodríguez said he shifted the conversation by blaming himself for failing his client. Several days later, his client came up to him and apologized and shared that he had a falling out with his mother. “Sometimes these youth are crying out for help, but they do not like to disclose what they might be going through in their lives,” said Rodríguez. “A lot of them are guarded and resistant toward seeking any type of treatment.” A critical aspect of the program is that the outreach workers are always out canvassing their neighborhoods, which means that program participants do not have to go to an office or wait until the next day to talk to someone. Instead of mulling over and getting angry about a recent argument with some perceived enemy, these individuals can find their outreach workers, who can then deescalate the situation.
To illustrate Cure Violence’s power to prevent violence, Rodríguez discussed one of the major conflicts in the Jacobi program’s target area. Two gangs, New Jack and Fever Block, had been engaged in an ongoing conflict, so the program conducted a formal mediation in the office on two consecutive days. Those sessions identified a Fever Block member as a good candidate to be an outreach worker, and in fact, the program hired him and he has become very influential in the two neighborhoods in which these gangs are active. Though still active, there have been no shootings between these two gangs, and they have even come together without conflict at multiple events.
The program treats violence as a community health problem, so it is imperative to engage the community as a whole, explained Rodríguez. This occurs on a daily basis as the caseworkers canvas their neighborhoods and interact with community residents. Program employees participate in shooting responses organized by clergy leaders, elected officials, and friends and family of the victims to help mobilize the community to partake in peaceful antiviolence marches 72 hours after a shooting. “It could be a stabbing, but we focus on shootings because our mission is to try to prevent gun violence in the community,” explained Rodríguez.
Over the 2 years the program at Jacobi has been operating, gun violence in the target area has fallen by 53 percent. An advantage of running this program out of a hospital is that it creates an opportunity to bridge the gap between the health system and the community. The Jacobi Medical Center is the primary trauma center facility in the Bronx, so all
shooting victims are taken there, giving the program’s hospital-based responders the opportunity to engage a victim in the emergency department and take steps to prevent retaliation. “There is someone by their bedside trying to engage them, something a social worker is unable to do,” said Rodríguez. The hospital-based responders are people who victims can identify with and relate to, so they are less guarded and may be more responsive to probing and provide information to the responders that may help prevent a violent retaliation.
The hospital also plays a role in the program once the patient is discharged, said Rodríguez. A team consisting of a social worker, pediatrician, and hospital responder sees the patient on a weekly basis. At the same time, a pastor and outreach worker get involved on a more constant basis to serve as mentors who can guide the individual through a difficult time. The hospital also serves as the nexus for follow-on support in the form of specialized social, educational, vocational, and recreational services.
For DeVone Boggan, the key to stopping gun violence is to engage directly with and be informed by those individuals who are suspected to be the most lethal, active firearm offenders and who have avoided sustained criminal consequences. It is important to understand that one’s journey to becoming a serial shooter occurs because less than 30 percent of shooters in most urban communities are ever prosecuted for their gun crimes, said Boggan. The message that statistic sends, he explained, is that the formal justice system does not work in those communities, that shooters can act with impunity, and that victims and their associates will find their own way to get justice, which often can involve becoming a shooter, too.
Any solution to this problem, said Boggan, should include and be informed by the people at the center of firearm conflict. The challenge, then, is to find, engage, and meet these people where they are in their development. Making this challenge more difficult, he said, is the fact that the experiences these individuals have had with people like him is that they come with empty promises and unrealistic expectations. We have to be willing to authentically engage these individuals in a respectful manner in spite of what they have allegedly done or are suspected of doing, in spite of the fact that he may have seven casualties on his belt,
4 This section is the rapporteurs’ synopsis of the presentation made by DeVone Boggan, founder and chief executive officer of Advance Peace. The statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
said Boggan. In doing so, he added, it is important to understand that these young men are isolated and alone, negotiating all kinds of direct and vicarious untreated traumas, and they are enraged. Accepting these young people as partners and as a significant part of the solution to reducing gun violence is a key step for success, he added, while acknowledging how hard that can be. These are our most difficult and challenging young people, he said, but we must see their inherent value and humanity. Only then can we embrace them.
For more than 8 years, Boggan was the neighborhood safety director for the City of Richmond, California’s Office of Neighborhood Safety. Richmond, located 17 miles northeast of San Francisco, has a diverse population of approximately 100,000 and has historically had a gun violence problem. Over a 20-year period from 1986 to 2005, nearly 700 people were murdered, an average of almost 35 per year. In 2006, Boggan recounted, the number of people killed by gunfire jumped to 42, and then to 47 in 2007 and 47 again in 2008. In Richmond, young men and women who are engaged in firearm activity come from an environment in which there have been generations of gun-related hostilities and where more often than not they have fathers, uncles, cousins, and friends who have been affected by gun violence. For the young men in North Richmond and Central Richmond, the feeling is that someone from the other side of town is responsible for a terrorist attack against them and they grow up believing it is their responsibility to bring justice to the enemy, year after year after year, generation after generation after generation, said Boggan.
In 2007, Boggan was hired as the founding director of the newly created Office of Neighborhood Safety. This non–law enforcement agency was formed to specifically address gun violence, rather than gang violence in general, and to be responsible for capacity building to support the reduction of gun violence and improve coordination of services across government and nongovernmental institutions in this area. The creation of this office was a big step, said Boggan, because gang violence prevention programs rarely focus on active firearm offenders. In fact, he added, most gang members do not become shooters, and neither do most people released from prison.
Given the authority to go directly to the individuals most responsible for gun violence, Boggan began hiring ex-felons with a gun-related crime on their record as full-time city employees. These individuals would be his program’s credible messengers. Although many people thought this was a strange idea, Boggan noted that the four individuals he hired in 2008 to be neighborhood change agents are still with the program today, which he said has led to increased trust on the streets between the city agency workers and the people they engage. This stability has been vital to their success. “It is not a revolving door as it relates to engaging this
population and better appreciating and understanding why they shoot and what is going to be required for them to not shoot to address conflict,” he explained.
From 2008 to 2009, Boggan and his four colleagues engaged in a broad and generalized street, community, and school outreach program that was very intentional in its efforts to identify those individuals who were most responsible for gun violence in the community. In discussions with local, state, and federal law enforcement officials working on gun crimes, Boggan learned that 28 people were thought to be responsible for 70 percent of the 45 gun-related murders and 186 non-fatal shootings in 2009. Astonished by the fact that 28 people were largely responsible for the gun violence in these communities, Boggan met with his outreach workers and told them that these 28 individuals would be the focus of his office’s efforts for the next year. “No more broad, hot-spot outreach activity,” said Boggan. “We were going to do hot-people engagement activity. Why hot people? Because hot spots are dictated by hot people,” and hot people can and do move. He gave his outreach workers 3 months to convince these 28 people to come to city hall to talk to him, to ensure them that this was not a sophisticated law enforcement sting, and that he had an alternative lifestyle opportunity he wanted to present to them.
In June 2010, the Operation Peacemaker Fellowship was started with the 21 young men—3 were lost to gunfire and 4 did not choose to participate—who arrived at city hall in three groups to discuss how they could partner with Boggan and his staff to reduce gun violence in Richmond. That 21 of the most lethal individuals in Richmond came to city hall was a testament to the outreach workers, but it also showed that these young men wanted something to believe in that was designed specifically for them. What the men got, said Boggan, was the offer to accept a non-mandated, high-touch graduate school–like Fellowship with six components. First, they would receive multiple contacts every day from several healthy people. Second, Boggan promised to sit down with each Fellow and create a life map with smart goals for the 18 months of the Fellowship and the opportunities that meeting those goals would afford them. Third, they would be connected with every social service opportunity, and not just by pointing them in the right direction, but actually taking them to appointments and making sure they get the best services available.
Fourth, the Fellowships came with a stipend of $9,000 over 18 months, and although the media liked to portray this as paying criminals to stop shooting, Boggan said he never asks these young men to stop shooting or even put down their guns. “Why not?” he asked. Boggan and his colleagues did not want their privileged perspective and position to render them non-credible, he explained. The Fellows live in war zones, and for
them it is a rational idea to carry a gun. Boggan added that $9,000 is a small amount of money for the city to pay men who are partnering with the city to reduce gun violence, particularly when compared to the high costs that accrue each time a young man is shot.5
The goal of this high-touch approach, he said, is to reduce shootings and to bring these young men into the mainstream so they can have meaningful opportunities to engage in the community, and so the program’s fifth component is to provide what the Fellows have told Boggan are transformative life excursions. In California, these young men can travel throughout the state with Boggan and other Fellows. They visit universities, talk to officials in the cities they visit, do community service activities they cannot do at home because of safety reasons, and above all, they have fun. “It is amazing when you take a 27-year-old young man to Disneyland and at the end of the day he walks up to you with Mickey Mouse ears on and he says, ‘Boss man,’ with tears in his eyes, ‘that’s one of the best experiences I’ve ever had,’” said Boggan.
The Fellows also get to travel out of the state and even out of the country, but for that opportunity the Fellows must be willing to travel with someone they are suspected of trying to kill and who allegedly has been trying to kill them. “It is an amazing experience to show up on Robben Island in South Africa with groups of men who have been trying to take each other’s lives for the last 3 to 5 years and they come to a common understanding,” and a new respect for one another, “not a Kumbaya experience,” said Boggan.
The sixth component puts a council of elders around each of these individuals, men who have retired or are near retirement and who have had successful careers and have successful, healthy families. Howard Pinderhughes (see Chapter 3), Boggan noted, is one of the men who works with his program. What is important is that these elders are not afraid of these young men and are willing to talk to them and meet them where they are, said Boggan.
After 18 months in the program, most of these men are not the same people they were when they showed up at city hall to hear the Fellowship offer. They have a better appreciation for authority and for showing up for work every day. Equally important, said Boggan, “We have a better understanding of who they are and what their interests and passions are.” Using that knowledge, he is better able to connect these young men to subsidized internships that they might actually want to stay in rather than getting them a job merely to have a job. Today, of the three cohorts
5 According to the California Legislative Analyst’s Office, the cost of incarcerating an individual in 2008–2009 in California was $47,102 per year. See http://www.lao.ca.gov/PolicyAreas/CJ/6_cj_inmatecost (accessed September 9, 2016).
that have finished the program and the fourth that is now enrolled, 94 percent of individuals—the most lethal active firearm offenders who are also the most likely to be victims of gunfire—are alive 2 to 5 years out, and 84 percent have not been injured by a firearm since becoming a Fellow. Perhaps more importantly, said Boggan, 79 percent of the Fellows have not become a suspect in a new firearm crime based on local and regional law informant intelligence. The bottom line, he said, is that these numbers translate into lives saved, as evidenced by a 75 percent reduction in firearm-related murders and a 66 percent reduction in firearm assaults with an injury between 2007 and 2015.
The take-home lesson, he said in closing, is that our most effective efforts to reduce urban gun violence must be comprehensive, developmental, and informed by the young men at the center of firearm conflict. “Only then [will our efforts be truly] credible and legitimate from their vantage point, and only then can it truly be responsive to who these young men are and what these young men have experienced,” said Boggan.
Lourdes Rodríguez began the discussion by commenting that the programs the two speakers described offer the potential to redefine where society invests its money—in programs that turn felons into Fellows, or in so-called million-dollar blocks,6 where millions of dollars are spent incarcerating people who live on particular streets. She then asked the panelists to comment on how they look past the problematic behaviors these individuals might have to see their aspirations and how their life experiences could lead to change. Boggan said there has to be a deliberate and intentional approach to value the assets these individuals bring to the table and to value these individuals as an important part of the solution to the problem of gun violence. He recounted how when he brought the first group of young men to city hall, he provided name tags with their legal names, not street names, informational Fellowship packets in front of their placards, and lots of good food. He then apologized on behalf of the city for taking so long to ask them to get involved in solving a problem that clearly required their help, experience, and expertise. On behalf of the city, Boggan was asking them to be partners in the effort to stop gun violence in Richmond. “How I, as the neighborhood safety director, communicated that day meant something, and that is why every one of the 21 young men who showed up said they wanted to be part of this team.” He noted that an evaluation of the program showed how the attitudes of
6 For more information, see http://www.npr.org/2012/10/02/162149431/million-dollar-blocks-map-incarcerations-costs (accessed August 31, 2016).
these young men changed because of their involvement—they saw the Office of Neighborhood Safety as family.
Roberto Rodríguez agreed that these young men are the agents of change and that the key rests in three words: self-esteem, empowerment, and optimism. “When you believe in folks who are prone to violence, prone to doing wrong, prone to negativity, it sends a strong message,” said Rodríguez. “It gives them a sense of hope.” He also said he knows this from his own personal experience, that having individuals believe in him is what enabled him to transform his life after spending 16 years in prison. “I believe that when you steer someone in the right direction genuinely, you will see good results.”
Catherine Baase of The Dow Chemical Company asked Boggan how to move upstream from the type of work he is doing, that is, how to intervene before individuals are past the point of transformation. Boggan responded that it is important to recognize how engaging these young men developmentally can work for the community as compared to broad law enforcement raids that pull them into the criminal justice system. “If we are able to successfully develop these young men, in spite of what they are suspected of doing, versus pulling them temporarily into the criminal justice system, what we are able to do is to begin to slowly change the dynamics of what is going on in that very community.” He noted that when law enforcement pulls these individuals out of the community, they are rapidly replaced by others or people simply wait for their return and the continuation of business as usual. By contrast, keeping the young men who are not charged or convicted in the community and turning them into change agents can stop that cycle and change behavior in the next generation of potential shooters.
These actions alone will not be enough, he added. He suggested that the current social services platform could be retooled to make it more outreach oriented so that staff people are going into the communities to reach young people standing on the corner rather than waiting for them to come to the community center for help. Boggan added that unless the mainstream social service and public health platforms are pushed to intentionally engage in the areas of a community where gun violence is concentrated where many young “upstream” individuals exist, but are rarely if ever touched by the current platforms, he will never be put out of business, which is his ultimate goal.
Daniel Webster of the Johns Hopkins Bloomberg School of Public Health noted that he has been studying how to prevent violence for about 25 years and what Boggan shared at the workshop is consistent with everything that he has learned. He then asked for ideas on how to engage these young men, many of whom want to kill one another, to get past the idea of retaliation and payback that is behind so much urban gun vio-
lence. Rodríguez replied that an approach his program has taken is to get these individuals together out of their comfort zones and expose them to a different environment, which enables these individuals to see each other in a new light and get them talking to one another as two humans rather than two adversaries. These interactions, said Rodríguez, can change the entire dynamics of their relationships. He recounted how one of his outreach workers, who had been a member of the Bloods, would not travel to an area considered Crips territory because he feared for his safety. However, when the program hired a Crips member from that area to be an outreach worker, the two ended up bonding and creating a relationship that is now changing the norms in their two communities.
Both Rodríguez and Boggan said that such a transformation is a process, not something that happens overnight. That process, explained Boggan, aims to take these individuals from a place where they do not care about the future to one where they do, from one where they feel alone to one where they feel loved and accounted for, which is new to them. Once these individuals start caring, they start reconsidering their decisions about how to negotiate conflict.
Boggan noted that nobody in his program can fail their Fellowship, even if they shoot someone during the 18-month program. Fellows can leave voluntarily or if they are taken into custody by law enforcement and convicted of committing a crime, they forfeit their Fellowship opportunity. “The Fellowship is designed for an active firearm offender, so why punish him for doing something that we know he does?” asked Boggan. The important thing, he said, is to continue to love these young men and to leverage every opportunity to continue to support these young men through the process of changing their mindsets. He added that every time he travels out of state, he brings several of these young men with him, often accompanied by his wife and children.
Sanne Magnan commented that what she heard from the two speakers and their stories is the importance of engagement, respect, building trust, and humility in keeping these young men alive. What she wanted to know, though, is what the narrative has to be with their bosses to keep these programs alive. Boggan said that in Richmond it has taken a great deal of effort as well as a very supportive city manager in addition to statistics that demonstrate the program’s success. He added that it is hard work and a challenging process because many people do not understand these young men. People are afraid of them and what they may attract to the organizational environment and therefore resist and neglect working to support their development. Boggan noted that the first thing to get cut when budgets are tight are these types of programs, despite their proven success, when in his opinion cities and investment partners such as philanthropy need to double down on their investment in these efforts. He
added that strong philanthropic support is important too, both in terms of financial support, but also in sending the message that these programs have to survive and remain a viable part of city government funding portfolios if further philanthropic resources are going to be committed and sustained.
Rodríguez commented that these young men are faced with a double-edged sword in that their reputations in their communities are what enable them to be credible messengers who are relevant in those communities, and yet they also need to move away from the behaviors that built those reputations. He also said that safety is a concern for him and his teams when they are out canvassing their neighborhoods. However, the outreach workers have learned when confronted by old adversaries how to make better judgments, and Rodríguez expressed confidence in their ability to diffuse a volatile situation without violence.
Maria Santiago of the Healing Center asked if these programs include discussions about partner violence and the roles men need to play in the lives of their partners and children. Rodríguez said Cure Violence’s treatment plans include peer-to-peer counseling and access to resources on parenting, substance abuse, and other subjects that can increase the vulnerability of these young men. He noted how important it is for these young men to identify with peers who have changed their lives because too many of them do not know how to ask for help. Boggan added that it is important to address all of the issues that impact young men, which includes family, parenting, and being a good partner.