I came to Chicago this year to help create and run a Level 1 adult trauma center for the South Side at the University of Chicago Medicine. It’s been only 50 days and 50 nights, and two words come to mind: helplessness and senselessness.
On Feb. 11, Takiya Holmes, 11, was shot while sitting in a van about a mile south of our medical campus and was brought to our Comer Children’s Hospital where, despite the heroic efforts of our pediatric trauma team, she died on Valentine’s Day.
On that same Saturday, a few miles away and half hour later,Kanari Gentry-Bowers, 12, was shot while playing basketball with friends on elementary school grounds. She died from her injuries at another hospital the day after Takiya.
On Valentine’s Day,Lavontay White Jr., 2, was shot and killed while in the backseat of a car on the West Side of Chicago. He was pronounced dead that day.
These children, seemingly all disparate cases, had something in common: Their fates were interlinked by the social context in which they lived.
You see, these events were not accidental. Even when they involve innocent bystanders, intentional violence is not accidental or random. The common link is that this occurs in certain communities that have particular demographic characteristics in urban America — from Baltimore to Chicago to New Orleans to Oakland.
It is all too easy to blame violent events on bad people doing bad things and being deserving of their fate. But this blame game and the discussion around it must change. We Americans must consider an alternative explanation for these tragic events so that we can devise a ways forward for ourselves and our children.
Living in a big city in America does not need to be a death sentence.
Before the Framingham Heart Study that began to follow a cohort of people in 1948 in a small city outside of Boston, heart attacks were thought to be unpreventable. They became known as “widow makers.” However, knowledge of heart disease progressed, and risk factors such as hypertension, diabetes, smoking and obesity became new targets for interventions that saved lives.
We have to apply similar approaches to prevention of intentional violence. Interpersonal violence is a disease that afflicts communities. It is not that individual people are violent or have the disease called “violence.” It is that there are risk factors for violence that can be reduced and community norms that can be altered to curb interpersonal violence.
The epidemic of violence is a public health problem plaguing urban communities across the United States. The impact of violence is far reaching and affects not just the person who is injured or dies from a gunshot wound but his or her family and all of their contacts.
If we are to improve the health and well-being of the population, we have to address the wider social determinants of health such as poverty, unemployment, lack of education, and opportunities that increase the risk of violence in our communities. Addressing the proximalsocial determinants of disease such as poverty, discrimination or unemployment will help to prevent violence.
We need to move the conversation away from the belief that someone “deserves” to be a victim of intentional violence to communities working to prevent intentional violence.
We can mitigate the risk factors that lead to violence much like we have learned do with heart attacks. Much like we have encouraged healthier lifestyles to reduce cardiovascular mortality, we can create and implement policies and programs that tackle upstream factors such as helplessness, hopelessness, homelessness, and lack of opportunity and education. We can and need to address the often-ignored toxic stress that results from repeated traumas in urban America.
We can do this through education, research, innovation and advocacy by:
- Raising public awareness about these social determinants of health.
- Forming partnerships between health care providers and those who seek to stop the cycle of violence through community outreach.
- Coming up with ways for victims of trauma to recover physically, mentally and logistically with the support and resources they need.
This takes community and civic engagement. This takes thought leadership and grand ideas. This takes guts and the willingness to make a difference.
This is how we turn helplessness to hopefulness.
Selwyn O. Rogers Jr., MD, is director of the Trauma Center and executive vice president of Community Health Engagement atThe University of Chicago Medicine.
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