Community Violence

Key Concepts

It is important for prevention efforts, including those in hospitals and emergency departments, to consider unjust social conditions disproportionately experienced by minority communities, and especially by African Americans; these include generational poverty, residential segregation, and other forms of racism that limit opportunities to grow up in healthy and violence-free environments.
Interventions should focus on altering the quality of life course for survivors of violence through targeting their total wellness and thriving through employment, education, financial stability and economic mobility, independence, and stable emotional health.
Hospital based violence intervention programs (HVIPs) that incorporate at least some brief intervention and case management demonstrate HVIP cost-effectiveness with decreases in injury recidivism.

Foundations

Population Characteristics and Violence

Young adults and adolescents in the United States (US) are exposed to crime and violence at much higher rates than those in other developed nations. Rates of violence in the United States also vary by location, with higher homicide rates in metropolitan communities compared to suburban or rural areas. Over 80% of the 12,979 firearm homicides in the United States in 2015 occurred in urban areas, and disparities are larger in certain areas of large cities (e.g., racially and ethnically diverse neighborhoods). For instance, in Philadelphia’s safest police district, which is approximately 85% white, there were no reports of anyone being killed by gun violence. Conversely, the most violent district, with a roughly 90% African American population, had over 180 shooting victims and 40 deaths. African American youth in the United States disproportionately carry the largest burden of violent experiences. The homicide rate for African Americans in the United States is eight times higher than that of their white counterparts, and African Americans are 500 times more likely to die this way. While African American young adults and adolescents only make up about 2.4% of the US population, they are disproportionately victims of injuries from assault (26%) and homicide (20.7%). ^,

Contributing factors to these differences in rates of violence by location are rooted in historical, present day, and persistent structural racism (e.g., racial segregation), inequality, and poverty. Structural barriers that impact present day rates of violence were established decades ago. In the 1930s, President Franklin D. Roosevelt (FDR) created opportunities for wealth-building to help Americans recover from their financial losses in the 1929 Great Depression, securing home ownership through access to guaranteed financial services. In the same decade, FDR’s administration established redlining, a practice with long-lasting effects that segregated America both racially and socioeconomically. Redlining policies drew red lines through cities across America, and residents living behind red lines were denied access to financial services (i.e., mortgages, loans, insurance companies) needed for wealth-building through home ownership and the benefits of home equity. A majority of people living behind red lines were people of color and low income. Redlining policies established two distinct socioeconomic populations that still exist today. Communities located behind historic red lines have lower rates of education attainment, income, and life expectancy, and higher rates of homicide. ^, ^, In general, populations in these communities have lower rates of health, as do their children as beneficiaries of their parents’ limited resources.

Community violence is a complex and persistent health issue that disproportionately affects low-income neighborhoods and communities of color in the United States. Community violence occurs primarily in public settings, occurs between individuals or groups who may or may not know each other, and is often an impulsive or loosely planned act. The effects of community violence are severe and often result in injuries or death. Both those who contribute to and are survivors of community violence are disproportionately young men and adolescent males from historically disadvantaged backgrounds and communities. Analysis of 2017 data from the National Vital Statistics System, National Crime Victimization Survey, and the Youth Risk Behavior Surveillance System concluded that African American young adults and adolescents are at a much greater risk of violence (e.g., homicides, fights with injuries, aggravated assaults) compared to their white counterparts. Furthermore, the frequency of exposure to community violence is higher in large urban cities and within impoverished communities. There is an overrepresentation of racial minorities, especially African American males, among youth who live in these communities and are disproportionately exposed to violence.

Further exacerbating community violence is the lack of economic growth in an area, further contributing to the cycle of urban flight. For instance, there is slower growth in businesses, new retail, and a depreciation of home values in communities with higher rates of violence. Families of victims and survivors of gun violence often experience financial stress, such as having challenges in paying rent, bills, and phone services because of the loss in earnings from employment and medical costs. Exposure to community violence can be very traumatic for individuals and contributes to poor health among African American young adults and adolescents. Community violence exposure has been found to be associated with an increase in psychological health problems, including posttraumatic stress disorder, depression or anxiety, and aggression. Alarmingly, the disproportionate impact of violence on young African Americans comes from forms of violence having the greatest immediate negative consequences on physical and mental health, such as aggravated assault and homicide.

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