“You shoot. Now what?”
Those words were projected on a screen at City Hall on Tuesday, during a hearing on the ongoing gun violence that plagues Philadelphia year after year.
The message was part of a proposal for a public awareness campaign about the consequences of gun violence that the Philadelphia Health Department plans to launch in the coming months.
Some might wonder why the Health Department is involved in dealing with criminal activity that police and prosecutors would normally handle. But, more and more, medical professionals, academics and elected officials are beginning to discuss tackling gun violence from a scientific, epidemiological approach: as a "public health" issue, not a strictly criminal one.
“Most of our efforts on gun violence in the United States have focused on catching and incarcerating perpetrators. ... It happens after a shooting has taken place,” said Dr. Thomas Farley, Philly health commissioner, at a City Council hearing Tuesday of the Special Committee on Gun Violence, chaired by Councilman Kenyatta Johnson. "Taking a public health approach means trying to prevent shootings.”
So far in 2017, there have been 1,117 people who have been the victims of shootings around Philadelphia.
It's an 8 percent decrease from the same time last year. But those who say gun violence should be treated as a "contagious disease" say gunshots are not isolated acts but events that ripple along complex, societal webs, inflicting trauma on communities and potentially causing even more violence.
Farley said the public health approach includes three key elements: focusing on the individuals who pull triggers, the gun and how it was procured, and the environment and factors that led to the violence.
Firearm homicide remains the leading cause of death for African-American men aged 15-34 nationwide — around 60 percent of the deaths in the group.
So far in 2017, there have been 291 homicides in Philly and 1358 total reported shootings.
In plain dollars and cents, as the city calculates it, every shooting costs the city $500,000 in hospitalization and other related expenses. And every homicide has a negative economic impact of $6 million, the city says.
Programs cited as examples of new strategies to fight gun violence included CeaseFire, based at Temple University and working in the 22nd police district and part of the 39th to enlist community members in "interrupting" or squashing beefs before they spark bloodshed. Another was Focused Deterrence, a program in South Philly's 1st, 3rd and 17th police districts that identifies youths at risk of involvement in violence and connects them with social services. From its launch in 2013 for the two following years, fatal and nonfatal shootings fell by 35 percent in the targeted areas.
The program models appeared to be successful, but they have not been implemented on a broad basis.
"Both CeaseFire and Focused Deterrence fall short," said Temple criminal justice professor Caterina Roman at the hearing. "They both succeeded in their key goal of reducing shootings — but as public health interventions, they fall short with regard to creating large-scale, sustainable change."
Just how these programs will become successful remains to be seen. But leaders at the hearing indicated research-based, scientific policies, along with data-sharing between city departments and medical and law enforcement agencies, could help lead the way to new solutions.
"I don’t think we should accept this violence as normal and inevitable," Dr. Farley said. "If we take a public health approach to this problem, experience says that, over time, we can make real progress and save lives.”