​by Mateja Mihinjac

In last week’s blog about Syracuse we introduced the Cure Violence program. We initially introduced Cure Violence seven years ago in our review of the film The Interrupters. Since then the program has expanded considerably.

Cure Violence is a public health approach to violence prevention, targeting at-risk youth to prevent shootings. Its founder, Gary Slutkin, sees violence as a contagious disease problem where violent behavior spreads from person to person as an epidemic with individuals adopting behaviors they observe in their social circles. Cure violence focuses on prevention through interrupting violent behavior and change through treatment and education.

The program shares the same vision as SafeGrowth - building capacity in neighborhoods to interrupt violence within neighborhoods themselves. However, whereas SafeGrowth focuses on a proactive way to plan long-term neighborhood development, the Cure Violence program responds to violence that has already erupted, or is about to erupt.


REPLACING PRISONS WITH PLAYGROUNDS

Slutkin envisions neighborhoods where prisons would be replaced with playgrounds and parks. This vision - reported in the Syracuse projects we discussed in our last blog - helps neighborhoods struggling with high levels of violence. That includes the Near Westside neighborhood in Syracuse.

Cure Violence relies on trained “violence interrupters”, individuals who, due to a similar history of criminality or gang membership, have credibility among the targeted groups.

The model is based on 3 components:

1. Interrupt transmission – violence interrupters detect and mediate conflicts to reduce likelihood of violent outbursts or retaliation
2. Identify and treat highest risk to prevent future spread – interrupters assess and refer individuals at high risk of engaging in violence to appropriate social services 
3. Change group norms – engage and organize community leaders, residents, local organizations and service providers and use outreach and education to denormalize violence.

​RESEARCH ON SUCCESS

Evaluation studies support the effectiveness of this approach. In Chicago, for example, the 2009 study reported a 41-73% reduction in shootings across intervention neighborhoods and a 56% decrease in killings in Baltimore.

In NYC, the most recent evaluation reported 27-50% reduction in gun injuries in two NYC communities and 63% reduction in shootings in one community while attitudes supporting violence have decreased and confidence in police increased.

Previous research also reported an 18% decrease in homicide across Cure Violence locations between 2010 and 2013 and 69% in non-targeted locations since the program was first implemented in NYC in 2009.

Cure Violence has to date been implemented in 10 countries across over 25 cities. These include Western cities as well as regions with high levels of violence in South America, Africa, Middle East and zones of conflict such as Iraq and Syria. This year Cure Violence also celebrated a jump in 10th place of the Top 500 NGOs in the world.

The Cure Violence model, therefore, holds a great promise to help reduce violence and victimization from gun violence in cities like Syracuse.

by Mateja Mihinjac

Criminologists like to compare crime prevention to disease treatment. The evidence-based proponents, specifically, point out that by failing to adopt the same rigorous scientific method used in medicine to inform policy and practice, criminology lags 150 years behind medical science. However, what these proponents miss is that advances in preventive medicine have moved beyond the traditional understanding of causes and treatment of diseases, also known as allopathic medicine. Today many forms of medical practice are evolving into integrative medicine.


CURE: A ONE SIZE FITS ALL APPROACH?

Prior blogs on ethics and going to the doctor have discussed the poor suitability of methods from physics for studying a complex social phenomena such as crime. This issue is further exacerbated by research that breaks problems into small bits for study – the reductionist approach – and attempts to generalize from those isolated findings.

Generalising from reductionist studies is even more problematic given that the complex environments where crime flourishes tend to mediate the impact of prevention outcomes. For this reason, artificial intelligence expert Jim Manzi is skeptical that an experimental revolution in social science will prove fruitful in addressing intricate social issues.


TREATMENT: INTEGRATIVE CRIME PREVENTION

With little success in treating chronic and complicated diseases using the allopathic model, integrative medicine emerged. Integrative medicine goes beyond simply treating symptoms, but rather deals with underlying factors in a holistic and partnership fashion. Patients assume ownership of their health while under the guidance and support of a health practitioner. Together they devise individualized treatment from a wide range of approaches that deal with a person’s complete physical, mental and social well-being. The ultimate goal is addressing root causes.

In criminology, many so-called evidence-based programs use reductionist experiments with little success. Therefore translating an integrative health care model into crime prevention means that we should be moving away from reductionist approaches and thinking more broadly about creating holistic and sustainable programs for individuals and their communities.

We need to identify multiple approaches that can work together towards achieving immediate prevention outcomes and also address the root causes of crime problems. This means that crime prevention professionals and researchers need to approach the problem by working together in an integrated way to fit solutions to the context, economy and politics of each neighborhood. Further, criminologists need to work with community members in such a way that promotes a two-way exchange of knowledge and a promotion of local ownership over problems.

It seems unjust to denounce current criminological methods as outdated because they lack the same scientific rigor of medical science (which itself is evolving). Instead, we should acknowledge advances made in integrative based medicine.

Crime prevention neglects these breakthrough developments and continues to believe that solutions grounded in reductionist forms of the scientific method will yield universal responses to unique problems. Instead, by drawing from the evolution of medical science into integrative medicine, integrative crime prevention offers a more fruitful path for our future work.

They maintain that by applying scientific techniques that allow for objective, comprehensive and rigorous assessments, they will be able to guide public safety professionals with approved solutions and thus eliminate guesswork that had guided their work in the past. It is a proposition long criticized as unrealistic by social research experts like National Academy of Science member Stanley Lieberson, former chair of the Sociological Research Association.

​
LIMITS OF EBA

Crime is a social problem characterized by complicated causes and interconnected underlying factors. The science that the EBA crowd follows is based on quantitative number crunching and the kind of controlled experiments that are simple to control in the chemistry lab, but far less so on the street where crime occurs.

How likely is it that the same methods in physical science are ideal methods for truly understanding the complexities of crime? How realistic is it to think the multifaceted social factors of social disorder and crime can be extracted, reduced to small components and then tested in experimental designs?

Harvard’s Malcolm Sparrow also warns that relying too much on evidence-based practice is a risky proposition; it risks dependence on a limited pool of validated solutions and dependence on quickly outdated solutions in today’s rapidly changing society. Further, Sparrow says that the excessive time needed to establish a knowledge-base to satisfy evidence-based policing proponents means that results may take too long to be operationally relevant.

​One argument for establishing evidence-based practice is to eliminate the disconnect between academics and practitioners. But escalating the evidence-based rhetoric does not help narrow this gap; in fact, it only perpetuates the division between the two.

This is especially true when EBA academics consider themselves as governors of the research that judges policies rather than establishing a mutually beneficial collaborative relationship. There is no worse way to create top-down solutions that exclude those who are affected by these policy decisions — the public.


TOWARDS AN ETHICS-BASED APPROACH
​
This does not mean, as the saying goes, that we should throw the baby out with the bathwater. Evidence-based practice has an important role to play, particularly in crime prevention and policing. Evidence-based research provides directional patterns that might support the effectiveness of certain measures.

However, decision makers should not rely solely upon today’s trending EBA promises especially when solutions may infringe upon social equality. Ethics cannot be pushed aside from decisions made too quickly from a complete lack of evidence, or too slowly from a plodding EBA platform in which “scientists” take months or years to conclude little of value.

Sparrow partially attributes the overwhelming focus of the evidence-based policing movement on place-based interventions such as situational crime prevention, CPTED or hotspot policing. In these cases, ethical questions seem very distant when researchers use secondary data, such as crime statistics collected by police, and their computational calculations do not directly involve people.

It is ultimately still people who will experience the effects of place-based interventions.

Apologies for some overindulgence. No stories this week. No new observations. Just a rant about calling a thing for what it is.

"Where does it hurt?" asks the doctor.
"Stomach".
"Let me see if I can feel where the pain is."
"It started this morning after breakfast."
"What did you eat?"
"Eggs, Here, I brought leftovers."
"I'll send them to the lab. When tests come back, we'll prescribe the right medicine."

It's called allopathic medicine. Symptoms - Diagnosis - Prescription. It's based on symptoms. 

Same in crime prevention. Crime shows up. Cops or prevention folk do analysis. A strategy emerges and they try it out. Allopathic crime prevention. We all do it, me included: situational prevention, CPTED, problem-oriented policing, Design Out Crime. Symptoms first! Makes sense, right? Except for what's missing…

...prevention!

Allopathic prevention prevents subsequent incidents and that's good. Just like going to the doctor. But it's not really "prevention" when it hasn't prevented it. 

Medicine is growing out of its allopathic adolescence. It is evolving into integrative medicine - nutrition, stress management, alternative therapies (good family medicine probably always did that). It teaches us how to live a healthy lifestyle to prevent illness. 

Meanwhile, far too much crime prevention still envisions safety as a product of strategies applied to a problem. Just like allopathic medicine. 

Here's the thing; most serious crime emerges from dysfunctional families, broken neighborhoods, and personal troubles like drugs. You prevent it by getting into those places to help neighborhoods help themselves. 

Let's call allopathic prevention what it is - crime repression. It represses what emerges and hacks at the branches. Prevention digs at the roots.

Rant over.