To Combat Gun Violence, Clean Up the Neighborhood
Mark Makela for The New York Times
by Dr. Eugenia C. South, an assistant professor of emergency medicine at the University of Pennsylvania and faculty director of the Urban Health Lab
PHILADELPHIA — Until a Black man turns 45, his most likely cause of death is homicide. After each such violent death, traumatic shock waves pierce through family and friends. Whole neighborhoods suffer. In some communities with high rates of violent crime, babies are more likely to be born early, children are more likely to struggle in school and adults are more likely to report being depressed, as well as face increased risk of heart disease.
A recent spike in violent crime in cities across the country has pushed the Biden administration to develop an important federal gun violence prevention strategy. Parents, leaders and activists in Black communities have been fighting against the terror of gun violence for decades. The country is finally catching up to their work.
President Biden’s strategy primarily focuses on bringing resources and services to the people most likely to commit violence and to the people most likely to be victims of that violence. In other words, this strategy focuses on high-risk people. Interventions focused on people who have been tangled in the cycles of violence, such as violence-interruption programs, are important and necessary.
Missing from the plan, however, is a focused investment in the high-risk places that allow violence to thrive. In large cities, a small number of streets account for an outsize number of violent crimes. Those streets are usually in segregated Black neighborhoods that, because of structural racism, have suffered from decades of disinvestment and physical and economic decline. Dilapidated homes with blown-out windows, blocks with no trees, barren, concrete schoolyards and vacant lots strewn with trash such as used condoms, needles, mattresses and tires often dominate the landscape.
Without changing these physical spaces in which crime occurs, violence-prevention efforts are incomplete. A focused and sustained investment in high-risk places should be a cornerstone in the effort to create safer and healthier communities.
My colleagues Charles Branas and John MacDonald and I have now conducted two large-scale studies where, instead of randomizing people to receive an intervention — as is typical in science — we randomly chose places to receive an intervention. Randomized controlled trials produce the highest level of unbiased results in research: Large, well-constructed R.C.T.s allow us to confidently say that intervention X causes outcome Y.
In partnership with the Pennsylvania Horticultural Society, our team transformed run-down vacant parcels of land by planting new grass and trees, installing low wooden post-and-rail fences around the perimeter and performing regular maintenance. We randomly selected hundreds of lots across Philadelphia to receive either this clean and green intervention, trash cleanup only or no intervention at all.
We found that after both the greening and trash cleanup interventions, gun violence went down significantly. The steepest drop in crime, up to 29 percent, was in the several blocks surrounding vacant lots in neighborhoods whose residents live below the poverty line. This signaled that communities with the highest need may benefit the most from place-based investment. Over 18 months, we analyzed for and did not find any evidence of crime simply being pushed to other parts of the city.
Study participants around both interventions reported feeling safer, and therefore went outside more often to socialize with neighbors. People around greened lots reported feeling less depressed. This experiment provided clear evidence that changing neighborhood conditions can improve — and improved — seemingly intractable community and mental health problems.
Next, our team conducted a similar trial where we studied abandoned houses, which often have shattered windows and crumbling facades and are riddled with trash. We randomly selected houses to receive either a full remediation (adding new doors and windows, cleaning the outside of the house and the yard), a trash-cleanup-only intervention or no intervention at all. Our findings, which are not yet published, demonstrate a clear reduction in weapons violations, gun assaults and shootings as a result of the full remediation.
Other similar interventions have strong evidence toward inclusion in violence prevention efforts. In Cincinnati, for instance, a loss of trees because of pest infestation was associated with a rise in crime. And in Chicago, people living in public housing with more trees in common areas reported less mental fatigue and less aggression than did their counterparts in relatively barren buildings. My team has also demonstrated that structural repairs to heating, plumbing, electrical systems and roofing to the homes of low-income owners were associated with a 21.9 percent drop in total crime, including homicide. The more homes repaired on a block, the higher the impact on crime.
Gun violence is expensive, costing billions of dollars annually. Simple, structural and sustainable changes are often low-cost and high-value interventions. We have demonstrated, for example, that in Philadelphia, for every $1 invested in greening, society saves up to $333 that would have gone toward costs such as medical expenses, policing and incarceration.
Across the country, efforts such as The Conscious Connect in Springfield, Ohio, and the Philly Peace Park, in Philadelphia, both led by Black men, are transforming physical spaces to positively influence physical, mental and social health. Organizations such as these, rooted in and led by the community, should be fully resourced in violence prevention efforts.
The reasons that improving places prevents violent crime are not immediately clear to many. Each time we leave our homes and traverse our neighborhoods, the environment is getting under our skin to influence our physical functioning, our thoughts, our behaviors and our interactions. This often happens without our conscious awareness.
A resident of West Philadelphia, a predominantly Black neighborhood, crystallized the connection between place and people in a qualitative study I conducted to better understand how people perceived the links between vacant land and health. The person said: “It makes me feel not important. Like I think that your surroundings, like your environment, affects your mood, it affects your train of thought, your thought process, your emotions. And seeing vacant lots and abandoned buildings, to me that’s a sign of neglect. So I feel neglected.”
I often think about this astute observation after I care for shooting victims in the trauma bay of my emergency department. Especially for those young Black men whose voices I never get to hear and whose names I never know, I wonder: What if we, as a country, made intentional decisions to invest in them and their neighborhoods? Instead of dying, would they flourish?