James’s Musings

thoughts, photography, and geeky stuff
from an unrelentingly curious Silicon Valley entrepreneur

Violencus Interruptus: The Epidemioloy of Gun Violence [Third in a Series on Gun Violence]

by James G. Beldock on May 4, 2008

Alex Kotlowitz‘s ar­ti­cle in today’s New York Times mag­a­zine sec­tion (“Blocking the Transmission of Gun Violence”) about CeaseFire and its founder, Dr. Gary Slutkin, an epi­demi­ol­o­gist by train­ing who be­lieves one can com­bat vi­o­lence by treat­ing it like a dis­ease, sent my mind reel­ing. Slutkin’s the­o­ry is that “vi­o­lence di­rect­ly mim­ics in­fec­tions like tubur­cu­lo­sis and AIDS, and so…the treat­ment ought to mim­ic the reg­i­men ap­plied to thse dis­eases: go af­ter the most in­fect­ed, and stop the in­fec­tion at its source.” I must ad­mit that I’m a bit of an epi­de­mophile: for what­ev­er rea­son, I have a preter­nat­u­ral in­ter­est in all things dis­ease-, trans­mis­sion-, and re­spon­se-ori­ent­ed. (Criteria for such an af­flic­tion: spend your last va­ca­tion de­vour­ing Steven Johnson’s en­thralling Ghost Map, about the 1854 London Cholera epi­demic, or rec­om­mend Douglas Preston’s ut­ter­ly ter­ri­fy­ing The Hot Zone, about the hor­ri­fy­ing­ly emer­gent Ebola virus, for friends suf­fer­ing from in­som­nia, on the the­o­ry they won’t be able to sleep af­ter they read it any­way!)

Don\'t Shoot: I Want to Grow Up
from the CeaseFire web­site

Thus Kotlowitz’s ar­ti­cle about Slutkin’s epi­demi­o­log­i­cal ap­proach to vi­o­lence struck a chord. In the epi­demi­ol­o­gy of dis­ease, there is al­ways an “in­dex case“—the first case on record. In vi­o­lence, there is a pre­cip­i­tat­ing event. And, just like an epi­demic, the in­ten­si­ty of trans­mis­sion am­pli­fies through­out the pop­u­la­tion: a par­tic­u­lar­ly vo­cif­er­ous an­tag­o­nist can re­sult in tens of crimes, nev­er mind an asym­met­ric num­ber of shoot­ings and homi­cides. Enter CeaseFire, an or­ga­ni­za­tion which seeks to in­ter­rupt vi­o­lence at its first, most crit­i­cal step: what epi­demi­ol­o­gists would cause “in­dex case transmission”—when the first vic­tim be­comes mo­ti­vat­ed ag­gres­sor.

And, just as pub­lic health deals with the re­sults of in­fec­tion (i.e., sick peo­ple who be­come pa­tients), so the re­sults of unchecked trans­mis­sion of the dis­ease of vi­o­lence are high­er crime rates, an ever-in­creas­ing rate of youth-in­volved gun vi­o­lence with­in the oth­er­wise fixed homi­cide rate, and an ex­plod­ing pris­on pop­u­la­tion. As my col­league Pascal Levensohn re­cent­ly sum­ma­rized, the pris­on pop­u­la­tion of the US might as well be its own na­tion. They are the vic­tims of a dis­ease just as sure­ly as were the nine­teen­th century’s lep­er colonies: shunned by so­ci­ety, the very de­f­i­n­i­tion of “out of sight, out of mind.”

Fortunately, or­ga­ni­za­tions like CeaseFire and PAX, about which I wrote pre­vi­ous­ly in “A PAX on Gun Violence”, un­der­stand that os­tracism of those in­fect­ed with this dis­ease isn’t the an­swer. Recognizing that the ounce of gun vi­o­lence pre­ven­tion cre­at­ed by the­se wor­thy or­ga­ni­za­tion is worth far more than its prover­bial pound of cure (ac­tu­al­ly, that was Benjamin Franklin), both PAX and CeaseFire ap­pear to un­der­stand that nip­ping vi­o­lence in the bud re­quires in­ter­ven­tion be­fore the dis­ease spreads.

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