Background

Gun violence is by far the largest driver of homicides in America, the overwhelming majority of which take the form of day-to-day shootings in underserved communities.1 Black and Latino young men living in urban neighborhoods are disproportionately impacted by this tragic violence—almost 75% of America’s 14,542 gun homicide victims in 2017 were either Black or Latino, and nearly 85% male.2

In order to adequately address this public health crisis, we need policies that address not only the supply of guns in impacted communities, but also the root causes of community violence. In addition to stronger gun laws, there are a number of highly effective intervention strategies that directly address gun homicides and shootings by working with high-risk individuals to disrupt cycles of violence. For more details on these strategies, see our Healing Communities in Crisis report.

Interpersonal Gun Violence in Maryland

In recent years, Maryland has suffered an average of 313 gun-related homicides and 825 non-fatal shootings per year and has the fifth-highest rate of gun homicide in the country.3 Interpersonal gun violence in Maryland is overwhelmingly concentrated in cities, especially Baltimore, which in 2016 alone experienced 275 gun homicides and 667 nonfatal shootings.4 This ongoing violence exacts an enormous physical, emotional, and financial toll on Maryland families and communities.

In addition to the human suffering, shootings in Maryland result in an estimated $1.2 billion in direct economic costs, including healthcare costs, law enforcement expenses, lost wages, and costs to employers.5 Many of these costs fall directly on Maryland taxpayers. The investment required to scale up and expand lifesaving gun violence intervention strategies solutions in Maryland cities is minuscule compared to the yearly cost of gun violence in the state.

To its credit, the State of Maryland, through its newly created Violence Intervention and Prevention Program, is one of just a small handful of states directly investing in the local implementation of evidence-based solutions to gun violence.6

Maryland’s Violence Intervention and Prevention Program (VIPP)

In early 2018, with assistance and advocacy from Giffords Law Center and a broad coalition of gun violence prevention and social justice organizations, the Maryland legislature passed legislation establishing the Maryland Violence Intervention and Prevention Program (VIPP). This legislation had strong bipartisan support and was signed into law by Republican Governor Larry Hogan.7

Administered by the Governor’s Office of Crime Control and Prevention in coordination with the State Department of Health, the VIPP provides critical funding to support effective gun violence reduction strategies. Under the program, local governments and nonprofits may apply for grants to implement evidence-based gun violence prevention and intervention programs.8

In awarding VIPP grants, preference is given to applicants that serve communities disproportionately affected by violence and applicants that propose to direct VIPP funds to programs that have been shown to be the most effective at reducing violence.

To ensure the long-term viability of such programs, funding will be made available to grantees for a minimum of three consecutive fiscal years. For Fiscal Year 2018-2019, Governor Hogan’s office announced that the VIPP would initially provide $4 million in grant funding. Awards were administered to seven grantees, with the largest grant going to the City of Baltimore in the amount of $2,725,000.9

According to Governor Hogan’s office, “grants were awarded based on applications received and amounts requested,” with an eye toward “crime prevention programs that make good use of hard-earned dollars and are effective at reducing crime.”10 In the first year of funding, this includes public health strategies for addressing violence such as street outreach work and hospital-based violence intervention programs in some of Maryland’s hardest-hit areas.

Street Outreach Work in Baltimore

Baltimore is leveraging this state funding, with an additional $1.3 million in matching city funds, to expand the Safe Streets program to several new neighborhoods.11 Safe Streets is a street outreach program based on the Cure Violence model of violence prevention, which treats gun violence as a communicable disease and works to interrupt its transmission among high-risk community members.12

The Cure Violence model employs “Violence Interrupters,” and “Outreach Workers,” individuals who understand the dynamics of street violence and are able to connect with those who are most at risk to commit or become the victims of gun violence. Violence Interrupters use their position of respect in the community to mediate conflicts and defuse potentially dangerous situations before they become violent. At the same time, Outreach Workers attempt to connect the most at-risk individuals with badly needed social support services. All of this occurs while a norm-changing campaign takes place to send the message that violence will no longer be tolerated by the community.13

Several evaluations have found this strategy to be associated with significant reductions in firearm homicides and assaults. In New York City, for example, researchers found Cure Violence to be associated with up to 63% reduction in shootings within implementation neighborhoods.14

Hospital-based Violence Intervention Programs

In addition to the grant provided to the City of Baltimore, smaller VIPP awards went to support violence intervention and prevention efforts in three Maryland hospitals, two community-based organizations, and one medical foundation.15 Several of these grantees are implementing Hospital-based Violence Intervention Programs (HVIPs), which interrupt cycles of violence by providing intensive counseling, case management, and social services to patients recovering from serious injuries.16

Research shows that the strongest risk factor for violent injury is a history of previous violent injury, with the chances of injury recidivism as high as 45% within the first five years.17 Hospitalization for a serious injury presents a unique “teachable moment,” as individuals are generally more open to positive intervention and behavior change at this time.

HVIPs screen patients based on predetermined criteria to identify individuals at highest risk for reinjury, and subsequently partner them with trained, culturally competent case managers.18 Case managers then help connect high-risk individuals to community-based organizations to give them access to critical resources such as mental health services, tattoo removal, GED programs, employment, court advocacy, and housing.19

Evaluations have shown that patients who receive HVIP services are four times less likely to be convicted of a violent crime and four times less likely to be violently reinjured than patients who do not receive such services.20 HVIPs are an effective method of breaking cycles of violence in urban communities and have positive impacts on clients and communities in which they are active.

Maryland’s increased investment in this strategy is likely to result in desperately needed reductions in levels of violence in the state with the nation’s fifth-highest rate of gun homicide.

Investing in Intervention

With the launch of VIPP, Maryland is now one of only six states providing meaningful support to cities and community-based organizations seeking to implement and sustain evidence-based gun violence intervention strategies at the local level.

Other states that have chosen to fund violence intervention and prevention strategies, including Massachusetts, New York, and Connecticut, have witnessed substantial reductions in gun violence—saving both lives and taxpayer dollars. To learn more about how states are supporting effective evidence-based gun violence reduction strategies, see our report, Investing in Intervention: The Critical Role of State Level Support in Breaking the Cycle of Urban Gun Violence.

Notes
  1. According to CDC data, out of 19,510 total homicides in the US in 2017, 14,542—or nearly 75%—were committed with a firearm. Centers for Disease Control and Prevention’s WISQARS Fatal Injury Reports, accessed October 9, 2019, http://www.cdc.gov/injury/wisqars/fatal.html. ⤴︎
  2. Id. ⤴︎
  3. Fatal firearm injury data came from the Centers for Disease Control and Prevention’s WISQARS Fatal Injury Reports (www.cdc.gov/injury/wisqars/fatal.html). Nonfatal firearm injuries came from the Agency for Healthcare Research and Quality’s HCUPnet Query System (https://hcupnet.ahrq.gov/#setup); 2017 state gun homicide ranking is from the Centers for Disease Control and Prevention, National Center for Health Statistics, Underlying Cause of Death 1999-2017, on CDC WONDER Online Database, accessed Dec 14, 2018, http://wonder.cdc.gov/ucd-icd10.html. ⤴︎
  4. “Victim Based Crime Data,” Baltimore Police Department, accessed July 26, 2017, https://data.baltimorecity.gov/Public-Safety/BPD-Part-1-Victim-Based-Crime-Data/wsfq-mvij. ⤴︎
  5. Giffords Law Center to Prevent Gun Violence, The Economic Cost of Gun Violence in Maryland, https://lawcenter.giffords.org/wp-content/uploads/2018/02/Cost-of-Gun-Violence-in-Maryland.pdf. ⤴︎
  6. Nick Wing, “There’s A Cheap And Effective Way To Reduce Gun Violence. Why Aren’t More States Doing It?” HuffPost, May 4, 2018, https://www.huffingtonpost.com/entry/urban-gun-violence-prevention_us_5ae35255e4b055fd7fcba726. ⤴︎
  7. Nick Wing, “Maryland’s GOP Governor Signs Broad Set Of Gun Bills Into Law,” HuffPost, April 24, 2018, https://www.huffingtonpost.com/entry/maryland-gun-laws_us_5ada332be4b04090e551f666. ⤴︎
  8. MD HB 432, http://mgaleg.maryland.gov/webmga/frmMain.aspx?id=hb0432&stab=01&pid=billpage&tab=subject3&ys=2018RS. ⤴︎
  9. “Hogan Administration Awards Close to $4 Million for New Violence Prevention Program,” Maryland.gov, http://goccp.maryland.gov/hogan-administration-awards-close-to-4-million-for-new-violence-prevention-program. ⤴︎
  10. Id. ⤴︎
  11. Ian Duncan, “Three Baltimore neighborhoods picked for new Safe Streets anti-violence sites,” Baltimore Sun, Dec. 14, 2018, https://www.baltimoresun.com/news/maryland/crime/bs-md-ci-safe-streets-expansion-20181214-story.html. ⤴︎
  12. “Safe Streets,” Baltimore City Health Department, https://health.baltimorecity.gov/safestreets. ⤴︎
  13. See Cure Violence, http://cureviolence.org. ⤴︎
  14. Sheyla A. Delgado, Laila Alsabahi, Kevin Wolff, Nicole Alexander, Patricia Cobar, and Jeffrey A. Butts, “The Effects of Cure Violence in the South Bronx and East New York, Brooklyn,” John Jay College of Criminal Justice, Oct. 2, 2017, https://johnjayrec.nyc/2017/10/02/cvinsobronxeastny. ⤴︎
  15. “Hogan Administration Awards Close to $4 Million for New Violence Prevention Program,” http://goccp.maryland.gov/hogan-administration-awards-close-to-4-million-for-new-violence-prevention-program. ⤴︎
  16. Nick Wing, “Hospitals Are Trying To Do What Politicians Haven’t: Stop Gun Violence,” HuffPost, Nov. 23, 2018, https://www.huffingtonpost.com/entry/gun-violence-intervention-hospitals_us_5bc0fbade4b01a01d68aadc6. ⤴︎
  17. J. Purtle et. al., “Hospital-based Violence Intervention Programs Save Lives and Money,” J. Trauma Acute Care Surg. 75, no. 2 (2013): 331–333. ⤴︎
  18. Rochelle A. Dicker et. al., “Where Do We Go From Here? Interim Analysis to Forge Ahead in Violence Prevention,” J. Trauma 67, no. 6 (2009): 1169–1175, http://violenceprevention.surgery.ucsf.edu/media/1691926/where.pdf; see also Naneen Karraker, MA, Rebecca Cunningham, MD, Marla Becker, MPH, Joel Fein, MD, MPH, and Lyndee Knox, PhD, Violence is Preventable: A Best Practices Guide for Launching & Sustaining a Hospital-based Program to Break the Cycle of Violence (National Network of Hospital-based Violence Intervention Programs, 2011), available for download at http://nnhvip.org/publications. ⤴︎
  19. Purtle, et al., “Hospital-based Violence Intervention Programs Save Lives and Money,” Journal of Trauma and Acute Care Surgery 75, no. 2 (2013): 331–333, https://journals.lww.com/jtrauma/Citation/2013/08000/Hospital_based_violence_intervention_programs_save.22.aspx. ⤴︎
  20. T.L. Cheng, et al., “Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-injured Youths Presenting to the Emergency Department: Results of a Randomized Trial,” Pediatrics 122 (2008): 938–946, http://www.ncbi.nlm.nih.gov/pubmed/18977971; see also C. Cooper, D.M. Eslinger, and P.D. Stolley, “Hospital-based Violence Intervention Programs Work,” J. Trauma 61 (2006): 534–540, http://www.ncbi.nlm.nih.gov/pubmed/16966983. ⤴︎