4/3/2014
1
Stopping Violence Before it Occurs:
Violence Prevention, Maternal and Child Health,
and Public Health
Stopping Violence Before it Occurs:
Violence Prevention, Maternal and Child Health,
and Public Health
Produced by the Alabama Department of Public HealthVideo Communications and Distance Learning DivisionProduced by the Alabama Department of Public HealthVideo Communications and Distance Learning Division
Satellite Conference and Live WebcastMonday, April 7, 2014
12:00 – 1:30 p.m. Central Time
Satellite Conference and Live WebcastMonday, April 7, 2014
12:00 – 1:30 p.m. Central Time
FacultyFacultyChris Gunther, MPH
Manager of Strategic InitiativesCity of New Orleans Health Department
Chris Gunther, MPHManager of Strategic Initiatives
City of New Orleans Health Department
Sponsored by the Tulane Maternal and Child Health Leadership Training Program with funding from the Maternal and Child Health Bureau,
Health Resources and Services Administration
Sponsored by the Tulane Maternal and Child Health Leadership Training Program with funding from the Maternal and Child Health Bureau,
Health Resources and Services Administration
OverviewOverview• Violence is a public health issue
• Primary prevention of violence is a
MCH priority
• Addressing trauma is essential
• Violence is a public health issue
• Primary prevention of violence is a
MCH priority
• Addressing trauma is essential• Addressing trauma is essential
• Violence is a complex problem that
requires comprehensive solutions
• Case study: New Orleans
• Addressing trauma is essential
• Violence is a complex problem that
requires comprehensive solutions
• Case study: New Orleans
Background: The New Orleans Health Department
Background: The New Orleans Health Department
• Vision
– To serve New Orleanians as a
21st century health department
• Vision
– To serve New Orleanians as a
21st century health department y p
and a model for the nation through
data-driven decision-making and
policy development
y p
and a model for the nation through
data-driven decision-making and
policy development
Background: The New Orleans Health Department
Background: The New Orleans Health Department
• Historically:
– Focused on individuals and
treatment of disease
• Historically:
– Focused on individuals and
treatment of disease
• Today:
– Population health focus, emphasis
on prevention strategies
• Violence is a major public health issue
• Today:
– Population health focus, emphasis
on prevention strategies
• Violence is a major public health issue
What Can “Full House” Teach Us About Violence?
What Can “Full House” Teach Us About Violence?
4/3/2014
2
Violence Is A Public Health IssueViolence Is A Public Health Issue• Violence is extremely pervasive
– In 2010, 4,828 young people ages
10 - 24 were victims of homicide
– Nearly two out of three children
• Violence is extremely pervasive
– In 2010, 4,828 young people ages
10 - 24 were victims of homicide
– Nearly two out of three childrenNearly two out of three children
have been exposed to violence
Nearly two out of three children
have been exposed to violence
Violence Is A Public Health IssueViolence Is A Public Health Issue• Violence negatively affects physical
and mental health
– Childhood exposure to violence
increases risk of chronic disease
• Violence negatively affects physical
and mental health
– Childhood exposure to violence
increases risk of chronic disease
and risky health behaviorsand risky health behaviors
Violence Is A Public Health IssueViolence Is A Public Health Issue• Violence is a significant health
disparity
– Among ages 10 - 24, homicide is
the leading cause of death for
• Violence is a significant health
disparity
– Among ages 10 - 24, homicide is
the leading cause of death for
African-Americans
• Like a host of other health issues,
violence is preventable, not
inevitable
African-Americans
• Like a host of other health issues,
violence is preventable, not
inevitable
Life Course Approach:Violence Is A MCH IssueLife Course Approach:
Violence Is A MCH Issue• Where people live, learn, work, and
play matters for violence prevention
• MCH expands the frame for potential
• Where people live, learn, work, and
play matters for violence prevention
• MCH expands the frame for potential p p
interventions
• MCH promotes a lifelong approach to
preventing violence
p p
interventions
• MCH promotes a lifelong approach to
preventing violence
Life Course Approach:Violence Is A MCH IssueLife Course Approach:
Violence Is A MCH IssueThe
Telescope
From Hosking, J, From Hosking, J, AmeratungaAmeratunga, S, Morton, S, & Blank, D. (2011). A life course approach to injury prevention: A “lens and telescope” , S, Morton, S, & Blank, D. (2011). A life course approach to injury prevention: A “lens and telescope” conceptual model. conceptual model. BMC Public Health, 11BMC Public Health, 11:695.:695.
The Lens
Trauma: Treatment is Prevention
Trauma: Treatment is Prevention
4/3/2014
3
Preventing Violence Requires A Collective Impact ApproachPreventing Violence Requires A Collective Impact Approach
• Common agenda
• Shared measurement
• Common agenda
• Shared measurement
Local health departments are wellLocal health departments are well--situated situated to serve as backbone organizations for to serve as backbone organizations for
violence prevention activitiesviolence prevention activities
Local health departments are wellLocal health departments are well--situated situated to serve as backbone organizations for to serve as backbone organizations for
violence prevention activitiesviolence prevention activities
• Shared measurement
• Mutually reinforcing activities
• Continuous communication
• Backbone support
• Shared measurement
• Mutually reinforcing activities
• Continuous communication
• Backbone support
From Turner, S, Merchant, K, From Turner, S, Merchant, K, KaniaKania, J, & Martin, M. (2012). Understanding the value of backbone organizations in collective impact. , J, & Martin, M. (2012). Understanding the value of backbone organizations in collective impact. Stanford Social Innovation ReviewStanford Social Innovation Review. Retrieved from . Retrieved from <http://www.ssireview.org/blog/entry/understanding_the_value_of_backbone_organizations_in_collective_impact_1>.<http://www.ssireview.org/blog/entry/understanding_the_value_of_backbone_organizations_in_collective_impact_1>.
Case Study: New OrleansCase Study: New Orleans
New Orleans’ Murder Rate Has Been 7- 8x The National Average For Over 30 Years
New Orleans’ Murder Rate Has Been 7- 8x The National Average For Over 30 Years
400
5002010 2011 2012 2013
0-17 12 19 12 13
0
100
200
300
53
242
19
79
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
AverageMurder Rate
Average #of Murders
18-24 62 64 58 47
25 and older
96 115 121 94
Unk. 5 1 2 1
Total 175 199 193 155
NOLA FOR LIFENOLA FOR LIFE• Stop the shootings
• Invest in prevention
• Get Involved and rebuild neighborhoods
P t j b d t it
• Stop the shootings
• Invest in prevention
• Get Involved and rebuild neighborhoods
P t j b d t it• Promote jobs and opportunity
• Improve the NOPD
• Promote jobs and opportunity
• Improve the NOPD
www.nolaforlife.orgwww.nolaforlife.org
Success To DateSuccess To Date• In 2013, murders down 20%
from the same period in 2012
• Impact of early efforts focused
on intervention and enforcement
• In 2013, murders down 20%
from the same period in 2012
• Impact of early efforts focused
on intervention and enforcement
– Group Violence Reduction Strategy
– Multi-Agency Gang Unit
– CeaseFire Central City
– Group Violence Reduction Strategy
– Multi-Agency Gang Unit
– CeaseFire Central City
Deepening Our Investment in Prevention
Deepening Our Investment in Prevention
• Focusing more resources on
children, youth, and families
• Sustaining reductions in violence
• Focusing more resources on
children, youth, and families
• Sustaining reductions in violence g
over the long haul
• Expanding our partnerships
• Vision: Children live in a city of
peace and prosperity
g
over the long haul
• Expanding our partnerships
• Vision: Children live in a city of
peace and prosperity
4/3/2014
4
Planning ProcessPlanning Process• Led by NOHD in collaboration with
planning core team
• Supported by National Forum on
Youth Violence Prevention
• Led by NOHD in collaboration with
planning core team
• Supported by National Forum on
Youth Violence Prevention
• 18 listening sessions with over
150 stakeholders
• Planning culminated with
Youth Violence Prevention Summit
• 18 listening sessions with over
150 stakeholders
• Planning culminated with
Youth Violence Prevention Summit
Planning ProcessPlanning Process• Partners reviewed and provided
feedback on draft plan• Partners reviewed and provided
feedback on draft planSpectrum of Prevention Asset Map
The Spectrum of Prevention is a signature tool of the Prevention Institute. For more information: www.preventioninstitute.orThe Spectrum of Prevention is a signature tool of the Prevention Institute. For more information: www.preventioninstitute.orgg
Spectrum Level
By 2020, 95% of Our Youth will Feel Safe in Their Schools
and Neighborhoods
By 2020, 95% of Our Youth will Feel Safe in Their Schools
and Neighborhoods
GradeStudents Who
Felt Safe in Their School
Students Who Felt Safe in Their
Neighborhood
Perceived Youth Safety, 2012 (CCYS)Perceived Youth Safety, 2012 (CCYS)
n = 2 338 Their School Neighborhood
6 81% 68%
8 77% 78%
10 79% 72%
12 69% 68%
n = 2,338
• By designing a structure to support youth
Designate a Structure for
Youth Violence Prevention
• By laying out a series of strategic
Coordinate and Integrate
Activities toward Shared Priorities
• By establishing a citywide goal to improve
th f t
Establish Benchmarks and
Foster Accountability
The NOLA FOR LIFE PLAYbook:Promoting Life for All Youth
The NOLA FOR LIFE PLAYbook:Promoting Life for All Youth
support youth violence prevention, the PLAYbookensures that youth violence prevention activities will be inclusive of diverse partners, coordinated, and sustainable.
strategic priorities for youth violence prevention, the PLAYbooktargets resources toward young peoples’ most pressing needs.
youth safety, the PLAYbooksets a benchmark to track the impact of youth violence prevention activities on young peoples’ lives.
NOLA FOR LIFE Team
• Integration with City
New Orleans Health
Department
• Dedicated staffing to
StructureStructure
Children and Youth
Planning Board
• Authorized by state law and murder
reduction efforts
• Input from senior City leadership
staffing to coordinate activities
• Data collection and tracking
• Communication among partners
state law and City ordinance
• Ensures input from a wide range of community partners
Shared PrioritiesShared Priorities
Up Front
Goal:
Stop
In The ThickGoal: Intervene at the first sign
AftermathGoal:
Repair and t
pviolence from happening before it occurs
the first sign of risk and respond effectively when violence does occur
restore our youth, families, and communities that have been affected by violence
4/3/2014
5
80.6%78 8%80%
85%90%95%
100%
Percentage of Students Who Feel Safe in Their School
Grade 6
Perceived Youth Safety, 2004 - 2012 (CCYS)Benchmarks
% of Students Who Feel Safe in Their School
63.2%
47.4%
77.0%
50.9%
78.8%
48.6%
69.2%
40%45%50%55%60%65%70%75%80%
2004 2006 2008 2010 2012
Grade 6
Grade 8
Grade 10
Grade 12
95% Goal
80%85%90%95%
100%
Percentage of Students Who Feel Safe in Their Neighborhood
Grade 6
Perceived Youth Safety, 2004 - 2012 (CCYS)Benchmarks
% of Students Who Feel Safe in Their Neighborhood
51.8%
68.4%
53.0%
78.1%
66.9%72.2%
58.8%
68.1%
40%45%50%55%60%65%70%75%80%
2004 2006 2008 2010 2012
Grade 6
Grade 8
Grade 10
Grade 12
95% Goal
Priorities for 2014:Preventing School Violence
Priorities for 2014:Preventing School Violence• Restorative justice
• Positive behavior interventions
and supports
• Restorative justice
• Positive behavior interventions
and supports Promoting pp
(PBIS)
pp
(PBIS)positive school
climates
--Reduced suspensions and expulsions
--Increased attendance
--Improved academic performance
Priorities for 2014:Preventing Family Violence
Priorities for 2014:Preventing Family Violence
• WIC a nexus for family violence prevention
– 62% of New Orleans children
5 and under are eligible for WIC
• WIC a nexus for family violence prevention
– 62% of New Orleans children
5 and under are eligible for WIC
– Domestic violence screening program
– Parenting education
• Triple P – Positive Parenting Program
• Play Nicely
– Domestic violence screening program
– Parenting education
• Triple P – Positive Parenting Program
• Play Nicely
Priorities for 2014:Preventing Family Violence
Priorities for 2014:Preventing Family Violence
DV Support
Public Benefits
Mental Health
WICBenefits
Parenting Resources
Social Services
Health Care
Services
Priorities for 2014:Building Public Health
Infrastructure
Priorities for 2014:Building Public Health
Infrastructure
4/3/2014
6
Conclusion:Keys to Success
Conclusion:Keys to Success
• Committed high - level leadership
• Clearly and consistently making the
case for prevention
• Committed high - level leadership
• Clearly and consistently making the
case for preventionp
– To policymakers, community
members, and funders
• Opening a big tent – build
partnerships locally and nationally
p
– To policymakers, community
members, and funders
• Opening a big tent – build
partnerships locally and nationally
Conclusion:Keys to Success
Conclusion:Keys to Success
• Embrace the challenge
– Solutions must be big and bold
• Pegging success to metrics and
• Embrace the challenge
– Solutions must be big and bold
• Pegging success to metrics and• Pegging success to metrics and
tracking progress
• Pegging success to metrics and
tracking progress
For More InformationFor More Information
Chris Gunther
Chris Gunther
(504) 658-2590
www.nola.gov/health
jg @ g
(504) 658-2590
www.nola.gov/health