A Grassroots Effort To
Across the country, health systems and hospitals are working with community-based organizations and advocacy groups to combat gun violence that has grown progressively worse in recent years, especially since the start of the COVID-19 pandemic. Trauma centers such as at the University of Chicago Medicine and Boston University Medical Center are on the front lines of the daily carnage, treating hundreds of gunshot victims monthly. Many have developed partnerships with grassroots organizations such as READI Chicago, LIFE Camp in New York, Faith in Action in Washington, DC, and Youth Over Guns in New York that are pursuing community-based solutions to gun violence by engaging young people who are at highest risk of falling victim to the senseless bloodshed. The goal is to break the cycle of violence, promote peace within the community, and give young people the help and support they need to further their education and pursue meaningful career opportunities.
Claudia Fruin
Bulletproof Kids Utah
Pediatrician Claudia Fruin, MD, was in a meeting as a leader with the Utah American Academy of Pediatrics in December of 2012 when news broke of the Sandy Hook Elementary School shootings. She and her colleagues were gutted. “I just thought, ‘We have to do something,’” she said.
Knowing the laws weren’t likely to change, Dr. Fruin asked herself what could possibly be done in Utah to promote gun safety without generating controversy. Gun storage, she realized, hadn’t been addressed on any kind of broad scale. By 2013, she helped establish Bulletproof Kids Utah, an initiative promoting safe gun storage.
Key to Bulletproof Kids’ mission statement is the idea that “Owning a gun is a right. Protecting children is a responsibility.”
Having Bulletproof Kids as a resource has helped pediatricians frame conversations about gun safety at home. Parents tend to believe that their kids don’t touch their guns, but children often report that they know how to access them — and sometimes already have.
Promoting safe gun storage is no different from making sure kids use seat belts or life jackets, Dr. Fruin said. Kids need protection from accidental shootings and gun suicide as much as they do from car accidents or drowning. She also hopes to strengthen Child Access Prevention (CAP) laws, which vary by state but generally provide a means of charging gun owners with criminal negligence if someone is killed or injured using their improperly stored gun.
“Suicide is the number-one cause of death in children,” she said. “Those are kids who should have no access to a weapon.”
Wes Siler
Outside Magazine Columnist
Wes Siler is an avid hunter and gun enthusiast, and he’s tired of the lack of reasonable discussion around gun safety.
“There are 450 accidental deaths from guns each year,” he said. “Every single one of them is 100 percent preventable. With 190 million gun owners in America, we should be able to have a normal conversation about gun safety.”
In Siler’s mind, the conversation he hopes for is stymied in large part to the National Rifle Association (NRA), which he says has devolved into nothing more than a political machine. The NRA’s three million members, many of whom joined by default rather than choice, don’t represent the vast majority of Americans who own guns, said Siler. “The NRA represents less than 1 percent of gun owners. They do not speak for us. They cannot claim to represent us. They dominate the conversation, and they shouldn’t.”
For example, any discussion about mass shootings gets twisted. “They say, ‘Well, not that many people actually die in mass shootings,’” he said. “But every kid in America has to go do mass shooting drills now. Every kid in America goes to school scared. That affects people’s psyches. That affects people’s mental health. It’s really terrifying.”
He favors reasonable gun safety measures, such as tiered licensing systems like he’s seen in other countries, extensive background checks, and effective gun safety training using demonstrated protocols. “We should encourage all gun owners to safely store their guns where children can’t access them,” he said. “As a person who enjoys guns, I want to find a way for something that I’m interested in and passionate about to be as responsible and safe as possible.”
He believes that most gun owners do care about doing the right thing. “Nobody wants to see kids die,” he said. “It’s not a problem we can’t solve if we all work together.”
Eddie Bocanegra
Senior Director, READI Chicago
Eddie Bocanegra is an investor. As senior director of READI Chicago under Heartland Alliance, he invests in people and communities to help curb gun violence in Chicago.
Bocanegra joined READI Chicago in 2017, in the wake of a spike in gun violence in the city. READI Chicago comes at the problem of gun violence from a different direction than law enforcement; rather than cracking down on crimes after they happen, the group identifies the individuals most likely to experience gun violence — those in the most danger of shooting someone or becoming a victim themselves — and invests in them. In partnership with the University of Chicago’s Crime Lab and Cook County’s Department of Corrections, READI Chicago uses predictive analytics to identify those at highest risk, typically men between the ages of 18 and 29.
Once those individuals are identified, “we saturate them with resources,” Bocanegra said. Among those resources are on-the-spot job offers, behavioral therapy, and “relentless engagement” — all trauma-informed.
Bocanegra is uniquely suited for this work. He grew up in Chicago, was in a gang by 14, and was in prison by 18 for homicide. After his release at age 32, he furthered what had been a tenth-grade education, ending up with a master’s degree in social work from the University of Chicago. He’s the first to admit that not everything the group attempts immediately works. “Progress is not linear,” he said, particularly when it comes to those with substance abuse problems. “It takes time to build something. It’s not an overnight change.” Funding, too, can be a problem, because even when money is available it doesn’t necessarily go where it’s most needed.
But READI Chicago has produced measurable positive results. For example, in a 24-month study, 80 percent of the men that READI Chicago actively engaged with proved less likely to be arrested for murder or attempted murder than those in the control group. Like so much in these communities, the foundation for success often comes down to trust and relationship-building over time. “It’s not enough to say ‘Hey, I want you to go into this program. It’s going to change your life,’” Bocanegra said. “They come to READI because of the job. They stay here because of the relationship. That’s powerful.”
Luis Hernandez
Youth Over Guns
On a sweltering June day in 2018, activists led a march into Manhattan across the Brooklyn Bridge carrying a child-sized casket. “It was a demonstration of how young people were being lost every day to gun violence, not just in one community, but across communities,” said Luiz Hernandez, co-founder of Youth Over Guns, who organized the march.
They expected dozens. Thousands showed up. “What would typically be a 45-minute walk over the Brooklyn Bridge became a three-hour march,” said Hernandez.
Youth Over Guns was formed in the aftermath of the shooting at Marjory Stoneman Douglas High School in Parkland, FL, in February 2018. Survivors there, and youth across the country, began recognizing that despite gun violence affecting their lives daily, no one was helping them — in policy or in practice. Young people, particularly young people of color, needed a voice, and they needed to change the narrative surrounding guns.
Hernandez isn’t interested in politics; he’s interested in root causes. In communities where people have to fight for basic resources — well-paying jobs, food on the table, quality schools — children are not only in the crossfire of gun violence, they are also more likely to grow up to be perpetrators themselves. Youth Over Guns faces the question: How can these cycles of violence and of generational trauma be interrupted?
“We really want to focus on gun violence as a public health crisis, and less as a criminal justice issue,” Hernandez said. “The legal systems have failed our communities over and over again.”
To Youth Over Guns, the narrative around dismantling the Second Amendment or taking people’s guns away couldn’t be further from their mission. “We don’t care that you have a gun locked up in a safe because you want to protect your children at home. That’s fine. We care about the guns being funneled into our streets.”
Hernandez is optimistic about today’s young people being tomorrow’s disruptors. Youth Over Guns supports young people in leadership, elevates the voices of young leaders around the country, facilitates peer-to-peer training programs, and champions an activist incubator for young people who are angry about the trauma they live with every day.
“What’s moved the needle on gun violence as a whole has been young people sharing their testimonies of gun violence, sharing their experiences — but also bringing forth solutions,” Hernandez said. “We’re going to continue to be hopeful and we’re going to continue to inspire people.”
From the front lines
Tanya Zakrison, MD
Trauma Surgeon, University of Chicago Medical Center
At the University of Chicago Medical Center on Chicago’s South Side, Tanya Zakrison, MD, MPH, a trauma and acute care surgeon, sees upwards of 400 trauma cases a month, more than half of which are gunshot wounds.
With some victims, it’s trauma on top of trauma. “We’ve learned that trauma can be transmitted through generations,” Dr. Zakrison said. Prolonged, acute trauma such as genocide or institutional racism can leave a biological mark. Inflammatory changes to white blood cells as well as certain stress hormones have been shown to impact both male sperm and the environment of developing fetuses.
Research is shifting. “We know what the problems are,” Dr. Zakrison said. Instead of merely counting incidents, researchers are digging into the “why” behind gun violence through a lens of classism, racism and sexism.
Victims and their families aren’t the only ones traumatized by gun violence. At the University of Chicago Medical Center, the mortality rate for penetrating trauma is 13 percent. That takes a toll on health care personnel. “All trauma surgeons talk about ‘the conversation in the quiet room’ with families,” she said, when the surgeon takes a victim’s family into a room to tell them their loved one has died. Every trauma surgeon has those conversations, and they remember every one.
When Dr. Zakrison operates on someone for a gunshot wound whose body already bears the marks of previous gun trauma, what is clear to her above all else is the colossal failure across systems — the health care system, the social system, our government — such violence represents.
“We see the bad here in the trauma center, but there is so much good and so much solidarity out there. It gives me hope that people are fighting injustice.”
If answers can be found to stem the tide of gun violence, they are societal, economic, and rooted in both history and activism. We can also learn from our wrongs, structurally. One way to do that in Chicago is through retroactive victim compensation of up to $27,000, which victims of gun violence are legally entitled to but for myriad reasons rarely access.
Meanwhile, community workers are fighting to protect their neighborhoods and make a difference. The University of Chicago Medical Center has integrated a violence recovery program that has proven helpful in reducing the rate of people returning with repeat injuries. These violence recovery specialists, often past victims of gun violence, help victims, beginning when they arrive at the hospital. Later, they help victims access mental health services, apply for victim compensation and assist them in finding jobs or re-enrolling in school. “We see the bad here in the trauma center, but there is so much good and so much solidarity out there. It gives me hope that people are fighting injustice.”
But none of this support is possible, Dr. Zakrison said, if people don’t have enough to eat or don’t feel safe where they live. “People are being denied the ability to develop their full human potential and live with dignity. If we can create a system where people don’t have to struggle to stay alive and feed their families and they’re allowed to develop the genius that is so clearly within them, we all only benefit from that.”
Members of the Boston Medical Center Violence Interruption Advocacy Program
Violence Interruption Advocacy Program
Boston Medical Center
Boston Medical Center, the largest trauma center in New England, treats 70 percent of the city’s trauma victims — but even the best medical treatment in the world can’t provide the community support people require once they leave the hospital. “Victims of violence need resources,” said Elizabeth Dugan, clinical director of the hospital’s Violence Intervention Advocacy Program (VIAP). VIAP guides trauma victims as they recover, offering support services, opportunities and skills training, with the goal of creating positive life changes and making communities safer and healthier.
It starts in the hospital. From the moment victims arrive, a trauma response team is dispatched to offer them everything from mental health support to communication with the medical team and, when necessary, bereavement counseling and help with funeral planning. Everything medical providers do is trauma-informed. “The chance we have to intervene comes and goes very quickly,” said Dugan; it’s a narrow window of opportunity, and it has to happen in the hospital.
But that’s just the beginning. The ripple effect generated by violence extends far beyond that one victim or that one hospital stay. “Trauma is vicarious,” said Dave Wiley, outreach coordinator for VIAP, who grew up in the communities he now serves. “The support needs to stay strong.” VIAP provides ongoing resources to anyone in the victim’s orbit, helping with medical insurance, housing applications, legal issues, financial literacy, even navigating school meetings.
VIAP advocates don’t just show up in the “bad” times; they gain trust by being visible and active in their communities. Violence prevention specialist Masika Gadson goes door-to-door to both residences and businesses to listen to concerns, shows up at community meetings, attends neighborhood carnivals, and even grocery shops for residents who might still be uncomfortable going out. In the event of a trauma, she is able to offer “psychological first aid,” not as a stranger, but as a visible, recognized and trusted member of the community.
VIAP, founded in 2006, faces constant funding challenges (Dugan estimates that she spends 60 percent of her time writing grant applications) but never loses sight of their mission to meet their clients where they are in life. Given the ready access to guns, they know that the victim they deal with today could be a perpetrator of violence the next time.
“Our victims are like family to us,” said Dugan. “They have names and faces and stories. They’re real people who want things just like everybody else, but obstacles and barriers have been put in their way through no fault of their own. People think it’s too late. It’s never too late.”