Gun violence wounds or kills more than 60,000 people per year in the U.S. The health consequences of gun violence are amplified beyond those killed or injured. Individuals in communities with high rates of violence experience more chronic stress, resulting in poorer cognitive performance and worse health outcomes. Within high-risk neighborhoods, perpetrators and victims of violence concentrate within small, identifiable social networks: in New Haven, CT, 83% of all gunshot victims can be found in a network that represents less than 1% of the population. Research has yet to examine how such networks are embedded within neighborhoods, and how neighborhood assets may be leveraged to prevent and mitigate the health effects from gun violence. In our prior work, we found elements of community resilience (a measure of the sustained ability of a community to utilize available resources to respond to, withstand, and recover from adverse situations) were associated with lower exposure to gun violence. The goal of this proposal, ?Building Resilient Neighborhoods and Positive Social Networks to Prevent Gun Violence,? is to use network science and a community based participatory research approach to systematically develop and evaluate neighborhood-based interventions to build community resilience and thereby prevent and mitigate the effects of gun violence in high-risk neighborhoods. We will build upon prior research to create a prospective social network map of gun violence (Aim 1). With this map, we will examine recent shootings in 3 intervention neighborhoods to identify (1) how network members are connected to positive neighborhood actors and (2) missed opportunities for preventing past episodes of gun violence. With these data, Community Resilience Teams of volunteer neighborhood residents dedicated to building resilience will use strengths, weakness, opportunities, and threats analyses to systematically identify opportunities for intervention(s) (Aim 2). We will test the hypothesis that building community resilience mitigates the health effects of gun violence. Using a pragmatic trial design, we will compare changes in neighborhood-level exposure to violence in the 3 intervention neighborhoods with 3 non- intervention neighborhoods using a difference-in-difference analysis of rates of arrest, incarceration, and healthcare utilization due to gun violence from administrative data (Aim 3). Secondary outcomes include levels of exposure to violence, social cohesion, and collective efficacy within each neighborhood. Novel aspects of this study include (1) framing gun violence as a chronic, manmade disaster with effects that can be mitigated through community resilience?an apolitical public health mechanism unrelated to gun ownership and (2) integration of network science in the design of neighborhood-based interventions targeting gun violence. Our proposal, designed by an experienced community-academic research team, addresses the imperative for evidence-based, systematic, community- and data-driven approaches to preventing gun violence and mitigating its community health effects.

Public Health Relevance

While gun violence primarily affects young African American and Hispanic men, its direct and indirect health effects are felt not only by those involved in gun violence, but also by entire neighborhoods living with chronic and persistent gun violence. We will apply a novel framework to mitigating the impact of gun violence in these neighborhoods by defining gun violence as a chronic, manmade disaster, where prevention efforts can be planned and ought to include the participation of neighborhood residents most impacted. Community-academic teams will design, implement, and evaluate neighborhood-specific interventions that apply network science and utilize existing neighborhood assets to build community resilience and mitigate the direct and indirect health impacts of gun violence.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD010403-03
Application #
9480603
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Zhang, Xinzhi
Project Start
2016-09-01
Project End
2019-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520