When you treat violence as a health problem, kids and communities heal, experts say

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

Next Step is a hospital-based violence intervention program based at Minneapolis' Hennepin County Medical Center that counsels gunshot victims to try to help lower the chances that they will be harmed again or seek to harm others. Focusing on young adults and their families, the program starts its work when a victim is hospitalized. The counseling and connections to support services can continue for months and even years.

The Wraparound Project at Zuckerman San Francisco General Hospital and Trauma Center turns gunshot victims' hospital stays into "a teachable moment," by providing them with services aimed at helping them avoid a repeat injury. Getting shot once is a key risk factor for a second injury, particularly for gun violence's most common victims, young Black men. Wraparound is one of the nation's oldest hospital-based violence intervention programs. It has helped about 850 clients, mostly with mental health counseling, housing, and jobs. The program is associated with a decreased reinjury rate in San Francisco.

The Healing Hurt People program, or HHP, is an ER-based violence intervention program that works on the public health-based notion that violence - like other diseases that spread - can be prevented. It targets services to those at highest risk, patients like those in Philadelphia, who are being treated for violent injuries in the city's emergency rooms. Unlike other programs, it recognizes and attempts to heal the underlying emotional trauma that results from, and often predates, violent injury.

Victims of violence that end up in the emergency room can return within two years with more injuries because of retaliation efforts. Philadelphia’s Healing Hurt People is a hospital-based violence intervention program that assists individuals who need medical care and mental health services. The hospital and social work collaboration helps reduce emergency room costs.

The United States now has a variety of federally-supported nutrition programs, but the health care system remains disconnected from the social determinants of health. Many doctors simply lack the resources to provide the comprehensive care proven to have greater impact on health than strictly medical treatment. A group called Health Leads is training young volunteers to treat the social factors, like poor nutrition and housing needs.

The Kearns Community Coalition in Utah is a collective community effort that aims to "help adults improve their parenting skills, help teens understand the harmful effects of substance use, and increase opportunities to connect youths to their schools and communities." Taking a data-driven approach to assessing community problems, the cross-sector team that forms the coalition implements evidence-based programs that address the gap between residents and resources.

Maryland's health care system is based on three pillars – all-payer rate setting, a global budget, and total cost of care – that, together, have shown positive results both for the patients and for the state's hospitals. Although evidence of success with regard to health care costs is limited, the model of incentiving investment in community health and preventive care has shown success in reducing readmission rates for hospitals across the state.

Milwaukee’s 414LIFE program is treating violence like a public health issue, seeking to interrupt and prevent its spread. The pilot program is a collaboration between the city’s Office of Violence Prevention, local nonprofits, and hospitals and healthcare networks. The initiative works closely with victims of violence to make sure they have the support and resources they need to prevent violent retaliation and employs people who are from the communities they’re responding to in an effort to take a hyper-local response.

Bridging the Gap is a violence prevention program at Virginia Commonwealth University Medical Center that emphasizes treating more than the physical wounds of gunshot victims. Starting in the hospital and continuing afterward, the program gives victims case managers and mentors to link them to services that will change their life's trajectory, including job opportunities. The aim is to interrupt the cycles in which the same people get injured repeatedly, sometimes leading to their deaths. Since the program started in 2007, people it has helped experience far fewer repeat injuries.