On a sleepy street corner in the Bronx last Thursday, Eddie Miranda, a 41-year-old outreach supervisor at a gun violence prevention program at Jacobi Medical Center, held a megaphone to his mouth and delivered a breathless and indignant plea.
“There should be peace where we walk in our neighborhoods," he cried. "We shouldn’t have to wonder if our kids are going to make it back home."
His voice blared into the distance, blending into a cacophony of honking car horns and roaring motorcycle engines. The sidewalks were nearly empty, and it was unclear how many people inside the apartment buildings heard his message. Afterward, he and roughly a dozen hospital staffers and community members began their bimonthly march, walking northward from Pelham Parkway underneath rumbling subway tracks.
As of mid-June, New York City has reported more than 700 shooting victims, the highest number to that point since 2002. The gun violence has sent shockwaves across the city, and become a highly politicized issue during a pivotal mayoral race. Eric Adams, a moderate candidate considered a frontrunner, has argued for more policing, namely in the form of random spot checks at Port Authority and a controversial plainclothes anti-crime unit that was disbanded last year. Meanwhile, Maya Wiley, the leading progressive contender, has called for reallocating $ 1 billion in annual police funds towards social service or public health programs that address issues like unemployment, poverty, and the trauma from living in violent surroundings.
Now entering its seventh year, the Jacobi program known as Stand Up to Violence is the first of its kind in the state to use a hospital-based approach that treats violence like a disease. There are roughly 18 gun violence prevention programs scattered across the city, several of which have shown promising results. But those behind the Jacobi initiative say its unique model and outcomes stand out among them: Between 2014 to 2018, gun violence in the areas it serves dropped by 45% compared to the four years prior before Stand Up To Violence was initiated, according to Dr. Noè Romo, a pediatrician who serves as the program's medical director.
Additionally, he noted that among the more than 2,000 patients admitted into Jacobi for either a gunshot wound, stabbing, or assault over the last seven years, the rate of re-injury is 59% lower than prior to the program.
Having operated relatively under-the-radar, the public hospital program is suddenly attracting interest from progressive lawmakers. U.S. Senator Chuck Schumer and Representatives Alexandria Ocasio-Cortez and Jamal Bowman recently met with hospital officials and called for $400,000 in federal funding to supplement the state and city aid it receives. The program is leanly staffed by less than a dozen hospital, social, and community outreach workers. Additional federal funds will allow the hospital to hire more social workers.
Ocasio-Cortez has gone out of her way to cite the Jacobi program as an alternative to increased policing and incarceration.
Stand Up To Violence is based on a Cure Violence model that was created in Chicago in 1995 and relies on community members known as credible messengers. They are often former gang members, or as Miranda describes, a person who "has lived through what these young people have lived through."
Growing up in Queens, Miranda had been a gang member and was incarcerated at one point.
But unlike other violence interrupter programs, Stand Up To Violence is based in a hospital. That allows outreach by the credible messengers to begin at a critical moment—when a gunshot victim is admitted to the emergency room and the clock begins on a potential retaliation. Outreach workers immediately try to get a sense of what led to the shooting and then attempt to mediate the dispute at both an individual and community level. They do not involve law enforcement.
According to Miranda, every case is different and no response plan—which can involve therapy and social workers—looks the same.
Romo said the work of outreach workers like Miranda has been critical to the program's success.
"Our outreach workers are individuals who live and work in their communities, who look like them, who may perhaps even know them," he explained, referring to violent offenders. "So they're able to open up to them and engage the conversation around what happened. And because we are connected to them, we automatically have gained trust with them as well, from a physician standpoint."
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In the mayoral race, the debate over gun violence has often been presented as an either-or proposition, pitting policing against public health programs like Stand Up To Violence.
Politics is generally something that those involved in Jacobi's program decline to talk about.
But Romo pointed out that gun violence is linked to a host of factors—social and economic inequities, systemic racism—which result in poverty and discrepancies in schooling and other community resources. Solving entrenched problems requires multiple strategies and also takes time, he said.
"It's difficult to just say that our approach is the best approach," he said, adding that other disciplines like policing have a role to play as well.
"I like to think that we're all complementing each other in the same fight and not necessarily replacing each other," he added.
After a two-and-a-half mile march, the group stopped below the Gun Hill subway station for a prayer as the trains roared periodically above.
Unbeknownst to them, several miles away, shots were erupting on another Bronx sidewalk where a gunman fired at a man who collided with a 5-year-old boy and his 10-year-old sister on a sidewalk. The children were not hurt, but the horrific scene was caught on surveillance video.
The prospect of children getting caught in the crossfire of gun violence, which happened in Far Rockaway earlier this month with the shooting death of a 10-year-old boy, has added another frightening layer to the crisis. During the march, Reverend Jay Gooding, who has been involved with Stand Up To Violence since its inception, noted the unthinkableness of such grief.
"When a child loses a parent, they're called an orphan," he said. "But there's no name for when a parent loses a child."