As a pediatric emergency medicine physician in Chicago, I have had the sad responsibility to care for children and adolescents who have been shot. It is heartbreaking to come to work and see a slew of news trucks outside our hospital reporting on the latest child who has been shot. As an injury prevention specialist, it is unacceptable. If we begin to treat violence as a health equity issue and truly come together to address the root causes, we can reverse this pattern and secure a safer tomorrow for our children.
First, some facts. Just this week, an Illinois Violent Death Reporting System brief created by my colleague researchers at Lurie Children’s Hospital shows that homicide rates have increased 8.6 percent from 2005 to 2015 in Chicago. But what is even more grim is the increasing disparities for African-Americans compared to Caucasians and Latinos. For example, homicide rates among African-Americans were eight times higher than Caucasians in 2005, 16 times higher than Caucasians in 2010, and 18 times higher than Caucasians in 2015. Over the same time period, cities like New York and Los Angeles have seen decreases in homicides.
We have to understand that Chicago is a city of neighborhoods that differ substantially in access to opportunities that contribute to health and well-being. In Healthy Chicago 2.0, the Chicago Department of Public Health developed a Child Opportunity Index that computes a composite community score for three domains of opportunity: educational, health/environmental and social/economic.
The components of the score include items such as adult educational attainment and proximity to employment. Most Chicagoans should not be surprised to learn that 1 in 2 African-American and Hispanic children live in low child opportunity areas compared to 1 in 50 Caucasian children. There are no violence indicators included in the composite score, but neighborhoods that have high rates of community violence tend to have low Child Opportunity Scores.
If we view violence not only as a learned behavior that can be prevented, but also as a health equity issue, we can address the root causes of violence, which include the social determinants of health (such as housing and education) and structural inequities (such as discrimination and segregation). We can begin with new investment in neighborhoods that scored lowest on the Child Opportunity Index.
Healthy Chicago 2.0 is Chicago’s four year community health improvement plan which was created by public health stakeholders and residents working together. It has an ambitious agenda to achieve health equity for all.
We can do this. We are a city that once reversed the flow of a river; we can certainly reverse the flow of violence.
By Dr. Karen Sheehan, MD, MPH, Medical Director
Strengthening Chicago’s Youth
Injury Prevention and Research Center
Ann & Robert H. Lurie Children’s Hospital of Chicago
Originally published in the Chicago Tribune on July 29, 2016.
