Baltimore has now had 343 homicides in 2017, sets record for killings per capita. (Baltimore Sun video)

As another violent year dawns in Baltimore City, with almost a homicide a day, a much more all-encompassing and coordinated plan is needed to staunch the bleeding. Although the police are trying initiative after initiative, it is simply impossible for the police to solve the problem alone. I propose a public health approach, in which we identify the vectors or root causes that lead to certain conditions and address them comprehensively.

The root causes of the violence in Baltimore are well known: literally hundreds of drug crews fighting over turf; inadequate constructive activities for young people in many areas of the city; yes, too many guns in the hands of those who should not possess them; violent acts begetting violent retribution; and a general lack of hope for a generation of young people — hope of a livable wage job, of having a successful life.

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What follows is a prescription for comprehensively and simultaneously tackling the various roots of violence in Baltimore:

1. Young people need more out-of-school activities. This can come in the form of a mentoring program, preferably attached to a community youth center. Keeping at-risk kids off the streets will help to reduce the large number of crimes committed by unattended youths.

2. Re-implement the Operation Safe Kids program for those juvenile offenders who are at highest risk for shooting others or being shot themselves. This program, which was quite successful in the O'Malley administration — resulting in a 43 percent reduction in recidivism — combined intensive community-based case management and supervision with immediate actions by city agencies to address the young offenders' needs. The program can be improved by adding intensive therapy to deal with the PTSD and depression that is so common among these juveniles

3. Expand the Safe Streets program to all communities with high levels of violent crime. This program has reduced retributive violence in neighborhoods after a violent crime has previously been committed.

People rally for the Baltimore Safe Streets program as concerns arise about a proposed budget cut to the city violence prevention program. (Wyatt Massey, Baltimore Sun video)

4. Bring back a form of the Operation Ceasefire program, which worked well in Boston, where violent drug gang offenders are swept up one gang at a time and a coalition of federal, state and local law enforcement agree to seek the maximum sentence possible unless the gang members forego violence and avail themselves of pro-social activities and options like GED courses. It may sound naïve, but it works.

5. We need to improve police-community relations. Homicides have risen dramatically since Freddie Gray's death and the resulting uprising in 2015. It is clear that his death and its aftermath have resulted in less community support for the police (no other major demographic variables have changed that would account for this phenomenon) leading to less community cooperation in providing information on crimes to police and police being skittish about pursuing offenders for fear of prosecution.

A new approach is needed for police-community relations, and an Iraq and Afghan War veteran named Chris Gonzalez has a promising blueprint for such a change in tactics. On the ground in Afghanistan, where mistrust between American troops and Afghan residents led to lack of cooperation and violent conflict, he was instrumental in implementing the Civil Affairs Model. It entails establishing trusting relationships between police and local community leaders and utilizing these leaders to address incidents in the community along with the police. Once these relationships are established, police and the community then develop individual plans and goals for the neighborhood — say, certain improvements to the local public school or increasing access to health clinics or workforce development programs — and work together to accomplish them. If such a model has worked in combat zones in Iraq and Afghanistan at reducing conflict, surely it can work here.

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6. Finally, the state and city absolutely must do a much better job coordinating their efforts. Far too often, the agencies responsible for protecting Baltimore's citizens are not talking to one another and are working at cross-purposes, resulting in less effective activities and wasted resources.

By treating Baltimore's overwhelming violence as a public health problem, a combination of actions can be taken immediately — along with others that will take a bit longer to implement, like providing tax incentives to companies that provide livable wage jobs to relocate to impoverished neighborhoods. This will go a long way toward alleviating the seemingly intractable problem of violence that afflicts Baltimore.

Dr. Peter Beilenson (plbeilenson@gmail.com) is a former Baltimore City health commissioner, former Howard County health officer and the former CEO of Evergreen Health.

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