I was driving down East Biddle Street on my way to a Kennedy Krieger Institute satellite office several months ago when I saw two young men fighting in the street. One was repeatedly slamming the other’s head into the pavement. Crowds of onlookers lined both sides of the street and a string of drivers passed by. Fearing for the young man’s safety, I called 911.
Late that evening I received a phone call from the police officer who responded to my report. She had been with the young man since early afternoon. He had undergone surgery and was not expected to make it through the night. He had no ID on him and she wondered if I had any information that would help to locate his next-of-kin. Unfortunately I did not, and I was the only person to call the police to report the incident.
The year 2019 closed in Baltimore with 348 homicides — the highest per capita murder rate in the city’s history. The year also ended with a 32% homicide clearance rate, the lowest rate of solved murders in three decades. The police commissioner and mayor have outlined comprehensive anti-violence plans that will be strengthened by building on existing successful initiatives that address the profound distrust residents feel toward the police and the endemic racism that has historically plagued the city.
In the highest risk neighborhoods in Baltimore, an estimated 80% of children have witnessed violence in their communities. Exposure to community violence and other adverse childhood experiences (ACEs) takes a toll, not just on an individual’s emotional well-being, but on their physical health too. These ACEs are typically defined as family problems such as child maltreatment, domestic violence, parental substance abuse and parental incarceration. In more recent years, the negative impact of adverse community environments, which includes experiences of racism, poverty and community violence, has also received systematic documentation. These negative community factors not only increase exposure to the ACEs and exacerbate their harmful impact, they also independently contribute to disparities and poor social, psychiatric and medical health outcomes.
Last month, the Abell Foundation released a policy report I co-authored on current scientific understandings of the effects of ACEs, the prevalence of ACEs in Baltimore and the availability of interventions in the city to address them. The report, “Prevention, Intervention, and Policy Strategies to Reduce the Individual and Societal Costs Associated with Adverse Childhood Experiences (ACEs) for Children in Baltimore,” concluded that rates of ACEs exposure in Baltimore are not acceptable. The end goal has to be a drastic reduction in children’s exposures to adversities, not just to help children bounce back after being a bystander shot in a drive-by shooting.
Awareness of the negative impact of ACEs has brought about widespread education campaigns, promotion of trauma-informed practices across service sectors and dissemination of evidence-based interventions to mitigate the effects of ACEs. In Baltimore there have also been many exciting grassroots efforts, multiple sector/discipline partnerships and new legislation passed to address ACEs. Without a doubt, there have been successes — like the work of Cherry Hill’s Safe Streets Program, which this past year celebrated 365 straight days with no firearm homicides and the effective mediation of nearly 2,000 conflicts.
Nonetheless, in Baltimore we are losing the battle for far too many children and families. To significantly cut violence in the city and increase homicide clearance rates — which will be a deterrent to future violence for some — the issue of residents’ distrust of the police needs to be addressed head on. The Ethical Policing is Courageous (EPIC) program, which was spearheaded by Baltimore Police Commissioner Michael Harrison when he was in New Orleans, led to rates of interactions with police being described as pleasant and courteous increasing from 53% to 87%, and a drop in homicide rates to a 47-year low. EPIC is a peer intervention program that works in collaboration with community partners and helps officers “police” one another.
Breaking the cycle of violence and high rates of childhood adversity in the city requires a broad, multifaceted approach. The recent passing of legislation that raises the minimum wage is an important step in addressing the economic influences that increase ACEs and support a culture of crime and violence. Ultimately, instilling hope and opportunity are key ingredients in building a better, safer, Baltimore.
Joan Kaufman (Joan.Kaufman@Kennedykrieger.org) is director of research of the Center for Child and Family Traumatic Stress at the Kennedy Krieger Institute and a professor of psychiatry at the Johns Hopkins School of Medicine.