CDC to Wilmington: Target at-risk youth for help

Keionia Fountain and Jovahn Speller rushed their three boys, twin 4-year-olds and a 2-year-old, into their rowhome on the 900 block of Spruce St. on Tuesday.

Even in the middle of the afternoon on a warm sunny day, Fountain and Speller don't want them outside in their neighborhood. They are afraid for their safety. In the last two days there have been two shootings in their neighborhood, including one Monday at dusk.

“I won’t walk my kids around here,” said Fountain, who said her family is looking to move out of Wilmington to Newark or a safer area of the state. “You can’t even go to play in the parks.”

The type of toxic stress that is driving Fountain, Speller and their children from the city is the subject of a historic, 15-page report by the Centers for Disease Control and Prevention examining "epidemic levels of urban gun violence" in Delaware's largest city. It is the first time the CDC has provided technical assistance to study the impact of gun violence as a public health issue.

According to the report, a series of indicators, including repeated exposure to violence and shootings, are constants in those who go on to commit gun violence.

“It is not the nature of people; it is the toxic environment,” said Councilwoman Hanifa Shabazz, whose efforts in December 2013 led to the CDC agreeing to study violence in Wilmington as a public health concern. “Our children are the victims here, so that being the case, we need to address it as adults and leaders to stop the epidemic.”

The study examined 569 Wilmington residents who were arrested for a violent gun crime between Jan. 1, 2009, and May 21, 2014. About 95 percent were male and most were between the ages of 18 and 25. The study results and recommendations were made public Tuesday.

Further study of their backgrounds showed common experiences. Many made emergency room visits for injuries including gunshot wounds, were unemployed in the quarter preceding the crime for which they were arrested, had been investigated as the victim of child maltreatment, had juvenile records and had received social assistance.

The CDC determined that in order to try to prevent individuals from committing gun crimes, the state and local social service agencies need to create a method to identify at-risk youth more effectively and provide them with services to change their lives.

“We cannot arrest our way out of this problem,” said Rita Landgraf, secretary of the Delaware Department of Health and Social Services, who worked with the CDC on the study. “We need to engage the science or root cause analysis with practice on the ground that will bring forth healthy outcomes.

The study offered a few recommendations including increasing collaboration between schools, hospitals and courts and sharing data in a risk assessment tool. The tool would assign specific point values to each indicator and provide a total of those points to social service providers to give them an idea of how at-risk each individual may be.

The study also recommended establishing a community advisory board to provide recommendations on a way to provide “wrap around” social services and programs to at-risk youth.

“They need a package of assistance,” said Dr. Paul Silverman, associate deputy director for Health Information and Science at the Delaware Division of Public Health. “These youth need intensive help to prevent them from becoming involved in future violence either as a victim or a perpetrator.”

Fountain said she fears if she stays in the city, her sons or their friends will be the ones shooting.

Shabazz would have liked to have seen recommendations that could be implemented more quickly. She pointed out that in the last two years, while the CDC conducted its study, many more have lost their lives and violence continues to rise.

“I think we are at a state of emergency that I would really ask that the governor do an executive order to demand that all of his Cabinet move immediately to do what is necessary to put this risk factor assessment in place and address the ills that we have,” Shabazz said.

In 2015, violence is on track to reach an all-time high. Since January there have been 133 shootings and 25 homicides. The record for shootings was 154 in 2013; the homicide record of 29 was set in 2010.

Dallas Robertson raised her three now-grown sons in Wilmington. “The fear and the stress is difficult," she said after hearing about the CDC recommendations. "But anything is worth a try.”

Shootings like one just up the block from her house on South Harrison Street on Tuesday afternoon "makes me feel that we are not safe anymore," she said. "Any time of the day they shoot whenever, even in broad daylight.”

While her sons have stayed out of trouble, Robertson said she knows a few of their friends who died through gun violence.

"The report indicates that all community stakeholders must begin exploring a preventive approach as we respond to violent crime,” said Mayor Dennis P. Williams in a statement. “Policing should only represent one area of a comprehensive strategy to attack gun violence, but we must also proactively target and provide the necessary services to those individuals who are most likely to become violent offenders in the future.”

Landgraf said there are some recommendations that her agency will move on quickly, but others will take time and patience. Before the end of the year, she said she hopes to establish the community advisory board so that the group can begin an inventory of which existing social services in the community are most effective.

“There are privacy laws, confidentiality, HIPAA [Health Insurance Portability and Accountability Act],” she said. “The CDC was able to do this on a pilot, but to be able to put it into the infrastructure will take probably some change in our Delaware code and probably at the federal level as well.”

Local health agencies see the CDC report as a valuable tool worth examining.

Dr. Sandra Medinilla, a trauma surgeon at Christiana Care, said in the hospital, issues surrounding gun violence impact at every level from maternal care, fetal medicine, family health and patients who are coming into the emergency room with gunshot wounds.

“When a young man is injured and comes into our hospital, I see how it impacts their mother and father and friends and the anguish on their face,” Medinilla said. “Every single time we have a patient that is injured by gun violence it is something that can be potentially preventable. It is a multifaceted problem.”

At Christiana Care, they have a program to try to impact youth by bringing them into the hospital for a mock trauma situation where they tell the story of a gunshot victim named Brandon. They also have a discussion program to talk with kids about what kind of choices can lead them into a violent situation.

Dr. Iman Sharif, division chief for general pediatrics and primary care at Alfred I. duPont Hospital for Children, noted that impacting violence is important, not only to protect the lives of victims of gun violence and those who might get caught in the crossfire, but also because violence can lead to greater health concerns for the community like increased rates of heart disease, diabetes, chronic obstructive pulmonary disease, alcoholism, drug use and violence.

Sharif said the recommendations of the CDC will help provide services for children who might find themselves in these traumatic situations and remove them before the impacts set in.

“It is about focusing and setting the stage to make sure that we have healthy communities and healthy environments early on in life,” Sharif said.

Wilmington Cease Violence has been working to provide services to families whose loved ones go into the hospital suffering gunshot wounds, said Robert Cannon, the organization’s program director.

“Whatever services we need, we try to get it to them,” said Cannon, who lost two sons to gun violence. “Just try to get them to take little, small steps.”

The ultimate goal, Cannon said, is to stop the family or friends from retaliating with another shooting and get them away from gun violence all together.

In order for the CDC’s recommendations to have an impact, Cannon said, the community, elected officials and social service agencies must buy in and work together.

“If we all say enough is enough, there is chance it will make a difference,” he said.

Contact Jenna Pizzi at jpizzi@delawareonline.com or (302) 324-2837. Follow her on Twitter @JennaPizzi.