Early Christmas morning, as Shelby County’s health director Michelle Taylor wrapped presents at her home near the University of Memphis, distant pops disturbed her.
“I remember being like, ‘Why are people shooting in the air on Christmas morning?’ Why is that a thing?’”
Later, she saw on the news that a stray bullet killed a 12-year-old boy, Artemis Rayford, while he played video games at home in Orange Mound. She doesn’t live far from there, so she considered whether the shots she heard — killed him.
“It’s heartbreaking to know that we have communities in Memphis that are dealing with this all the time,” Taylor said. “All the time. Not just on Christmas, not just when Young Dolph was killed. We have families who are grieving their loved ones right now, because of this gun violence issue.
“We’ve got to figure this out,” Taylor said. “But we also have to understand that the way we’ve been approaching it needs to change.”
Taylor, among others, hopes that change is a shift from the narrow lens of the criminal justice system’s punishment-only approach to one informed by the big picture view of public health. After all, every year, nearly 40,000 people die from gun violence. And between medical and mental health services, incarceration and lost quality of life, gun violence costs more than $280 billion each year. That makes it a community problem.
The public health approach would mean getting past the “what” to ask why — studying what about society causes people to shoot, understanding who’s most at risk of firing a gun or being shot, testing prevention strategies, educating the public about gun violence, and pushing lawmakers and community leaders to adopt proven prevention strategies.
Communities in Atlanta and Milwaukee have seen progress with the approach. Community leaders there have trained people to intervene when violence is likely to occur. Hospital staff has been trained to talk gun violence victims away from retaliation. Leaders have advocated for redirecting funds from policing and incarceration to preventative measures. And researchers study closely what works and what doesn’t.
“Imagine if the resources that we brought to bear to cover COVID were brought to bear on gun violence prevention,” Taylor said.
Understanding public health
Before she became a state senator earlier this month, then-Rep. London Lamar proposed a move toward the public health approach with a bill that asked for collaboration from state agencies to produce a gun violence report every two years with data and analysis of the health and economic impacts of gun violence in Tennessee. Republican legislators have been hesitant to support it, leaving it stuck in committee. But for Lamar, it’s a first and necessary step in treating gun violence in a new way.
This bill, Lamar said, would begin to answer key questions about “…our methods around solving gun crime: How we want to do it (and) who’s going to be responsible? But don’t get it twisted; it’s everybody’s responsibility. Not just government, not just law enforcement … and it’s not just families, it’s all of us collectively.”
Shared responsibility for solutions is a key difference in the public health approach.
Public health studies community health rather than the health of individuals, according to Courtnee Melton-Fant, an assistant professor in the University of Memphis’ School of Public Health. Public health experts also focus more on understanding and preventing the leading causes of death in communities.
In public health terms, “gun violence” is a broad umbrella that includes forms of assault, accidents, mass shootings and legal gun use, such as when police officers shoot people.
Suicides are a little more than half of all gun deaths in the United States, according to 2020 data from the Centers for Disease Control and Prevention. Almost all of the other half of deaths are homicides, about 80% of them involving a gun. Tennessee has the 10th highest firearm death rate and suicide is the ninth leading cause of death.
Across the country, Black people are disproportionately homicide victims. Homicide is the seventh leading cause of death in Shelby County and the homicide rate, adjusted for population, is 57.3% for Black people and 6% for white people. In Shelby County, homicide is the leading cause of death for Black males ages 15-24, according to 2020 CDC data.
On Valentine’s Day, someone shot and killed Damein Smith Jr., a 15-year-old from South Memphis. A police report says Marcus Orr, 38, argued with the kids about hanging out near his porch, but for some reason, as they walked off, he shot at them, killing Smith.
“It hurts, it hurts real bad, especially this one, coming home from school, doing nothing, just being a child. That hurts,” said his aunt, Shirley Nash.
Smith was Nash’s third nephew shot and the second to die from their wounds. As a community member, she’s asking for some of the same supports Taylor and others described in a public health approach.
“Everything that they took from out of our community, they need to put it back.” Nash, 60, said. “Put the money where it needs to go, in the community for the children. That’s where the money needs to be.”
Years ago, there were plenty of places with after-school activities in her South Memphis neighborhood, but now “from Georgia Street to the Foote Homes,” there’s only one spot, she said. “An idle mind is the devil’s workshop. That’s not only for children but adults as well.”
“Quit treating our children like animals,” Nash said. “They are human beings reaching out for help, but who’s paying attention? Who’s really paying attention to the children? Nobody.”
Now that COVID-19’s spread seems to be slowing, Taylor, who became director last summer, is finally able to think about something other than the pandemic. She would like to put the same muscle that went into managing COVID-19, into addressing gun violence.
But Taylor noted that a public health approach isn’t limited to the health department. Our criminal justice system could implement a public health approach by pursuing “true rehabilitation,” she said. When a young person commits a crime, they could be evaluated for challenges preventing them from being successful in school, for example.
“We need to get out of this mode of thinking that once a child gets to a certain age, if they’ve done something bad, we just need to throw them away, or they’re a lost cause,” she said. “It doesn’t have to be that way. It only is that way if we accept that.”
Young people from Nash’s South Memphis community could be rehabilitated in the criminal justice system if its leaders gave the same care they do to white communities, she said. “Their children can do stuff and get off scot-free. Our children do something, they throwing them in jail for life, but they ain’t sitting there talking to them.”
Taylor and Melton-Fant also mentioned a task force, like the Joint Task Force for COVID, that would keep the focus on gun violence between high-profile incidents.
“There’s this public outrage and then it just goes away, so there’s no sustained kind of effort, structures or funding,” said Melton-Fant. “You can’t just do it with no money. It takes resources and commitment.”
The task force could include a lot of fields, including public and mental health experts, lawmakers and law enforcement. But both Melton-Fant and Taylor said the community needs to lead conversations on solutions, which is foundational to a public health approach.
“I would start with the communities that are disproportionately affected and ask them what they think the issue is, and what they feel like they need, and start from there,” Melton-Fant said.
A public health response also includes funding financial and social supports, such as food assistance programs and afterschool programs and testing strategies to interrupt violence in Memphis neighborhoods, some of which the county already funds in part.
The underlying causes of the gun violence crisis are tied to poverty, Taylor and Melton said, so homicides will continue to be a symptom until economic injustice is cured.
“A lot of times people get stuck in, ‘Hey, they did this, they shouldn’t have done it. That’s it.’ Yeah, that is a set of facts, but it’s not all the facts,” Taylor said. “And until we get brave enough as a community to start to confront the rest of the facts, even at an institutional level … we’re going to keep going around in circles.”
Public health challenges
The division sparked by mask mandates and vaccinations during the pandemic demonstrates that not everyone agrees on public health strategies, Taylor said.
“There’s always a chance that you will have naysayers that say, ‘We don’t want to do a public health approach. I don’t want to know about their childhood. I want to know that they’re being locked up because they used a gun. And I’m not going to spend money on studying all of these other life-course issues if I don’t think it’s going to do any good.’”
Melton added that because Memphis’ predominantly Black and low-income neighborhoods disproportionately suffer from homicides, the issue is “racialized,” inviting racist and classist stereotypes into the discussion and leaving little room to understand other factors.
“It’s just seen as a Black problem,” Melton said, which comes with misconceptions like, “we need tough crime policies. They’re acting this way, because they don’t value education. They (have) fatherless homes and we need to prosecute the parents. Everything about it is ‘lock them up, lock them up, punish them, punish them, punish them.’ And you don’t see that attitude if you’re talking about people dying by suicide or other things.”
Reshaping gun violence as an issue beyond the scope of law enforcement is also crucial to getting over another barrier — funding.
For years, researchers have suggested a public health response to gun violence, but some politicians and lobbyists have hampered funding for it. In 1996, Congress passed a law with an amendment pushed by the National Rifle Association and a Republican congressman that effectively prohibited federal funding for research that could be seen as advocating for gun control. In 2018, the law was clarified, prompting some funding, but the public health field still feels the effects of decades of underfunding, Melton-Fant said.
“We don’t know as much information about policies that work and policies that don’t work because there hasn’t been the funding for it. We just don’t have the information that we have on other public health issues.”
The man accused of killing Smith has been arrested and is waiting for a trial. In late February, Nash was an usher at her nephew’s services at Mt. Nebo Baptist Church in South Memphis. Her family will seek justice for Smith, she said, not only in court but also by continuing to pressure government leaders to address gun violence.
“DJ’s death, it ain’t gonna go in vain,” Nash said. “We’re going to be his voices.”
Carrington J. Tatum is a corps member with Report for America, a national service program that places journalists in local newsrooms. Email him at firstname.lastname@example.org
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