Juvenile Arrested in Fatal Shooting of Hog & Rocks Line Cook

Anti-gang strategy takes a health tack
$1.1M grant funds early prevention
By JULIA REYNOLDS
Herald Staff Writer
Posted: 09/13/2011 01:25:39 AM PDT
Updated: 09/13/2011 07:32:25 AM PDT

Those on the front lines of Salinas gang violence often speak in terms of triage.

How do we stop this week’s retaliatory shootings? Which violent gang members can we get off the street today?

Those who work in public health think differently.

That’s because they look at violence the way doctors look at the spread of diseases.

Surgeon General Regina M. Benjamin said that makes sense. After all, homicide is the second-leading cause of death among young people in the U.S. In some years, it’s the leading cause of death among young Latino males in cities like Salinas.

Doctors have long preached that prevention is much cheaper and far easier on the patient in the long run.

“Prevention is the foundation of the nation’s public health system. Youth violence is preventable,” Benjamin said earlier this year.

She said that in the past 10 years, research has shown youth violence prevention efforts can be “cost-effective, scientifically supported and proven to work.”

Monterey County Public Health Director Hugh Stallworth agrees.

“If we can prevent something, it’s less expensive over the long run and it’s easier on the person,” he said.

Under Stallworth’s direction, Salinas will be one of four American cities funded to take the concept of violence prevention to a new level using public health strategies.

Salinas, Houston, Boston and Portland, Ore., are partners in Striving to Reduce Youth Violence Everywhere, known as STRYVE, a national
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initiative to prevent youth violence led by the Centers for Disease Control and Prevention.

To study and implement earliest-stage violence prevention over the next five years, the Monterey County Health Department has received a $1.125 million grant from the CDC.

Starting young

Unlike traditional violence prevention programs that work closely with individuals, public health experts like to step back and take a wide-angle view.

“We look at groups of people — factors in the family, the community,” said Linda McGlone, in charge of special projects at the county’s Public Health Bureau. “We look at how to shift a population over.”

In a sort of micro-version of the famous Framingham Heart Study, which followed more than 5,000 people through three generations to learn the causes and warning signs of heart disease, officials in Salinas will spend the next five years trying to find out when Salinas youth do or don’t fall into violent lifestyles — and why.

“The beauty of it is looking at a hundred kids,” Stallworth said. “Let’s see what are some of the factors, early warning signs. It’s information that we can use.”

Although the number of studies measuring gang intervention efforts is growing, little research has been done on catching warning signs in very young children — long before they’re considered “at risk,” Stallworth said.

He describes three stages of disease prevention, and says they apply to violence, too.

Primary prevention might be giving a vaccine to a child and preventing a disease before exposure. Secondary prevention might be “catching it early,” he said.

“Tertiary prevention is lying in the emergency room with a heart attack,” Stallworth said. “Something bad has already happened.”

He stressed that even then, “All is not lost. You can change your way of living and do very well. But at that point, things are very expensive and very hard on the patient.”

It’s that first stage that interests Stallworth most.

By the time a youth is wearing red or blue and sketching gang symbols in a schoolbook, the “disease” has already taken hold, he said.

“The kid that’s already in the gang is not where we’re going to go” with this research, Stallworth said.

Education correlation

What public health officials look for in disease prevention are corollaries. Not much exercise, a fatty diet and smoking are corollaries to heart trouble.

“We talk about correlations, not causes,” he said.

Stallworth suspects that a poor education is one likely corollary to involvement in gangs and violence.

“We see it not only in Western countries, but all over the world,” he said. “We know that the better the education, the healthier people are. Not just health, but taking part in healthy activities — like better nutrition, exercise, not smoking.”

Stallworth said successful, healthy kids have “some kind of education experience. It may not be formal. But they have the belief that tomorrow will be better than today. If you don’t have that, there’s going to be no incentive for protective behavior.”

McGlone said she has seen the lack of that hope when speaking with gang-involved youths in custody.

“They say, ‘I’m not going to be here in 10 years,'” she said.

Compounding the problem, local educators estimate about 20 percent of youths in juvenile hall and the Monterey County Youth Center have some kind of learning disability. That’s double the rate of normal classrooms, McGlone said.

All of this is just the kind of local data that are already available and will be studied during the STRYVE program’s first year in Salinas.

After that, local health officials, with advice from the CDC and help from the county’s Community Alliance for Safety and Peace, will seek out partners to test a number of promising prevention approaches for a year or more.

In the final phase of the five-year project, results will be analyzed and more funding sought for the strategies that are shown to work.

This kind of rigorous evaluation sets the public health approach aside from some popular gang-prevention programs that may seem promising but are untested.

“This is not business as usual,” McGlone said. “We’ve spent millions of dollars doing the same things over and over.”

‘Not a quick fix’

Combined with data from the other three cities, results from the STRYVE-funded pilot test programs in Salinas will be used to help other communities around the country.

As the only agricultural community in the program, Salinas’ research could help other rural communities, McGlone said.

Still, health officials know that even with the right knowledge, making community-wide changes can be slow going.

“This is going to take some time,” Stallworth said. “People turn away from (prevention) because you’re talking about a generation. This is not a quick fix.”

He said many others, including Salinas police, are doing good work in trying to lower Salinas shooting rates for the short term, especially with the research-based Ceasefire model.

Prevention, intervention and suppression are all important, he said.

But his role is more that of a patient doctor. Or maybe gardener.

“The rose bush doesn’t start out with pretty roses on it,” he said. “This is a process that flowers along the way.”

Julia Reynolds can be reached at 648-1187 or jreynolds@montereyherald.com.

Preventing youth violence

To study and implement earliest-stage violence prevention, the Monterey County Health Department has received a $1.125 million grant from the CDC. Here’s a breakdown of the five-year plan.

First year: Gather and evaluate local data
Second/third years: Implement test programs
Fourth year: Continue and evaluate
Fifth year: Evaluate best practices and add them to the Community Strategic Plan, developed by the Community Alliance for Safety and Peace.

Source: Monterey County Health Department

nice job officers