chippowerpoint

Washington DCWard 4Brett SperryMax Freed: 

Washington DC Ward 4 Brett Sperry Max Freed

Objectives: 

Objectives Get to know Ward 4 Major health care issues plaguing the neighborhood History of firearms in DC Still “The Murder Capital”? Proposed Interventions

Community Definition: 

Community Definition Geographic boundary Surrounding landmarks Rock Creek Park Ward 3 appendage

Community Characterization: 

Community Characterization Geography/Environment History Demographics Socio-Economic Indicators Health Care Opportunities Health Status

Population by Race (USA): 

Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006 Population by Race (USA)

Slide8: 

Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Socio-Economic Indicators: 

Socio-Economic Indicators Income Levels Housing Costs Education Levels

Housing Costs and Education Levels: 

Housing Costs and Education Levels Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Health Care Issues: 

Health Care Issues Physicians (per population) Health Profession Shortage Areas (HPSAs) Health Care Programs Health Care Facilities

Health Care Facilities: 

Health Care Facilities Major Medical Centers in Ward 4 Union Multi-Care Medical Center Walter Reed Army Medical Center Hospitals Nearby Providence Hospital Washington Hospital Center VA Medical Center Children’s Hospital / Children’s Medical Center

Health Status: 

Health Status Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Leading Causes of Death(per 100,000 people): 

Leading Causes of Death (per 100,000 people) Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Leading Causes of Death: 

Leading Causes of Death Deaths from Heart Disease and Cancer are disproportionately high in Ward 4 Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Problem Prioritization: 

Problem Prioritization Ward 4 Community Members Adrian Fenty, Congressman – Ward 4 Nicole Peltier, Principle – Nativity Catholic Academy Mark Fuhrman, Police Officer – Ward 4 Richard James, Elderly Resident Nancy Robinson, 45 year old housewife Most Significant Health Issues Heart Disease, Cancer, Homicides, Hypertension, HIV/AIDS Magnitude, Severity, Feasibility of an Intervention

Leading Causes of Death: 

Leading Causes of Death Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Problem Prioritization: 

Problem Prioritization Top Priority Issue: Firearm Homicide 5.7x the national average in Ward 4 Disproportionately affects people in their primes (18-34) Community is demanding increase in public safety – Neighborhood Reports (2001) History of DC Gun Ban (1977) District of Columbia Office of Planning, 2002 Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Gun Violence on a National Scale:Ward 4’s Priority Issue: 

Gun Violence on a National Scale: Ward 4’s Priority Issue Firearm is murder weapon in 7 out of every 10 homicides in the USA.٭ Firearms disproportionately kill African-Americans. About half of murder victims are black.٭º Homicide more frequent in urban areas.º ٭FBI Uniform Crime Report 1996 º FBI Uniform Crime Report 2005

Slide20: 

Source: FBI Uniform Crime Report, 2005

10 Leading Causes of Death, District of Columbia1999-2003: 

10 Leading Causes of Death, District of Columbia 1999-2003 Source: WISQARS/CDC WONDER Produced By: Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention Data Source: National Center for Health Statistics (NCHS), National Vital Statistics System

DC Gun Ban: Did it work?: 

DC Gun Ban: Did it work?

The rise of Crack: 1984-1990: 

The rise of Crack: 1984-1990 Source: FBI Unified Crime Report 1995

Where are the guns coming from?: 

Where are the guns coming from? Maryland and Virginia border DC on all sides: open borders. ~50% of guns seized in DC from MD/VA* VA requires a permit only for concealed handgun possession. “Shall-issue” state MD more restrictive. Straw buyers: continuing problem “One gun a month” *The Washington Post. January 1996.

Case study: Australia: 

Case study: Australia Legitimate firearm uses, few controls Public mass killings in 1987 & 1998 Gun law reform: registration and licensing National firearm amnesty + buyback Firearm deaths declined with time (Ozanne-Smith, et al) Differences from USA Ozanne-Smith, et all. “Firearm Related Deaths: The Impact of Regulatory Reform”. Monash University, Victoria Australia. 2004

Other Interventions: 

Other Interventions Rochester NY, Richmond VA: Project Exile Strengthen sentences Federal prosecution: “Exile” Publicity/Education Oakland: Gun tracing program DC: “crime emergency” of 2006 Isolated police response

Who is shooting?: 

Who is shooting? Nationally, 93% of black victims were murdered by black offenders in 2005. Nationally, 90% of murderers were male. Interventions should target young black men, who are most likely victims and perpetrators of firearm-related deaths. Risk begins at age 14! FBI Uniform Crime Report 2005 Howard Freed M.D., David Milzman M.D. et al, 2005

Intervention: The Goals: 

Intervention: The Goals 1. Reduce firearm homicide rate 2. Reduce the # of illegal guns on the streets 3. Reduce the % of returning felons who reoffend

Objective A: Policing: 

Objective A: Policing More efficient and effective MPD patrols Police Visibility and Deterrence “Policing for Prevention” Policing Methods Long term expansion of police force Community work with residents Focus on high-traffic areas Georgia Avenue Clubs/Bars, Metro stations

Objective B: Guns off Streets: 

Objective B: Guns off Streets Reduce # of (illegal) firearms in Ward 4 Fight gunrunning into DC Shut down flow of guns at the source Anti-gun Methods Initiate gun amnesty program Lobby for federal buyback funding Shut down chronic ‘crime gun’ stores Undercover policing of gun sales

Education and Consequences: 

Education and Consequences Project Exile: shift prosecutions to Federal Publicity campaign: illegal gun = faraway prison term Educate young men about consequences of firearms: legal and medical School programs to counter movie mystique of firearms: real injuries

Miscellaneous Methods:: 

Miscellaneous Methods: Resell or bulldoze abandoned properties After school activity programs Lobby VA to limit sales to residents only Halfway programs for convicted felons Resettle returning cons in new neighborhoods

Evaluation and Monitoring:: 

Evaluation and Monitoring: Process: How many hours have MPD patrols increased? Relations with VA/MD? Impact: How many crime gun stores have been closed? How many guns have been collected? Are homicides decreasing?

Evaluation and Monitoring II: 

Evaluation and Monitoring II Outcomes Is there a greater % of murder convictions? Have homicide rates decreased to levels of comparable cities (e.g. Philadelphia)? Do unrelated arrests and searches result in fewer discoveries of illegal handguns? Is homicide still a top-5 cause of death in DC? Are there more patrol officers than before?

Conclusion: 

Conclusion Ward 4 is a family oriented community with serious urban problems Gun violence disproportionately affects Ward 4’s young adult population Isolated interventions are ineffective Success requires community support

APPENDIX: 

APPENDIX

Geography/Environment: 

Geography/Environment Location: Urban Area (size): 7.68 square miles Climate: Humid subtropical climate with four distinct seasons – summer highs in the 80s and 90s, winter highs in the 20s and 30s Potomac, Anacostia and Rock Creek Rivers Rock Creek Park

History: 

History Founded July 16, 1790 DC initially split into four districts “The Federal City” Georgia Avenue Day

Demographics: 

Demographics Population: 75,001 in Ward 4 Race and Ethnicity Age Distribution

Slide40: 

Census 2000 by Ward. http://www.planning.dc.gov/planning/cwp/view,a,1282,q,569299.asp, October 25, 2006

Physicians: 

Physicians 5,062 total physician in DC 572,059 total population 208 physicians/100,000 people US average 885 physicians/100,000 people DC average Physician Related Data Resources. http://www.ama-assn.org/cgi-bin/sserver/datalist.cgi, November 1, 2006

Health Profession Shortage Area: 

Health Profession Shortage Area Three HPSA’s in the Ward 4 area (out of 25) CT 23.01 CT 24.00 CT 25.02 These Census Tract areas are on the border of Ward 5 and Ward 1 Significant because aforementioned hospitals are nearby

Health Care Programs: 

Health Care Programs Commodity Supplemental Food Program (CSFP) Farmers' Market Nutrition Program (FMNP) Seniors Farmers' Market Nutrition Program (SFMNP) Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Health Professional Loan Repayment Program Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE)

Interventions: What’s been done?: 

Interventions: What’s been done? Gun Bans/Gun Control Many states restricted handguns from 1979-1998. DC banned all handguns and ammunition in 1977-78. Most restrictive law in USA. Did it work?

Intervention: Did it work?: 

Intervention: Did it work? The DC gun ban did not significantly reduce the homicide rate in DC: The murder rate is higher now than it was before the ban, and still much higher than the average for US cities. Remains politically popular. Other states’ handgun laws didn’t ‘work’ Why did it fail? The Washington Post, July 27, 2005

Australia: 

Australia -british colony w/lots of legitimate hunting & agriculture needs, settler society, military tradition -mass killings of 1987 prompted many but not all provinces to reform gun laws -port arthur massacre of 1996 changed public opinion against guns -nationwide mandatory licensing and registration enacted, plus semiauto restrictions -followed by firearm amnesty and a 1% income tax to fund a buyback scheme -firearm deaths declined nationally, first in victoria (ozanne et al) -different from USA -but from 1985-2000, 78% of firearm deaths in australia were suicides -and that was only 5% of suicides (Australian bureau of statistics http://www.abs.gov.au/) -guns remain legal with a license -different from USA

Do gun bans work?: 

Do gun bans work? The state handgun laws of 1979-1998 not associated with a significant decrease in handgun homicide or suicide. (Rosengart et al.) When can gun bans work? National Effort Popular Support An evaluation of state firearm regulations and homicide and suicide death rates. M Rosengart, P Cummings, A Nathens, P Heagerty, R Maier and F Rivara.