Urban gun violence is driven by small groups of high-risk individuals—what some of us call “gangs.” They’re high-risk for perpetrating violence and for being shot and killed.
Note: This season of American Diagnosis was originally published under the title In Sickness & In Health.
Celine Gounder: Hi, everyone. This is Dr. Celine Gounder. I’m the host of this show, “In Sickness and in Health.” If you like our approach to health storytelling, do me a small favor. This week tell one friend about the podcast. The more listeners we get, the more shows we can make, the more topics we can cover, and the more ambitious we can be. Thanks for listening. Now, on with the show.
Gamba Oba: How is it that someone could be laying on the ground bleeding… and you’re taught to keep your mouth shut.
David Kennedy: We know who you are, we know what you’re doing, we’re not going to let this continue. We are focusing on you because you are the most violent group in the city right now, and therefore you have gotten our attention.
Gamba Oba: That’s real dangerous mentality to have, to just not care.
Stan Ross: We know that you’re going to have to make a choice one day, and hopefully that choice will be a positive one.
Celine Gounder: Welcome back to In Sickness and in Health, a podcast about health and social justice. I’m Dr. Celine Gounder. This season we’re looking at gun violence in America.
Celine Gounder: Back in 2006, Cincinnati was cracking down on crime. Several white suburbanites were shot and killed while buying drugs in downtown Cincinnati. The police responded with a zero tolerance policy. It was called Operation Vortex.
Stan Ross: They get results, but that was no way of doing things.
Celine Gounder: This is Stan Ross. Stan manages a gun violence prevention program called the Cincinnati Initiative to Reduce Violence or CIRV.
Celine Gounder: When Operation Vortex was getting started, police relations with the black community in Cincinnati had long been in shambles.
Celine Gounder: Just a few years earlier, in 2001, riots raged for three days after police shot and killed an unarmed black teenager named Timothy Thomas.
Gamba Oba: It just took off like a wildfire. I’ve never seen nothing like that in my life.
Celine Gounder: This is Gamba Oba. He was 19 when the riots broke out.
Gamba Oba: I hated the police. I hated the police at that time. I was strongly active in the streets then. … I already had a disregard for authority at that time already. That was just like, okay, that’s the green light to really go there.
Celine Gounder: Operation Vortex confiscated guns and made arrests. But the homicide rate didn’t drop.
Stan Ross: The police understand that they can’t arrest their way out of the problem. So the community has a role, a big role, that they play.
Celine Gounder: The authorities in Cincinnati realized, they needed to try something very different. They got police, parole officers, social workers, and community leaders to invite gang members in for a chat.
Celine Gounder: So, is getting one of these letters like getting a party invitation or is it like being served a warrant?
Stan Ross: No. Well… It can be both, but as far as the party invitations, because naturally they don’t know— There is some distrust that’s going on both sides.
Celine Gounder: Gamba was 26 when he first met Stan Ross at one of these meetings. He’d just done five years in prison. And he was not excited to get one of Stan’s party invitations.
Gamba Oba: I didn’t have a open mind because, for one, I was forced to go. I was forced to go. I didn’t want to be there. I knew it was held at the federal courthouse then, and it was set up where it was two sides in the courthouse.
Gamba Oba: One side was Stan Ross and a lot of resources and so many people that can help us in so many different fields, and on the other side of the courtroom was a multitude of different fields of law enforcement. … U.S. Marshall, federal prosecutors, regular prosecutors, federal agents, state police.
Celine Gounder: CIRV is based on the idea that small core groups drive most of the violence in a community. If you can reach those groups and convince them to stop the shooting, you can dramatically reduce gun violence.
Gamba Oba: You had a message from CIRV, “We trying to help you get your life together, and if you don’t get your life together, the other side of the room explain the repercussions of not getting your life together… transitioning out of certain behaviors in a way that you think.”
Celine Gounder: Repercussions like ending up in prison again or getting shot. The idea is to be as candid as possible about what law enforcement will do to them if they don’t stop the violence while also giving them the help they need to leave that life behind.
Stan Ross: Really the long and short end of it, Dr. Celine, is how do you get guys to participate in their own rescue.
Celine Gounder: Gamba heard what CIRV was saying.
Gamba Oba: I really did listen to… the help side. Stan Ross, and all the people that he got together and that’s here to help us and things of that nature, I really did get that.
Celine Gounder: But he wasn’t ready to change his life. At least, not yet.
Gamba Oba: I was defensive. My thought process was: I’m being defensive. I don’t like the play— I don’t care what they talking about. I don’t want to be here. I got stuff to do.
Celine Gounder: What stuff did you have to do, in your mind, at the time?
Gamba Oba: Sell drugs. People call on my phone. I’m missing money. I’m looking at it like I’m missing money, and you’re all making money.
Celine Gounder: Gamba wouldn’t be ready to leave that life and start over for several more years. But his story helps explain how we can target those small groups behind most of the crime.
Celine Gounder: In today’s episode, we’ll look at how programs like CIRV approach gun violence and the people behind it. And. like Gamba’s story will show, why it’s never too late to make a change.
Celine Gounder: When Gamba was growing up, he was a good student. He played a lot of sports. But then his parents split up. His mom struggled with alcohol. She even lost custody of Gamba and his siblings for a while. Gamba started getting into fights.
Gamba Oba: Sixth grade I really started fighting in school a lot. I fought in the neighborhood as a kid, but I started fighting in school a whole lot.
Celine Gounder: Gamba eventually ended up in a neighborhood gang.
Gamba Oba: …we were selling drugs and had a gun or two, burglaries, B & E’s. These are the things that we did as hobbies, going to neighborhood parties, knowing that this neighborhood don’t like our neighborhood, but we’re ready to fight and get into whatever it is that we’re going get into because we making a name for ourselves.
Gamba Oba: Growing up in that environment it’s almost like eat or get ate. You got to survive. …to be passive in that environment… mean that you basically were somebody’s lunch. People can do anything that they want to do to you because you’re not going to do nothing.
Celine Gounder: With everything Gamba was facing—poverty, trouble at home, living in a violent neighborhood—you might not be that surprised he ended up in a gang.
David Kennedy: One would think from that everybody in the community is kind of doomed because those risk factors are unfortunately extremely prevalent. You’d think that all the kids are on a conveyor belt to becoming violent offenders and violent victims.
Celine Gounder: This is David Kennedy. He directs the National Network for Safe Communities at the John Jay College of Criminal Justice.
David Kennedy: The root causes and the risk factors would predict much, much higher levels of violence that we in fact see. … The fact is that almost everybody will grow up and not be part of that tiny, high-risk population.
Celine Gounder: Gun violence spreads like a contagion. But it’s not like the common cold. It spreads more like a sexually transmitted diseases within social networks and groups.
David Kennedy: When one realizes this most central fact about serious violence, which is that it is suffered by and produced by very, very small numbers of high-risk folks, it changes everything. It means that we should turn our idea that there are bad communities full of bad people absolutely upside down.
Celine Gounder: If you want to stop gun violence, you need to target these vectors these small groups, what a lot of people would call gangs.
David Kennedy: When people couch that as “gangs,” the idea of a gang usually brings with it notions of organization and hierarchy and leadership. … The reality is on the ground nearly all groups like this do not have that kind of organization and purpose. They’re not hierarchical. There’s no real leadership. Their membership is undefined and fluid. Most of the violence is not in any way aimed at making money or at group interest. It’s overwhelmingly street code stuff and honor culture issues around respect and disrespect, and reciprocal vendetta, and that sort of thing. … Most of the high-risk folks are more traumatized and scared than they are predatory. … It’s probably more meaningful to think about them in terms of their victimization. … A lot of us just don’t worry about gangs or gang membership or what a gang is or gang definitions anymore. We just look for these high-risk groups and networks.
Celine Gounder: So how do you reach these high-risk groups? First, we’ll have to go back to Boston in the 1990s.
Celine Gounder: The homicide rate was jumping higher and higher every year.
Celine Gounder: The police and community were both at a loss.
Celine Gounder: But eventually police, parole officers and community leaders started to piece together what was driving the violence: small groups of high risk individuals. So, they tried something novel. They got them all together in one place and asked them to stop.
David Kennedy: Nobody ever done such a thing before. … This was really put together like, honestly, a piece of Community Theater or something like that. It was scripted. It was blocked. People had their roles they’d rehearsed.
Celine Gounder: The first group they reached out to was the Vamp Hill Kings, a gang in Boston. Probation officers made some Vamp Hill Kings attend the meeting. But outreach workers on the street persuaded others to come too.
David Kennedy: On the day in fact there were a goodly number of Vamp Hill Kings in the room, and we were able to close the door and get on with it.
Celine Gounder: The message was simple.
David Kennedy: Violence will not be tolerated, and not only is there a way to get out of the life if you want to, but also there will be consequences for certain acts of violence.
Celine Gounder: These meetings led to some realizations contradicting much of we think about these so-called gangs.
David Kennedy: It’s very, very common for groups to do terrible things, up to and including killing people, and when you talk to the group members behind closed doors, they hate what’s going on, but they think that everybody else likes it, and so the group continues to do horrible things. Group members will say, “I don’t mind going to jail. Jail’s the cost of doing business.” Nobody wants to go to jail, but as long as they think everybody thinks that jail’s okay, then people are going to go to jail.
Celine Gounder: Gamba felt this first hand.
Gamba Oba: That was the mentality that we adopted. It was like we never stop to think like, well maybe that doesn’t really sound right. Like the behaviors just kept progressing and progressing and progressing, and the levels of danger and the risk became so much greater as we got older. But… this is a normalcy. We see this every day. People being shot, people being hauled off to jail—this was every single day.
Celine Gounder: These meetings gave gang members a chance to break with these beliefs and behaviors and even gracefully leave that violence behind.
David Kennedy: You just have to say, “Look at what happened to the last group that shot somebody. They’re in big trouble. I would love to go with you and shoot up this house, but we’d really better not. It’s not worth it.” You can do that without burning any of your bridges and not losing face, and that’s what we came to see as an honorable exit.
Celine Gounder: All this sounds like it shouldn’t work. Violence interrupters in places like Chicago go out of their way to avoid interacting with the police. It’s seen as killing their street cred.
David Kennedy: Everybody who knows anything about street work knows that that’s right. The mistake comes when that’s then assumed to mean that there can be no legitimate and effective and even professional relationship. So having outreach workers not be perceived and not in fact act as informants for the police in no way means that they can’t work together effectively. That turns out to be the best way to do it is to have correct relationships.
Celine Gounder: This is a delicate balancing act. And not just for that small group of people driving the violence.
David Kennedy: What is becoming very, very, very clear is that criminal justice is a lot like chemotherapy. … Chemotherapy may save your life if you get it just right. But it’s also highly, highly toxic, and it will always make you sick… It will make you worse, and it will even kill you.
David Kennedy: We want law enforcement to do as little damage as possible in the course of producing public safety.
Celine Gounder: Crackdowns like Operation Vortex in Cincinnati come out of a desire to stop the shootings. But they criminalize entire communities when most people aren’t breaking the law. And that kills trust in the police.
David Kennedy: The work that I’ve been part of is built on resetting relationships with communities at large. Making it very clear, even to high-risk folks on the street, that their safety is of absolute central importance. “Alive and free” is the phrase a lot of us use. We want people alive, unhurt and in the community, not dead or wounded or in jail. That the police and other parties are there first and foremost to keep people safe, and in the course of doing that, one is going to do the absolute minimum of actual law enforcement necessary to produce that safety.
Celine Gounder: The lessons that came out of David’s early work in Boston eventually gelled into a program called Ceasefire. Its basic tenets—focusing on the small core of violent offenders, explaining the consequences, and giving them the resources to change—David’s brought these ideas to other cities across the U.S., including Cincinnati. CIRV, the program that Gamba went to it was an outgrowth of a Ceasefire project.
Celine Gounder: But after that first meeting with CIRV, Gamba wasn’t ready to leave the violence behind. He ended up in prison again just a few years later.
Gamba Oba: Conspiracy drug charges and firearm charges. … I ended up doing six years.
Celine Gounder: That was six years in a federal prison. Gamba says it left him a changed man.
Gamba Oba: The federal justice system is a whole ‘nother ball game. There’s a lot of, a lot of guys in there, and they’re doing a lot, lot, lot of time, and I started realizing that I wanted something better for my life, and especially for my kids. Like I said, I came home 33. I had seven kids.
Celine Gounder: Gamba made up his mind to break with his past. But this was scary. Gamba had never faced anything like it before.
Gamba Oba: I was afraid.
Gamba Oba: I was 33 years old with no work history and seven children. Nowhere to go. Homeless. What do I do?
Celine Gounder: Gamba’s first step into a life without violence was his parole officer.
Gamba Oba: She introduced herself, and she was like, “I’m here to help you. How can I help you?” … It was really maybe the first time that I really, really recognize that somebody cared.
Celine Gounder: So, you didn’t feel like there were people who cared about you up until that point?
Gamba Oba: I didn’t recognize it. From the mentality of being in the streets, and… people trying to set you up to be killed and things of that nature, it guards you. It has you feeling guarded. It’s like, “Why is this person being so nice to me?” … when in all actually, this person really cares, but you don’t recognize it.
Gamba Oba: It was actually my federal probation officer that reintroduced me to Stan.
Gamba Oba: I slowly but surely started recognize that people care about me, and Stan was one of those guys.
Celine Gounder: Today, Gamba works with CIRV. He’s a mentor with the Positive Influence Team.
Gamba Oba: There are federal judges involved. There are police involved. There are prosecutors involved. I’ve never thought I would have relationships with people in the criminal justice system, because in my old mentality I hated the criminal justice system, anything or anybody that represented the criminal justice system.
Gamba Oba: We mentor these at-risk teenagers. We groups that we do with the federal Probation Department.
Gamba Oba: …some of these groups with guys that I’ve known from my neighborhood, from neighborhoods all over the city, and I’m seeing evolution.
Celine Gounder: Efforts to reduce gun violence need to start with the neighborhood and be for the neighborhood. It took the deaths of whites from the suburbs to bring real attention to the violence plaguing downtown Cincinnati. But that didn’t turn things around. It took a show of concern for everyone. The city stopped cracking down on whole neighborhoods. Instead they policed the small groups responsible for the violence, offering them a carrot and a stick real help to turn their lives around, and real consequences if they continued to terrorize their communities.
Celine Gounder: Cincinnati is seeing good results. Shootings are at an all time low since CIRV came on the scene. But these programs aren’t magic. If they’re not done right, you don’t see results. Even Ceasefire in Boston, David’s first group violence program isn’t as effective as it used to be.
David Kennedy: For all of its success as time went by, naturally people moved on. They got promoted. They moved to other jobs. There was not the kind of institutionalized attention to maintaining it that there could have been.
Celine Gounder: The long-term sustainability of Ceasefire was never insured. And things fell apart.
David Kennedy: Boston has never really put it back together; not in a fully-fledged and correct way. … There was competition for attention and careerism and grants and credit. There were some personality conflicts that became pretty serious within the group. And when those things started to stress the operation, there was not the institutional backup to survive them, and it fell apart.
Celine Gounder: In our next episode we’ll look at a tale of two cities. We’ll see what went right, and what went wrong when group violence reduction strategies were rolled out in Oakland and New Orleans. That’s next time on “In Sickness and in Health.”
Celine Gounder: Today’s episode of “In Sickness and in Health” was produced by Zach Dyer and me. Our theme music is by Allan Vest. Additional music by The Blue Dot Sessions. If you enjoy the show, please tell a friend about it today. And if you haven’t already done so, leave us a review on Apple Podcasts. It helps more people find out about the show! You can learn more about this podcast and how to engage with us on social media at insicknessandinhealthpodcast.com. That’s insicknessandinhealthpodcast.com. I’m Dr. Celine Gounder. This is “In Sickness and in Health.”