From Social Determinants to Individual Prevention: A Comprehensive Intervention to Address Firearm Injury

Project Summary:

Firearm violence is the leading cause of death in all children. It disproportionately impacts young men of color and is the second and third leading cause of death for Latino and Black American men respectively, both nationally and in Milwaukee, Wisconsin. Gunshot wound survivors are 20-40% more likely to die from gun violence in the subsequent five years, making gun violence a social determinant of health. Risk for exposure to violence is non-random and influenced by such factors as individual and neighborhood level poverty. Moreover, firearm violence exposure clusters in Milwaukee, creating a chronicity of exposure that impacts the sense of safety and mental health of residents. In essence, ongoing clustered violence creates a perpetual cycle of individuals living with a lack of safety and potential need to protect themselves with limited opportunity for upward mobility.

Community violence intervention (CVI) approaches have been developed to prevent the spread of violence. While CVI programs have moderate level evidence for effectiveness, they are not designed to address the cycle of poverty that leaves those at high-risk with few options for growth. While programs focused on violence prevention are vital, scaling up of CVI programs is necessary to address the complex etiology of firearm violence.

This project team proposes a new program called MKE Empowerment (ME) that addresses social determinants of health in addition to violence prevention efforts (with the 414LIFE Program) to improve the lives of those at risk for violence related injury. This project will assess the feasibility of the ME Program to enroll and engage at-risk adults in a comprehensive program to address housing insecurity, job insecurity, and psychological safety, in addition to violence prevention activities. The team expects that the outcomes of this project will help to inform the integration of programming to address the upstream etiology of firearm violence while also preventing firearm related injury.