Hidden Brain - Radio Replay: Crime As A Disease

Episode Date: November 18, 2017

In moments of anger, it can be hard to take a deep breath or count to ten. But public health researcher Harold Pollack says five minutes of reflection can make all the difference between a regular life and one spent behind bars. This week, we visit a Chicago program that helps young men learn how to pause and reflect. Plus, we ask whether we should think of violence as a disease, similar to a blood-borne pathogen in its ability to spread from person to person.

The fight was over a pair of Gymshoes. At night, on the south side of Chicago, and this is what came of it. One teenager faces years in prison. Another, a boy of just 15, is dead. The incident might not have even made the news, except the victim was the grandson of a long-serving congressman. At a press conference, that congressman, Danny Davis, did something unusual. He grieved not just for his own grandson, but for his grandson's killer. I grieve for my family. I grieve for the young man who pulled the trigger. I grieve for the young man who pulled the trigger. I grieve for his family, his parents, his friends,

some of whom will never see him again. It is so unfortunate when these tragedies continue to occur and re-occur. And somehow or another our society has not been able to find and exact the answers and solutions. The solutions we do have often produce more disputes than results. Conservatives call for harsher sentencing and better policing. Liberals want gun control and more social service programs. One thing's clear, even as we argue, people are dying. Even as we argue, people are dying. In 2016, Chicago had the highest number of killings in two decades. 762 people were murdered.

What can be done? Well, one community group has an unusual idea. It believes perhaps violence can be stopped with a breath, a few moments, and a tiny tweak to the way we think. Very, very often, if they could only take back five minutes of their life, a lot of these kids, a lot of the people that are locked up would have a very different life. This is Hidden Brain, I'm Shankar Vedantam.

On today's show, we discuss crime. Why people choose to kill and how we can prevent them from picking up the gun in the first place. Our story begins with another death on the south side of Chicago. One night in the fall of 2007, Amadou Sis, a young PhD student from Senegal, was walking home after a gathering on the University of Chicago campus. He was confronted by a stranger, 17-year-old Demetrius Warren. Warren stuck a stolen 22-calibre handgun in Sissas Chest, and tried to take his water bottle and backpack. And I don't think anyone knows exactly what happened. Maybe Amidus Siss didn't let go

of his backpack or his water bottle quite quickly enough and then Demetrius Warren pulled the trigger and Chatham basically a point blank range in the chest and killed him. This is Yen's Ludwig. He's an economist at the University of Chicago focusing on social policy and crime. He says the murder of Amidu Siss was a very definition of senseless. If they thought about it for even one second, it is very hard to imagine that anyone would think that it was a good idea to shoot someone at point blank range in exchange for a book bag and a water bottle that would surely have a resale value of not more than a couple bucks at best. If they thought about it for even one second, it turns out many murders in Chicago occur

because someone didn't stop for that one second. We went to the medical examiner's office and we just reviewed quite a number of case files in which young men had been murdered. Harold Pollack is a public health researcher who works with the ends of the University of Chicago Crime Lab. Not long after the killing of Amidou Siss, Harold decided to figure out what was behind the many

homicides in the city. And so many of these incidents, you just read the story. And the Medical Examiner's report is typically pretty brief. You would get a lot of details about what happened to the physical body, but usually there would be a two-paragraph report about what happened. And many of these cases, you would just read it and say, wow, I just can't believe that someone ended up dead. And there was nothing at stake here that was anywhere near the stakes of a human life. When most people might imagine that killings occur because of a gang hit or cold blooded

revenge or premeditated murder, the records reveal the laundry lists of slights. Someone stepped on someone else's shoe or stole a coat or lobbed an insult. And from that tiny spark, things escalated into violence and murder. Harold is interviewed incarcerated young men who tell him that regret comes almost as fast as anger. The kid who committed the homicide, five minutes later, himself, he's thinking about, wow, this was over a jacket, you know, very very often, you know, if they could only take back, you know, five minutes of their life, a lot of these kids, a lot of the people that are locked up would have a very different life. As Jens and Harold puzzled over how minor incidents could spiral out of control, they realized

they were asking a question that was fundamentally psychological. Why do people do irrational things? Why do people act so unthinkingly? And then they had a flash of insight. Teenage boys on the south and west sides of Chicago are not the only ones who act without thinking. We all do it. Psychologists even have a term for this behavior. Automaticity. A lot of our thinking that we do in life is very scripted and is very automatic. And we couldn't go through life if we didn't have very quick reactions to things that we don't give a lot of thought to. Partly because it just takes too much time.

If someone gets in my face right away and there's an immediate threat to my safety, I have to respond automatically if I sort of stop and conduct a little mental onj trial before I respond, that's not going to be very functional for me. In other words, we often act almost unconsciously. A door is in front of us and we open it. We don't think how do I open this door? We just do it. If someone hits us, we might also, just as fast, hit back.

Harold remembers an incident that occurred to him. He was an a burger king, and someone else in line shoved him. Harold's not a fighter, but for a moment, he felt a primal urge to lash out. I felt that burning sensation, and then I kind of reminded myself that I'm a nerdy middle aged professor and I should just throw my tray away and move on. But it was, you know, I thought about it. And I think if I were, if the 17-year-old me might well have ended up, you know, with a gash in his head. Harold didn't get into a fight because before he acted, he thought for one second about the situation and the consequences. Could it be Harold and Jens wondered that this simple step, think before you act, could

be a solution to violent crime in Chicago? A lot of the violence problem, at least this was our hypothesis doing the study. A lot of the violence problem on the streets of Chicago is not necessarily driven by bad people. It results from bad decisions that people make in the moment. Our hypothesis was if we could identify some promising intervention that could help people avoid some of these common kind of judgment and decision-making errors, that that might be helpful in reducing the violence problem. Researchers have spent years studying ways to get people to behave less automatically to change the scripts in their head. One technique that's often used is called CBT,

Cognitive Behavioral Therapy. The idea is to develop new scripts and new habits to address problems. An alcoholic, for example, might need to practice taking a different route home from work, a route that doesn't go by their favorite bar. Someone with anger problems might need to practice counting to 10 before responding. A person prone to depression might need to talk to themselves

about how feelings of sadness can be transient. Changing the way we behave can change the way we think, and changing the way we think can change our lives. Mostly, this kind of therapy takes place one-on-one with a trained expert. How do you do this on a large scale with thousands of kids from some of the poorest and most violent neighborhoods in Chicago? You can't bring them all in for one-on-one psychotherapy. As it turned out, Yens and Harold found a local group called Youth Guidance that was already

trying something similar. It was offering kids a kind of low-budget psychotherapy within their neighborhood schools. There was nothing fancy about the program. Kids checked in with counselors regularly, talked about issues, tried to develop new habits. Jens and Harold wanted to find out if this low-budget effort might be effective on a mass scale in combating crime. They wanted to test the program rigorously.

They wanted to conduct a randomized controlled study the same way it's done in medicine. They didn't want to be misled by their hopes and intuitions. We basically have a bunch of well-intentioned city and state governments and a bunch of well-intentioned NGOs out there, innovating and trying lots and lots of different things over time, but not doing that in a way where we can actually rigorously study and evaluate which things are working. And without good feedback about which of our innovations are actually helpful, it's very hard to move

in the right direction. Performing a randomized controlled study in the real world is very difficult, but Harold and Yens teamed up with Youth Guidance to study the program. Now, the specific program is very difficult, but Harold and Yens teamed up with Youth Guidance to study the program. Now, the specific program is called BAM, short for Becoming a Man. The researchers compiled a list of young men living in some of the most dangerous parts

of Chicago. They were thousands of teenagers to choose from. We basically flipped the coin to decide which of the kids would get offered the program and which wouldn't. Before I tell you what they found, I want to take you into the programs so you can see how it works. Bam brings together young men who are barely scraping by, most have a de-average. Nearly 40% have been arrested.

Their chances of dropping out of school and ending up in prison are extremely high. And they live in neighborhoods like West Garfield Park. It has the highest rate of violent crime in crime written Chicago. In just one random 30-day period recently there were 34 robberies in West Garfield Park, 18 batteries, 15 assaults, 6 sexual assaults, and one homicide. This is the home of the BAM program at Orr High School. We head there after this break, I'm Shankar Vedantam and you're listening to Hidden Brain. And this is NPR. This is Hidden Brain, I'm Shankar Vedantam. Or high school in Chicago, Illinois, feels like a place that was built on big dreams.

It was designed in the early 1970s by the firm of the legendary architect, Mies Van der Rohe. It's huge, but interconnecting clusters were supposed to make it less overwhelming for the 2000 students expected to attend. Maybe it worked at first, but that dream school no longer exists. Or it's now struggling. Vast sections said empty. Enrollment is dwindled as kids flee to charter schools. The empty hallways echo. A police cruiser idles outside, kids walk through a metal detector to enter the school. Or high school is home to the Becoming a Man program, better known as BAM.

It's a mentoring program for young men from Chicago's most violent neighborhoods in hopes of preventing them from falling into a cycle of crime. In one classroom, Larry Pots, a BAM counselor, waits for students to arrive. Larry thinks of his job as a calling. I'm bored into this. I mean, I've been in this community for 45 years. I used to be a police officer in this community. And there's nothing for me to gain,

but to help reach every kid. Larry says part of what motivates him now is what he saw as a cop when he could look into the lives of the people around him. I saw a lot of mental illness in the families. When you would make domestic cars, you would see mental illnesses in the homes. You would see a lot of addictions.

You would see people going to jail and being torn apart without having a mother and father. You would see a lot of poverty, people not having jobs, not having skills, not being able to work and take care of their families. But one of the worst things that I've seen is that when people do make mistakes, there's no way to rewrite that mistake. So that's what Larry's doing now. Trying to keep kids from making those mistakes, there's no way to rewrite that mistake.

So that's what Larry's doing now, trying to keep kids from making those mistakes, they won't be able to correct. Each week, 11 young men come in for a counseling session that he helps to lead. Shortly after noon, the young man file in, and then it's time for a check-in. Everybody okay? The session's always begin with this check-in, a brief summary of what's going on in everyone's lives. People have to talk about how they feel physically, intellectually, emotionally, and spiritually. The young men give raw and honest answers. My name is Shavante and I'm checking in physically. I'm feeling good. I'm tired. I'm checking in my name James. Physically, physically

I'm tired. I didn't get that much sleep last night carrying boxes all night. It's a luxury I've been thinking about this math test on Friday. I've been studying the hard to push myself to a B and eat a better than a A because I know Ducca bring my grade up a lot. The check-in takes a lot of time and I find myself glancing at my watch, but then I realize these are kids without a lot of emotional support in their lives. Larry says they need space to talk, to be heard, and most of all, to feel they're not alone. That someone is listening.

Someone has their back. That's one of the things that we really value here in our groups is, it's again the trust of people. Teachers come to the school all the time, principals come to the school all the time, and they're gone. And the kids know this, and they have no one they can depend on every day. After the check-in, the young men usually tell stories, role play, and then do various exercises. On this day day they do a

trust walk where one student closes his eyes and is led around various obstacles in the classroom by a partner. Hold on, we're gonna wait. We got a little bit traffic ahead of us. Okay, we're gonna turn this way. I notice something as the students are walking around the classroom. The young men who have their eyes closed start out looking tense, but then they relax. All they have to do is focus on what their friend is telling them. Their partners meanwhile focus on protecting them. For a brief moment, they're not looking out for themselves, but for someone else. It's a forced kind of intimacy, but very quickly, it becomes real. When it's over, there's a real kind of intimacy, but very quickly it becomes real.

When it's over, there's a real happiness in the air and a sense of pride. It feels good, because I'm doing it, but see, I visualized the room before I did it. So I already knew what I was at. I felt the sunlight on my eyes, so I knew I was bad on winter, I smelled the pizza, I knew I was over here. Another bad exercise is the fifth. Students again are divided into pairs. One of them is given a ball. The other is told he has 30 seconds to go get the ball. Almost always, the second student tries to wrestle the ball away.

When times up, a counselor asks, did you ever consider there might have been an easier way? What about just asking for the ball? On one level, these exercises seem almost hokey. They are teaching age-old lessons. Trust your friends, look out for each other, think before acting. But these are lessons we all forget. We all need reminding, especially maybe, if we happen to be 17, to slow down. The BAM program tries hard not to be preachy and tell the young men what to do. It's mostly trying to show them that they have options. If we tell these

kids you're never fight, that's just so unrealistic for the world in which they live. What we have to help them with is the idea, you know, you may have to fight sometimes. But what else you got in the toolkit? And, you know, which tools do you reach for first? Research at Harold Pollack lays out a dilemma that a young man at Orr might face. If you're a 17-year-old kid and you have a really nice jacket and you're walking home from school with it, you can't be the kind of kid that other kids think they can just come and take your jacket.

You have to be tough. And so there's a very practical need that they have to deter the predations of other people around them. How do you avoid fights without communicating weakness? One of the students in the band program says he faces this dilemma all the time. My name is Contr�, and I'm physically, I'm happy, but I'm a tense, pons waiting, you know, because I'm already old. Cantr� and I stepped outside so he could tell me his story. He's been in and out of trouble.

For a while, he was sent to a residential behavioral health program to help him get his anger on the control. Even there, Cantrell says, he sometimes lost it. I had a roommate and he was like, he was real nice, he used to pee on the toilet seat and doing the cleaning at all. So I guess he had anger too and then I told him about it so then he kept doing it. So then we used to argue with fighting,, just blank out and just start fighting and stuff like that. And then every time that happens, I never think about the consequences.

Cantrell strikes me as a curious mixture of toughness and vulnerability. He slender and stares at the ground a lot, but there is a coil inside him. That coil can unspring in an instant. Like the time some kids tried to steal his jacket outside school. To can trial, it was more than just about the jacket. It was a sign of disrespect. The other kids were saying, you're a punk, we can push you around. To me, like, as a man, all I... it's not a good thing to say, but I look at myself like a man as a prideful and myself, and I feel like they downgraded my pride and they respected

me. When they did that to me, and they heard my pride real bad, and to like, give, like, earn my pride back and feel back honored, I want to teach them a lesson. Cantrell smoldered all night about the incident. The next day at school, he attacked a student he thought was part of the group that had jumped him. I was mad, so I just ran into him, hit him in his face like I had him in these like 3 times, now buses look. It turned out Cantrell got it wrong. The student he attacked hadn't been involved. He realized this was the kind of behavior he needed to change. He needed to make better decisions, to slow

down, to think. Cantrell told me his anger surged when he recently saw a guy talking to his girlfriend. Again, he saw it as disrespect. In his mind, the other student was saying, you aren't man enough to keep your girl. But instead of punching the other student as he had wanted to do, Cantrell went up and talked to him. The other student said he had no interest in Cantrell's girlfriend. They were just chatting. That was it. All of a sudden, something that could have ended in blows ended with a nod. When I say goodbye to Cantrell, I feel uneasy. I have the sense he's on a knife edge.

I can see him graduating and doing well in a couple of years, but I can also see him getting into trouble. And that brings us back to Jens Ludwig and Harold Pollack, the researchers who were studying the effectiveness of the BAM program. What they found precisely mirrors what I saw in Cantrell. Does BAM work? Will it keep young men like Cantrell out of jail? Well, the answer is yes and no. Let's start with a good news. Remember the idea of controlling automatic behavior? Well, it says Harold, that works. When kids are participating in BAM, they're responding less automatically to dangerous situations. In fact, the results of the control study of BAM showed that it worked jaw-droppingly well. While students were in BAM, arrests plummeted by 44%.

Here's the ends. I fell off my chair when I saw the initial set of results, indicating that the arrest rates for kids in the becoming a man program were 44% lower than the non-participants. These are massive reductions in violent crime arrests. Yens calls the results stunning, almost miraculous. And there was more good news. Bam even seemed to help with school. Kids were more likely to come to school.

They were more likely to be enrolled at the end of the school year. There's less likely to have dropped out. And they are less likely to fail their classes." Jensen Harald can now say with certainty that the BAM program works. It's a huge success for young men without many good options. But sadly, there is a catch. The reduction in violence doesn't stick once young men lack control are done with school and done with BAM. They are offending at the same rates as the control group after the program is over. So if I look at their arrest rates in the year after they're done with the program

and I compare their arrest rates with kids in the control group in the same year after the program is over, I really don't see differences there. Harold and Jens don't know why what's taught in BAM doesn't last once the program ends, but it actually makes sense. All of us need reminders of advice we've gotten many times in the past. Take a breath, look at things in perspective, talk to a friend if you're feeling down. Yens says it's hard to change behavior, especially for kids who've led traumatic lives. But he still feels the program offers more reason to be optimistic than pessimistic. I'm an economist by training and the way that I think about whether a social program is

worth doing or not is I think about what the program costs and then I think about what it does to help kids and society as a whole and whether the value of the social impact is enough to justify the program cost and a 44% reduction in violence involvement for at-risk kids for one year generates benefits to society that easily outweigh the program costs. So we've estimated that the benefit cost ratio might be as high as 31 for this inter-engined. And there are tangible benefits to the young men who stay crime-free, even if it's just for a year.

If I have a year where I have fewer offenses, then even if I commit offenses after that, it's still, you know, it's accumulating into a less destructive record for me if people are talking about does this person need to be held in a secure facility or something like that? Of course, when you've met young men like Cantrell on the knife edge, you want more for them. A less destructive criminal record isn't enough. These scenes haven't failed in any irreparable way as yet. I see it like this. A scientific study has found that you can build a new kind of bridge, one that is good and strong. It could take these young men to a successful adulthood. But that bridge is

only halfway done. At the end of every BAM session at OR High School, the students have to check out to say one word that is on their minds. When I hear those words, I want that bridge completed. Faith, and with that I'm out. Session, with that I'm out. Excited, excellent. I'm out. Fantastic, and I'm out.

Love, and with that I'm out. I should say it. Thank you. Excellent. Fantastic, you can come out. Love and we're dead on the mountain. When you want to fight a health problem, there are two ways to go about it. The first is to treat individuals. Someone comes into a hospital with a bacterial infection and you prescribe them antibiotics. Someone comes in complaining of stress. You give them psychotherapy. But there's a different way to think about health and disease. Public health specialists ask, can you change things in the environment

to make it less likely a disease will flourish? If you vaccinate millions of people that doesn't treat anyone individual, but it makes it hard for a virus to spread. If you clean up the drinking water or make sure cars have exhaust filters, you can reduce the risk of asthma or cholera. Can this public health model be applied to crime? If crime is an epidemic, if it's a disease, we should take this analogy a bit more seriously. Treating crime as a disease when we come back. I'm Shankar Vedantum and you're listening to Hidden Brain. This is NPR.

This is Hidden Brain, I'm Shankar Vedantam. My name is April Zioly. She's an associate professor in the School of Criminal Justice at Michigan State University. Some years ago, April was looking at a map. She and her team compiled nearly three decades worth of homicide data from Newark, New Jersey. Every single homicide from January 1982 through September 2007, and mapped out the killings over time. Newark traditionally for the past 30 years has a homicide rate that is three times higher than the United States average. April wanted to see

if there were patterns to the maim. When she overlaid maps showing crime data from one year to the next, she noticed something interesting. The blotches that showed the highest levels of crime seemed to metastasize from year to year. If a safe neighborhood happened to be located next to a high crime neighborhood, the safe one might start to see an increase in assaults and burglaries the following year. We used SAT scan, which is a statistical tool that has been used in health studies to surveil clusters of disease and how disease moves in space and time. So we're able to see that homicide started in central Newark and we're able to watch it move slowly, westward and southward and eventually move out of central Newark and we're able to watch it move slowly westward and southward

and eventually move out of central Newark. There's obviously no virus that causes crime but April started to wonder is it possible that crime can spread like an infectious disease can it jump from one neighborhood to the next and if so can we predict where crime is going to occur the following year based on patterns this year? Many researchers would have dismissed the idea as crazy, but April stayed with it. She asked herself the kind of questions a public health researcher would ask when confronted by an outbreak. To spread an infectious disease needs three things. One.

A source of the infection. So that's conditions that make it more likely that interactions will lead to homicide. Conditions like lots of lower-level crimes, such as drug dealing or selling illegal guns. The second thing an infectious disease needs to spread is... A mode of transmission, people need to hear about homicide, people need to find it necessary to commit it. So it can be person to person or through the media. And last but not least... We need a susceptible population. So those who are more likely to commit homicide.

In the case of Newark and many other cities, those who are more likely to commit murder are often in gangs. Once you take all these factors into account, April says. This model is telling us that the movement and duration of homicide clusters can be predicted. It's telling us that homicide stays in particular areas for a long amount of time and then moves out of those areas or moves out of those areas and new work at least. The crime blobs at April studied were comprised of many different crimes. Each had its own motive, each had a different perpetrator and a different victim. By stepping back and looking at them as a collective,

April was going against the grain of the way we usually think about crime. We think of individuals who commit homicide and we wonder why they did it, what their specific motivation was for doing it. And often we view these individuals as being unlike the rest of us. They are different in some way. They are either crazy crazy or substance users or you know had a bad childhood there's some reason specific to the individual that they are committing homicide. So that's kind of the traditional. In other words when you have a motor you sort of say well what are the motives of this person what are they starting to gain, what was the conflict, what would they meet at antecedents, and we basically

say, that's what it's sort of the law and order on TV approach to cry like this. Correct, yes. And I mean, this has served us well for a long time, I think, right? So what's the problem with that approach? Well, it served us well in that we've been able to catch criminals, but we haven't been able to prevent the homicides from happening in the first place. And that's where we need to go. That's the direction that we need to move in to address more root problems that make those

individuals more likely to commit homicide. We know that gang members are uniquely susceptible to committing homicide. So we can work on reducing the need for people to join gangs. People join gangs for a reason and often that reason can be that they don't feel safe in their communities without the protection of a gang. If we can get their communities to be safer, if we can revitalize communities, then people may be less likely to join gangs for protection. So we can do that, we can discover why these people are more susceptible, why they're joining gangs, and we can increase

their resistance by making their community more economically viable, by making their community safer. Our longstanding approach to crime has been based on individuals. In health parlance, we approach crime as a medical problem. Just as doctors treat patients, individual by individual, cops and prosecutors address crime on a case-by-case basis. But remember how there's another way to talk about health? Public health researchers are not focused on individual cases, they are focused on collective problems, and the kinds of solutions that work on a wholesale basis.

The appeal of a public health solution to crime is that it prioritizes prevention. Just as a vaccination campaign can prevent a population from falling sick, is there a way to inoculate a community against crime? We need to focus on areas with high homicide rates, but we also need to focus on neighboring areas that maybe don't have high homicide rates yet.

This model is about prevention. We actually had some areas within Newark that were resistant to homicide, despite being surrounded by areas with high homicide rates, and despite having by areas with high homicide rates and despite having similar structural characteristics to those areas. So we need to investigate more why those areas, why those little islands of low homicide or no homicide exist. And if we figure out why they exist, what's going on in those areas over time, then we can employ methods to get other areas more similar to them. We can increase the immunity of other areas to homicide. Scientists call this positive deviance.

In other words, when you have an epidemic, one of the things you really want to study is areas that are not affected by the epidemic. You want to look at those areas and study everything you can about them. You want to get clues about how you can inoculate other areas and prevent the epidemic from spreading. For April, that is the ultimate goal of her research. I come at it from a perspective of primary prevention, so I don't want people that have to get to the emergency rooms in the first place. I don't want them to be shot. We want to prevent people from committing lethal violence. Andrew Papa Christos is a professor of sociology at Yale. When it comes to studying crime,

Andrew says social scientists and public health researchers spend lots of time talking about risk factors. The study of gun violence, especially gun homicides and non-fatal shootings, often focuses on risk factors. And so we have a lot of social science equations and public health equations that say, if you have these risk factors, you're at elevated risk of being a victim. So being young, being poor, being black, being a gang member, all these things sort of increase both the rate of gun violence in your community but also your individual sort of risk. And one of the things we kind of forget about is that most people with those risk factors actually never become victims. Too many do, let's let me be very clear, right? The rates are off the charts when you start to look at these risk factors.

Let me be very clear, right? The rates are off the charts when you start to look at these risk factors. But even when you go to high crime communities, like the West Side of Chicago, these risk factors only take you so far. Andrew is a native of Chicago. Chicago faces an epidemic of gun violence. If I were to call them a crime epidemic,

violent crime epidemic. A violent crime epidemic. A huge crime epidemic. President Donald Trump tweeting about the new resources for Chicago, quote, crime and killings in Chicago have reached such epidemic proportions that I'm sending in federal help. Hearing TV news anchors describe his city as being plagued by a crime epidemic, made Andrew ask himself, if the metaphor the TV anchors were using could be more than just a metaphor.

And so what I started really thinking about along with my colleagues was, look, if crime is an epidemic, if it's a disease, we should take this analogy a bit more seriously. What kind of disease is it? Is it an airborne disease? Is it a blood-borne disease? What do we mean by that? Unpack that from you. If I tell you that a disease is airborne or a disease is blood-borne and you're a public health official,

what are the set of ideas or concepts that immediately come to mind? Right, so when you start talking about gun violence as an airborne pathogen, you then talk about oftentimes very broad sweeping policies to kind of quarantine, right? So if you have kids and the flu is going around, you keep them home, you can take very small behavioral steps, but it becomes very hard to stop it because you're in a public space. And if somebody sneezes, you can get it,

right? In contrast, when you're talking about a bloodborne pathogen, if you know a disease is spread through very particular types of contacts, the interventions can be much more precise, and they can actually affect potentially fewer people. So if we talk about needle exchange programs or providing condoms, say, to sex workers or other people at risk. You're doing interventions that are much more precise and targeted as opposed to having broad sweeping policies. Andrew says that even though you may not realize it, we typically talk of gun violence as if

it's an airborne pathogen. Someone in an area where gun crimes are prevalent is likely to become a victim of one of those crimes. And so being in these communities, being around certain people, sort of increases your risk. And there are cases where you have kind of a straplet or a truly tragic shooting that doesn't make sense.

But the vast majority of gun violence in our cities is far from random. or a truly tragic shooting that doesn't make sense. But the vast majority of gun violence in our cities is far from random. And what I try to do and what we argue in research in general is that gun violence is much more like a blood-borne pathogen. There are specific types of things above and beyond these usual risk factors which increase your likelihood of being a victim himself and in some ways it becomes much more like the spread of diseases

through needle sharing or unprotected sex rather than catching a bullet from somebody sneezing. What kind of things make you more likely to catch a bullet? Helping someone else commit a crime, what researchers call co-offending behavior. So if you and I committed a crime together, I essentially established a tie between us. And all it says is that one particular point in time, you and I engaged in a behavior that was probably kind of risky, right? We robbed a bank, we maybe sold drugs together, we robbed somebody together.

Using a dataset of nearly a decade of crime reports and arrest records, Andrew and his team created a network of people connected to each other by crime. One of the things you realize immediately is that this is a relatively small network, which is about 4% to 5% of the entire city population, but almost all of the city's gun violence is in this network. So about 70% to 75% of all gunshot victims are in this network. And it looks almost like sort of a nervous system running through the city. And you can kind of see and you can trace it pathways in some ways when you think about

a street map of the city. It's very similar except it's a map of people's social relationships. And what do we find when we look at this network? There's relatively small network in Chicago, 4% of the city compared to 3 million people, what do we find in this network? So there are two key findings from this research at the moment.

The first is just how severely concentrated gun violence is within high crime communities. And so we've known for a long time that violence isn't distributed across place. But even when you go into Chicago's highest crime communities, what you see is that being in this network, this small network of four or five percent of the population, increases your risk of being a homicide victim by 900%. 900%. According to Andrew's research, Chicago residents involved in this close-knit crime network

are essentially walking targets. That's the first key finding is just how severely concentrated gun violence is in cities like Chicago and elsewhere. The second is the power of these networks in shaping who gets shot. And when I'm saying who gets shot, I'm not talking about rates, I'm talking about individual probabilities. And what we found is that exposure to gun violence in your network, in your

associates, in your friends and the people around you has an effect on your probability of getting killed. And the more exposure you have around you, the effect on your probability of getting killed. And the more exposure you have around you, the greater your own probability of also being a victim. So I'm just trying to understand this at the level, I mean the analogy of the epidemic is helpful, but of course at some level this is not an epidemic. There is no virus that is actually being transmitted. What is being transmitted if it's not actually a pathogen? So one of the reason this analogy works for gun violence,

especially in a city like Chicago, is if you are going to get shot, you have to be around guns, or if you want to shoot somebody, you actually have to acquire a gun. And unlike drugs, for example, which once you use them, they're gone, these guns get passed around. They actually get transmitted, much like a virus. But it's not just the guns. It's also the norms and ideas and behaviors

around gun use. So if you're in a network where there are guns around you, maybe immediately or one or two hands shakes away, you may also very well be in a network that says when an argument happens one way to settle it is through violence or you might be in a context where that's one of the expected behaviors. The other thing that gets transmitted and this is important as well as from the prevention side of things is this need for protection. If you're in a network where there are shooting victims

around you, you don't feel safe. And what do people in this country do when they don't feel safe? A lot of them, not just in Chicago, but in rural areas in the south and the north, is they rely on guns for personal safety. That's no different here. And in fact, maybe heightened because they're living in a network, they're going to school in a network where violence is so pervasive.

So it's really interesting because of course it turns the idea of sort of this criminal violence on its head which is that it's not so much that you I I got get a gun because I want to mug you Andrew. I get a gun because I'm afraid that you Andrew are going to kill me. That's the number one reason for gun ownership or gun acquiring among young men in Chicago. They don't feel safe. We know from research about gang members, from every generation from the 1960s forward, their number one reason for joining gangs is protection. It's the number one reason it doesn't matter which city, it doesn't matter which era.

People join gangs because they want to feel safe. So when you think about this network evolving and growing, you start from one and you can start anywhere in the network really and eventually you'll find ties that lead out to the rest of the network that sort of grow out in different ways. Obviously some people are going to have more connections to others in the network than others. What's the implication of being at one of those notes? It's actually, and this was surprising to us, not about the number of ties that you have, but sort of where you're situated in the network.

Oftentimes, this is a person who is actually, they might live in one particular community, and they hang out one particular community, and they have a cousin or a relative that lives in another community. And so, you know, they're doing what they're doing in their neighborhood, and then when they go to visit their cousin or their relative or their friend, some place else,

in a different neighborhood, they're actually acting as a bridge without knowing it. Thinking about crime as if it's a public health problem produces a very different set of answers than thinking about crime as if it's a medical problem. To be sure, these are metaphors. Their ways to stretch our thinking, to see crime as being more than your standard cops and robbers story on television. But if Jens Ludwig, April Ziole and Harold Pollacka write,

there are things we can do to help individuals become less vulnerable to crime. We can help young people learn to pause for a moment, take a breath, and think about the consequences of their actions instead of just reacting. The bridge that these young men need is a psychological bridge, something that can carry them over the chasm of adolescence and young adulthood to a state of mind where they don't feel the need to reflexively defend their honor over trivial slides. Thinking of crime as a disease broadens the scope even further from our traditional model of how bad people do things that harm good people. When something bad happens, it's important to catch the bad guys, put them in handcuffs

and lock them up. That satisfies something deep in us, it gives us a sense that justice has been delivered. But what that doesn't do is to understand how crime can have a mind of its own. It's all well and good to arrest people who do bad things. But what you really want to do is put handcuffs on the disease. This week's show was produced by Parth's and Jennie Schmidt and edited by Tara Boyle. Our team includes Maggie Penman, Raina Cohen and Raina Clar. On their Grunman is NPR's Vice President for programming.

One last thing before we go. We're working on an episode about the Cassandra Effect. According to Greek mythology, Cassandra was given the gift of prophecy but was condemned to have no one believe her. She could foretell the future but couldn't get anyone to take her seriously. Have you ever felt like Cassandra when you talk to your kids or your employees or members of your community? If you have such a story, please record a voice memo and email it to us at hiddenbrainatnpr.org or call and leave a message at 661-772-7246.

That's 661-77brain. Remember, we want the details of the story, so feel free to include all the drama. I'm Shankar Vedantam, see you next week. I'm Shankar Vidantam, see you next week.