Cure Violence model
The Cure Violence model, formerly Chicago CeaseFire, uses a public health approach to prevent violence. Cure Violence treats violence like a communicable disease and includes efforts to detect and intervene in potentially violent situations, educate and mobilize communities against violence, and connect individuals at high risk to social services. Outreach workers develop relationships with individuals at high risk of violence and promote community norms to reject the use of violence. Violence interrupters, in some cases former gang members, identify and directly mediate potentially dangerous conflicts. Cure Violence programs work with law enforcement to select intervention areas, refer individuals at high risk to social services, and organize community events1.
Community violence interventions typically focus on reducing homicides and shootings. Communities may experience many forms of violence, such as police violence, gender-based violence, sexual violence, child abuse, intimate partner violence, and others. We recognize that solutions to gun violence are important and also acknowledge that community violence interventions may exclude other forms of violence that deserve further attention and investment.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced gun violence
What does the research say about effectiveness?
There is mixed evidence about the effects of the Cure Violence model on gun violence2, 3, 4, 5, 6.
Some studies find that Cure Violence programs do not impact gun violence or are associated with increases in gun violence3, 4, 5, 7, 8, 9, 10. Other studies find that Cure Violence programs lead to reductions in gun violence6, 11, 12, 13.
Efforts to ensure implementation fidelity and quality are essential to program success2. Experts suggest that program success may be associated with increased social services availability for program participants, including wraparound services, financial resources, and mental health resources5. Researchers suggest that a violence interrupter’s skills in conflict mediation and knowledge of gang conflict and violence, credibility with a community, and comprehensive community embeddedness are particularly important to successful implementation7, 14.
A survey of Chicago workers who intervene in communities to limit violence found that workers were exposed to high levels of violence; this suggests that violence intervention programs should prioritize safety and providing support for workers15.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
It is unclear what impact the Cure Violence model could have on disparities in gun violence. Disparities in gun violence exist across gender and racial groups, with firearm homicides being the highest among Black men16. Firearm homicide is the leading cause of death for Black boys and young men aged 15 to 2417.
The Cure Violence model seeks to change attitudes and norms about gun violence2. While the Cure Violence approach can be viewed as an improvement over punishment-oriented responses to violence, critics have pointed out that Cure Violence can focus heavily on individual responsibility and ignore systemic factors that influence rates of violence18. Experts recommend that solutions for community violence involve cross-sector coalitions that include housing, education, employment, health care, and justice system organizations19, 20.
What is the relevant historical background?
In the U.S., gun violence rates are linked to gun availability, racial segregation, poverty, and income inequality21, 22, 23. Throughout U.S. history, discriminatory housing, lending, and exclusionary zoning policies entrenched racial residential segregation and concentrated poverty24, 25. This systemic disinvestment and exclusion by both government and private entities created and maintains community environments with limited resources, deteriorating infrastructure, and many other factors that are linked to higher rates of violence and contribute to poorer health outcomes among people of color and people with low incomes23, 26, 27, 28. Communities shaped by discriminatory policies are more likely to experience violence19; for example, neighborhoods that were “redlined” by the Federal Housing Administration (FHA) in the 1930s experience higher rates of gun violence today29, 30.
Past and current discriminatory policing produced and maintains justified distrust and negative attitudes toward police among racially minoritized communities, especially Black communities. Police in the U.S. originated with slave patrols in the 1700s that used excessive force in attempt to control people who were enslaved31, 32. Law enforcement has a long history of both enforcing discriminatory policies, such as Jim Crow laws, as well as disproportionately targeting Black communities33, 34, 35. Today, Black Americans are three times more likely to be shot and killed by a police officer than white Americans17.
Equity Considerations
- What forms of violence exist in your community? To what degree do community conditions associated with higher risk of violence (e.g. income inequality, racial segregation) show up in your community? How might these conditions impact violence?
- Who is most affected by violence in your community? What supports or resources are available for those who are most affected? What supports or resources are not available but needed?
- How can community violence initiatives, such as Cure Violence programs, work to build relationships with those most affected by violence? How can the perspectives of those most affected be incorporated into community violence interventions?
Implementation Examples
Cure Violence models have been implemented across 25 cities in 17 states and Washington, D.C.1.
Implementation Resources
‡ Resources with a focus on equity.
Cure Violence - Cure Violence Global. Experience in effective violence prevention.
Footnotes
* Journal subscription may be required for access.
1 Cure Violence - Cure Violence Global. Experience in effective violence prevention.
2 Butts 2015 - Butts JA, Roman CG, Bostwick L, Porter JR. Cure Violence: A public health model to reduce gun violence. Annual Review of Public Health. 2015;36(1):39–53.
3 Hureau 2023 - Hureau, D. M., Braga, A. A., Lloyd, T., & Winship, C. (2023). Streetwork at the crossroads: An evaluation of a street gang outreach intervention and holistic appraisal of the research evidence. Criminology, 61(4), 758–794.
4 Chwalisz 2023 - Chwalisz, N. (2023). Beating the gun—one conversation at a time? Evaluating the impact of DC’s “Cure the Streets” public health intervention against gun violence. Crime & Delinquency, 001112872311607.
5 Buggs 2022 - Buggs, S. A., Webster, D. W., & Crifasi, C. K. (2022). Using synthetic control methodology to estimate effects of a Cure Violence intervention in Baltimore, Maryland. Injury Prevention, 28(1), 61–67.
6 Delgado 2017 - Delgado, S. A., Alsabahi, L., Wolff, K. T., Alexander, N. M., Cobar, P. A., & Butts, J. A. (2017). The effects of Cure Violence in the South Bronx and East New York, Brooklyn. John Jay College.
7 Fox 2015 - Fox AM, Katz CM, Choate DE, Hedberg EC. Evaluation of the Phoenix TRUCE project: A replication of Chicago CeaseFire. Justice Quarterly. 2015;32(1):85-115.
8 McVey 2014 - McVey E, Duchesne JC, Sarlati S, et al. Operation CeaseFire-New Orleans: An infectious disease model for addressing community recidivism from penetrating trauma. Journal of Trauma and Acute Care Surgery. 2014;77(1):123-128.
9 Boyle 2010b - Boyle DJ, Lanterman JL, Pascarella JE, Cheng CC. The impact of Newark’s Operation Ceasefire on trauma center gunshot wound admissions. Justice Research and Policy. 2010;12(2):105-23.
10 Wilson 2011b - Wilson JM, Chermak S. Community-driven violence reduction programs: Examining Pittsburgh’s One Vision One Life. Criminology & Public Policy. 2011;10(4):993-1027.
11 Skogan 2008 - Skogan WG, Hartnett SM, Bump N, Dubois J. Evaluation of CeaseFire-Chicago. Rockville: National Criminal Justice Reference Service (NCJRS); 2008.
12 CCI-Picard-Fritsche 2013 - Picard-Fritsche S, Cerniglia L. Testing a public health approach to gun violence: An evaluation of Crown Heights Save Our Streets, a replication of the Cure Violence model. New York: Center for Court Innovation; 2013.
13 JHSPH-Webster 2012 - Webster DW, Whitehill JM, Vernick JS, Parker EM. Evaluation of Baltimore's Safe Streets program: Effects on attitudes, participants' experiences, and gun violence. Baltimore: Johns Hopkins Bloomberg School of Public Health (JHSPH); 2012.
14 Whitehill 2014 - Whitehill JM, Webster DW, Frattaroli S, Parker EM. Interrupting violence: How the CeaseFire program prevents imminent gun violence through conflict mediation. Journal of Urban Health. 2014;91(1):84-95.
15 Hureau 2022 - Hureau, D. M., Wilson, T., Jackl, H. M., Arthur, J., Patterson, C., & Papachristos, A. V. (2022). Exposure to gun violence among the population of Chicago community violence interventionists. Science Advances, 8(51).
16 Rees 2022 - Rees, C. A., Monuteaux, M. C., Steidley, I., Mannix, R., Lee, L. K., Barrett, J. T., & Fleegler, E. W. (2022). Trends and disparities in firearm fatalities in the United States, 1990-2021. JAMA Network Open, 5(11), e2244221.
17 Giffords-Nguyen 2024 - Nguyen, A., Drane, K. (2024). Gun violence in Black communities. Giffords Law Center.
18 Riemann 2019 - Riemann, M. (2019). Problematizing the medicalization of violence: A critical discourse analysis of the ‘Cure Violence’ initiative. Critical Public Health, 29(2), 146–155.
19 Armstead 2021 - Armstead, T. L., Wilkins, N., & Nation, M. (2021). Structural and social determinants of inequities in violence risk: A review of indicators. Journal of Community Psychology, 49(4), 878–906.
20 Mayfield 2022 - Mayfield, C. A., Siegal, R., Herring, M., Campbell, T., Clark, C. L., & Langhinrichsen-Rohling, J. (2022). A replicable, solution-focused approach to cross-sector data sharing for evaluation of community violence prevention programming. Journal of Public Health Management and Practice, 28(Supplement 1), S43–S53.
21 Schleimer 2022 - Schleimer, J. P., Buggs, S. A., McCort, C. D., Pear, V. A., Biasi, A. D., Tomsich, E., Shev, A. B., Laqueur, H. S., & Wintemute, G. J. (2022). Neighborhood racial and economic segregation and disparities in violence during the COVID-19 pandemic. American Journal of Public Health, 112(1), 144–153.
22 Johnson 2021a - Johnson, B. T., Sisti, A., Bernstein, M., Chen, K., Hennessy, E. A., Acabchuk, R. L., & Matos, M. (2021). Community-level factors and incidence of gun violence in the United States, 2014–2017. Social Science & Medicine, 280, 113969.
23 Wong 2020 - Wong, B., Bernstein, S., Jay, J., & Siegel, M. (2020). Differences in racial disparities in firearm homicide across cities: The role of racial residential segregation and gaps in structural disadvantage. Journal of the National Medical Association, 112(5), 518–530.
24 Zdenek 2017 - Zdenek RO, Walsh D. Navigating community development: Harnessing comparative advantages to create strategic partnerships. Chapter: The background and history of community development organizations. New York: Palgrave Macmillan; 2017.
25 Kaplan 2007 - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.
26 Braveman 2022 - Braveman PA, Arkin E, Proctor D, Kauh T, Holm N. Systemic and structural racism: Definitions, examples, health damages, and approaches to dismantling. Health Affairs. 2022;41(2):171-178.
27 Prochnow 2022 - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.
28 McAndrews 2022 - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.
29 Poulson 2021 - Poulson, M., Neufeld, M. Y., Dechert, T., Allee, L., & Kenzik, K. M. (2021). Historic redlining, structural racism, and firearm violence: A structural equation modeling approach. The Lancet Regional Health - Americas, 3, 100052.
30 Jacoby 2018 - Jacoby, S. F., Dong, B., Beard, J. H., Wiebe, D. J., & Morrison, C. N. (2018). The enduring impact of historical and structural racism on urban violence in Philadelphia. Social Science & Medicine, 199, 87–95.
31 Ward 2022 - Ward, M. (2022). The legacy of slavery and contemporary racial disparities in arrest rates. Sociology of Race and Ethnicity, 8(4), 534–552.
32 NAACP-Police origins - NAACP. The origins of modern day policing. Retrieved August 28, 2024.
33 History-Jim Crow laws - History.com. (2024, January 22). Jim Crow laws.
34 Mesic 2018 - Mesic, A., Franklin, L., Cansever, A., Potter, F., Sharma, A., Knopov, A., & Siegel, M. (2018). The relationship between structural racism and Black-white disparities in fatal police shootings at the state level. Journal of the National Medical Association, 110(2), 106–116.
35 Siegel 2020a - Siegel, M. (2020). Racial disparities in fatal police shootings: An empirical analysis informed by critical race theory. Boston University Law Review, 100, 1069–1092.
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