Trauma Awareness Helps Boston to Reduce Violence & Its Community Impact

Boston is beginning to see evidence that this multisector approach to violence prevention is having an effect. Rates for nonfatal assault-related gunshots/stabbing emergency department visits have fallen since 2008, and, importantly, rates for Black and Latino residents also decreased from 2008-2012. And, from 2011 through the end of 2014 homicide rates have decreased by 16%, and overall violent crime has decreased by 9%.

Violence, particularly among youth, is an epidemic in American cities. Youth violence is the leading cause of injury and death for young people aged 10-24 years old, and in many of the country’s largest jurisdictions, homicides and violent crime rose significantly in the first half of 2015. Meanwhile, the Attorney General’s National Task Force on Children Exposed to Violence reports that 46 million of the nation’s 76 million children - roughly 60 percent - are exposed each year to violence, crime and abuse. The result: the nation pays a high price in lives, money and in lost potential.

Those who experience repeated exposure to violence can begin to process the experiences as something that is part of normal social life. Consistent exposure to violence at home or in the community can become desensitizing to individuals. Violence makes it hard to feel safe, leading to anxiety, depression, less physical activity in communities, and social isolation.

Many cities look to law enforcement-driven policies to stem violence, but in recent years more and more cities have taken a public health approach to violence. Boston, Kansas City and Minneapolis are among those showing that when violence—and its root causes—is addressed as a contagious disease, significant progress can be made in reducing and preventing it.


In Boston, where violence is the leading cause of death among Black and Latino children and nearly 50 percent of high school students report knowing someone who has been shot or killed, the Boston Public Health Commission (BPHC) has been working hand-in-hand with the police department and other city agencies to address and prevent youth violence.  Its Division of Violence Prevention has invested in strategies that prevent violence through skill development for children and youth, training and capacity building among providers, and effective service delivery to individuals who have experienced violence, and resident leadership. 

In 2012, BPHC received a grant from the Department of Justice for the Defending Childhood Initiative, to take a trauma-informed approach to violence prevention. The extra resources helped the city develop and test practical, sustainable strategies for implementing trauma-informed practice in six early care and education centers. The trauma-informed practices, policies and environments were deemed a success by evaluators.

Out of the grant, officials developed tools to make it easier to teach and learn about trauma, and developed a 3-day training institute that has reached thousands of health care providers, teachers, parents and others. Similarly, BPHC programming also includes a network of 8 community health centers with specially trained staff who lead activities in the neighborhoods with the highest rates of violence. Staff provide trauma response and recovery services to affected residents and lead prevention-oriented events through the health center. The focus: provide specialized support to residents and give them the skills and resources they need to recover from a violent incident.

BPHC has undertaken a number of other activities to help stem the violence tide and address those impacted by events, including:

  • Building out services for survivors of violence to ensure that they get needed services to recover from such an event.  This includes partnering with Boston Medical Center, the city’s primary level 1 trauma center, to implement a case management program for survivors of shootings and stabbings and their family members. 
  • Working with the Boston Police Department to identify and provide services for the 300 young men identified as being at high risk of being a victim or perpetrator of gun violence. This initiative– Partners Advancing Communities Together (PACT) – is a multidisciplinary, comprehensive service delivery strategy targeted at high-risk youth, where partners work together to connect youth to long-term, meaningful relationships with trusted adults and to education and employment services. A 2014 evaluation found that “a dollar invested in Boston’s PACT program could be expected to gain a savings of nearly $7.40 in crime-related cost savings.”