Health System Violence Intervention Programs Yield Promising Results

In the past three triennial community health needs assessments (CHNA) conducted by the Milwaukee Health Care Partnership (MHCP), violence has been identified as a top community health issue. Findings from the most recent 2021 CHNA ranked violence as the second leading health issue and elevated an interconnectedness with all other health issues.

In coordination and alignment with the Blueprint for Peace, the MHCP’s Plan Priorities include violence prevention as a key focus area, and MHCP members convene in several ways around this issue. Members of the MHCP Violence Intervention Steering Committee identified direct intervention with victims of violence as having the greatest potential impact for addressing immediate needs and preventing subsequent violent incidents (recidivism), be they the result of firearms, assaults, or domestic or sexual violence. Two critical programs that address violence through health care interventions in Milwaukee are Children’s Wisconsin Project Ujima and 414LIFE, a collaboration between the Medical College of Wisconsin Comprehensive Injury Center and the City of Milwaukee.

“We understand that violence is a complex community health issue in which many sectors and community members need to be involved in order to address it. We also understand, as health care providers, we have a role to deliver care that reduces the risk of increased violence, and we are uniquely positioned to have positive impact,” said Bridget Clementi, Vice President Community Health at Children’s Wisconsin. “One way we can do that is by establishing a consistent and evidence-based intervention process and making available expert personnel who can support victims of violence and their families, and help them connect to medical, mental health and social services.”

414LIFE and Project Ujima are hospital-based violence interruption programs that offer an immediate intervention to victims and families in a hospital setting and subsequent home and community-based services. 414LIFE deploys hospital responders to work with victims of gun and assaultive violence ages 15-35 years. The program is currently available at Froedtert Hospital and was recently expanded to Ascension St. Joseph’s in 2023 due to a high presence of gun violence victims (nearly 180 victims in 2022). Expansion to other health care organizations, including Aurora Sinai Medical Center, is expected before the end of the year. Project Ujima deploys crime victim advocates who support youth victims of violence and their families presenting at the Children’s Wisconsin Emergency Department, in addition to other referral sources including the Milwaukee Homicide Review Commission.

To date, 414LIFE has received 1,196 total hospital referrals from Froedtert Hospital, and Project Ujima has received 1,648 referrals since 2018. MHCP members are working together to scale these programs across health systems and health centers and best leverage resources and knowledge for greater impact through shared strategy.

“Other communities nationwide have siloed hospital-based violence intervention efforts. I think we are unique in our approach, coming together through the MHCP to collect and analyze cross-sector data, exchange information about effective practices and share personnel and other resources to expand services and reach more people efficiently and effectively,” said Terri deRoon-Cassini, Executive Director at the Medical College of Wisconsin Comprehensive Injury Center. While many factors contribute to interpersonal violence, recent data suggest a promising trajectory. After a steady increase in firearm violence and homicide trends throughout 2022, we are seeing significant decreases in 2023 when comparing monthly change year over year. As of May 2023, homicides are down 50%, and non-fatal shootings are down 30% compared to 2022.