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Salinas

Even though Salinas, California, is known for its abundance of natural resources, one of the city’s most valuable assets —youth—was under threat. To help cultivate the future of Salinas as a “A City at Peace,” the Monterey County Health Department joined community leaders working to reduce and prevent youth violence.

Where is Salinas and who lives there?

Located on the Central Coast of California, Salinas is a study in contrasts. With a population of just over 142,000, this primarily rural community also happens to be the largest city in Monterey County. According to 2010 Census estimates, approximately 73% of Salinas’ residents are Hispanic. Youth ages 10-24 years make up nearly 25% of the population.

While agriculture has long been king in the area—attracting a large migrant worker population—the area’s close proximity to Silicon Valley (high tech’s home base) has had a major impact on the cost of housing. Further, the combination of overcrowding, lack of jobs, and high rates of poverty and crime has created a perfect storm of conditions that negatively affect the overall well-being of the community.

What issues does the city face in terms of youth violence?

Youth violence accounted for 81.5% of all homicides in 2009 in the areas surrounding Monterey County compared to 53% for the state of California. In 2009, among Salinas youth ages 10 to 24 years, the rate of gang-related crimes was 1,438 per 100,000, the rate of gang-related arrests was 474 per 100,000, and the homicide rate was 44.8 per 100,000.

Linda McGlone, a senior health educator at the Monterey County Health Department, attributes the gang problem in Salinas to a legacy of multi-generational gangs. She says many young people find themselves inheriting a connection to one of the active gangs from birth.

While youth violence is a city-wide problem in Salinas, the eastern area of Salinas, called “The Alisal,” is particularly hard hit. The Alisal, a low-income, Hispanic neighborhood of about 50,000 people, has the highest levels of poverty, low-literacy, language barriers, violence, and single parent homes in the city.

How and when did STRYVE enter the picture?

In 2011, the Monterey County Health Department received STRYVE initiative funding from the Centers for Disease Control and Prevention to address violence as a public health issue. McGlone was named the STRYVE Coordinator for Salinas.

Recognizing that youth violence is a complex issue that cannot be prevented by one organization, Salinas STRYVE partnered with Community Alliance for Safety and Peace (CASP), an existing coalition of local leaders dedicated to gang reduction in the city. CASP is made up of more than 30 organizations from a variety of sectors, including social services, criminal justice, housing, law enforcement, education, business, faith, and the local government. Through STRYVE, public health leaders were able to add their voice to the mix.

“We had not really been at the table. … So when we got this grant, [CASP] really didn’t know what to make of it and how this was going to change things, or what the health department was going to do,” McGlone says. “It was a very slow process to demonstrate to them that we had a certain skill set that would be of value to them in terms of using data.”

What did the public health approach to youth violence entail?

Salinas STRYVE offered CASP resources and a step-by-step process to strengthen the coalition’s existing plan and helped them choose a focus area and strategies based on the best available evidence. In addition to analyzing existing community data, Salinas STRYVE conducted 21 community listening sessions and a school survey to learn what residents had to say about youth violence in the area – what might be causing it and what could be done to prevent youth violence in the future.

“You have to know what the problem is and what your strengths are,” McGlone says. “We heard what the community said and then we looked at the data.”

Through this planning process, Salinas STRYVE ultimately identified 3 strategies: a youth empowerment strategy, a built environment strategy, and a bullying prevention strategy.

What has been the immediate impact of one of these strategies?

Principal Gabriel Ramirez worked with Salinas STRYVE to implement an evidence-based bullying prevention strategy at his elementary school in The Alisal, which serves approximately 600 students.

“At first there was resistance and a lot of us teachers were hesitant. We honestly believed we didn’t have bullying issues going on here,” says teacher Roberto Zamora. “But after the students took the survey to find out if there was any bullying taking place here, we were shocked to find out there was a lot of bullying taking place.”

Through STRYVE, teachers learned how to address the issue and support their students in feeling safer at school with a bullying prevention program that included classroom check-in meetings. Zamora says those meetings, where students can talk about problems they are having at home or at school, have been an essential way to promote positive and productive conversations that are making a difference in the community.

Principal Ramirez has seen the value of implementing this program, too. “It’s always important to look at what can I do now and not what can I do tomorrow,” Ramirez says. “Because, in reality, tomorrow we could lose several children to the violence.”

How will youth violence prevention efforts be sustained in Salinas?

The objectives for Salinas STRYVE aligned with CASP’s long-term objectives and provided a framework for planning, pilot testing, evaluating, and sustaining youth violence prevention efforts. While it’s too early to measure the impact of the three strategies that Salinas chose to implement, the work of CASP—with support from STRYVE—is making a difference. Violent crime has significantly decreased, and the rate of violent assaults on youth has also significantly declined.

“I absolutely believe we’re going to make changes.” McGlone says. “The process that we’ve taken on is so methodical, and you can see that you’re marching towards a goal. I absolutely believe it’s going to make a difference.”

[NOTE: data are from 2011]

Houston

Most people are familiar with the saying, “Everything is bigger in Texas.” Houston, Texas, has one of the largest and youngest populations in the nation. Community leaders could easily be overwhelmed by the sheer scope of youth violence in their city. Instead, a coalition led by the local health department chose to start small and focus prevention efforts at the neighborhood level.

Where is Houston and who lives there?

Houston is the largest city in Texas and the 4th largest city in the United States. Of the nearly 2.2 million people who live in this sprawling metropolis, more than 25% are younger than age 18. As a major port city where nearly 90 languages are spoken, Houston is a multicultural hub of activity with a diverse set of needs.

According to the city government, Houston is divided into 88 Super Neighborhoods. These are geographically designated areas where communities have been grouped together based on location and common physical characteristics, identity, or infrastructure. Of particular note are the five Super Neighborhoods that make up Houston Police Department (HPD) District 14: Sunnyside, South Park, South Acres/Crestmont Park, OST/South Union, and Minnetex.

What should I know about HPD District 14?

HPD District 14 is a community in southern Houston with high-risk indicators related to poverty, teen violence, communicable diseases, and poor health outcomes. African Americans (80%) and Hispanics (14%) make up the majority of the population. From 2005-2009, nearly one-third of the area’s residents were living below the poverty level. Additionally, 30% of residents ages 25 and older reported that they had not graduated from high school.

What issues does Houston and specifically HPD District 14 face in terms of youth violence?

Youth violence is widespread in Houston and particularly within HPD District 14. In 2010, the Houston Department of Health and Human Services (HDHHS) conducted a survey of youth from across the city. More than half reported not having safe places to go or programs to participate in. Many said they had safety concerns or experienced violence at school.

Youth living in HPD District 14 accounted for nearly 8% of all juvenile crime in 2010. In fact, that same year, the juvenile crime rate in this community was 25% higher than that of the entire city. In some areas, it was more than twice the Houston rate.

Data from juvenile probation showed that African American and Hispanic youth received the greatest number of probation referrals for most types of crime from 2006-2010.

How and when did STRYVE enter the picture?

In 2011, HDHHS received STRYVE initiative funding from the Centers for Disease Control and Prevention to address youth violence as a public health issue. Sheila Savannah was named the STRYVE Program Director for Houston. While statistics surrounding youth violence presented dire facts, Savannah says the city did not need to start from scratch to find a solution. They just needed to migrate what others were already doing to a stronger model, and in a specific community.

“We really were committed to identifying evidence-based strategies that fit with the culture and the direction that our youth-serving agencies were going,” Savannah says. “[STRYVE] helped us apply core public health functions to the problem of youth violence and catapulted existing partnerships and activities forward.”

Houston STRYVE’s multi-sector coalition chose to focus prevention efforts in HPD District 14. In addition to using data from local schools and the police to guide their planning, the coalition also recognized the need to hear from the community.

“If you’re talking about sustainability and you’re talking about seeing real change, you must engage the community from the very beginning or they’re not going to be with it,” says Faith Foreman, Assistant Director at HDHHS.

Team members of Houston STRYVE went door-to-door in select neighborhoods to examine needs and concerns on a more personal level. They provided residents with access to fresh food and basic health services, both clinical and educational. They also asked residents about the challenges facing their community—how violence affected them and what they thought could help make their neighborhoods safer and healthier. Youth played a significant role in conducting interviews and voicing solutions.

“By connecting youth voice and health to youth safety, we began to establish a comprehensive violence prevention plan that was strength-based,” Savannah says.

Other key partners included the City of Houston, which had experience in addressing youth violence through the Mayor’s Anti-Gang Office. Faith-based organizations and local foundations helped the coalition map neighborhood assets.

“I think you always have to balance youth violence with youth potential,” Savannah says. “You have to say, ‘You know what? Young people have the capability of making good, safe decisions, and we want to make that stronger.’”

What has Houston STRYVE’s approach to youth violence entailed?

Using technical assistance and tools from STRYVE, the coalition selected two evidence-based strategies to address youth violence and build a way for youth to have a stronger role in the community.

So far, Houston STRYVE has piloted a youth empowerment strategy at eight sites in HPD District 14, with plans to expand to other locations. More than 100 youth have participated in the program.

“To see students change from being teenagers into being adults and taking the responsibility of citizenship and community service, that’s the greatest reward that any educator could have,” says Pablo Sanchez, an after-school program coordinator.

The coalition is also working to create safe physical spaces for the community to enjoy through an environmental design strategy.

“Residents felt a fear to use their community. They felt almost traumatized to go outside or walk through the parks,” Savannah says. “[This strategy] helps us look at those systemic things that keep communities from using their community resources.”

How have these youth violence prevention efforts been evaluated and sustained?

While evaluation of the two programs is ongoing, Houston STRYVE has expanded its coalition of individuals and organizations wanting to work together to prevent youth violence. The group continues to engage young people as solution leaders, too.

“Our comprehensive plan is designed not as a plan that sits on a shelf,” Savannah says. “The way we’re hoping to keep it alive is to really help it be something that transfers from one person to another, from one organization to another, from the community that we started in to other communities and city and countywide efforts.”

[NOTE: data are from 2011]

Portland

While Portland, Oregon, is known as one of the most eco-conscious places in the country, sections of the city are still plagued by the toxic issue of youth violence. Recognizing that a healthy environment requires more than just “going green,” the Multnomah County Health Department used community outreach and engagement to address youth violence and help residents become part of the solution.

Where is Portland and who lives there?

Portland, the largest city in Oregon, is located in Multnomah County—a mainly urban area in the northwest corner of the state. Persons of color make up one-third of the population of youth between the ages of 10-24 in Multnomah County. However, in the North/Northeast (N/NE) section of Portland, persons of color account for more than half of youth ages 10-24. N/NE Portland has traditionally been the home of the county’s African American community (in 2011, 42% of African Americans in Portland resided there). The Latino community has also had a strong presence for a number of years.

What issues does N/NE Portland face in terms of youth violence?

Racism and its consequences have caused African Americans, Latinos, and other communities of color to be disproportionately affected by risk factors for youth violence, including poverty. Within N/NE Portland, 62% of persons living in poverty are racial/ethnic minorities. Additionally, 70% of students are eligible for free or reduced cost lunches (nearly 20% higher than the countywide average). [NOTE: data are from 2011]

Homicides, gang activity, and incarceration, which tend to occur more often in areas of high poverty, are particularly elevated within this part of Portland:

  • 18% of homicides with a youth* victim were in N/NE Portland [2003-2007].
  • 36% of all documented youth arrests for gang activity took place in N/NE Portland [2005-2010].
  • 20% of all youth in juvenile corrections/detention facilities were residents of N/NE Portland [2010].

*Individuals who are 10 to 24 years old

For many community leaders and residents, these grim numbers represented the need for a more innovative approach to youth violence than just increased police presence. According to Antoinette Edwards, director of the Office of Youth Violence Prevention for the City of Portland, the common refrain was: “We cannot arrest our way out of this.”

How and when did STRYVE enter the picture?

In 2011, STRYVE initiative funding from the Centers for Disease Control and Prevention presented the opportunity for an alternative response to the problem. The Multnomah County Health Department received the funding to address violence as a public health issue. Rebecca Stavenjord was named the STRYVE Coordinator for Portland.

Stavenjord says the first task of the project was to create a forum where the science of prevention could be combined with community insight. With help from community leaders like Edwards, Portland STRYVE formed a multi-sector coalition that included law enforcement, business leaders, nonprofits, faith-based organizations, public health experts, educators, residents, and representatives from the local government.

“We wanted to create a space where everyone’s expertise was valued, whether that be professional, academic, lived experience, or otherwise,” Stavenjord says. “We spent a lot of time discussing root causes of violence, social determinants of health, what the role of the health department is in this work, and what violence as a health issue means.”

In addition to these conversations, the group looked at existing community data on crime and violence and gathered additional information through street interviews with youth.

“The conversations went from technical to very real, talking about the emotions and the actual conditions of the people or the individuals they were trying to assist,” says Abdul Hafeedh bin Abdullah, a community member involved with Portland STRYVE.

What has Portland STRYVE’s approach to youth violence entailed?

Using STRYVE resources and tools, the coalition identified four geographic areas to focus their efforts and selected two prevention strategies. To date, Portland STRYVE has implemented a youth empowerment program with 50 school-aged youth in the most at-risk neighborhoods in Portland. The coalition has also engaged youth in creating a safer community through environmental design projects.

One of the most innovative approaches to addressing youth violence that Portland STRYVE identified is the use of Community Health Workers (CHWs). During the first year of the project, the coalition hired and trained two part-time CHWs to advocate for individual and community needs, serve as a liaison between communities and the health care and social service system, and help make health education and information more accessible to residents.

Abdullah is a CHW with Portland STRYVE. The former gang member says it’s a role that has helped him dismantle a violent past and aid others in building healthier futures.

“My ambition is to shift that background of what I call destruction—the culture of destruction—towards being an advocate for the culture of development,” he says.

According to Stavenjord, CHWs like Abdullah have been crucial in Portland STRYVE’s ability to fully involve community members and under-represented groups in youth violence prevention efforts.

“These are men and women who have been doing this work within their communities for years, maybe decades,” Stavenjord says. “What we are trying to do is highlight, encourage, and formalize the profession of community health workers. They are absolutely critical to our work.”

How does Portland STRYVE plan to build on the success of the CHW approach?

The successful integration of CHWs into youth violence prevention work highlights the potential to use CHWs in public health efforts across multiple issues. Therefore, Portland STRYVE is focused on providing CHWs with comprehensive training and professional development.

Over 140 CHWs have completed approved certification training with the Multnomah County Health Department’s Community Capacitation Center. Portland STRYVE staff are working to develop a specific module around youth violence prevention for that training.

Boston

In schools across the country, children learn about the important role that Boston, Massachusetts, played in the American Revolution. Fast-forward to the present and residents of the city are leading another powerful movement. With help from the local health department, community members have formed coalitions to drive youth violence prevention efforts in their neighborhoods. Once again, and one community at a time, Boston is reclaiming its future.

Where is Boston and who lives there?

Boston, Massachusetts, is one of the oldest cities in the United States and the largest city in New England, with a population of over 600,000 people. The Greater Boston area is home to 4.5 million people, making it the 10th largest metropolitan area in the country. Twenty two percent of the population of Boston is under the age of 19. The city is racially and culturally diverse, with a quarter of the city’s residents having been born outside the United States.

Despite its diversity, Boston is made up of a collection of largely segregated neighborhoods. Three adjoining neighborhoods—Roxbury, Dorchester, and Mattapan—contain two-thirds of the city’s Black/African American population and 10% of its White population. Compared with residents of Boston’s four highest-income neighborhoods, residents of Roxbury, Dorchester and Mattapan have a 30% higher death rate from all causes.

What issues does Boston face in terms of youth violence?

The 2008 Boston Youth Survey was given to 1,878 youth in 22 public high schools across Boston. Results from the study revealed that 69% of the youth reported witnessing violence in the past year. A large number of youth also expressed concerns about safety, with:

  • 27% reporting that neighborhood gangs inhibit their everyday activities “some or a lot”,
  • 13% reporting feeling unsafe in their own neighborhoods, and
  • 34% reporting feeling unsafe in other neighborhoods.

The majority of homicides and non-fatal shootings and stabbings in the Boston area are concentrated in Roxbury, Dorchester, and Mattapan. Because of the number of homicides, these neighborhoods are considered “hot-spot” areas for violence and other crimes.

How and when did STRYVE enter the picture?

Tania Mireles is the director of Violence Intervention and Prevention Initiative (VIP) at the Boston Public Health Commission (BPHC), the nation’s first health department. In 2011, the BPHC received a STRYVE grant from the Centers for Disease Control and Prevention to enhance the capacity of existing VIP coalitions to address youth violence in the city.

Through Boston STRYVE, Mireles and a dedicated team developed neighborhood youth violence prevention plans in Roxbury and Dorchester where there were many people who were committed to addressing the issues facing their community. As the first step, resident-led neighborhood coalitions, 70% of whom were youth ages 16-24, participated in a vision-setting and planning process with support from BPHC/VIP staff. These public health partners initiated the planning process to strengthen resident engagement and participation in each of the communities. According to Mireles, this collaborative approach proved to be a key part of giving STRYVE efforts a solid start in Boston. “I think that the real foundation under it was that it was resident driven,” she says.

What has Boston STRYVE’s approach to youth violence entailed?

As an outcome of the initial planning process, each VIP coalition submitted a proposal for evidence-based youth violence prevention projects. During this initial phase, two strategies were selected and implemented in three VIP neighborhoods; implementation has since expanded.

The first effort was an evidence-based youth development strategy designed to help youth gain new skills, hold jobs in local organizations, and develop leadership abilities. In addition to driving down shooting incidents and other forms of community violence, Mireles says the goal of the strategy is also to inspire feelings other than discouragement and fear. “ I'm hoping that it creates a sense of opportunity and hope in residents of a neighborhood and particularly young people,” she says.

The first effort was an evidence-based youth development strategy designed to help youth gain new skills, hold jobs in local organizations, and develop leadership abilities. In addition to driving down shooting incidents and other forms of community violence, Mireles says the goal of the strategy is also to inspire feelings other than discouragement and fear. “ I'm hoping that it creates a sense of opportunity and hope in residents of a neighborhood and particularly young people,” she says.

“I feel like the tree is the parent and the branches or the leaves are your children,” Majia says. “[If parents] are able to feel strong within themselves and know how to parent and how to support their children, then that is the way to reach them.”

In addition to implementing these two evidence-based strategies for youth violence prevention, the VIP coalitions formed a Neighborhood Advisory Council (NAC). Members of the NAC include residents, youth and neighborhood partners as well as representatives from local community organizations, businesses, and schools. The City of Boston also has a presence through staff from the Boston Police Department and the Boston Public Health Commission (BPHC).

NAC meetings provide a forum for residents and other community stakeholders to stay involved and give feedback on how STRYVE strategies are put into place, carried out and adapted.

How have these youth violence prevention efforts been evaluated and sustained?

While evaluation of the two selected evidence-based programs is ongoing, the BPHC has learned that community coalitions, specifically their NAC members, continue to play an important role in guiding the ongoing implementation of violence prevention strategies for new and existing initiatives in VIP neighborhoods.

In addition to providing input and advice on strategy implementation, NAC meetings are also used as capacity building opportunities. Boston STRYVE provides trainings and facilitates discussions with the NAC about various topics related to violence prevention work within a public health framework.