Violence Is a Contagious Disease: Theory and Practice in the USA and Abroad

  • Gary SlutkinEmail author
  • Charles Ransford


Violence is fundamentally a health issue, which is a predictable result of exposure, contagion, and trauma. Further, health and public health methods—and in particular epidemic disease control methods—have been proven effective in reducing violence without the major toxicities commonly caused by many criminal justice approaches. Violence is the only public health issue not primarily managed by the health sector. The Cure Violence approach uses standard epidemic control methods to detect and interrupt violent events, identify and change behavior among the highest-risk persons and groups, and shift the group and community norms.

As of the beginning of 2018, in more than 100 communities across 16 countries, the Cure Violence Health Model has been implemented and adapted to address community violence, as well as other types of violence, including prison, school, sectarian, and ideologically inspired violence. Multiple evaluations of the Cure Violence Health Model have shown strong effects on violence, including a reduction in shootings of up to 73% in Chicago, 63% in New York City, and 44% in Baltimore. In Latin America, the Cure Violence Health Model has led to reductions of 88% in shootings and killings in San Pedro Sula, Honduras; 67% in woundings in Port of Spain, Trinidad; and 50% in killings in several communities in Juarez, Mexico. Additionally, the Cure Violence approach has been shown to shift norms such that persons are more likely to reject the use of violence and more likely to trust local police; this model has also demonstrated several other positive results related to employment, education, and parenting. In this paper, we describe in detail how the components of Cure Violence are implemented and review the applications and impact of the model to date. It is long overdue for the health and public health sectors to step up and use this and other related and connected methods to eliminate this epidemic, as the health sector has done for so many other epidemic diseases and problems.


Violence Contagious Trauma Epidemic Health Public Health Outreach Interruption Aggression 


  1. Ahmad, F., Riaz, S., Barata, P., & Stewart, D. (2004). Patriarchal beliefs and perceptions of abuse among South Asian immigrant women. Violence Against Women, 10, 262–282.CrossRefGoogle Scholar
  2. Anderson, E. (2000). Code of the street: Decency, violence, and the moral life of the inner city. New York: WW Norton & Company.Google Scholar
  3. Bandura, A., Ross, D., & Ross, S. (1961). Transmission of aggression through imitation of aggressive models. Journal of Abnormal and Social Psychology, 63, 575–582.CrossRefGoogle Scholar
  4. Bingenheimer, J., Brennan, R., & Earls, F. (2005). Firearm violence exposure and serious violent behavior. Science, 308, 1323.CrossRefGoogle Scholar
  5. Butts, J. A., Delgado, S. A. (2017). Repairing trust. Young men in neighborhoods with cure violence programs report growing confidence in police. John Jay College of Criminal Justice. Available at Accessed 11 Sept 2017.
  6. Butts, J. A., Wolff, K. T., Misshula, E., & Delgado, S. (2015). Effectiveness of the cure violence model in New York City. John Jay College of Criminal Justice. Available at Accessed 11 Sept 2017.
  7. City of New Orleans. (2016). NOLA for life (2016 Progress Report. City of New Orleans). Available at Accessed 11 Sept 2017
  8. Cron, T. (1986). The surgeon general’s workshop on violence and public health: Review of the recommendations. Public Health Reports, 101, 8–14.PubMedPubMedCentralGoogle Scholar
  9. Delgado, S. A., Alsabahi, L., Wolff, K., Alexander, N., Cobar, P., & Butts, J. A. (2017). The effects of cure violence in the South Bronx and East New York, Brooklyn. Accessed 11 Sept 2017.
  10. Dorland, D. (2010). Dorland’s illustrated medical dictionary (32nd ed.). New York: Elsevier, Saunders.Google Scholar
  11. Ehrensaft, M. K., Cohen, P., Brown, J., Smailes, E., Chen, H., & Johnson, J. G. (2003). Intergenerational transmission of partner violence: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 71, 741–753.CrossRefGoogle Scholar
  12. Henry, D., Knoblauch, S., & Sigurvinsdottir, R. (2014). The effect of intensive ceasefire intervention on crime in four Chicago police beats: quantitative assessment. Chicago, IL: Robert R. McCormick Foundation.Google Scholar
  13. Maguire, E. (2017). Cure violence in trinidad and tobago: Mid-term evaluation. Unpublished report.Google Scholar
  14. Mead, H. K., Beauchaine, T. P., & Shannon, K. E. (2010). Neurobiological adaptations to violence across development. Development and Psychopathology, 22, 1–22.CrossRefGoogle Scholar
  15. Milam, A. J., Buggs, S. A., Furr-Holden, C. D., Leaf, P. J., Bradshaw, C. P., & Webster, D. (2016). Change in attitudes towards guns and shootings following implementation of the Baltimore safe streets intervention. Journal of Urban Health, 93(4), 609–626. Scholar
  16. Mullins, C. W., Wright, R., & Jacobs, B. A. (2004). Gender, streetlife and criminal retaliation. Criminology, 42, 911–940.CrossRefGoogle Scholar
  17. Picard-Fritsche, S., & Cerniglia, L. (2013). Testing a public health approach to gun violence. New York: Center for Court Innovation.Google Scholar
  18. Ransford, C., Cruz, G., Decker, B., & Slutkin, G. (2015). The positive effects of the cure violence model for families and children. Cure Violence. Available at Accessed 11 Sept 2017.
  19. Ransford, C., Decker, R. B., Cruz, G. M., Sánchez, F., & Slutkin, G. (2017). El modelo Cure Violence: reducción de la violencia en San Pedro Sula (Honduras)/The Cure Violence model: violence reduction in San Pedro Sula (Honduras). Revista CIDOB d’Afers Internacionals, 179–204.Google Scholar
  20. Ransford, C., Decker, R. B., Cruz, G. M., Sánchez, F., & Slutkin, G. (2018). El modelo Cure Violence: reducción de la violencia en San Pedro Sula (Honduras). Revista CIDOB d’Afers Internacionals, 116, 179–206.Google Scholar
  21. Ransford, C., Silverstone, D., Decker, R. B., & Slutkin, G. (2018). Cure violence model adaptation for reducing prison violence.
  22. Ransford, C. L., Kane, C., Metzger, T., & Quintana, E. (2010). An examination of the role of CeaseFire, the Chicago police, project safe neighborhoods, and displacement in the reduction in homicide in Chicago in 2004. In R. J. Chaskin (Ed.), Youth gangs and community intervention (pp. 76–108). New York: Columbia University Press.Google Scholar
  23. Roman, C., Klein, H., Wolff, K. T., Bellamy, M. D., & Reeves, K. (2017). Philadelphia CeaseFire: Findings from the impact evaluation. Philadelphia, PA: Temple University.Google Scholar
  24. Salzman, S. L., Regan, S. C., Quintana, E., Wisnieski, E., Mack, C. F., Stone, L., Smith-Singares, E., Thomas, Y., & Giloth, B. (2010). [unpublished manuscript].Google Scholar
  25. Singer, M. I., Anglin, T. M., Song, L. Y., & Lunghofer, L. (1995). Adolescents’ exposure to violence and associated symptoms of psychological trauma. JAMA, 273, 477–482.CrossRefGoogle Scholar
  26. Skogan, W., Harnett, S. M., Bump, N., & DuBois, J. (2009). Evaluation of CeaseFire-Chicago. Chicago, IL: Northwestern University Institute for Policy Research.Google Scholar
  27. Slutkin, G. (2013). Violence is a contagious disease. In D. M. Patel, M. A. Simon, & R. M. Taylor (Eds.), Contagion of violence: Workshop summary (pp. 94–111). Washington, D.C.: National Academies Press. Accessed 11 Sept 2017.Google Scholar
  28. Spano, R., Rivera, C., & Bolland, J. (2010). Are chronic exposure to violence and chronic violent behavior closely related developmental processes during adolescence? Criminal Justice and Behavior, 37, 1160.CrossRefGoogle Scholar
  29. Spinetta, J., & Rigler, D. (1972). The child-abusing parent: A psychological review. Psychological Bulletin, 77(4), 296–304.CrossRefGoogle Scholar
  30. Ungar, M., & Brisson, J. (2016). Ceasefire annual evaluation report. Halifax, Nova Scotia: Resilience Research Centre. Annual evaluation report submitted to the National Crime Prevention Centre, Public Safety Canada (Unpublished).Google Scholar
  31. University of Chicago. (2015). Unpublished data.Google Scholar
  32. Watson-Thompson, C. V., Jones, M., & Taylor, D. (2014). Aim4Peace 2013 annual evaluation report. University of Kansas Work Group for Community Health and Development, Lawrence, KSGoogle Scholar
  33. Watson-Thompson, C. V., Jones, M., & Taylor, D. (2015). Aim4Peace 2014 annual evaluation report. University of Kansas Work Group for Community Health and Development, Lawrence, KS. Available via Accessed 11 Sept 2017.
  34. Webster, D. W., Whitehill, J. M., Vernick, J. S., & Parker, E. M. (2012). Evaluation of Baltimore’s safe streets program: Effects on attitudes, participants’ experiences, and gun violence. Johns Hopkins Center for the prevention of youth violence. MD: Baltimore.Google Scholar
  35. Webster, D. (2016). Summary of findings from external evaluation of safe streets. Memo to Leanna Wen, March 17, 2016.Google Scholar
  36. Widom, C. S. (1989). The cycle of violence. Science, 244(4901), 160–166.CrossRefGoogle Scholar

Suggested Reading

  1. Patel, D. M., Simon, M. A., & Taylor, R. M. (Eds.). (2013). Contagion of violence: Workshop summary. Washington, D.C.: National Academies Press.Google Scholar
  2. Ransford, C., & Slutkin, G. (2017). Seeing and treating violence as a health issue. In F. Brookman, E. R. Maguire, & M. Maguire (Eds.), The handbook of homicide (pp. 601–625). Chichester, England: Wiley-Blackwell.Google Scholar
  3. Slutkin, G. (2017). Reducing violence as the next great public health achievement. Nature Human Behaviour, 1(1).
  4. Slutkin, G., Ransford, C., & Zvetina, D. (2018). How the health sector can reduce violence by treating it as a contagion. AMA Journal of Ethics, 20(1), 47.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Cure ViolenceChicagoUSA

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