Eugenia C. South is an assistant professor of emergency medicine and vice chair for inclusion, diversity and equity in the department of emergency medicine at the University of Pennsylvania, and faculty director for the Urban Health Lab.
On Oct. 26, Walter Wallace Jr., a 27-year-old Black man, was shot by police near his home in West Philadelphia, the community in which I attend church and work as an emergency medicine physician. Wallace was rushed to my hospital for care, and our team worked hard to save his life. They could not.
Gun violence killed Black people at alarming and unprecedented rates last year, and this surge has been palpable in my emergency department. I have participated in countless thoracotomies, a procedure involving a large incision to open a patient’s chest to stop bleeding from a bullet. In December, after my team performed a thoracotomy in our final — but unsuccessful — attempt to revive a young Black man, we held a moment of silence to honor his life. After, as I stripped off my bloody gown, I broke down and sobbed.
My tears were from intense sorrow, because I could not help but imagine my two Black sons, ages 7 and 3, lying lifeless on the gurney. My tears were also from anger, because I know gun violence, including at the hands of police, is preventable.
As a nation, we have made a choice to largely ignore what the evidence says about creating safe neighborhoods. We have declined to fund place-based interventions, such as parks and trees, that actually work to protect citizens. And through our inaction, we have decided that Black lives do not, in fact, matter as much as White ones.
Urban gun violence disproportionately affects segregated Black neighborhoods marked by concentrated disadvantage. Over time, a lack of investment into neighborhoods’ physical infrastructure has led to a crumbling housing stock, blighted spaces, and a dearth of green space such a trees and parks. These conditions trace to legacies of state-sanctioned structural racism such as redlining, as well as other long-standing and ongoing discriminatory real estate and bank lending practices.
More recently, mass incarceration extracts resources and talent from Black communities, and an on-the-ground police surveillance state feeds prisons with bodies. The inevitable results — entrenched poverty, lack of economic opportunity, underfunded and failing public schools, and deteriorating neighborhood environments — are the root causes of gun violence.
Caring for victims of gun violence early in my career motivated me to turn to science for answers on prevention. I have worked with a team of researchers at the Penn Urban Health Lab, which I now direct, to study place-based interventions that promote safe communities. Philadelphia, like many cities, has tens of thousands of dilapidated vacant spaces, often filled with trash, used condoms and needles. For people living nearby, these undesirable but unavoidable spaces result in fear, stigma and stress.
A simple, low-cost, structural change to the neighborhood environment can improve safety and foster well-being. Our research has demonstrated that turning vacant land into clean and green space reduces gun crime. People living nearby feel safer and less depressed, and they forge deeper social connections with their neighbors. In fact, some residents reclaim these spaces for social activities such as barbecuing and gardening.
Green space has consistently been associated with health benefits. Simply walking past an urban space with grass and trees calms the body, including lowering heart rates. Stress reduction and the positive impact on mental health may explain why being near trees has been associated with lower risk of gun assault among Black adolescents. In another study, we found that for pregnant women with a history of anxiety or depression, urban tree canopy was associated with less stress.
Clean and accessible parks, trees and micro-green spaces should not be a luxury amenity reserved for those living in affluent, mostly white neighborhoods that have benefited from decades of intentional, government-backed investment. And yet that is precisely the situation we are in, with Black, formerly redlined neighborhoods having the least amount of green space in the present day.
The family of Walter Wallace Jr. reported that he had bipolar disorder and was experiencing a mental health crisis the day he was killed. I have often wondered: What if he had come to my emergency department as a mental health patient instead of a shooting victim? What if he never reached crisis level because his neighborhood conditions supported mental health?
Reimagining safety means making intentional decisions to address the root causes of gun violence through policy changes and financial investment in Black people and Black neighborhoods. One promising opportunity is to reallocate dollars from expansive police budgets — which make up the largest budget item in most big cities — to evidence-based non-police interventions. Place-based initiatives — including restorative natural outdoor spaces — should be at the top of the list.