Opinion Why are my patients still isolating in their homes? Gun violence.

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Philadelphia police investigators work the scene of a fatal overnight shooting on South Street in Philadelphia on June 5. (Michael Perez/AP)
Philadelphia police investigators work the scene of a fatal overnight shooting on South Street in Philadelphia on June 5. (Michael Perez/AP)

Dorothy R. Novick is a pediatrician at Children’s Hospital of Philadelphia and a scholar with CHOP’s Center for Violence Prevention.

“I don’t want to call you, Dr. Novick, to tell you one of these kids has been shot.” That’s how the grandmother of one of my patients explained why her grandson, a star athlete, is learning remotely. There are too many shootings on his walk home from school, so he stays in his room now, with no sports and no hope for a college scholarship.

As a pediatrician in Philadelphia, I hear this sentiment every day. More families than I can count live their entire lives inside homes to avoid gun violence. Many have lost loved ones; others are petrified they will. Children are home-schooling, withdrawing from activities and avoiding games with friends on their blocks. The combination of loss, fear and social isolation creates a degree of suffering unlike any I’ve seen over 26 years in this work.

It is not only the sheer number of gun homicides across our city — more than 200 so far this year — that drives families indoors. It’s also how often the bullets fly in their own communities.

The “law of crime concentration” explains that shootings tend to cluster into incredibly small, specific locations — street corners or short stretches of blocks — within neighborhoods. These hot spots, or “micro-geographic” areas, are often static over time, so the same families endure repeated loss and trauma over multiple generations. This is the case in Philadelphia, and it holds true nationally as well. A minuscule 1.5 percent of this country’s population lives in areas that endure more than a quarter of our homicides.

“It’s like a war zone,” one mother recently told me. “We don’t even let our kids walk to the store, with the way it is out there.”

She wasn’t referring to the brazen, horrific mass shootings that make national news, such as the one a mile from my home that killed three people this month. The shootings that keep my patients in their bedrooms are those that happen routinely at bus stops, outside schools, in corner stores and at playgrounds.

Five children in my practice have lost a parent to gun violence. One was playing near her house when she heard a shot — and looked up to find her father lying dead in the street. Several others have lost siblings. Many more have lost cousins and best friends. The devastation and trauma repeat, and result in crushing fear that lingers for a lifetime.

It is no wonder their families keep them indoors.

Mapping out the shootings in Philadelphia shows this concentrated gun violence in haunting visual terms. Mounds of small circles cluster together, each representing a person who has been maimed or killed.

Gun violence in

Philadelphia this year

There were more than 1,000 shootings in Philadelphia this year so far, and 198 deaths. One-fourth of the victims were under 21.

Shootings

Somerton

Philadelphia

95

Center

City

University of Pennsylvania

Note: Data as of June 8.

Source: Philadelphia’s Office of the Controller

THE WASHINGTON POST

Gun violence in Philadelphia this year

There were more than 1,000 shootings in Philadelphia this year so far, and 198 deaths. One-fourth of the victims were under 21.

Shootings

Somerton

Philadelphia

Torresdale

95

NEW JERSEY

Center

City

University of Pennsylvania

Note: Data as of June 8.

Source: Philadelphia’s Office of the Controller

THE WASHINGTON POST

Gun violence in Philadelphia this year

Somerton

There were more than 1,000 shootings in Philadelphia this year so far, and 198 deaths. One-fourth of the victims were under 21.

Shootings

Philadelphia

Torresdale

95

Carroll Park

Kensington

Center

City

University of

Pennsylvania

95

PENNSYLVANIA

NEW JERSEY

Delaware

River

Note: Data as of June 8.

Source: Philadelphia’s Office of the Controller

THE WASHINGTON POST

Last year, students from a single high school in North Philadelphia mourned the loss of nine classmates. A few weeks ago, as students were leaving the same school, shots rang out, and three teens were struck. An elementary school was also dismissing down the block.

The geography of the most affected areas overlaps almost perfectly with the discriminatory lending practices of the last century. This is far from coincidence. Labeling certain neighborhoods “undesirable” — and denying them opportunity for upkeep and growth — exacerbated precisely those factors that aggravate violent crime: crumbling buildings, failing schools, overgrown green spaces and a dearth of economic opportunity.

This is how the trauma of gun violence overwhelmingly affects Black and Brown families who already suffer the ongoing effects of systemic racism in health care, justice, education, housing and employment. The connection of gun violence to place reflects the extent to which violence takes over when we abandon entire communities.

There are things we can do, if only we have the will. In Pennsylvania, as in most other states, children can purchase powerful assault-style weapons on the day they turn 18. Gun owners can legally leave firearms loaded and unsecured. There are more guns in this country than people, and the research is clear: Common-sense gun control dramatically reduces firearm death and injury.

But for us to solve the problem of this highly concentrated, place-based violence, we also need to focus on the places it occurs and the people most impacted. Reinvestment in struggling communities needs to be integral to any solution.

Studies show that it works. In Philadelphia, a project that greens spaces, remediates dilapidated buildings and cleans trash from the streets has been shown to reduce gun violence by an incredible 29 percent. Studies also show that offering mentorship for youth, providing job training and employment opportunities, and incorporating trauma-informed care can have enormous impact.

Neither common-sense gun laws nor interventions that address root causes of place-based violence will happen in time to return my patient to his athletics. But together, they might just give his children the lives they deserve.

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