New Orleans health director Dr. Jennifer Avegno went before the city council last month to present a vision for a new “public health” driven approach to gun violence — describing the killings in the city, which have reached the highest levels in years, as an epidemic. 

She emphasized the need for robust programming to address the underlying conditions of violence, along with targeted interventions to interrupt conflicts before they escalate and to provide services to those most likely to be involved.

“There must be a community-wide, public-private collaborative with real infrastructure and capacity that works solely on a violence reduction strategy and can implement it quickly,” Avegno told the council. “This group should survive political administrations. It should be highly resourced.” 

It was presented as a new approach. But it sounded remarkably similar to the plan Mayor LaToya Cantrell rolled out when she created the now-embattled Office of Gun Violence Prevention just two years ago. 

That was also pitched as a long-term public health approach to “meaningfully reduce the number of gun-related murders in the city over the next 50 years” by treating the violence as an epidemic. And it was meant to bring all the violence reduction efforts under a single umbrella, attract private funding, rigorously evaluate the various approaches, and scale up what worked. 

So, what happened?

The Office of Gun Violence Prevention technically still exists, but as a shell of what it once was. At the beginning of the year, it laid off all its employees — aside from its Director Patrick Young — and ceased nearly all operations. The given reason for the shut down was a lapsed cooperative endeavor agreement between the office and its fiscal sponsor, the Urban League of Louisiana. But while a spokesperson for Mayor Cantrell’s administration told The Lens in mid-January that a new CEA would be signed within two weeks to resume its programming, it appears that has not yet happened. 

A spokesperson for the city has not responded to any inquiries from The Lens related to the gun violence prevention office for the past month, including questions about whether or not the office had any reason to believe its former employees would return to work.

Even prior to its ostensibly temporary shut down, the office has been under fire by members of the New Orleans City Council. The critics have claimed that the office has never shown that their programming is effective in actually reducing violence, and that it has not been transparent with how it spends money. In addition, they say the office’s relatively modest funding — around two million dollars between city funding and private dollars, shows it was never a priority for Cantrell’s administration in the first place, despite the grand rollout. 

They have also questioned the office’s decisions to shift away from a violence interruption model that existed under Mayor Mitch Landrieu known as CeaseFire, and later Cure Violence, that use “credible messengers” to intervene and mediate conflicts before they turn violent. Under Cantrell’s Office of Gun Violence Prevention, there were social workers dispatched to the scenes of shootings and at hospitals to offer services, but not primarily to mediate and prevent violence through interruption. 

So now, as the city faces a crisis of violence, that at this rate will leave 1 in 14 Black children dead before they reach 35, it currently lacks any coordinated non-law enforcement program to attempt to stop it. Meanwhile, in other cities, tens of millions of dollars are being poured into those efforts. 

That is all despite the fact that Cantrell pledged to make non-law-enforcement intervention central to her violence reduction strategy during the early days of her administration. 

Council looks to health department

Frustrated with the current situation, the City Council last month passed a motion instructing the health department to develop a new violence prevention strategy — essentially telling one city agency to recreate the work that another was already tasked with doing.  

Moreno, who introduced the motion, told The Lens that she is confident that the leadership at the health department — in particular, Avegno —  will be able to accomplish what she says the gun violence prevention office hasn’t. Ultimately, she said she hopes the program will grow to be on par with the more robust intervention programs in other cities, and anticipates a price tag of anywhere between $25 and $50 million dollars to implement. 

It’s unclear what the ultimate relationship will be between the Office of Gun Violence Prevention and the new program under the health department. In an interview, Avegno said that she works well with Director Young, but “they’re in a tough spot at the moment, because he’s kind of their only staff.”

In any case, she said that the program she hopes to develop will be sustained beyond the current mayoral administration. 

“It’s got to transcend any one administration,” she said. “If you’ve lived here long enough, you’ve seen various initiatives start. And they do some things for a couple of years, and then they go away. And then we’ve got to restart all over again.”

An equivalent investment

Avegno told The Lens that she hopes to make the case to the mayor and the City Council in the coming weeks and months that the few million dollars that has historically been spent on targeted non-law enforcement gun violence prevention is a fraction of what is needed.

“I’m glad that we’ve been able to dedicate tens of millions of dollars to police, and to criminal justice improvements in the last year or so,” Avegno said. “We need a robust, equitable, stable law enforcement. What I really want to do is make the case that we need an equivalent investment of tens of million dollars that is sustainable and lasting in really what are human services programs.”

Currently, she said, she is working on a “landscape analysis” of existing public health and intervention programming in the city meant to address violence to determine what should be continued and what could be scrapped — including, ostensibly, those programs previously being run by the Office of Gun Violence Prevention.  

“What programs do we have?” she said. “Who are they serving? How many people are they serving? Do we have evidence to suggest that they’re doing what they’re supposed to be doing? Or that they’re effective? What are the gaps?” 

Initially she plans to advocate for several initial allocations of federal funding to get started on “catalytic” programs that she believes already have shown evidence of effectiveness — mostly money from the American Rescue Plan Act. Like past iterations of violence reduction programs in the city, she said that ultimately she anticipates that much of the funding will be routed to independent non-profits to do the work of violence prevention. 

Last month, city council crime analyst Jeff Asher, who Avegno says she has been working with on her analysis, produced a document of programming in other cities that has been shown to reduce violence with varying degrees of success. 

Some strategies focus on environmental improvements, such as increased street lighting and pollution reduction. For instance, the report suggested that ensuring households in neighborhoods with historically high violent crime rates having access to affordable air conditioning and heating with high-quality HEPA filters could reduce violence, citing a study in Los Angeles that showed violent crime increased by 6.1 percent on days when wind brought in dirty air to the city.

Others focused on economic opportunities, including a summer youth employment program and occupational training and subsidized employment for out of school residents. 

Perhaps the most robust program included in the report is an initiative launched in Chicago in 2017 called the Rapid Employment and Development Initiative (READI), which uses referrals from community organizations, along with an analytics tool based on law enforcement data to identify individuals with the “highest risk for violence involvement” and provides them with twelve months of programing that includes subsidized employment, cognitive behavioral therapy, skills training, and other support services. According to Asher’s report, participation in READI significantly reduced the likelihood of arrest for homicide or shooting, as well as the possibility of victimization. That program costs around $20,000 per participant.

The READI program claims that the list of individuals they develop is never shared with law enforcement, but the use of similar predictive data analytic tools has proved controversial in New Orleans in the past.  

In 2018, The Verge revealed that Mayor Mitch Landrieu’s administration had been quietly using software developed by the technology company Palantir to produce a list of individuals to target as part of the Group Violence Reduction Strategy — part of his broader NOLA for Life murder reduction effort. Some of those individuals were “called-in” with social service providers and various law-enforcement agencies and given the option to participate in social programs or be subject to “enhanced prosecution.” 

After the agreement with Palantir lapsed in 2018, The Lens obtained emails showing that the Cantrell administration was working to develop another tool utilizing law enforcement data to identify individuals with the help of sociologist Andrew Papachristos — this time to target for “impactful social interventions.” But little was made public about the effort, and civil liberties groups again raised transparency concerns, along with questions about how the information would be used and whether or not it would be shared with law enforcement. 

It is unclear what, if any, new tools might be utilized in the new effort being developed by the health department to identify individuals. 

Moving forward

Avegno, who was a proponent of CeaseFire even before she became health director, said that reviving a violence interrupter model that utilizes credible messengers would also be an early priority for her. She said that she envisioned both a hospital intervention program run by the University Medical Center — the city’s lone trauma center —  along with a community violence intervention program with people actively working in neighborhoods who attempt to diffuse tension before it escalates to violence.

But she said she was also concerned that interrupters shouldn’t be the only thing people rely on in the city to prevent violence from happening. 

“I think, in previous times, and in other cities, everything is put on that one program’s shoulders,” Avegno said. “That’s setting them up to fail. So I just want to be mindful that they fit as a key part of a whole larger strategy.”

Moreno said that in some ways she hopes the new health department program will resemble Landrieu’s NOLA for Life program, but with more continued emphasis on the social services and violence interrupter portions as opposed to law enforcement. 

“On the policing side, you can have, you know, the best police department in the world with as many police officers as you need,” she said. “But if you don’t do the preventative piece, and you don’t do it, right, and you don’t have enough funding for all the programmatic pieces that are necessary, and you’re not working with the school system, and you’re not providing job skills, and all those different things, you’re never going to break that cycle.”

The council didn’t give any specific timeframe for when Avegno should have the plan completed by.

“My hope is that I will get them something before they start asking for it,” she told The Lens.