The Yale Schools of Medicine and Public Health and the Urban League of Southern Connecticut are teaming up with more than a dozen nonprofit organizations and local government agencies to see if an infusion of community programs and interventions in New Haven can mitigate systemic racism and reduce gun violence in the city.
The effort is part of a novel study, called TRUE HAVEN: Trusted Residents and Housing Assistance to Decrease Violence Exposure in New Haven. The study is being led by Yale Brita Roy, MD, MPH, MHS, assistant professor of medicine (general medicine) and of epidemiology (chronic diseases) and core faculty of the SEICHE Center for Health and Justice, and Virginia Spell, chief executive officer of the Urban League of Southern Connecticut.
Roy first became involved in this work a decade ago as a Robert Wood Johnson Clinical Scholars Program fellow (now the National Clinician Scholars Program), through the community-based participatory research curriculum of Yale’s Center for Research Engagement. As faculty, she continued this partnership to understand how social cohesion and community well-being can influence rates of gun violence. Previously, she and the community-academic research team had found that eviction rates and fractured bonds within neighborhoods were both associated with higher rates of gun violence.
“Places with higher levels of social cohesion and collective efficacy had lower rates of exposure to gun violence,” Roy said. “So that provided some support for our theory that to break the cycle of chronic community gun violence, we could try to improve social cohesion within neighborhoods that have high rates of violence.”
As part of the study, every year for the next three years, families in six primarily Black and Hispanic/Latino New Haven neighborhoods will gain access to a wide range of intervention programs — including tailored financial education and housing assistance, as well as access to trauma-informed counseling — in an effort to counteract what prior research has shown to be a precursor to gun violence: systemic racism.
“We don’t want to see people get involved in gun violence again after release from prison,” Spell said. “We want to create the conditions that allow people to have a fresh start and be able to secure and sustain stable housing and become productive members of society.”
Spell said she was immediately intrigued by Roy’s proposed approach to reducing violence and strengthening communities in New Haven.
“When Brita brought the opportunity to the Urban League, I was excited that we would be offered the opportunity to participate in it because for us, it really is about housing stability,” Spell said. “It's about addressing health disparities in our community. And it's about reducing gun violence. So, everything seems to sync together so well for us.”
The two leaders of the project hope it will be replicated in other communities if it is successful.
“I think that's the exciting thing about this,” Spell said. “We have a model that might be replicated all over the country, if not all over the world, in addressing gun violence and housing stability. I think it's unique. We've not seen anyone do it quite like this. And we've got the right partners at the table that really can play a role in ensuring that we're successful.”
Over the course of the study, TRUE HAVEN plans to enroll 1,400 families who have experienced the effects of incarceration first-hand, including those with members living in prisons or returning home. The researchers will employ a stepped-wedge design, applying community-developed interventions in two neighborhoods every year until all six targeted areas have interventions in place.
It’s an ambitious plan that has the community support systems — and the money — in place to test some big hypotheses, Roy said.
“Yale University, the Yale New Haven Health System, local philanthropy, and other organizations have contributed over $1.25 million to date to be used for housing support and other forms of expertise for these neighborhoods and families,” Roy said. “The city of New Haven and the state have also offered direct access to housing assistance programs. Importantly, these programs will not exclude people with a history of incarceration.” Organizations like Ice the Beef and ConnCAT aim to engage children in youth programs and mentorship. Clifford Beers Clinic, a counseling nonprofit in New Haven will equip community leaders with trauma-informed strategies needed to spot mental health crises and point families in the right direction for help and destigmatize getting such help.
An award from the National Institutes of Health will provide an additional $3.9 million over five years for the implementation and evaluation of the TRUE HAVEN program, she explained.
Study leaders will measure a broad range of outcomes to assess the success of the different interventions. They will consider how much money is saved by each family during the study, the extent to which participants’ credit scores improve, and the number of people counseled by community members, among dozens of other metrics.
The New Haven Police Department will provide vital statistics to understand the trends of gun violence across the city.
Addressing structural racism
The researchers are also seeking to counter systemic racism through education and policy changes at the local, state, and federal levels.
TRUE HAVEN researchers are assembling a group of local leaders and government officials to address laws that may directly and indirectly contribute to gun violence, including hiring and home loan policies that exclude those with a criminal record. This group, called the Community Advisory Board, will also oversee the project’s partnerships with partner organizations and the study interventions.
Separately, the Urban League of Southern Connecticut is spearheading an effort to teach financial literacy classes to members of participating neighborhoods – an education that many in historically neglected regions miss out on.
“We work on helping them clean up their credit and live on a budget and all of the basic things that oftentimes, in communities of color, we didn't get at the kitchen table,” Spell said. “Talking about how to manage a budget and manage a household weren't things that you were taught. So, we're stepping in to fill that role. We really want to take people back to basics, and make sure that they have the tools and the skills that help them be successful long term.”
Spell hopes the study might be able to help break the cycle of gun violence on a more permanent level.
“We believe in not just giving people fish and teaching people how to fish, but also ensuring that people in the community have a say in who is allowed to fish and equitable access to fishing poles and bait” she said. “That's what creates long-term sustainability.”