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ISEP: An approach to preventing violence and homicide

by Dr. Bruce W. Randolph —

According to the Memphis Shelby Crime Commission’s STATS, gun related violent incidents in Memphis increased 19.3 percent in 2020 compared to 2019. In 2020, 65.5 percent of all total violent incidents were gun related compared to 60.2 percent in 2019. 

Memphis Police Department reported that a record high of 332 homicides occurred in Memphis in 2020. This is 139 (73 percent) more than the number of homicides (191) reported in 2019. 38 (11 percent) of these homicide victims were under 18 years of age.

In 2017, there were 19,510 deaths by assault (homicides) in the United States, 556 in Tennessee and 195 in Shelby County. Homicide rates were 6/100,000 people for the United States, 8.3/100,000 for Tennessee, and 20.8/100,000 for Shelby County. In essence, the overall homicide rate in Shelby County is 3.5 times higher than that of the Nation and 2.4 times that of the State.  

Of the 195 deaths that occurred in Shelby County in 2017, 49.2 percent involved victims ages 18-34 and 39.0 percent of the victims were ages 35-65. Therefore, 88.2 percent of the homicide victims were ages 18-64. Also, 84.6 percent of the victims were male compared to 15.4 percent female; 85 percent were African American compared to 12.8 percent white and 92.3 percent of the homicides involved a firearm. 

Further analysis of homicide deaths in Shelby County revealed that the homicide rates by County Commission Districts ranged from the lowest rate 5.2/100,000 (District 2) to the highest rate 127.5/100,000 (District 10).  

The four County Commission Districts with the highest homicide rates are District 10 (127.5/100,00), District 8 (92.5/100,000), District 7 (91.4/100,000), and District 9 (85/100,000).

The four County Commission Districts with the lowest homicide rates are District 2 (5.2/100,000), District 4 (9.3/100,000), District 11 (17/100,000), and District 12 (25.5/100,000). 

Only one County Commission District (District 2) has a homicide rate which is less than the rates for the State and Nation. The homicide rate in District 10 (127.5/100,000) is 25 times higher than that of District 2, 6 times higher than Shelby County (total), 15 times higher than the State, and 20 times higher than the Nation.

In an attempt to understand and explain the disparity in homicide rates between County Commission District 10 and County Commission District 2, I reviewed some demographic data from the US Census Quick Facts pertaining to Shelby County, Memphis and Collierville.  Although the data are not specific for the two Commission Districts, I believe the data are representative. 

County Commission District 10 encompasses the following neighborhoods: South Memphis, Central Gardens, Chickasaw Gardens, Cooper-Young, Midtown, Orange Mound, and Overton Square. While County Commission District 2 encompasses Collierville and portions of unincorporated areas of Shelby County surrounding Collierville.

When comparing Memphis to Collierville, the poverty rate in Memphis is 6.4 times higher, the median household income is 2.8 times lower, and the median value of owner-occupied homes is 3.1 times less (Table 1). 

Do these disparities explain why the homicide rate in County Commission District 10 is 25 times greater than the homicide rate in County Commission District 2? I don’t think so. There are many poor people who do not commit violent crimes or homicide, and there are many rich people who do. While a lack of money may be a contributing factor to violence, I do not think it is the underlying cause. 

Poverty alone does not explain why some people will drive down the interstate shooting at each other. Nor does it explain why someone will shoot innocent children playing in the yard, or shoot someone during the course of an argument. 

Poverty is not an excuse nor does it explain why we are experiencing an epidemic of violence and homicides in Shelby County. We must explore deeper to get to the root cause(s)of violence and homicides). Just as a plant has multiple contributing roots, so do violence and homicide have multiple contributing causes.

Disparities in health status, life expectancy, and excess deaths between whites and blacks are well known and acknowledged. Health status is poorer, life expectancy is lower, excess deaths are higher amongst African Americans compared to whites. 

In developing strategies to address these disparities, two important things must be considered:

First, one must look outside the health sector and ask the question, who owns and controls income and wealth in the society? Health disparities are reflections of disparities in income, wealth, and political power in a given society.

Secondly, one must understand the relationship between the determinants of health and illness. These determinants include biological, environmental, behavioral, social, political and economic factors. 

Numerous studies have shown that there is a relationship between socioeconomic status and health status. The higher the socioeconomic status, the better the health status of the individual or group. The lower the socioeconomic status, the poorer the health status of the individual or group. This relationship has been known to exist since the 12th century.

Analysis of the demographics of Shelby County, Memphis and Collierville has led me to conclude that the relationship between socioeconomic status and health status that has existed since the 12th century continues today into the 21st century. 

Today this relationship is known as “social determinants of health” –  conditions in which we are born, live, learn, work, play, worship, age and die. Health disparities that persist today are the result of disparities that exist in these “social determinants of health”.

Risk factors for homicide include race, gender, mood or mental health disorders, reckless behavior, gang involvement, drug involvement, access to weapons or firearms, family history of violence, drug use, low family socioeconomic status, antisocial behavior, family abuse, substance abuse, minimal family involvement, and increased neighborhood crime. Often, the victim and suspects are acquaintances, friends, spouses, intimate partners, and family members.   

Given that the contributing factors to violence and homicide are multifactorial, strategies for preventing violence and assault related deaths must involve multiple, simultaneous, comprehensive and sustained approaches. The approach that I am proposing involves practicing the concepts of “ISEP”:

I – Intellectual Transformation resulting from:

  • Acquisition of knowledge and skills (education)
  • Enhanced awareness and consciousness
  • Commitment and willingness to change
  • Positive thinking
  • Love and respect of self and others, and one’s culture, and heritage

S- Social Change brought on by:

  • Changing attitudes, values, practices, norms, and culture
  • Establishing positive, productive, and healthy personal relationships
  • Developing social cohesiveness and unity
  • Engaging in collective work and responsibility

E- Economic Empowerment resulting from:

  • Working productively
  • Earning, saving, and investing money
  • Spending and consuming wisely
  • Developing businesses and creating jobs
  • Pooling resources and forming coalitions

P- Political Engagement by:

  • Becoming organized, forming coalitions and getting involved
  • Influencing public policy and legislation
  • Voting and seeking public office
  • Advocating, lobbying, and campaigning
  • Promoting and protecting one’s interest

The concepts of “ISEP” must be practiced on multiple levels: individual, family, community, city, county, state and nation. Unless, we individually and collectively, practice the concepts of “ISEP”, no significant changes in social determinants of health, violence and homicide will occur. 

What would be the response of the people living in County Commission District 2 if the homicide rate was 127.5/100,000 instead of 5.2/100,00, almost 25 times higher? I believe that the response would be very different than the response that is currently occurring in County Commission District 10. I also believe that the reason why the homicide rate in County Commission District 2 was 5.2/100,000 rather 127.5/100,000 is because the people living in District 2 practice the concepts of “ISEP”.

We must come to realize that the change that we desire begins within, within our minds, hearts, families, neighborhoods and communities. We must realize that we have the power to bring about change if we have the will to do so. Others may help, but only we can liberate ourselves from the bondage and terror of violence, assault related death, and disparities in education, income, wealth, and health. 

It is important that we understand that the first step toward freedom is to overcome fear. A fearful people will never become a free people. As a society, we must no longer allow our children, families, neighborhoods and communities to be terrorized.  

Lessons from our country’s history teaches us that change never occurs without struggle, sacrifice, and service. The questions that we must all ask and answer are: 

What struggle am I willing to engage in, what sacrifice am I willing to make, and what service am I willing to give? 

Am I willing to practice the concepts of “ISEP”?

(Dr. Bruce Randolph (MD, MPH) is the health director for Shelby County.)

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