Surgeon says interventions can help disrupt cycle of violence

Dr. Moncure.

Violence tears apart too many young lives in minority communities, but interventions at crucial times can help reduce such violence and its effects, Dr. Michael Moncure said at the 2018 Dr. Reaner & Henry Shannon Lecture, held Feb. 23.

In his presentation at the UMKC School of Medicine, “Factors Associated With Interpersonal Violence in Minority Communities,” Moncure recounted anti-violence efforts from his career as a trauma surgeon. And he praised and drew hope from such recent efforts as Kansas City’s AIM4PEACE, which de-fuses violence with effective actions backed by research.

The direct results of violence are devastating, Moncure said, citing Centers for Disease Control statistics for 2015: 44,000 suicides; 17,000 homicides; and $107 billion in lost wages. In Kansas City, Missouri, he noted, homicides spiked in 2016 and remained high in 2017. The toll on minority communities can be devastating, and particularly tragic when young lives are lost or disrupted.

Moncure, a professor in the Department of Surgery at the School of Medicine, said his first job was in Camden, New Jersey, at the time notorious for crime and poverty. Moncure got involved with a program much like the TV show “Scared Straight,” which showed young people in high-crime areas how bad life could be if they committed violent crimes and were imprisoned.

“Those programs had some splash, but they weren’t evidence-based,” Moncure said. The programs ultimately were ineffective. “We even got a little cocky, and shared some of our materials with adults” in the criminal justice system. It was a reality check, he said, when those adults were unimpressed and even incredulous that Moncure and his colleagues thought their efforts would have any effect.

Research on violence and trauma and their causes and effects has come a long way since then, Moncure said, and trauma has come to be seen much more broadly than shootings or other violent crimes. Many studies have associated both recurring violence and adult diseases such as cancer, diabetes, heart failure and hypertension with the number and severity of someone’s ACES — adverse childhood experiences. ACES include poverty, divorce, and incarcerated parent, violence in the home and sexual abuse.

But research also has shown that interventions to support trauma victims at the right times can reduce the effects of such trauma and often prevent more violence.

For example, Moncure said one shooting often leads to another in retaliation. But an intervention specialist quickly summoned to a hospital bedside can help the wounded person and calm friends and relatives who might think they know who fired the shots and are bent on revenge.

In Kansas City, Missouri, Moncure said, the AIM4PEACE program specializes in such interventions, builds healthy relationships and gets results. Those efforts also are part of a community-wide plan that includes social support, counseling, job training and other efforts to combat violence. Another benefit of having research behind these efforts is demonstrating that they are cost-effective. Moncure believes this has helped get support from the Kansas City business community.

Henry and Dr. Reaner Shannon sponsor the annual lecture, given Feb. 23 by Dr. Moncure.

Thankful to be part of the annual Dr. Reaner and Mr. Henry Shannon Lectureship in Minority Health, Moncure noted that the series, developed to create awareness about health disparities affecting underserved and minority communities, encouraged exploring solutions to society’s problems.

“There’s no better use of science,” he said.