slate | Gary Slutkin is a professor of epidemiology and public
health at the University of Illinois at Chicago. He is the founder and
executive director of CURE Violence. Two shocking street killings by
children inspired him apply the tools of epidemiology to violence—and
discover how to immunize against it.
Madhumita Venkataramanan: You began your career working on infectious diseases. What was your focus?
Gary Slutkin: I began to understand how diseases spread—and how to control them—with tuberculosis. From 1981 to 1984, I was an infectious-disease fellow at San Francisco General Hospital and was then made responsible for controlling TB in the whole city. I had to learn all the characteristics of spread and how to find active cases and "contacts"—people who can transmit it invisibly. Later, I worked on cholera and TB in Somalia. And from 1987, I worked at the World Health Organization for seven years on HIV and AIDS epidemics in Africa.
Gary Slutkin: I began to understand how diseases spread—and how to control them—with tuberculosis. From 1981 to 1984, I was an infectious-disease fellow at San Francisco General Hospital and was then made responsible for controlling TB in the whole city. I had to learn all the characteristics of spread and how to find active cases and "contacts"—people who can transmit it invisibly. Later, I worked on cholera and TB in Somalia. And from 1987, I worked at the World Health Organization for seven years on HIV and AIDS epidemics in Africa.
What strategies were most successful for stopping the spread of disease?
Controlling HIV was almost entirely about changing behavior. I ended up hiring a lot of psychologists and others who understood how to change community norms. In Uganda we ran an education campaign to destigmatize HIV-positive patients, explain how HIV is transmitted, and promote prevention, including using condoms. The dominant message was "stick to one partner."
Controlling HIV was almost entirely about changing behavior. I ended up hiring a lot of psychologists and others who understood how to change community norms. In Uganda we ran an education campaign to destigmatize HIV-positive patients, explain how HIV is transmitted, and promote prevention, including using condoms. The dominant message was "stick to one partner."
What prompted your shift from disease to street violence?
After 10 years working in Africa, I moved back to the United States in 1994 and was looking for how I could be useful at home. Two incidents from that time had a big impact on me. One was a 12-year-old boy who performed an "execution style" killing under a bridge. The other was another 12-year-old who threw someone, making them fall seven to 10 flights from a housing project, for not giving him some candy.
After 10 years working in Africa, I moved back to the United States in 1994 and was looking for how I could be useful at home. Two incidents from that time had a big impact on me. One was a 12-year-old boy who performed an "execution style" killing under a bridge. The other was another 12-year-old who threw someone, making them fall seven to 10 flights from a housing project, for not giving him some candy.
When I looked into it, I thought the strategies being used against
violence had no chance of working. They had little scientific basis and
grossly misunderstood and overvalued punishment. I knew violence was a
behavior – just like exercise, smoking, overeating, or having sex. It
looked to me like a field with a giant gap.
