Will Minneapolis’s “leap of faith” leave the city in the dark?

Some rousing words and a cautionary tale from Minneapolis, whose public health Blueprint for violence prevention has been earning the plaudits of the US National League of Cities.

The League represents municipal government throughout America promoting cities as “centers of opportunity, leadership and governance”.

The Minneapolis initiative, which began in 2007, has been built on an impressive community alliance spreading outward from the office of Mayor R T Rybak, and taking expert advice from the Schools of Public Health at the universities of Minnesota and Harvard.

The Harvard expertise was provided by professor of public health practice, Deborah Prothrow-Stith [1], whose advice went into the Blueprint in the form of a five-point desiderata:

• violence is preventable; be intentional about participation with young people and hear from the diverse group around you
• look at the full spectrum of prevention – if you deal with only one age, you’ll never get out of the box
• get in for the long haul – it won’t happen short-term
• use a “Johnny Appleseed” approach – not a “cookie cutter” approach
• avoid never getting out of the dock: design the perfect vessel but don’t worry about it being perfect – take a leap of faith.

The equivalent exhortation from Minnesota professor and pediatrics and public health, Michael Resnick [2], was for a strategy based on protective factors borne by ideas about connectedness – to parents and family, school and community – and the definition of child development as an "intentional process of providing support, relationships, experiences, resources and and opportunities that promote positive outcomes for young people”.

Minneapolis translated these messages into four goals:

• support for for every young person in the city from at least one trusted adult in their family or their community
• intervention at the first sign that youth and families were at risk for or involved in violence
• resolve never to give up on “our kids”; work to restore and get them back on track
• recognition that violence is learned and can be unlearned by reducing the impact of violent messages in our media, culture and entertainment.

On the back of these stirring recommendations and goals, Minneapolis launched a plethora of mentoring, skills building and coaching programs – some, such as Functional Family Therapy, Multisystemic Therapy and Big Brothers Big Sisters, more familiar than others (the city KidsChange agency, for example, is offering choices of early intervention programs from a menu of around 70).

In its latest report, The State of City Leadership, the National League of Cities congratulates Minneapolis on its efforts and calls the Blueprint one of the three most innovative US city models for preventing youth violence, alongside initiatives in Portland Oregon and Fort Worth, Texas

Crucially, the League adds, “Minneapolis has successfully reframed youth violence as a public health issue through an extensive process of planning and community engagement which has united and galvanized community leaders and residents around a broader vision of youth violence prevention”.

The cautionary aspect of the city’s progress concerns the collective approach to evaluation methods and “outcomes”. Nine measures were published at the outset, four of them relating directly to violent acts committed by or against young people – homicides, aggravated assault arrests, simple assault arrests and school suspensions for violence-related incidents.

Three more measures were intended to address risk factors associated with violence: curfew and truancy pick ups, weapons possession arrests and teenage pregnancies.

High school graduation rates; and college “readiness” also figured but they were not regarded as being as valuable .

In November last year, the possible confusion between administrative outputs and child development outcomes became more noticeable, when Minneapolis newspapers began to publish stories attributing falls in the juvenile crime rate to the success of the preventive effort

One writer, Scott Russell of the Twin Cities Daily Planet broke ranks. “Here’s the timeline,” he wrote. “The city presented the Blueprint January 7. The program coordinator started in April. The implementation plan was completed by May. How could the Blueprint impact crime in the first six months of 2008, before it was even implemented?

He went on to question the disconnection between initiatives, such as increased youth programming in city parks, attempts to recruit 50 city employees as Big Brothers/Big Sisters and increased funding for home-visiting nurses, and the likelihood of crime reductions

“Here is the challenge. The Blueprint touts increased public health visits to teen moms. Yet it takes no measure of cuts to Hennepin County child protection funding. What is the net effect on prevention?"

Russell went on: “The city doesn’t have a comprehensive view of prevention programs. The city has no way to judge whether the number of opportunities – in sports, arts or community service - are up or down. It lacks data on programs or participation.”

Mayor Rybak acknowledged the argument, conceding that the reduced crime rate was probably due to a change in enforcement strategy that predated the city Blueprint, and – yes – prevention was a longer haul .

But last month’s National League citation persists, quoting a Blueprint report that points to a 29% decline in juvenile crime since since 2007, and 37 percent fall since 2006. “What’s more, in four of the five target neighborhoods, youth violence was down by an average of 39 percent since 2007 and 43 percent since 2006.”

See Minneapolis juvenile crime trends look good, but don’t credit prevention work—yet [3] and Minneapolis gets national acclaim for preventing youth violence [4].