October 2002

Grant Results

SUMMARY

The Carter Center worked to mobilize community action against youth firearm violence.

Under the project, named "Not Even One," Community Action Teams (CATs) were formed at demonstration sites in three states (California, New Mexico, and Georgia). CATs included local community members, parents, clergy, and representatives from law enforcement, education, and public health agencies. CATs were to:

  • Collect public health data on fatal firearm injuries on youths.
  • Collect data sufficiently detailed to prepare written portraits "putting a face" on the victims.
  • Use the data to develop viable, effective interventions at the community level and, eventually, nationally.

Key Results

  • By early 1998, CATs had collected information on 75 victims of firearm violence, but they were not successful in obtaining all the desired epidemiologic and other public health data.

    Barriers included the reluctance of law enforcement agencies to share data on cases still under investigation and families' unwillingness to discuss the deaths of their loved ones.

    Citing the data-collection problems, the Carter Center shut down the three sites in May 1998 and hired an independent evaluator to conduct a review of the project.

Key Findings
The evaluator concluded that:

  • CATs potentially could be trained to collect public health data.
  • That activity might also be assigned to a group with more experience in this area, such as a local health department or an academic institution, allowing CATs to focus on intervention activities.

The Carter Center subsequently proposed shifting responsibilities for data collection from CATs to local public health agencies. RWJF and the Carnegie Corporation of New York declined to support the modification, bringing the project to an end.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $507,771 in partial support for the effort.

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THE PROBLEM

Firearms are a significant public health problem in the United States, and they have an especially great impact on youth. Homicide and suicide — the bulk of which are committed with firearms — are among the leading causes of death for adolescents and young adults.

Even so, there is a limited understanding of the problem of firearms, and as with many complex problems, community-level analysis of the problem and activities based on this analysis may have a greater capacity to make improvements than more distant or speculative policy changes.

Founded by former President Jimmy Carter, the Carter Center promotes human rights, conflict resolution, and health care in the United States and abroad. In February 1994, the center's Interfaith Health Program and the Carnegie Corporation of New York convened a meeting on the problem of firearm violence among young people. This meeting led to the publication of Not Even One: A Report on the Crisis of Children and Firearms (Atlanta, Ga.: The Carter Center, 1994), which outlined a preventive, local approach to youth firearm violence.

The goals of this approach were to identify the risk factors for firearm violence and then use this knowledge to develop viable, effective interventions at the community level and, eventually, nationally. It was named Not Even One, reflecting the conviction that not even one child's death is acceptable or inevitable.

Central to the Not Even One approach was the formation of Community Action Teams (CATs) made up of local community members; parents; clergy; representatives from law enforcement, education, and public health agencies; and residents who personally had experienced the effects of child firearm violence.

Public health and research professionals were to train CAT members to identify firearm-related deaths of young people and to collect a variety of epidemiologic and other data that might provide clues to the causes of and solutions to youth firearm violence. Through initial grants from the Carnegie Corporation of New York and an anonymous donor, CATs were formed in the Compton and Long Beach communities of California and in the Santa Fe and Albuquerque communities of New Mexico.

From these initial demonstration sites, which were chosen because of their diversity, the Carter Center hoped eventually to affect the project's replication in communities throughout the country.

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THE PROJECT

This grant from RWJF to the Carter Center provided partial support for Not Even One. It was co-funded by the Carnegie Corporation of New York. Not Even One was to continue its work in its two demonstration sites and add a third in Atlanta, Ga.

At all three sites CATs were expected to:

  1. Collect public health data on fatal firearm injuries of youths up to age 19 (age 24 in Santa Fe).
  2. Collect data sufficiently detailed to prepare written portraits that would put a face on the victims.
  3. Use both pieces of data to encourage systematic changes likely to result in fewer firearm deaths among youth.

The Carter Center planned to compile, analyze, and disseminate the teams' findings.

By early 1998, CATs at the three sites had collected information on a total of 75 firearm deaths of young people (of these, 64 were homicides, 8 were suicides, 2 were from accidents, and 1 was undetermined). However, none of the site teams were successful in obtaining all of the desired epidemiologic and other public health data. A number of barriers contributed to CATs' difficulties, including:

  • Law enforcement agencies were reluctant to make data available in cases still under investigation.
  • In many cases, the family dealing with the loss of a child was not yet ready to discuss their child's death. In other cases, the family had moved away and could not be located by CAT members.
  • A lack of coordination between the local police and the federal Bureau of Alcohol, Tobacco, and Firearms (ATF) in tracing guns exacerbated the difficulty of investigating cases, especially those not yet solved.

In May 1998, citing the data collection problems, the Carter Center shut down the three sites and contracted an independent evaluator, Kenneth Powell, M.D., M.P.H., an epidemiologist retired from the federal Centers for Disease Control and Prevention, to conduct a review of the project. His September 1998 report included the following findings:

  • Although the assembled data are too inconsistent in quality to be useful, they do serve to reaffirm the magnitude and severity of the problem. The experiences and data from the three sites provide "poignant vignettes as well as simple numbers about the tragedies of fatal firearm injuries of youth," and they found that the assembly and systematic dissemination of similar information could highlight the problem and suggest solutions.
  • Although the results indicate CATs could collect public health data if sufficiently trained and focused, that task might also be given to local health departments, academic institutions, or other groups accustomed to data collection and management, allowing CATs to focus on intervention activities. "The real utility of the [CATs] has yet to be demonstrated," Powell wrote. "I would expect community action teams to be more effective data users than data collectors."

Following the review, the Carter Center proposed shifting data collection responsibilities from CATs to local public health agencies. Both RWJF and the Carnegie Corporation of New York declined to support this modification, effectively ending the project. The Carter Center returned unspent monies to both foundations.

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LESSONS LEARNED

  1. It is vital to establish the primary focus of a project early. The funders focused on the community-action potential of the project, which they assumed would be informed by the data collection activities. The Carter Center envisioned the project as a blend of public health science and community activism, but ultimately it judged the project's success on the quality of the public health data collected. Had the project developers and funders developed a joint focus, the project might have proceeded differently.
  2. Engagement of local residents in solving a community problem can help them gain understanding of their role and power in the community, but tasks must be appropriate to what groups can accomplish, or they must be augmented with professional experts. If the project had not been shut down, it is likely that CATs would have succeeded in assembling profiles of the youthful victims of firearm violence in order to put a face on the problem, but they were not trained nor were they accustomed to collecting epidemiologic and other public health data. The teams would have been more effective had they included professional epidemiologists to guide the data-collection efforts.

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GRANT DETAILS & CONTACT INFORMATION

Project

Developing Community Responses to Youth Firearm Violence

Grantee

The Carter Center (Atlanta,  GA)

  • Amount: $ 507,771
    Dates: February 1997 to January 2000
    ID#:  030871

Contact

William H. Foege, M.D.
(404) 687-5603
Wallace S. Woodard, Ph.D.
(404) 206-5007
tapwsw@langate.gsu.edu

Web Site

http://www.cartercenter.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Powell K. An Epidemiologic and Public Health Evaluation of the Carter Center's "Not Even One" Project. Atlanta, Ga.: The Carter Center, September 1998.

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Report prepared by: Janet Spencer King
Reviewed by: Richard Camer
Reviewed by: Michael H . Brown
Program Officer: Janet Heroux
Program Officer: Floyd Morris