Guess What Can Reduce Violence? (Hint: Rhymes With LlamaCare)

Five years ago, after the Virginia Tech massacre, I wrote about various aspects of the difficult societal task of reducing violent acts. (I think it still holds up, if you're interested.)

While reporting that piece, I had a great conversation with Bill Woodward of the Center for the Study of Prevention of Violence at the University of Colorado. The center compiles and analyzes research and practices, in hopes of providing empirical support for policy-makers.

During the interview, I got the impression that almost everything about violence prevention is ambiguous, unknown, or understudied. Ask about an approach, and you'll find that it either doesn't show any positive result, shows marginal results that may not be reproducable, or hasn't been measured in any serious way at all.

I asked Woodward whether there was anything that we know actually works. Oh, sure, he said -- there is one program that we absolutely know dramatically reduces violence (and other problems) over time. As I described it in that article, the program

...assigns a registered nurse to first-time at-risk mothers-to-be, to meet and discuss approaches to a healthy pregnancy and child-rearing over the course of two years.

It's called the Nurse Family Partnership, and it's been the subject of long-term tracking studies since the 1970s. In addition to all the short-term gains -- less child abuse and neglect, less need for government aid, increased school readiness, and so on -- the kids are less than half as likely to be arrested by age 20, and commit far less violence as juveniles.

A review of home-intervention methods conducted last year found the Nurse Family Partnership far and away the most effective in achieving measurable positive outcomes. As Woodward explained to me, the program has been studied enough to know what specific criteria are necessary. For example, it has to be an RN; it doesn't work with social workers. And it has to be the mother's first child.

Back in 2007, Woodward told me that the program was not expanding beyond the occasional trial here and there -- and the reason was simple: there's no political interest in funding something that doesn't show results for many years.

Well, today that's changing -- the Nurse Family Partnership is now operating in 40 states, and expects to serve more than 50,000 families by 2016.

That's mostly because of a $1.5 billion funding stream included in the Affordable Care Act -- aka ObamaCare -- for evidence-based home-visit programs.

Woodward was unaware of this development, when I spoke with him today -- but he was glad to hear it. He says there is increasing interest among policy-makers to use "evidence-based" programs, especially when a dollar figure benefit can be attached to it. A RAND Corporation study has estimated a $5.70 payback for every dollar invested in the Nurse Family Partnership; a new Washington State Institute for Public Policy study puts the number lower, but still more than two-to-one.

It would be folly, of course, to say that this or any social policy would prevent any specific act. But the evidence is very clear that, down the line, far fewer people will be harmed by violence if these programs are implemented.

Which, of course, they won't be if Mitt Romney and Congressional Republicans repeal the Affordable Care Act, as they have vowed.


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