Missouri gun violence is a public health problem: experts

Arletha Bland-Manlove cried out desperately for her nephew, driving with her sister from one end of Kansas City to the other, looking for him.

She knew he had been shot, but she didn’t know how or why, or which hospital he had been taken to. She didn’t know how badly he was hurt. As she drove, she bargained for his life.

“‘Please God, he’ll do this, he’ll do that, if he just makes it through,’” Arletha said. “I never believed he would die.”

With five bullet wounds in his body, Matthew Bland-Williams was already beyond saving by the time they found him at Centerpoint Medical Center in Independence. He died on July 23, 2020, just three months after his 26th birthday.

This, as the Bland family sees it, is the result of a system that undervalued his life, and of government leadership’s failure to protect it.

Police soon arrested the young man accused of shooting Matthew — he was caught on video — but that won’t bring Matthew back, family members said. Nor will it stop more young people like him from dying in future shootings in a place like Missouri, which leads the nation with its rate of Black homicide deaths.

“His death is a reflection of how society throws away Black life,” Arletha said. “And it is also a reflection of the way society has taught us to throw away Black life.”

Public health experts, gun violence researchers, and many public officials agree.

In Missouri, as elsewhere across the country, government leaders have for decades tried treating gun violence as a crime problem to be solved with law enforcement. But despite hundreds of millions of dollars spent every year on law enforcement budgets and prisons, the problem is worse than ever. Missouri recorded its highest levels of gun violence in history in 2020.

Instead, experts say, the state should look at gun violence as a public health problem to be solved by investing in improvements in underlying life conditions that put people at greater or lesser risk: income, housing and food security, schools and living environments — what researchers call the social determinants of health.

In Missouri, as elsewhere, structural racism puts Black residents at a disadvantage in those categories and is itself another risk factor.

Kim Gardner, the St. Louis Circuit Attorney, said the current system of enforcement and imprisonment does not lower gun violence.

“If more arrests and more prosecution equaled safer cities, the city of St. Louis should be the safest city in America,” Gardner said. “But it’s not, because we’re not dealing with the root causes of violent crime.”

To understand how public health issues inform real solutions to gun violence, The Star is launching a series of stories over the next several months exploring how Missouri communities are grappling with problems in income, housing, food security, education, environmental health and structural racism.

This story is the first of that series, examining how past strategies emphasizing law enforcement have proven insufficient and how community leaders see the way forward in addressing root causes. To produce this story, reporters met with families who have suffered from gun violence, interviewed public health experts, doctors, and elected officials, and analyzed federal, state, and local public health data.

The effort is undertaken as part of the Missouri Gun Violence Project, a two-year, statewide solutions journalism collaboration supported by the nonprofits Report for America and the Missouri Foundation for Health.

The Star found that it is no accident that Missouri lags the rest of the country by many public health indicators and also ranked third in the nation last year with its rate of gun deaths.

About 1 in 8 Missourians — more than the national average — lived below the poverty line in 2019, according to the U.S. Census Bureau. A similar number suffered from food insecurity — not having reliable access to enough good food.

Kansas City and St. Louis, where gun violence problems are the worst, had higher eviction rates than 75% of other large U.S. cities, according to Princeton University’s Eviction Lab.

The state ranks sixth-to-last in the nation for public health system funding, and 46th for state funding of higher education. When Gov. Mike Parson announced $209 million in new budget cuts last year, $131 million came from K-12 schools.

Dr. Mallory Williams, a trauma surgeon at Howard University Hospital in Washington, D.C. and member of the task force on gun violence for the National Medical Association, said social and health inequities that are ingrained in society have a big influence on the outcomes of peoples’ lives.

“When you don’t have thriving communities, then the firearm violence tends to go up in parallel with the misery,” Williams said. “When we go back and do an intellectual autopsy of these times, we’ve really got to take a close look at our culture and who we are as Americans.”

Across Missouri, lack of access to public health resources goes hand in hand with gun violence, both in the state’s largest cities and in rural areas.

St. Louis leads the state in gun violence and has the highest level of food insecurity, with 20% of the population struggling to eat well. Almost 40% of St. Louis children live in poverty, according to census data.

There and in Kansas City, Black men made up roughly three quarters of the homicide victims — a reflection, experts say, of social inequities in the state’s biggest and most diverse cities.

But in other parts of Missouri too, rural, mostly white counties facing high levels of poverty and low rates of education funding also have gun death rates that rival their more urban counterparts.

Pemiscot County, in southeast Missouri’s Bootheel region, has a population of about 15,000 but suffers from a higher rate of gun deaths than all but six of the state’s 114 counties. It also has the worst poverty and unemployment rates in the state.

Parson’s office, when reached by The Star to talk about public health approaches to gun violence, declined to make anyone available to discuss the topic.

Instead, a staffer directed a reporter to a fact sheet about Parson’s stance on the Second Amendment

When Parson, a former sheriff, has spoken publicly about violence, he has almost always framed it in terms of crime, avoiding language about guns. That leaves out the issue of suicide, which kills more than a thousand Missourians each year, easily outpacing homicides.

Parson’s responses to gun violence have typically remained in the realm of law enforcement. He supported Operation Legend, the Trump administration’s short-lived federal enforcement program. A special legislative session he called on violent crime saw two bills passed — one setting up a witness protection fund and another allowing St. Louis police to live outside the city.

For this year, Parson increased the Missouri Department of Corrections budget by more than $22 million to around $803 million while decreasing by $2 million funding for the Office of Rehabilitative Services which oversees education classes and addiction treatment programs in correctional facilities.

But research shows those are exactly the types of programs needed to reduce gun violence.

Missouri State Rep. Ashley Bland Manlove, a Democrat, represents a long section of Kansas City stretching north-south along Troost Avenue, from south of 95th Street to the Country Club Plaza area.

She’s also a cousin of Matthew Bland-Williams.

But long before her cousin was killed, the state lawmaker, recently appointed chair of the Legislative Black Caucus for the Missouri General Assembly and ranking minority member of the public safety committee, has been critical of Parson’s approach to gun violence.

“He has taken the position of I’m going to be hard on crime, instead of addressing the underlying causes of crime,” Manlove said. “We know that crime is caused by lack of education, lack of health care, lack of stability, housing.”

“Instead of addressing and actually working on low-income housing tax credit or fully funding the education formula or funding after school programs,” Manlove said. “He has not done any of those actual actions, outside of saying, Black and brown people are scary and we’ve got to lock them up.”

‘Just a kid’

Matthew Bland-Williams and his cousin, the Missouri lawmaker, were close. They thought of each other more like siblings.

Bland-Williams stopped by Manlove’s parents’ house every weekend, often bringing his dog Zeus and, sometimes, sneaking up to the windowsill to scare his aunt. He was a prankster all his life.

But by his mid-20s, he was growing up and starting to come into his own, his family says. He was someone younger cousins looked up to and older family members relied on for help.

“He was like a little brother, so it was beautiful to see him learn and grow,” Manlove said. “I always thought it would never be us, never be him, never be me.”

Last summer, as the end of July approached, Bland-Williams was planning to move in with his best friend and start a new business. He was working at a church pantry, his mother said.

In the late afternoon of Thursday, July 23, he was picking up food and had just finished up a call with his mom when he stopped at the home of a woman he knew.

Soon after he arrived, he was confronted by a man with a gun. They struggled. Bland-Williams was shot. Still, he took the gun away from his attacker and fired back as the man escaped in a car.

The shooting was captured on video, and police quickly arrested a 23-year-old Lee’s Summit man, Arieous Walton-Merritt. Charged with second-degree murder, he is in the Jackson County jail while the case works through the courts. His lawyer declined an interview with The Star.

The Bland family doesn’t know Walton-Merritt. But they’ve learned some things about him in recent months.

They know his mother was incarcerated when he was a child, and he was raised by his grandparents. They know he spent the last seven years in and out of prison.

When he allegedly shot Bland-Williams, Walton-Merritt was on parole for a drug offense. “Just a kid,” said Pamela Bland, Matthew’s mother.

The family is angry with Walton-Merritt and want him to be punished. But they also see his family and their own as victims together of a bigger system.

“As a mother of an African-American person, I sympathize with him and his family, because even not knowing where he came from, the little bit that I have heard is not all his fault,” Pamela Bland said. “Our system failed him, and I don’t think he was really given any other options.”

After Bland-Williams’ death and Walton-Merritt’s arrest, the gun violence continued in Independence. Six more people were shot and killed before the end of the year.

Independence, where Matthew Bland-Williams was killed, saw more homicides than all but five Missouri cities last year. With a population of about 116,000, its 11 gun homicides in 2020 were nearly twice the national average rate.

It also ranks high on national eviction rankings, with a higher rate than 80% of all large cities.

John Syme, a spokesman for the Independence Police Department, said a special gun crimes team investigates shootings in the city. But he disagreed with the idea that gun violence is driven by social determinants of health such as poverty, housing insecurity or living environments.

“Drug transactions, robberies have resulted in homicides. We’ve had domestic violence as well — I would say those would be the top three,” Syme said. “I have not seen anything remotely directly connected to poverty.”

Some Missouri law enforcement agencies have included public health initiatives in their policing strategies. In both Kansas City and St. Louis, health care workers accompany officers on some service calls, particularly when an individual is at risk for suicide.

However, such efforts have not gone much further. When asked about what drives gun violence, Capt. David Jackson, a Kansas City Police Department spokesman, pointed to drugs and the inability of people to solve conflict without guns.

Mikel Whittier, a justice and social equity strategist at the St. Louis Integrated Health Network, said attitudes like these play a role in creating an environment where violence thrives.

“That really grinds my gears,” said Whittier, whose own grandfather was a police officer. “There is enough finger pointing to go around, but there is no accountability, with their police department [saying that]. We have proof that arresting people out of this will not work. You can’t police your way out of that.”

In Missouri, tough-on-crime strategies not only have failed to improve gun violence problems but have been shown to fall hardest on Black men and women.

Even in a state with very few restrictions on guns, law enforcement in Missouri manages to lead the nation in charging Black people with illegal firearm possession.

Federal prosecutors in the Eastern District of Missouri, which includes St. Louis, ranked No. 1 in the nation for their number of felon in possession convictions. The Western District, which includes Kansas City, ranked No. 3.

Nationally, 55% of those convicted between 2015 and 2019 were Black, four times greater than the proportion of Black residents in the overall population.

Meanwhile in Kansas City, which recorded a historic number of homicides last year, police typically make arrests in fewer than half of fatal shootings during the year they occurred.

Police say a lack of witness cooperation makes it harder to solve cases. But community leaders have questioned whether the department places a high enough priority on solving shootings. The police department employs about 1,300 police officers, yet allocates fewer than 40 to investigate homicides.

Kansas City funds its police department at a level of more than $200 million. But it contributes less than a quarter of a percent of that amount of money to Aim4Peace, the city’s public health-centered violence prevention program.

The program, which is based on the Cure Violence model, has shown results in major cities across the country. In Kansas City it works with a budget of about $1 million. The majority of the funding comes from federal grants.

“They have been able to have enough funding to keep their doors open, but not enough to expand, to hire more workers and to reach more people with their services,” said Marvia Jones, the violence prevention and policy manager at the Kansas City Health Department.

“We need to be intentional and efficient with funding so that programs like Aim4Peace have a chance to be as effective as they can be.”

‘Trying to survive’

Kortney Carr’s client sat across from her on a tan couch at her private therapy practice in the Historic Lincoln Building in Kansas City’s 18th and Vine district.

The pandemic had just begun. The man was suddenly jobless for the first time in a decade. After running into problems with unemployment and exhausting all other reasonable options, he told Carr he was going back to selling marijuana.

Carr, a licensed social worker and second year KU PhD student studying trauma and its effects on violence, knew that the man had previously sold drugs about a decade before. But in early adulthood he had stopped, and he found work doing carpentry and maintenance.

That was until the pandemic’s economic disruptions ripped away his financial stability.

While his body language remained calm, Carr sensed his frustration and maybe even fear. He is the primary breadwinner for his family, which includes his partner’s children.

Selling drugs comes with a risk of violence, Carr said. There’s the chance of someone trying to rob him, she said, adding that there’s a common misconception that people who sell drugs have a lot of money, which is rarely the case.

Carr understands the challenges. She grew up in the 64128 ZIP code on Kansas City’s East Side, which stretches from 27th Street in the north to 39th Street in the south, and from Prospect Avenue to Van Brunt Boulevard. It’s a place where, historically, redlining defined neighborhood borders and its poverty.

Of the area’s population, which is 80% Black, more than 30% lives below the poverty line, according to census data.

“To this day, it is a ZIP code that you’re going to see on the map is red, because it doesn’t have the access to the resources that it needs,” she said.

“Data will show that those communities are very much going to be ones who have higher rates of violence and also lower access to resources, lower scores and social determinants of health, all of that.”

As of Friday, Carr said her client was still looking for employment. It’s been months since he lost his job.

Survival looks different for each person, Carr said. Her client is a determined individual who enjoys working with his hands. He is laid-back and has a good sense of humor.

“I could see a lot of people who would have a lot of negative things to say about him, or have suggestions that really aren’t realistic for his situation,” Carr said. “But ultimately he is showing resilience. He’s showing commitment.

“He’s a good person. He’s just trying to survive.”

Facing resistance

When St. Louis Circuit Attorney Kim Gardner was starting out as an assistant prosecutor, she watched as judges asked questions about the men who stood before them charged with crimes.

What was their background? What education did they have?

Many had never completed middle school, but it never seemed to make any difference. They would be sentenced to years in prison, only to emerge later jobless, without any resources or options, their worsened circumstances pushing many into more serious crime.

She decided to educate herself about public health, and earned her master of science in nursing in 2012.

As the chief prosecutor in St. Louis, Gardner has made violence prevention a core part of her office, bringing in new reforms to the way prosecutions are managed.

She implemented diversion programs in 2017, offering addiction treatment and drug and education programs as an alternative to prison for some non-violent offenders.

Her reforms have not been well-received by everyone. Last year, Parson tried to outsource her work to Eric Schmitt, Missouri’s attorney general.

Gardner dismissed Parson’s actions as political maneuvering. But the added attention made her a target for death threats and racist hate mail, said Allison Hawk, a spokeswoman for Gardner’s office.

Hawk said the same kind of hate mail arrives at the doorsteps of many other prosecutors — especially Black women — who try to implement public health reforms to their part of the criminal justice system.

“There are about seven or eight women, African American women who are prosecutors around the U.S., and the kind of racial threats and verbal violence against them has been unbelievable,” she said.

“The kind of things that they are standing up for and getting attacked for, it’s really challenging to see.”

‘It’s social justice’

Dr. Michael Moncure has treated thousands of shooting victims in Kansas City over the past two decades.

In the last year alone, as a trauma surgeon and critical care specialist at Truman Medical Center, he treated patients shot in the liver with military-grade weapons and stomach wounds that were harrowing even to his experienced eye. In some cases, he restarted their hearts when they stopped.

As a professor of surgery at Truman, he asks his students to consider the social and economic factors at play for each shooting victim.

Did they have access to a good education? Did they grow up with untreated trauma in the family? Did they suffer from a lack of sufficient income? Not everything is a matter of personal choices, he says.

“It’s not as simple as some of the messages coming out of some of the politicians who are totally ignorant and think they can just solve it by just being tougher,” he said.

“Just putting more police or going out and giving motivational talks to not shoot or don’t get into abuse and arguments, that’s naive. It’s social justice.”

Moncure himself grew up in a single-parent household in Oakland, in a community where he saw violence and social inequities firsthand. He often went with his mother to her job working in an emergency room

Over the years he lost family members to gun violence, including relatives caught up in gangs and a cousin killed by her partner. In elementary school, two of the 20 students in Moncure’s class were killed before they reached ninth grade. One of them was his rival in the spelling bee.

“That kid had so much potential and it made me just realize how close we are to anything like that happening to any of us, and that’s what makes my heart cry out when I see kids now that I come across,” Moncure said.

His career took him through trauma departments across the country, in Washington, D.C., Baltimore, and Camden, New Jersey.

In Kansas City, Moncure decided to get involved beyond healing gunshot wounds. He joined local efforts to prevent more people from being wheeled into his operating room in the first place.

“I want to make sure I’m there to do my part, but also that I don’t want to just keep patching people up,” he said.

Moncure now sits on the board of Kansas City’s Ad Hoc Group Against Crime, a nonprofit that bills itself as Kansas City’s social service emergency room. And he works with Aim4Peace.

He tries to talk to all of his patients, once they are stabilized. He hears about their lives, and learns about the forces many Kansas Citians have going against them: underperforming schools, food scarcity, no economic opportunities, parents working three jobs to pay rent, the prison industrial complex and incarceration.

“It makes me angry that we put our kids in these situations where they’re doomed to potential failure,” he said. “It takes almost an act of God to succeed with lack of resources.”

“These are things we need to be thinking about, because all these things are related. All of them,” he said. “We’ve got to wake up. We have the potential to make some drastic changes, but they’re going to need to be drastic.”

Anger, grief and understanding

For the Bland family, following the criminal case against Walton-Merrit, their feelings are complicated.

If things had gone differently for him early on, he might have stayed out of trouble. And even after he got into trouble, if he had been kept out of prison as Kim Gardner is seeking to do for others in St. Louis, maybe he would have course corrected.

Now, he is accused of killing a member of the Bland family. He faces serious prison time, and that is what the family wants. They want justice, and they are angry at him. Some even feel like they hate him. They want justice; they want the charges upgraded to first-degree murder.

Walton-Merritt allegedly ended the life of Pamela Bland’s only son, and that feels impossible to forgive.

“Just the arrogance of thinking that you can just say ‘I’m sorry. I learned my lesson,’ ” she said.

At the same time, members of the family also see him as a product of a situation that did not set him up to succeed and a penal system that failed to rehabilitate him. He was another young Black man pushed into prison without being helped to cope with underlying problems and then thrown back into the street without being given the tools to live a stable, healthy life.

The Blands acknowledge that, if they were in the position of Walton-Merritt’s family, they would be doing everything to keep him out of prison now.

It is a tricky combination of anger, grief and understanding, Pamela Bland said.

“For the first hearing that we went to, I just saw a person as scared,” she said. “And I was like, why?”

Corrections: An earlier version of this story misspelled the name of Missouri Attorney General Eric Schmitt. The story also incorrectly described Missouri State Rep. Ashley Bland Manlove’s leadership position in a state legislative caucus. She is chair of the Legislative Black Caucus for the Missouri General Assembly. An earlier version of the story also gave incorrect figures for the Missouri Department of Corrections budget, which was $803 million this year, while funding for the Office of Rehabilitative Services decreased by $2 million.