In the nearly three weeks since President Donald Trump deployed the National Guard to the nation's capital, he has threatened to send troops to other cities, including Baltimore, New York, and Chicago, most recently calling that midwestern metropolis "a hellhole." Longtime public health experts say the administration's focus on gun violence solely as an urban issue, purportedly driven by communities of color, fails to address its complexity and could cost lives.
"We have heard this rhetoric before; it was used by the Nixon administration, Reagan, and Bush....it's a national narrative to frame cities as chaotic when in all of the cities that are mentioned, statistically, violence has decreased," said Dr. Joseph Richardson, an anthropologist and epidemiologist at The University of Maryland. "For decades, leaders have been able to prey upon the American psyche of putting people in a culture of fear that's not actually grounded in science and data."
Richardson and other public health experts say the federal action in D.C. represents a public health failure. They point to the president's choice of language describing the city as a hotbed of 'bloodshed, bedlam, and squalor,' as invoking racial stereotypes, rather than a substantive public health approach to get resources to the most vulnerable communities across the country, including those that supported the president in the 2024 election and have some of the highest rates of firearm mortality.
"Cities' rates of violence have gone down, and for some, they are down to 30-year lows in terms of gun violence," said Dr. Charles Branas, the chair of epidemiology at Columbia University's School of Public Health. "For decades and decades, the basic message of our research is that gun violence is everybody's problem; it's not simply an urban or rural issue."
Dr. Jonathan M. Metzl, a psychiatrist at Vanderbilt University who has studied the relationship between mental health and gun violence for more than 15 years, emphasized that gun violence goes beyond a simple narrative of crime in cities, explaining that its increased politicization threatens decades of research progress. "I think it's important that we see it in its totality," Metzl said. "Two-thirds of gun deaths are gun suicide, and we haven't done nearly enough to address this."
A Trace analysis of gun violence data between 2014 and 2023 found that half of all shootings occurred outside of large cities, and that 13 of 20 towns with the highest rates of shootings were in Southern and rural communities -- none of which are getting the president's attention. Some states that have sent troops to D.C. -- Louisiana, Tennessee, South Carolina, Ohio, and West Virginia -- suffer from higher rates of gun homicide than the nation's capital, according to a Trace analysis of Centers for Disease Control data. In 2023, West Virginia had one of the country's highest rates of firearm suicide.
"Deaths from firearms are everybody's problem in the United States; it is not simply just an urban or rural issue," said Branas, who first began to analyze rural gun deaths 25 years ago. At that time, metropolitan areas were the epicenter of violence, he said, and both the research community and the general public focused on violence in cities. Decades later, a growing amount of research has found that rates of firearm deaths in smaller communities are on par with -- if not higher than in -- cities, but the political narrative around urban centers of violence stuck. That's the narrative President Trump is capitalizing on to attack his political opponents, Branas said. "To paint it as one particular area's problem harms that area, but it also harms the other areas that then have their problem derecognized."
Research shows that gun violence in the Democratic-led cities Trump has threatened to send troops to is at historic lows, a testament that holistic approaches to community violence intervention (CVI) can work effectively, according to health experts. "We have to give credit to CVI, which we are really just beginning to see the promise of [the programs] as Trump is slashing funding," Richardson said.
Funding for CVI expanded tremendously during the COVID-19 pandemic, as rates of firearm violence skyrocketed. Between March 2020 and March 2021, the monthly averages of homicides increased by 31 percent, largely because of firearms, according to a report published earlier this year by the Center for American Progress. During the same time period, largely thanks to federal and state pandemic funding, CVI programs expanded to parts of the country, like the South, that had never had those resources.
Now, that progress is at risk. Violence intervention programs have been subjected to the administration's most recent funding cuts. Since taking office in January, the administration has laid off thousands of staff members at the nation's leading health agencies, effectively terminating thousands of research projects as well as shuttering the first national Office of Violence Prevention. Along with slashes to health agencies, the president has made drastic changes to the nation's suicide prevention efforts, most recently gutting the suicide hotline for LGBTQ+ youth.
Self-directed violence makes up a significant portion of the shooting deaths in rural counties, which had a 54 percent higher firearm suicide death rate than the most urban counties, according to a 2023 research study. As The Trace has previously reported, Southern and rural communities face greater challenges in addressing firearm violence because of their sparse populations, lack of health infrastructure, and the stigma around suicide. Experts say the administration's defunding of suicide prevention and CVI, while deploying law enforcement to areas already making progress, exacerbates the problem.
"For the first time in hundreds of years, we are turning our backs on knowledge as we attempt to address social problems in the U.S.," said Dr. Garen Wintemute, an emergency physician for over four decades and the director of the Centers for Violence Prevention at the University of California, Davis, noting the intersecting consequences of lower immunization rates, less access to healthcare, and decreased resources for violence prevention.
Branas explained that these issues are likely to worsen because of recent proposed cuts to Medicaid and hospital closures.
"Rural communities are on life's edge in terms of their locations, and by moving some of those, Level II and IV trauma centers and closing them down in those communities, it's devastating," said Branas. "They literally already have nowhere to go."