By Logan Seacrest

In 2020, while the world battled one pandemic, a different kind of outbreak in St. Louis, Missouri, reached a fever pitch. It had its own transmission vectors and hotspots, spreading from person to person and overwhelming the city’s defenses. As fatalities hit a 50-year peak, the epidemic felt like a permanent, incurable fact of life. But the death and suffering weren’t caused by a novel virus or force of nature—it was something far more intimate and entrenched: lethal violence.

For seven years, St. Louis had among the highest per-capita homicide rate for cities with 250,000 people or more. Yet, against this bloody backdrop, a new story began to unfold. Over the past four years, St. Louis has witnessed a remarkable and sustained decline in murders. By 2023, homicides had dropped to their lowest point in a decade—a staggering 39.1 percent reduction since the peak. Other key indicators like “shots fired” calls and juvenile shooting victims are also trending downward. This turnaround isn’t the result of getting “tough on crime” or deploying the military on the streets; it’s due in large part to a group of people with a shared belief: that violence behaves like a disease—one that can be diagnosed, treated, and even cured.

The backbone of this network is the city’s Office of Violence Prevention (OVP), established in July 2022 as a central hub to coordinate and fund community violence intervention (CVI) strategies. This move marked a critical turning point, transforming what was once a collection of promising but isolated community programs into a unified, city-wide public safety apparatus.

According to Brett DeLaria with OVP, the goal is to “create a truly integrated and strategic approach to violence reduction.” Relying on a combination of street outreach, cognitive behavioral therapy, and focused deterrence, CVI provides a pathway out of violence, inoculating communities at the source of the infection.

While many factors influence urban crime trends, a more granular look at the data from St. Louis provides evidence for CVI’s direct impact. From 2023 to 2024, the specific neighborhoods targeted by the OVP saw a 52 percent decrease in murders and non-negligent manslaughter, significantly outpacing declines seen elsewhere in the city. This data point is critical because it functions as a natural experiment: In locations where the city tried CVI, the results were disproportionately positive.

Just as a compromised immune system makes infection more likely, violence thrives in environments weakened by poverty, housing instability, and generations of segregation and disinvestment. As in any other city, violence in St. Louis isn’t random—it’s highly concentrated. In 2022, over 90 percent of regional homicides happened in either St. Louis County or St. Clair County. Across these jurisdictions, violent crime clusters among hotspots that account for a disproportionate share of the region’s shootings. Just as epidemiologists track a disease to its source, CVI programs identify the specific individuals and locations at highest risk.

While data suggests that the fever of violence may be starting to break, statistics do not necessarily capture the day-to-day reality for many folks in St. Louis. According to a recent poll, a majority of residents still identify gun violence as the region’s most urgent problem, highlighting the gap between reality and perception. Underscoring the fragility of the city’s progress, federal funding for the OVP is set to dry up next year. While the office will continue to be funded by the city, this shift places the onus squarely on local leaders.

The question facing St. Louis is no longer if this approach works, because the evidence confirms it does. The question is whether the city has the political will to continue. For a community so thoroughly brutalized by violence, turning back now would be a form of public health malpractice—a deliberate choice to let the epidemic flare back up.

Washington, DC: R Institute, 2025.