It is interesting to compare and contrast the findings from New York City and Baltimore City on homicide rates in the context of Dickens’ opening paragraph for the Tale of Two Cities. He said: “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way – in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.”11
We believe that these data raise several major clinical and contemporary medical policy issues. First, the successes in New York City did not happen overnight or even within 1 year. Second, these successes occurred despite persistent poverty and skyrocketing income inequality within New York City.12 The root causes for the marked differences in murder rates, overall, as well as among whites and blacks, are undoubtedly complex. If better understood, they might point the way to the abolition of what is, perhaps, in some senses, “the worst of times” for Baltimore City as well as many other cities in the United States as they seek to reduce high murder rates.
Consideration should also be given to understanding contrasts between the stability of New York City rates between 2013–2014 and 2015–2016 and the significant increase in Baltimore City even though both experienced similar tragedies of unarmed black men being killed while in police custody. It is tempting to speculate that deaths from homicide need to be addressed by authorities as well as the population in a collaborative manner. Those in charge of policing the community should openly recognize the issues at hand, engage with the community, and together establish programs that use community assets most effectively for the good of all. In this connection, we should follow the wisdom of George Santayana, who said, “Those who cannot remember the past are condemned to repeat it.”