Where To Look For Gun Violence? Start With The Kids

Last year after Sandy Hook, the American Academy of Pediatrics (AAP) and their Past President, Judith Palfrey, came in for an extended and indecorous series of attacks by the NRA and other supporters of the gun lobby.  In particular, the AAP and Dr. Palfrey were attacked for voicing the bizarre idea that guns in the home were a danger to children’s health.  And since the only way to get rid of all those guns would be to confiscate them or worse, the AAP became Public Enemy #1 in the eyes and mouths of people and organizations sworn to defend the right of all law-abiding Americans to own a gun.

This campaign to create a cordon sanitaire between pediatricians and the American family had already been elevated to a level far beyond nasty rhetoric when the State of Florida decided to criminalize physicians, mostly pediatricians, who had the audacity to ask their patients about guns. The law was first passed in 2011, was overturned at the District level in 2012, and recently reinstated by the 11th Circuit, and now is probably on its way to the Supreme Court.

docs versus glocks               The attempt to keep physicians out of the gun debate can only be understood if we look at the issue creating the argument in the first place.  Which goes like this.  Each year roughly 100,000 Americans are killed or injured by guns, which is 4% of violence-related injuries and deaths that occur each year.  Of this total, roughly 20,000 are gun suicides and the remaining 80,000 are either homicides or aggravated assaults.

Both sides in the gun debate agree that the way to deal with the suicide problem is to “fix the mental health system,” whatever that means.  On the other hand, both sides also agree that people who use guns to consciously hurt others have committed a crime. Tap the average gun owner on the shoulder and ask what to do with people who commit a gun crime and he’ll probably say, “Lock ‘em up and throw away the key,” or words to that effect.  Tap the average non-gun owner on the shoulder, ask the same question and you’ll probably get, ”We have too many guns,” or words to that effect. Guns don’t kill people, people kill people says the NRA; hence, control the people.  Guns kill a lot more people than if we didn’t have guns, says the Violence Policy Center; hence, control the guns.  That’s where the gun argument begins and ends.

Both of these arguments obscure the reality of the problems they seek to correct.  Increasing the severity of punishments assumes that one can stick the perpetrators in one category and the victims in another, when in fact most violent crime, in particular gun homicides, usually occurs because both the perpetrator and the victim are contributors to the criminal act.  As for getting rid of the guns by registering transactions, what do you do about the more than one million guns that are reported stolen or lost each year and are overwhelmingly the guns that show up in cases of murder and aggravated assault?

In a brilliant study Marvin Wolfgang found that 6% of all juvenile offenders committed more than half of all juvenile crimes.  And guess what happened when they became adults?  The chronic juvenile offenders became the chronic adult criminals and committed the most violent crimes. Wolfgang looked  at juveniles over the age of ten. What’s missing in the debate about guns and violent crime in is what Wolfgang did not incorporate into his work, namely, whether or not interventions occurred with kids who became chronic offenders before their delinquent behavior took place.  And where could such interventions have happened?  During consultations with pediatricians who are trained to look for anti-social behavior during pre-school years.

Pushing pediatricians out of the orbit of caregiving for children means eliminating contact with a professional committed to reducing harm that puts a child’s health at risk.  Anyone who wants to put their 2nd Amendment ‘rights’ ahead of their child’s health better hope they have lots of luck.

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