Can We Reduce Gun Violence With A Public Health Approach?

              Our friends at the Coalition  to Stop Gun Violence (CSGV) recently posted an editorial that described gun violence as a ‘public health crisis’ because it has an “adverse impact on community health.” The notion that we can reduce and ultimately eliminate the 40,000 gun deaths suffered each year by taking a public health solution to the problem has become the standard mantra in gun-control circles, not the least of which because of the possibility that CDC research money on gun violence may be coming back into play.

              We love the notion of public health. Maybe we didn’t invent it, but we sure have used the public health approach to deal with serious threats to the human community, most notably and recently AIDS. And since gun violence is certainly widespread enough to be considered a threat to the human community, and since it also tends to impact most severely on certain identifiable groups within the community, obviously we can and should utilize the public health approach to this health threat as well. So say all the public health experts on gun violence.

I’m not a physician. I’m not a public health researcher. I can, if I choose, ask to be introduced as ‘Doctor Weisser,’ but that’s only because I earned a lowly Ph.D.

 On the other hand, I know something about guns. And based on what I know and what all these public health experts don’t know,  I disagree.

I disagree with the ‘public health approach’ to gun violence because the information that we need to evaluate in order to figure out a valid public health response to this particular threat to the human community doesn’t exist. And it won’t exist even if the CDC dumps not just 50 million into gun research, but 500 million or more.

I don’t hear any of the public health experts talking about this problem at all. In fact, these experts go out of their way to deny the importance of even collecting such data, despite saying again and again that any public health strategy must be ‘evidence-based.’

A public health approach requires that first you figure out why certain people get sick. Then you figure out how the sickness spreads from victim to victim, then you figure out how to prevent the spread of the illness either through immunization strategies, public policies or both. In the case of gun violence, we know who gets sick. But we have absolutely no idea how the illness spreads from one person to another because we don’t know anything about the agent who spreads the disease – the shooter – and we don’t know anything about the instrument whose presence creates the disease – the gun.

We don’t know anything about the agent because in the case of self-inflicted fatal injuries the agent is dead. In the case of the agent spreading the disease, he either isn’t identified or if he is, he’s locked up in jail. At which point we aren’t dealing with a public health issue. We’re dealing with a crime. Finally, both groups of agents use the same instrument, a gun, and we don’t know how they got their hands on the gun.

Back in March, three major public health scholars appeared before a House committee and testified about the need to restore CDC gun research funds. When asked, all three esteemed experts denied the necessity to create a national gun registry – not needed at all. A national registry happens to be the only way to figure out the movement and use of the instrument which has to be present in every instance of gun violence. Somehow, this never gets said.

I’m saying it now. Either my friends in the public health community stop promoting the nonsense that whatever they are doing won’t threaten the beloved 2nd Amendment, or they can stop pretending that they can come up with any kind of serious public health solution to the threat posed by guns. It’s simple.  Either – Or.

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6 thoughts on “Can We Reduce Gun Violence With A Public Health Approach?

  1. We don’t need much more research on gun violence to take some effective steps in reducing it. I think we know enough now to make a big dent in gun crime. We just don’t have a government willing to do something.

  2. “A public health approach requires that first you figure out why certain people get sick. Then you figure out how the sickness spreads from victim to victim, then you figure out how to prevent the spread of the illness either through immunization strategies, public policies or both. ”

    This may be the the public health approach to communicable diseases but public health also takes on lead poisoning, cancer from tobacco and other problems caused by the environment. If the public health people want to study people dying from guns they need to start with socialization from TV or movies showing people guns are the solution to problems or how you become famous if you shoot a bunch of people you never met in a confined area.

  3. I think media/social media is an important element to confront, as pankr003 suggests. We seem to have entered a #metoo era of shooters. So is attacking the opioid epidemic, which is killing about 2x as many people as bullets. So is our rudderless ship economy which encourages people to take drugs or put out the lights.

    As far as registration, that would help track guns up and to the point where they enter the underground economy. The latest BJS report I looked at indicated a lot of different pathways to that economy (so did Phil Cook’s work) and once in that economy, guns are little and can stay there a long time undetected. Perhaps registration would instill the fear of God in people when making transactions but if we have universal registration, that pretty much implies universal BC’s as well.

    But we are all good guys until we turn bad, so while UBCs can help choke off the guns going to bad guys route, we will still have suicides and newly minted bad guys (such as the honor student who shot up the San Diego synagogue) with us. As long as there are a lot of guns around, these low frequency events (in a nation of 350 million people, shooters are rare events) will remain. Short of putting a chip in people’s brains in some futuristic dystopian world, I doubt there is a foolproof way to predict when someone will open fire.

    This is a political issue. Gun rights vs. gun control. I think with a changing demographic, guns will become increasingly unpopular in a future urbanized USA and this debate will get increasingly polarized. Anyone want to predict where the red v blue situation will lead?

  4. As a former public health guy (President of The Chicago Board of Health etc) I can assure you that I believe that a national gun owner registry “”database IS the way to go. It would be cost effective and provide great data and would help solve the problem in relatively short order. See my recent letter to the “Annals of Internal Medicine”. The Trauma committee of the ACS has backed the idea as well. It does not, by the way, interfere with the 2nd.

    • I’d like to see the actual data behind your assertion that this would solve the GV problem. It might, as Mike says, help track guns but that’s not a silver bullet.

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