Cigarettes and smoking may seem like obvious threats to health now, but in the 1950s, many Americans did not believe smoking was a health problem. The tobacco industry fought scientists and public health experts who dared to say otherwise, and that conflict led to the Surgeon General's 1964 report which identified smoking as a cause of lung cancer. Evidence about the other dangerous consequences of cigarettes has grown for decades, and Americans now accept smoking as a danger to health despite all the tactics used by Big Tobacco to convince them otherwise. We are experiencing a similar denial process (nurtured by industry, ideological misinformation, and bad politics), when it comes to recognizing gun violence as a public health crisis.
Thousands of medical and public health experts are urging our fellow Americans and political leaders to broaden their approaches to stopping gun violence. What qualifies doctors and public health workers to talk about gun violence is that we witness and treat the short-term and long-term consequences suffered by Americans because of firearms. It is our duty to have tough conversations to prevent further injury and death. With that in mind, here are just a few of the many reasons why guns are a health problem:
1. Guns and Mental Health are a Dangerous Combo, Just Not the Way You Think
Mass shootings lead to media narratives and political rhetoric about stopping "crazy evil monsters" from accessing guns, which increases stigma and makes inaccessible treatment even less utilized. Furthermore, we completely miss the real danger guns pose to mental illness: the increased risk of suicide. In America, over 60 percent of gun deaths are due to suicide, and over half of all suicides are done with a firearm, meaning we need to not only strengthen mental health systems, but we must also limit access to guns if we are going to save lives. It is untrue, cruel, and cynical to say people who want to kill themselves are going to do it regardless of whether they can access a gun or not. For people who have attempted suicide and survived, 90 percent do not go on to kill themselves later. I have cared for a few patients who either attempted or survived suicide. Their struggle and their mental health providers need more than just resources and funding -- they need their fellow Americans to get real about guns.
2. Guns are a Threat to Women's Health
In America, 1 in 3 women have suffered physical violence from their intimate partners. Based on data from the FBI, domestic abusers shoot and kill 52 women every month. Domestic violence is thus a major health problem in our country, with mental and physical health consequences that last long after law enforcement has done its part. While some think arming a woman with a gun is an appropriate "prescription," there is evidence that the presence of a gun in a domestic violence situation increases the risk of homicide by 500 percent -- for the abused, not the abuser. Women struggling with domestic violence need their fellow Americans to prevent guns from undermining safety and recovery. Let's close the "boyfriend loophole" in the Brady Handgun Violence Prevention Act, which prohibits gun ownership for certain kinds of domestic abusers, but not dating partners and stalkers.
3. Unintentional Shootings Are Not Accidents
At least 100 children were killed in unintentional shootings during just one year after the December 2012 Sandy Hook elementary school massacre. 84 percent of these preventable shootings happened in a home or vehicle owned by the victim's family, relatives, or friends. If gun owners had stored their weapons unloaded and locked over two thirds of these children's deaths could have been prevented. Just like one does not need to be a chemist to advise parents on safe storage of cleaning supplies, a health care provider does not need to be a ballistics expert to guide families on safe storage of firearms.
Limiting gun violence to a law enforcement issue is clearly not enough for the millions of patients and families seen across the country by physicians like myself. Some of the health problems described above include some steps we can take to reduce the impact of firearms on individual, family, and community health. There is no single law or technology that will stop all gun violence. A diversified public health approach should include the following:
1. End the Ban on CDC Research of Gun Violence
For the past 20 years, Congress has not appropriated funds for the CDC to research gun violence despite over 30,000 dying each year from firearms. Over 140 medical groups, including the American Medical Association, Doctors for America, the American Academy of Pediatrics, the American Psychiatric Association, and many others are demanding Congress to support CDC and NIH endeavors to ask tough questions, do credible analyses, and share truthful approaches to reducing gun violence. The knowledge acquired can strengthen how we think about guns in our society, and how we protect each other from preventable tragedies.
2. Let Doctors Talk About Guns
As described earlier, the presence of guns is particularly dangerous for naturally curious children, people suffering from mental illness, and for families struggling with domestic abuse. In asking all of our families whether they have a gun in their homes, health care providers are starting conversations about safety that can save lives. "Gag laws" undermine public health when they punish doctors for opening this dialogue with patients about guns. We need our fellow Americans to repeal "gag laws" in Florida and stop other states from passing them.
3. ASK Your Friends About Guns
Conversations about guns need to happen in non-clinical places as well. The Brady Center to Prevent Gun Violence and the American Academy of Pediatrics have been partners in the yearly June 21 ASK Day Campaign, an initiative to encourage parents to ask relatives and friends whether they own a gun and how it is stored before allowing children to play or visit. One third of homes with children have guns, many improperly stored, and the majority of children know where their families guns are hidden. With these facts in mind, asking friends and family about the presence and storage of guns is one of the most things parents can do to protect their children from unintentional shootings.
We can no longer deny that gun violence threatens our public health. Medical and public health personnel need our fellow Americans to be part of the changes in policy and culture that will prevent injuries and save lives. The wide range of problems caused and worsened by gun violence require a similarly wide range of solutions. One size will not fit all, and building a safer, healthier union free from gun violence will require individuals, families, policymakers, and private sector institutions to do their respective parts. The time to join this journey is now.