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Preventing gun violence requires a comprehensive public-health approach

Marit Brock

Imagine that you received the following in your inbox:

Urgent News Bulletin!

International cancer researchers made a unified statement to the world today. They have concluded that since there is not one solution that will cure all cancers there is no point continuing their work toward a cure. They send their thoughts and prayers to cancer patients and their families.

That sounds ridiculous, right? Yet after each highly publicized mass shooting in America politicians, gun lobby experts and your belligerent brother-in-law Bob will boldly and unapologetically argue that “there is not one law we can make that will eliminate all gun deaths” — and this is presented as a logical and suitable end to the discussion. Or worse, they offer solutions that are likely to cause even greater harm, such as arming schoolteachers so there can be more “good guys with guns.” Even those working to prevent gun violence fall into this trap when they focus energy primarily on assault-weapons bans as the first step to end our epidemic of gun violence in America. 

96 Americans die every day at the end of a gun

Mass shootings capture the news headlines for a brief amount of time, but the more shocking reality is that, on average, 96 people die at the end of a gun every day in America. Of those 96 people shot and killed every day, seven are children or teens, 50 are women shot by an intimate partner. While assault weapons receive a lot of attention and derision, very few daily incidents are caused by assault rifles. The overwhelming majority of deaths and injuries are caused by handguns, rifles and shotguns.

Can you imagine any other health issue where seven children die every single day and there is no action taken to prevent it? Each year 500 or more children die by gun suicide, and tragically they often use a gun owned by their parents or another relative. Yet the fact of their deaths is ignored by the media and the gun lobby continues to stoke the fear that leads adults to buy guns for self-defense.

The facts may make us feel hopeless, but there is plenty we can do if we focus on an evidence-based and comprehensive public health approach to solving each area of gun violence. Because of a virtual ban on research into gun violence prevention it is difficult to build a list of priorities specific to gun policy. However, using the example of gun suicide we can use research and methods developed in mental health and crime prevention that will save lives. 

Preventing gun suicide is an urgent priority

In Minnesota 78 percent of gun deaths are gun suicides. A common response to this statistic is, “Well, they would’ve killed themselves a different way if they didn’t have a gun,” but this has been soundly disproven. A review of research shows that 90% of those who survive a suicide attempt will not die by suicide later. Unfortunately, when you compare how a suicide is attempted you find startling differences in effectiveness – attempting suicide with a gun results in death more than 85 percent of the time while an overdose results in death approximately 2 percent of the time. This information, taken together, says that preventing suicide is worthwhile, and preventing gun suicide is an urgent priority. 

The website of Harvard’s T.H. Chan School of Public Health, Means Matter, offers family members, clinicians, communities and gun shop owners specific tips to reduce access to the most lethal means of suicide – guns. This public health approach offers very specific and targeted solutions using a variety of angles to prevent death or injury. Notably, this approach shows it is possible to take meaningful action to prevent suicide without legislative changes. 

Specific legislative changes are an important component, however, that will make other suicide prevention efforts more effective. Requiring criminal background checks on all gun sales, or closing the “gun show loophole,” is a specific and targeted approach that I once heard a public health researcher refer to as a “no-brainer.” In states where this change is in place they see a more than 40 percent decrease in all types of gun deaths, including suicide. Reducing the means to gun suicide by making guns more difficult to purchase reduces gun death.

Temporary action during personal crisis

Even more focused action like the Extreme Risk Protective Order (ERPO) law recently passed in Florida allows family members, law enforcement and the courts to temporarily remove guns from those in a crisis. A Minnesota version has been introduced at our state Capitol, although it appears stalled. This law would provide one more life-saving tool to those trying to avert a crisis, and maybe even prevent a mass shooting. 

Even though these proposals enjoy broad popular support, our legislators have failed to act. Your role in ending our epidemic of gun violence is to call your state and federal legislators today to urge them to take action. For too long the gun lobby and belligerent gun activists have been the only ones making those calls. Preventing gun violence – whether in the form of mass shootings or the everyday violence that kills 96 people each and every day — requires a comprehensive public-health approach. It is not about partisan politics. It isn’t just about stopping the next mass shooting. It is about everyday action to save the lives of the people we love.

Marit Brock is a mom, gun violence survivor and founding member of the Minnesota Chapter of Moms Demand Action. She currently serves as the deputy chapter leader for the Minnesota chapter and believes passionately in the power of grass roots organizing to create positive change.

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Comments (9)

  1. Submitted by Curtis Senker on 04/11/2018 - 12:31 pm.

    Want to reduce gun violence by 1/2 and protect kids?

    1. Make parents responsible for raising well adjusted, productive citizens rather than letting the streets or public schools inculcate moral and ethical values.

    2. Stop teaching kids that there is no right or wrong. Hold them accountable for their behavior.

    3. Stop glorifying the lowest common denominators from Hollywood and the music industry.

    4. Get fathers back into the house.

    • Submitted by Pat Terry on 04/11/2018 - 02:00 pm.

      Total nonsense

      Some of these things aren’t even things that “we” can even do. And some things – the idea that Hollywood/the music industry has an impact, for one – arent supported by evidence.

      If you want to reduce gun violence, start by working from actual facts. Like the points made in the article. Or gun control. Spoutng nonsense about responsibility and touting falsehoods isn’t going to do it.

    • Submitted by ian wade on 04/11/2018 - 04:14 pm.

      Gee, you forgot to work in George Soros somehow.

      How about we take baby steps and start with expanded background checks, ban bump stocks, limit magazine capacity and require a proficiency test every three years. I know many responsible gun owners that would have no issue with any of those, me included.

  2. Submitted by Ray J Wallin on 04/11/2018 - 02:01 pm.

    Want to reduce gun violence, part II

    Don’t call your opposition ‘belligerent gun activists’ like this author did. They get angry and go out and buy more guns.

    This will help you raise well-adjusted kids by teaching them right from wrong, as Curtis mentioned.

    • Submitted by Jon Kingstad on 04/12/2018 - 10:03 am.

      Angry gun activists

      “We” all can and should do what we can to raise healthy, well balanced children who know right from wrong. But “we” are not responsible for others who don’t or simply fail in that task. Was it the fault of the parents of the mass shooters at Colombine and these others tragedies that their children turned to massacre innocent people? Or is it a society and culture that worships firearms that can’t even muster enough collective will to regulate the possession and use of lethal weaponry?

      When I see photos and films of Wayne LaPierre and Dana Loesch, two of the most visible spokespersons for the NRA and the gun activist movement, they are angry and truculent. Remember Charlton Heston as NRA president ranting about “taking his gun from his cold, dead hands”? These “belligerent gun activists” seem to be popular with the gun activists they represent. That’s how they come across to the rest of us who would like to see reasonable regulation of guns. I don’t understand how you can teach kids right from wrong when you tell them to ignore the truth they can see with their own eyes.

  3. Submitted by Ray Lewis on 04/11/2018 - 02:37 pm.

    What we need to reduce gun violence is evidence

    There are other policies that can be tried, but research would help determine what is effective, acceptable, affordable and sustainable in America

    Funding for empirical research would help, but signs are beginning to appear that the NRA’s choke-hold on political support and funding can be pried loose if voters turn out:
    A lack of funding for research on firearm trauma has left the country with a significant gap in the information needed to make progress on this important public health issue. That’s why Kaiser Permanente is investing $2 million in research for gun injury prevention.
    https://share.kaiserpermanente.org/article/kaiser-permanente-commits-2-million-to-gun-injury-prevention-research/

    “Priorities for Research to Reduce the Threat of Firearm-Related Violence” with some of the BEST research questions about how to save lives from gun violence.
    https://www.nap.edu/read/18319/chapter/1#ix

    This APHA fact sheet outlines areas where more gun violence research is needed: bit.ly/290Lvon
    https://www.apha.org/~/media/files/pdf/factsheets/160317_gunviolencefs.ashx

    Although the omnibus Appropriations Action of 2018 signed by President Trump still prohibits using funds to advocate or promote gun control, an accompanying report recognizes a recent statement by the Secretary of Health and Human Services that “the CDC has the authority to conduct research on the causes of gun violence.”
    Gun Regulation: Room For Action Even After Heller
    https://www.healthaffairs.org/do/10.1377/hblog20180323.730582/full/

    Researchers who study gun violence, however, remain skeptical; the chilling language is still present in the bill and Congress did not specifically appropriate funds to public health agencies to research gun violence. It seems for now that whether research focuses “on the causes of gun violence” or on “promoting gun control” will be at the whim of the Secretary. The nation needs to enable its public health agencies to do their work, without a political chill, and fully fund badly needed research. 

  4. Submitted by Diana Zuckerman on 04/12/2018 - 02:59 pm.

    Gun violence is a public health issue

    Whether we’re talking about homicide or suicide, access to guns makes killing much more likely. We already know that from research comparing access to guns in different states and different countries. Thanks to Marit Brock for an interesting and important article. And for more information see http://www.center4research.org/does-gun-control-really-work/ or these infographics on guns and suicides among adults: https://www.pinterest.com/pin/388998486559452867/
    and children: https://www.pinterest.com/pin/388998486559451873/

  5. Submitted by Kevin Vick on 04/12/2018 - 05:51 pm.

    Fact Checking

    Do you see the slight of hand going on? She talks about 80% of deaths by people using guns for suicide and then pivots to legislation that won’t do a thing to reduce suicide by gun.

    As she states, nearly 80% of Minnesota deaths caused by people with handguns are suicides. Here’s the rest of the story. Overwhelmingly these are middle-aged white males that live in rural areas. How do so-called “universal” background checks, closing the alleged “gun show loophole”, or protection orders going to curb these suicides when these men have had guns in their homes their entire lives? The fact is they won’t. She’s intentionally obfuscating.

    The fact is background checks do not stop people from obtaining firearms. 40% of guns used in crime are obtained illegally, 40% are from friends/family, and 15% are bought through dealers and subject to background checks – Department of Justice. Of all guns used in crimes, .7% are obtained at gun shows. Firearm accidents are at their lowest point since 1903 and represent 1% of all accidental deaths – National Safety Council.

    We already have protective orders. What Ms. Brock is advocating is stripping people of property without due process. A spiteful partner or family member can easily abuse this process without the accused even having the opportunity to have their day in court to defend themselves. That’s not what we do here in the USA.

    As for her use of the term “epidemic of gun violence”, she never lets the facts get in the way of her agenda. Gun homicide is down over 50% in the past twenty years – Department of Justice / Pew Research.

    Everyone, including myself, wants to see the already plummeting rate of homicide by people using guns to continue to go down. In order to do that we need to speak from the facts, not the bought and paid for “research” provided by the anti-gun zealot, Michael Bloomberg, provides.

  6. Submitted by Paul Udstrand on 04/18/2018 - 09:42 am.

    Let’s stay focused

    Anyone with any experience working in the field of psychiatry or mental health should be able to tell you that mental health professionals can never provide an effective firewall against gun violence, or any other kind off violence for that matter. Yes, our health care system can always be improved, and our mental health system can certainly be improved, these are ubiquitous and ever present issues. But the idea that mental health practice will reduce gun violence is simply facile.

    The reasons mental health systems can’t prevent gun violence are to legion to catalog here but I can provide a few highlights. 1) We simply don’t have any reliable instruments that predict violent behavior, the best predictor is previous behavior, and people with mental health issues are actually less violent than the general population. 2) Any “assessment” you perform can only be a snapshot at a the time of the assessment. One who “passes” today is likely the one who goes on a shooting spree two month from now when they lose their job or find out their spouse is cheating on them. So when and how often do we “screen” people, and with what do we screen them? 3) Medical records are confidential, and we want it to stay that way. Whatever results may flow out of mental health tests, will be part of a medical record, not available to law enforcement, or sellers of guns. The Duty to Warn standard is far too high to trigger warnings based on psych evaluations alone. 4) It’s actually not at all clear that diagnosable mental illness actually plays a significant roll in gun violence. Whether we’re talking about domestic assaults, gang violence, robbery’s, or mass shootings, most of this violence can’t be categorized as expressions of mental illness. For instance all of the school shooters committed well planed attacks that they spent weeks of not longer preparing for. Even Adam Lanza who was probably Autistic carried out a well planned attack. These attacks are not the product of disorganized psychosis.

    We need to stay focused on the problem when we talk about gun violence and resist the impulse to exploit that problem on behalf of other constituencies. The best way to prevent mass shootings is to ban the sale of the weapons that are used. Any attempt to make mental health professionals a central feature of this initiative will more than likely just create another cottage industry for ineffective “screening” of some kind. I would expect the mental health industry to be no more effective at preventing gun violence than it is at preventing drunk driving. Not to mention the dangers of pathologizing normal ranges of behavior and stigmatizing those who get some kind of diagnosis.

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