Gun violence galvanizes the health professions
Organizations representing a half-million physicians issue "a call to action" to help their patients survive.
With over
, many with narrow perspectives, it’s easy for the medical community to miss the big picture of what’s most important to the public’s health.
Not this time. Seven major medical organizations joined together Monday evening to publish “a call to action” for the health professions to address gun violence as a public health problem. Firearms were responsible for more than 33,000 deaths in the United States in 2013, about one every 15 minutes. Such a threat to the health of patients in every conceivable type of treatment galvanized health professionals around a common cause.
The American Academy of Family Physicians, American Academy of Pediatrics, American College of Emergency Physicians, American Congress of Obstetricians and Gynecologists, American College of Physicians, American College of Surgeons, and American Psychiatric Association were joined by the American Public Health Association (of which I'm a proud member) and the American Bar Association in their five-page statement in the Annals of Internal Medicine.
The representatives of health organizations with more than a half-million members highlighted five areas for action to mitigate the impacts of firearms on human health:
1. Allowing physicians to talk with their patients about firearms: Smoking is risk factor a heart attack, as is high blood pressure. If you have high blood pressure, it’s sensible for your doctor to ask if you smoke, and to provide information about smoking cessation if you do. Similarly, a gun in the home is a risk factor for teen suicide, as is clinical depression. If your teenage son is clinically depressed, it’s sensible for your doctor to ask if you have a firearm in your home, and to and provide information about safe gun storage if you do. Logical as this may seem, some elected officials have tried to prevent doctors from talking to their patients about guns. The statement expresses opposition to these “gag laws” because they inhibit doctors from acting in the best interests of their patients.
2. Mental health: Severe mental illness is a relatively minor part of gun violence—the overwhelming majority of people with serious mental illness are not violent towards others. Mental illness and firearms, however, are a lethal combination when it comes to suicide. There are approximately 350,000 suicide attempts in the U.S. annually, of which only 9 percent result in death. When a firearm is used, however, the death rate increases to 85 percent. The statement emphasizes that ensuring access to, and reducing stigma about, mental health services is crucial to decreasing the toll of firearm-assisted suicide. Consistent with this perspective, the statement recommends against blanket reporting laws that require physicians to notify authorities when a patient displays signs that they might harm themselves or others. Although such notifications could prevent harm a small percentage of the time, an across-the-board reporting requirement could further stigmatize mental health services and deter people from seeking care, actually increasing the risk.
3. Restricting access to assault weapons: Military-style weapons with large-capacity magazines are designed to kill a lot of people quickly. Sadly, these weapons function as intended—as evidenced by several mass shootings. A 2013 survey found that 69 percent of U.S. residents approved banning the sale of assault weapons (77 percent of non-gun owners and 46 percent of gun owners). Assault weapons pose a threat to public safety and the statement, like most Americans, supports restrictions on access to assault weapons.
4. Requiring criminal background checks for all firearm purchases: Background checks are required for firearms purchased at licensed gun dealers, but not those purchased at gun shows or through private sales between individuals. As a result, anyone who would not pass a background check can easily get their hands on a gun. As with assault weapons, most U.S. residents (89 percent, 90 percent of non-gun owners and 84 percent of gun owners) support background checks for all gun sales).
5. Conducting quality research: The National Institutes of Health spends around $30 billion annually on research to improve health and prevent premature death, but virtually none of it goes to study firearms. Why? As I previously reported, the pro-gun lobby has successfully prevented federally-funded research on firearm injuries. In January 2013, President Obama issued a Memorandum clarifying that federal dollars could, and should, be used for firearms research. Despite this, some federal agencies are still hesitant. The statement emphasizes that evidence-based programs and policies to reduce gun violence depends on funding for high quality research.
Action to address gun violence often becomes mired in the question of whether it's guns that kill people or people who kill people. In an editorial accompanying the statement, eadlined "Reducing Firearm-Related Harms: Time for Us to Study and Speak Out," the Annals of Internal Medicine's editor in chief, Dr. Christine Laine, and executive deputy editor, Dr. Darren B. Taichman, write that the answer is that it doesn't matter. We have a public health crisis on our hands and something needs to be done.
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