One of the most remarkable and - yes - ignorant reactions I ever got from a parent happened when as part of my routine well child exam safety screening I asked:
“Are there guns in the home?”
You would have thought I was personally hovering over him with an axe.
The father stood up and screamed “YOU HAVE NO FIRST AMENDMENT RIGHT TO ASK ME THAT QUESTION!”
(!!!)
I calmly explained that I owned a weapon. (It was true…. I had my father’s 20 gauge break-action shotgun which he had used to hunt quail in his teens…. Although I’d never used it.)
I also explained that I had done small bore competition when I was younger (also true) and that the issue was whether the weapons were safely stored.
I didn’t point out that the first amendment has nothing to do with guns and that I had every right to ask any question related to his child’s health…
After they left I couldn’t stop thinking about the impact that intense outburst must have had on the boy…. And how damaging those rage episodes are…. And how that boy would model his dad’s behaviors.
One of my first reasons for subscribing to YLE was finding out that Dr. Jetelina was one of the leaders in tracking gun violence as an epidemic. I am a retired cop, one who spent 15 of my 28 years of full-time employment developing and teaching use of force application and policy. I am thrilled that her category of discharges describe "unintentional" rather than "accidental".
Excellent column, as always. For people to suggest than gun violence isn't a public health issue is either a misunderstanding of the field, or willful ignorance. I tend to go with the latter since by "allowing" a public health framing of the issue, it'll bring up the good, bad, and ugly that will rub everybody the wrong way in some capacity.
Less willful ignorance and more willful delusion IMO. The NRA has spend four decades telling firearm owners "gub'mint a-comin' fo yo guns, cuz - better go buy summore" and it's created a cult of 2A fetishists. Any government action on anything to do with guns feeds the narrative, and their fears.
I'm hopeful that the tide is turning, but I expect that pushback against Murthy's announcement has just started. There's probably a whole new department being organized at the Federalist Society as we type here, dedicated to organizing lawfare strategies to attack the Biden administration (and Murthy personally) over recognizing that firearms - like smoking - are a public health issue.
The scourge of gun violence is real and of course IS a public health issue. The current rallying cry of anti gun activists is the increase in "child" deaths from firearms. The ONLY way to come up with this extremely misleading statistic is by including 18 and 19 year old ADULTS in the perverted definition of "CHILD". If we remove gang on gang deaths with illegal firearms by repeat violent offenders, this part of the firearm epidemic is greatly reduced. IF Democrat politicians would join conservatives in locking up violent offenders this one part of the epidemic would be drastically reduced. Let's join together to immediately solve this portion of gun violence!
But the Progressive idea is that criminals are the real "victims," and to lock them up is unfair to them. A recent article in WaPo or NYT (forget which) is calling mandatory work for people in prisons "slavery."
Sentences are far too light for violent offenders. It should be a one-strike you're out kind of approach.
....and, ironically, the people who suffer from not locking up violent criminals are low income folks and minorities. My wife was a police officer in Seattle, in 1975. First group of women allowed into the academy. She had black mothers coming up to her literally begging her to get rid of the 'bad guys' before they could get to their children. So ironic with Progressives claiming to care about the little guy, and then jumping at every police problem they can find, to see that their (unknowledgeable) opinions are actually hurting they people they supposedly care about.
My career goals while in college were to be a pastor, counselor or police officer. I ended up being a police officer for a time. My experience mirrored your wife's. Those most injured by liberal progressive policies are those the liberals claim to want to help.
So perhaps the conservative states could lead the way in showing just how gun homicides could be reduced?
(And, psssst, the U.S. has the highest incarceration rate in the developed world...in fact, it is #6 in the world overall, but I guess throwing even more people in jail will solve the problem?)
Do I support your carefully cherry-picked data point meant to deflect blame solely to Democrats while ignoring the mass evidence of a much bigger gun violence problem in states run by those who claim to be tough on crime?
My comment was an actual attempt to solve one part of the problem that is easy to solve. If you have actual proposals to help solve the problem, please share them.
If you google "police evidence-based strategies for reducing youth gang homicides" there are literally dozens of papers on approaches and efforts that have been proven effective in use.
I've spent the last half hour researching this very topic, and I'm yet to come across a reputable study (ETA: actually, any study) which shows that a sole focus on more aggressive incarceration would solve the problem.
It not only would solve this portion of the problem, but it would greatly reduce criminal gun violence in general. Ask any cop you know how many times they have arrested a person for a gun related crime that DID NOT have gun related criminal violence in their history. EVERYONE in the criminal justice system knows the problem but can't do anything about it because of Democrat anti-cop, soft on crime District Attorneys and legislators that refuse to allow the punishment of criminals for using guns in crimes. I don't understand why anyone would even question this.
Not sure we agree that every problem is a public health issue. Is, for example, criminal behavior a public health issue? Does making guns a public health issue open the door for just about anything being framed that way?
Mostly what we would like to see in articles about gun control, and even in peoples' comments about guns and gun control, is whether they have guns themselves.
One of the major theories we have (no studies to prove it) is that people who don't own guns are much more in favor of gun control than people who have guns. For people without guns there are no trade-offs for gun control measures, so it is far easier to recommend them.
p.s. In keeping with this idea, we have guns. We have spent 3 1/4 years in our 60s traveling, camping, and hiking on public lands. There are no police to call, and occasionally we have run into some very off-balanced, and dangerous, people. My wife would know---she was one of five women who were the first female police officers in Seattle, in 1975. Worked in law enforcement her entire career. (In case you are wondering, I was a college professor, so at the first sign of trouble I hide behind her).
Anything that is the #1 cause of death of children is a public health issue. I think we can all agree that the number of children dying from gun violence needs to be reduced. It’s heartbreaking and preventable. The thing is, it’s a waste of time to randomly try different things and just wait and see if it helps. Taking away 100% of guns would definitely solve the problem, but gun owners have the right to own guns. I live in Alabama and the “Right to Carry” lobby here managed to get an “Open Carry” law that makes in legal for anyone who owns a gun, concealed or otherwise to carry that gun without a permit. Women drop their purse in Walmart and their gun fires. People keep loaded guns under their car seat and toddlers find them and discharge them. In order to justify making any changes to what we’re currently doing Public Health Epidemiologists need to study and compare different interventions. Money will be spent to study existing records of what is happening. That data will inform interventions. During the interventions detailed records are created. Those records are studied to measure the effect of the intervention. All of this activity has to be funded and public health has the qualified staff to conduct the studies.
You asked the question, “Is criminal behavior a public health issue?”. Any behavior that impacts the health and safety of people and can be observed, recorded, and studied can ultimately be predicted and therefore prevented. Funding through Public Health can accomplish that.
The thing is, gun violence is *not* the #1 cause of death in children. The studies that make that claim invariably include 18- and 19-year-olds in their death count (which unsurprisingly drives the numbers much higher).
The more nominally honest among those studies include the caveat that the data refer to "children and teens" or "children and young people", but it doesn't change the fact that gun violence is something that has orders of magnitude more impact on reckless teenagers than innocent young children.
It’s interesting to note that suicides start a steady upward trajectory in 2004/2005 - the same timeframe Facebook was born and social media was unleashed.
I’m still chewing on “if it’s predictable, it’s preventable.” Many things are predictable yet can’t be prevented. Gravity, taxes, Taylor Swift concert sellouts.
One of the lessons from covid is that Public Health cannot prevent everything, even if it’s predictable, even if enormous resources are spent, even if mandates are implemented.
Where to draw the line between what PH should attempt to prevent and where it should steer clear is something that merits more consideration by PH officials.
I think that phrase "if it is predictable, it is preventable" is still valid, even if it is not universal. When looking at gun violence, the presence of a gun is the only way that gun violence can occur. By factoring in other safety measures, many of the negative outcomes can be prevented.
I see your point and somewhat agree. Unfortunately the motto for many in PH is: if we can predict it, we must prevent it.
Often this type of thinking leads to wasted money and unintended consequences. If covid vaccines hadn’t been mandated, would we see so much pushback today for common sense mainstay vaccines for children?
I don't know; without the mandate, I don't think that the production would have been nearly as supported. I always look at someone who sports the "Don't tread on me" attitude as a tween saying "You're not the boss of me"...
This is my first comment on your Substack (I upgraded to “paid” specifically to post it) and I hope it’s taken with the spirit of constructive criticism that’s intended. A few details about my background are included at the bottom* of the comment for context.
I think epidemiology can add valuable insights to gun violence policy; you’re very correct that your profession is good at systematically noticing patterns. That said, there are several pitfalls that need to be strenuously avoided if you all want to have the best possible impact in this area.
1. Lumping “children and adolescents” or “children and teens” into a single category.
A naïve 5-year-old playing with a carelessly stored gun at home isn’t anything like a 19-year-old who chooses to join a gang and gets shot in public by a rival gang member. When gun violence epidemiologists describe both of these examples as “firearm deaths among children” – and prominently tout that statistic – they look less like serious analysts attempting to notice patterns, and more like charlatans engaged in linguistic sleight-of-hand to get the general public too worried about their young children to be properly skeptical of the facts presented.
2. Too much advocacy for “point-of-sale” gun control (e.g. background checks, “assault weapon” bans, and most of the other items in the Vox list you link) when “point-of-supply” (e.g. prosecuting straw purchasers to deter others from helping someone evade the point-of-sale restrictions) or “point-of-use” gun control (e.g. stop-and-frisk to detect a habitual criminal carrying an illegal handgun) are what’s indicated by the analysis.
You’re correct that a lot of point-of-sale restrictions are broadly popular*. But they’re also, not without reason, frequently perceived as something imposed on rural and suburban Americans (who, as more frequent gun owners bear the cost of complying) by urban Americans (who support gun control most strongly). By focusing so much advocacy on point-of-sale restrictions, it needlessly alienates rural and suburban gun owners and supporters of gun ownership – something that’s only made worse by the extent of the rural-urban partisan divide.
3. Going wobbly in order to avoid noticing the racial patterns in gun violence.
Bluntly, young Black men – as a statistical average, not as individuals – are around an order of magnitude more likely than young men generally to be perpetrators (and victims) of gun homicides. It’s not necessary to give ammunition to racists by speculating about the “why” of this statistical fact, but the fact itself needs to be widely known – because any policy developed to engage with the concentration of violence, no matter how good in principle, can be inevitably be expected to have a “disparate impact” on young Black men.
Unfortunately, given the degree to which statistical disparate impacts are seen as always morally indefensible (as opposed to, say, indicators that merit follow up and might require a defense of the policy that created them), professionals go far out of their way to avoid creating them. Public health has been no exception to this.
Again, I hope this is constructive to our shared goal of reducing gun violence.
*My personal background relevant to this comment: I’m a center-right professional working in a heavily quantitative occupation who lives in an affluent, left-leaning large metro suburb, generally votes for Republicans, served in the military including two deployments to a combat zone, doesn’t personally own guns but has plenty of family and friends who do, married with two young children.
**To be open about my own positions: mental health restrictions, background checks, and red flag laws are acceptable with a devil’s-in-the-details caveat; magazine capacity limits and assault weapons bans are demonstrably worthless.
Thank you for your rational explanation. It is nice to read something clear headed and " nonpartisan." Please keep writing, you're doing excellent work.
A terrible problem. As you note "Gun deaths differ by race/ethnicity, physical location, age, and many other factors. This suggests who and how we engage with matters to make an impact." Honestly acknowledging those differences can surely play a role in working toward reducing the numbers. Which is why I'm surprised you shied away from more openly acknowledging the huge race and sex differences in rates of different kinds of gun-related deaths. Males commit suicide with guns at much higher rates than do females, and black children are more than an order of magnitude more likely to be victims of a gun violence homicide (with the perpetrators also black in the huge majority of the homicides) than is the case for non-Hispanic Whites, while the rates are significantly lower for Asians than for Whites.
These may be uncomfortable truths to acknowledge, but that should not stop the public health community from taking those differences into account when working toward reducing the rates of gun violence deaths.
Female use of firearms for suicides have noticeably increased since 1985. They still don't rise to the same raw numbers, but I can tell you that since about 2005 or so, there have been far more gun suicides from females than there were prior to that time.
Gun violence is, indeed, a public health issue. The presence or absence of guns in the home and community has a significant impact on the safety of the community. Properly stored guns - which includes storing them unloaded and with the ammunition stored separately - are significantly less likely to be used improperly, if only because accessing them requires more forethought than grabbing a gun stored improperly.
Thank you for this in-depth explanation of the issues involved, as well as mentioning so many other public health issues that are often not considered to be such. The intersection between individual freedoms and the public good as expressed by public health is often misunderstood - especially by people who consider their individual rights to be more important than the public good.
The only purpose of a gun (handgun or rifle or tank) is to kill a living object (animal, bird, human, etc). That's it. Guns should not be thought of as objects of worship. Guns are not talismans of luck or good fortune. To think so is silly.
A portion of my teenage years I worked on a 4200 acre cattle and sheep ranch. This was an environment just made for guns. However, the seriousness of guns was such that only the manager of the ranch was permitted to carry a gun. He had a custom lever action rifle that he wore on his right hip. During the two years I was on this ranch I saw him use the rifle only once… a rabid fox had wandered into the main compound and the manager fired and killed the fox.
I learned a lot from his action… a gun should only be used for necessary defense. Any other use apart from periodic training, had no basis in reality.
Years later I had a friend whose teenage son had been killed by another similar age child "playing" with his father's handgun. I knew her years after this happened. No amount of "healing" or "closure" could bring her son back or make whole her pain.
Thanks for the excellent article on gun violence as a public health issue. Important points you make, Public Health "is the science of protecting and improving the health of people and their communities."
Education is key to improving health individually and collectively.
I personally wonder how well our medical schools are doing to educate future providers to broadly support individual and community wellbeing.
I believe that there should be a law against "negligent storage" of fire arms.
In any home where there are guns, if they are stored in a manner that a minor can get to them, and the minor is either injured by an unintentional discharge, or injures another either intentionally or not, the owner of the gun should be charged with the same crime as the person who caused the weapon to fire.
I question whether suicide should be subdivided into catigories.
There are suicides that are directly connected to mental illness.
There are suicides where the victim is despondent over external factors, that had the circumstance been missing, might not have occurred. These might include financial pressures, loss of a loved one either because a relationship ended, or untimely death. Loss of a home etc.
If the stressor were removed the suicide might not have occurred.
I suggest that there are suicides where the individual is of sound mind, has minimal external stressors etc, the just don't want to cintinue living.
Think of it as Physician assisted suicide, but without the MD.
Should we be able to exercise our free will to end our life at a time and manner of our own choosing without triggering the prevention impulses our society is so found of?
I know that a lot of religions have strictures banning suicide from any cause.
Frankly, I think this is driven by financial concerns of the religion industry. No butts in pews, no chance to collect funds to pay for the operation of the church and the salaries of the church "operators"…
So, should we lump all self inflicted deaths in one bucket, or is it more nuanced?
As a geriatric practitioner, I bring up the issue of guns in the homes of persons with dementia. We strongly advise families on gun safety, and provide, for example, strategies for removing guns from the home. There have been many situations requiring "delicate handling" of a gun in the home and some very creative solutions have been successful.
One of the most remarkable and - yes - ignorant reactions I ever got from a parent happened when as part of my routine well child exam safety screening I asked:
“Are there guns in the home?”
You would have thought I was personally hovering over him with an axe.
The father stood up and screamed “YOU HAVE NO FIRST AMENDMENT RIGHT TO ASK ME THAT QUESTION!”
(!!!)
I calmly explained that I owned a weapon. (It was true…. I had my father’s 20 gauge break-action shotgun which he had used to hunt quail in his teens…. Although I’d never used it.)
I also explained that I had done small bore competition when I was younger (also true) and that the issue was whether the weapons were safely stored.
I didn’t point out that the first amendment has nothing to do with guns and that I had every right to ask any question related to his child’s health…
After they left I couldn’t stop thinking about the impact that intense outburst must have had on the boy…. And how damaging those rage episodes are…. And how that boy would model his dad’s behaviors.
Public health is broad…and generational.
That is chilling, Doc.
One of my first reasons for subscribing to YLE was finding out that Dr. Jetelina was one of the leaders in tracking gun violence as an epidemic. I am a retired cop, one who spent 15 of my 28 years of full-time employment developing and teaching use of force application and policy. I am thrilled that her category of discharges describe "unintentional" rather than "accidental".
Thank you for this post.
Excellent column, as always. For people to suggest than gun violence isn't a public health issue is either a misunderstanding of the field, or willful ignorance. I tend to go with the latter since by "allowing" a public health framing of the issue, it'll bring up the good, bad, and ugly that will rub everybody the wrong way in some capacity.
Less willful ignorance and more willful delusion IMO. The NRA has spend four decades telling firearm owners "gub'mint a-comin' fo yo guns, cuz - better go buy summore" and it's created a cult of 2A fetishists. Any government action on anything to do with guns feeds the narrative, and their fears.
I'm hopeful that the tide is turning, but I expect that pushback against Murthy's announcement has just started. There's probably a whole new department being organized at the Federalist Society as we type here, dedicated to organizing lawfare strategies to attack the Biden administration (and Murthy personally) over recognizing that firearms - like smoking - are a public health issue.
The scourge of gun violence is real and of course IS a public health issue. The current rallying cry of anti gun activists is the increase in "child" deaths from firearms. The ONLY way to come up with this extremely misleading statistic is by including 18 and 19 year old ADULTS in the perverted definition of "CHILD". If we remove gang on gang deaths with illegal firearms by repeat violent offenders, this part of the firearm epidemic is greatly reduced. IF Democrat politicians would join conservatives in locking up violent offenders this one part of the epidemic would be drastically reduced. Let's join together to immediately solve this portion of gun violence!
But the Progressive idea is that criminals are the real "victims," and to lock them up is unfair to them. A recent article in WaPo or NYT (forget which) is calling mandatory work for people in prisons "slavery."
Sentences are far too light for violent offenders. It should be a one-strike you're out kind of approach.
....and, ironically, the people who suffer from not locking up violent criminals are low income folks and minorities. My wife was a police officer in Seattle, in 1975. First group of women allowed into the academy. She had black mothers coming up to her literally begging her to get rid of the 'bad guys' before they could get to their children. So ironic with Progressives claiming to care about the little guy, and then jumping at every police problem they can find, to see that their (unknowledgeable) opinions are actually hurting they people they supposedly care about.
My career goals while in college were to be a pastor, counselor or police officer. I ended up being a police officer for a time. My experience mirrored your wife's. Those most injured by liberal progressive policies are those the liberals claim to want to help.
My local sheriff didn’t want prisoners to work, either. Think of the potential for litigation if anything happens, and you’ll agree.
Sorry, but gun violence deaths are the highest in conservative states. And, no, it's not just the cities, either.
https://www.cdc.gov/nchs/pressroom/sosmap/firearm_mortality/firearm.htm
https://www.forbes.com/sites/ariannajohnson/2023/04/28/red-states-have-higher-gun-death-rates-than-blue-states-heres-why/
https://www.thirdway.org/report/the-21st-century-red-state-murder-crisis
https://www.politico.com/news/magazine/2023/04/23/surprising-geography-of-gun-violence-00092413
https://www.congress.gov/118/meeting/house/116676/documents/HHRG-118-JU08-20231213-SD004.pdf
So perhaps the conservative states could lead the way in showing just how gun homicides could be reduced?
(And, psssst, the U.S. has the highest incarceration rate in the developed world...in fact, it is #6 in the world overall, but I guess throwing even more people in jail will solve the problem?)
My comment only discussed one particular subset of the gun violence problem. Are you disagreeing with me on my comment?
Do I support your carefully cherry-picked data point meant to deflect blame solely to Democrats while ignoring the mass evidence of a much bigger gun violence problem in states run by those who claim to be tough on crime?
Um, no.
My comment was an actual attempt to solve one part of the problem that is easy to solve. If you have actual proposals to help solve the problem, please share them.
If you google "police evidence-based strategies for reducing youth gang homicides" there are literally dozens of papers on approaches and efforts that have been proven effective in use.
I've spent the last half hour researching this very topic, and I'm yet to come across a reputable study (ETA: actually, any study) which shows that a sole focus on more aggressive incarceration would solve the problem.
It not only would solve this portion of the problem, but it would greatly reduce criminal gun violence in general. Ask any cop you know how many times they have arrested a person for a gun related crime that DID NOT have gun related criminal violence in their history. EVERYONE in the criminal justice system knows the problem but can't do anything about it because of Democrat anti-cop, soft on crime District Attorneys and legislators that refuse to allow the punishment of criminals for using guns in crimes. I don't understand why anyone would even question this.
https://nypost.com/2022/06/04/why-improving-gun-related-convictions-would-solve-gun-crime/
Great article.
Not sure we agree that every problem is a public health issue. Is, for example, criminal behavior a public health issue? Does making guns a public health issue open the door for just about anything being framed that way?
Mostly what we would like to see in articles about gun control, and even in peoples' comments about guns and gun control, is whether they have guns themselves.
One of the major theories we have (no studies to prove it) is that people who don't own guns are much more in favor of gun control than people who have guns. For people without guns there are no trade-offs for gun control measures, so it is far easier to recommend them.
p.s. In keeping with this idea, we have guns. We have spent 3 1/4 years in our 60s traveling, camping, and hiking on public lands. There are no police to call, and occasionally we have run into some very off-balanced, and dangerous, people. My wife would know---she was one of five women who were the first female police officers in Seattle, in 1975. Worked in law enforcement her entire career. (In case you are wondering, I was a college professor, so at the first sign of trouble I hide behind her).
Anything that is the #1 cause of death of children is a public health issue. I think we can all agree that the number of children dying from gun violence needs to be reduced. It’s heartbreaking and preventable. The thing is, it’s a waste of time to randomly try different things and just wait and see if it helps. Taking away 100% of guns would definitely solve the problem, but gun owners have the right to own guns. I live in Alabama and the “Right to Carry” lobby here managed to get an “Open Carry” law that makes in legal for anyone who owns a gun, concealed or otherwise to carry that gun without a permit. Women drop their purse in Walmart and their gun fires. People keep loaded guns under their car seat and toddlers find them and discharge them. In order to justify making any changes to what we’re currently doing Public Health Epidemiologists need to study and compare different interventions. Money will be spent to study existing records of what is happening. That data will inform interventions. During the interventions detailed records are created. Those records are studied to measure the effect of the intervention. All of this activity has to be funded and public health has the qualified staff to conduct the studies.
You asked the question, “Is criminal behavior a public health issue?”. Any behavior that impacts the health and safety of people and can be observed, recorded, and studied can ultimately be predicted and therefore prevented. Funding through Public Health can accomplish that.
The thing is, gun violence is *not* the #1 cause of death in children. The studies that make that claim invariably include 18- and 19-year-olds in their death count (which unsurprisingly drives the numbers much higher).
The more nominally honest among those studies include the caveat that the data refer to "children and teens" or "children and young people", but it doesn't change the fact that gun violence is something that has orders of magnitude more impact on reckless teenagers than innocent young children.
It’s interesting to note that suicides start a steady upward trajectory in 2004/2005 - the same timeframe Facebook was born and social media was unleashed.
I’m still chewing on “if it’s predictable, it’s preventable.” Many things are predictable yet can’t be prevented. Gravity, taxes, Taylor Swift concert sellouts.
One of the lessons from covid is that Public Health cannot prevent everything, even if it’s predictable, even if enormous resources are spent, even if mandates are implemented.
Where to draw the line between what PH should attempt to prevent and where it should steer clear is something that merits more consideration by PH officials.
I think that phrase "if it is predictable, it is preventable" is still valid, even if it is not universal. When looking at gun violence, the presence of a gun is the only way that gun violence can occur. By factoring in other safety measures, many of the negative outcomes can be prevented.
I see your point and somewhat agree. Unfortunately the motto for many in PH is: if we can predict it, we must prevent it.
Often this type of thinking leads to wasted money and unintended consequences. If covid vaccines hadn’t been mandated, would we see so much pushback today for common sense mainstay vaccines for children?
I don't know; without the mandate, I don't think that the production would have been nearly as supported. I always look at someone who sports the "Don't tread on me" attitude as a tween saying "You're not the boss of me"...
Good afternoon Katelyn / YLE,
This is my first comment on your Substack (I upgraded to “paid” specifically to post it) and I hope it’s taken with the spirit of constructive criticism that’s intended. A few details about my background are included at the bottom* of the comment for context.
I think epidemiology can add valuable insights to gun violence policy; you’re very correct that your profession is good at systematically noticing patterns. That said, there are several pitfalls that need to be strenuously avoided if you all want to have the best possible impact in this area.
1. Lumping “children and adolescents” or “children and teens” into a single category.
A naïve 5-year-old playing with a carelessly stored gun at home isn’t anything like a 19-year-old who chooses to join a gang and gets shot in public by a rival gang member. When gun violence epidemiologists describe both of these examples as “firearm deaths among children” – and prominently tout that statistic – they look less like serious analysts attempting to notice patterns, and more like charlatans engaged in linguistic sleight-of-hand to get the general public too worried about their young children to be properly skeptical of the facts presented.
2. Too much advocacy for “point-of-sale” gun control (e.g. background checks, “assault weapon” bans, and most of the other items in the Vox list you link) when “point-of-supply” (e.g. prosecuting straw purchasers to deter others from helping someone evade the point-of-sale restrictions) or “point-of-use” gun control (e.g. stop-and-frisk to detect a habitual criminal carrying an illegal handgun) are what’s indicated by the analysis.
You’re correct that a lot of point-of-sale restrictions are broadly popular*. But they’re also, not without reason, frequently perceived as something imposed on rural and suburban Americans (who, as more frequent gun owners bear the cost of complying) by urban Americans (who support gun control most strongly). By focusing so much advocacy on point-of-sale restrictions, it needlessly alienates rural and suburban gun owners and supporters of gun ownership – something that’s only made worse by the extent of the rural-urban partisan divide.
3. Going wobbly in order to avoid noticing the racial patterns in gun violence.
Bluntly, young Black men – as a statistical average, not as individuals – are around an order of magnitude more likely than young men generally to be perpetrators (and victims) of gun homicides. It’s not necessary to give ammunition to racists by speculating about the “why” of this statistical fact, but the fact itself needs to be widely known – because any policy developed to engage with the concentration of violence, no matter how good in principle, can be inevitably be expected to have a “disparate impact” on young Black men.
Unfortunately, given the degree to which statistical disparate impacts are seen as always morally indefensible (as opposed to, say, indicators that merit follow up and might require a defense of the policy that created them), professionals go far out of their way to avoid creating them. Public health has been no exception to this.
Again, I hope this is constructive to our shared goal of reducing gun violence.
*My personal background relevant to this comment: I’m a center-right professional working in a heavily quantitative occupation who lives in an affluent, left-leaning large metro suburb, generally votes for Republicans, served in the military including two deployments to a combat zone, doesn’t personally own guns but has plenty of family and friends who do, married with two young children.
**To be open about my own positions: mental health restrictions, background checks, and red flag laws are acceptable with a devil’s-in-the-details caveat; magazine capacity limits and assault weapons bans are demonstrably worthless.
Excellent and appropriate comments.
Thank you for your rational explanation. It is nice to read something clear headed and " nonpartisan." Please keep writing, you're doing excellent work.
A terrible problem. As you note "Gun deaths differ by race/ethnicity, physical location, age, and many other factors. This suggests who and how we engage with matters to make an impact." Honestly acknowledging those differences can surely play a role in working toward reducing the numbers. Which is why I'm surprised you shied away from more openly acknowledging the huge race and sex differences in rates of different kinds of gun-related deaths. Males commit suicide with guns at much higher rates than do females, and black children are more than an order of magnitude more likely to be victims of a gun violence homicide (with the perpetrators also black in the huge majority of the homicides) than is the case for non-Hispanic Whites, while the rates are significantly lower for Asians than for Whites.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832380/
These may be uncomfortable truths to acknowledge, but that should not stop the public health community from taking those differences into account when working toward reducing the rates of gun violence deaths.
Female use of firearms for suicides have noticeably increased since 1985. They still don't rise to the same raw numbers, but I can tell you that since about 2005 or so, there have been far more gun suicides from females than there were prior to that time.
Just jumped from YLE to Scotusblog and back to say I wish more lawyers came to the law with scientific training, head and heart.
Gun violence is, indeed, a public health issue. The presence or absence of guns in the home and community has a significant impact on the safety of the community. Properly stored guns - which includes storing them unloaded and with the ammunition stored separately - are significantly less likely to be used improperly, if only because accessing them requires more forethought than grabbing a gun stored improperly.
Thank you for this in-depth explanation of the issues involved, as well as mentioning so many other public health issues that are often not considered to be such. The intersection between individual freedoms and the public good as expressed by public health is often misunderstood - especially by people who consider their individual rights to be more important than the public good.
I just read an article about graduating class of Sandy Hook survivors, thank you for this and everything you do.
The only purpose of a gun (handgun or rifle or tank) is to kill a living object (animal, bird, human, etc). That's it. Guns should not be thought of as objects of worship. Guns are not talismans of luck or good fortune. To think so is silly.
A portion of my teenage years I worked on a 4200 acre cattle and sheep ranch. This was an environment just made for guns. However, the seriousness of guns was such that only the manager of the ranch was permitted to carry a gun. He had a custom lever action rifle that he wore on his right hip. During the two years I was on this ranch I saw him use the rifle only once… a rabid fox had wandered into the main compound and the manager fired and killed the fox.
I learned a lot from his action… a gun should only be used for necessary defense. Any other use apart from periodic training, had no basis in reality.
Years later I had a friend whose teenage son had been killed by another similar age child "playing" with his father's handgun. I knew her years after this happened. No amount of "healing" or "closure" could bring her son back or make whole her pain.
Thanks for the excellent article on gun violence as a public health issue. Important points you make, Public Health "is the science of protecting and improving the health of people and their communities."
Education is key to improving health individually and collectively.
I personally wonder how well our medical schools are doing to educate future providers to broadly support individual and community wellbeing.
I believe that there should be a law against "negligent storage" of fire arms.
In any home where there are guns, if they are stored in a manner that a minor can get to them, and the minor is either injured by an unintentional discharge, or injures another either intentionally or not, the owner of the gun should be charged with the same crime as the person who caused the weapon to fire.
I question whether suicide should be subdivided into catigories.
There are suicides that are directly connected to mental illness.
There are suicides where the victim is despondent over external factors, that had the circumstance been missing, might not have occurred. These might include financial pressures, loss of a loved one either because a relationship ended, or untimely death. Loss of a home etc.
If the stressor were removed the suicide might not have occurred.
I suggest that there are suicides where the individual is of sound mind, has minimal external stressors etc, the just don't want to cintinue living.
Think of it as Physician assisted suicide, but without the MD.
Should we be able to exercise our free will to end our life at a time and manner of our own choosing without triggering the prevention impulses our society is so found of?
I know that a lot of religions have strictures banning suicide from any cause.
Frankly, I think this is driven by financial concerns of the religion industry. No butts in pews, no chance to collect funds to pay for the operation of the church and the salaries of the church "operators"…
So, should we lump all self inflicted deaths in one bucket, or is it more nuanced?
Sincerely
Steve
As a geriatric practitioner, I bring up the issue of guns in the homes of persons with dementia. We strongly advise families on gun safety, and provide, for example, strategies for removing guns from the home. There have been many situations requiring "delicate handling" of a gun in the home and some very creative solutions have been successful.