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“An Ounce Of Courage”: We Need To Talk About Guns, Whether The NRA Likes It Or Not

The medical community has been no match for the National Rifle Association for decades. By the time Congress leaves town for the holidays, we’ll know if senators have shown an ounce of courage or if the NRA has bagged one more trophy. Either way, we won’t get the high-stakes discussion we need about guns.

At issue is the fate of Dr. Vivek Murthy, nominated over a year ago to be surgeon general but consigned to limbo due to his completely unremarkable view that gun violence is a public health problem. Murthy’s pre-nomination Twitter feed attests to his passion for the tighter gun laws that he, like most doctors, believes would cut down on deaths and injuries. But if Murthy lands the job, don’t expect him to talk about any of that. He told a Senate committee in February that he wouldn’t use the post as a bully pulpit for new gun laws.

So much for the surgeon general’s role as “the nation’s leading spokesman on matters of public health.” And so much for standing up to the NRA.

The group blasted out of the box charging that Murthy supported “radical gun control measures” and would use the office of surgeon general to advance “his pre-existing campaign against gun ownership.” Kentucky Sen. Rand Paul, an ophthalmologist and 2016 presidential prospect, said Murthy would attack the constitutional right to own firearms “under the guise of a public health and safety campaign” and said he would try to block his confirmation.

The 2014 campaign, with its band of skittish red-state Senate Democrats vulnerable to NRA attacks, put Murthy’s future on hold. His pivotal moment — vote? no vote? failed vote? — has finally arrived, and it happens to coincide with the Dec. 14 anniversary of the murder of 26 children and educators at Sandy Hook Elementary School in Newtown, Connecticut. The juxtaposition is illuminating.

One rap against Murthy is that, in Paul’s words, he would encourage doctors to “use their position of trust to ask patients, including minors, details about gun ownership in the home.” To which I say, if only. If only the health professionals who examined and treated Adam Lanza had asked him and his mother those questions and managed to get that home arsenal out of reach before he went on his Sandy Hook rampage two years ago.

Paul also said he was concerned that Murthy considers guns “a public health issue on par with heart disease and has diminished the role of mental health in gun violence.” But in a lengthy study of Adam Lanza’s “psychological deterioration” released last month, Connecticut’s Office of the Child Advocate said repeatedly that guns are the critical factor in mass shootings.

“The conclusion that access to guns drives shooting episodes far more than the presence of mental illness is inescapable. Those countries that have tight gun controls in general experience less overall gun violence and have fewer episodes per capita of mass shootings,” the authors wrote. They said mental illness “plays only a small role” in mass murder while guns, “especially assault weapons with high-capacity magazines,” play a “ubiquitous role.” Widespread access to such weapons and ammunition “is an urgent public health concern,” they wrote.

Medical professionals agree. The American Academy of Pediatrics website lists eight priorities in its federal advocacy section, and No. 1 is “Keeping children safe: Gun violence prevention.” Banning assault weapons is the top item on its state advocacy page. The American Medical Association favors an assault weapons ban and closing loopholes that allow gun buyers to avoid background checks.

Gun safety activists marked the second anniversary of Sandy Hook by releasing a study that found at least 95 school shootings in 33 states have occurred since that tragedy. Sen. Chris Murphy (D-CT) called Congress “complicit in these murders if we continue to sit back and do nothing to reverse this trend.”

There was never a more complicit moment than in April 2013, four months after Sandy Hook, when the Senate tried to pass a bipartisan bill to require background checks online and at gun shows. Supporters needed 60 votes to break a filibuster, and only mustered 54.

Under Senate rules for nominations, Murthy needs only 51 votes. If he prevails, he told senators he’ll focus primarily on obesity, “the defining challenge of our time.” In other words, he’d be another Michelle Obama, who chose obesity as a worthy but relatively non-controversial First Lady cause. He wouldn’t be another C. Everett Koop, the Reagan-era surgeon general who crusaded against tobacco and mailed sexually explicit AIDS information to every household in America.

Restraint could get Murthy confirmed. To make real progress against gun violence, he’d need to channel Koop.

 

By: Jill Lawrence, The National Memo, December 11, 2014

December 12, 2014 Posted by | Guns, Mass Shootings, National Rifle Association | , , , , , , , | Leave a comment

“Are Guns A Public Health Issue?”: Let Us Count The Ways…

Is calling guns a public health issue a political statement? That’s become the underlying issue in the nomination of the White House’s pick for surgeon general, Vivek Murthy. In 2012, Murthy sent out a tweet: “Tired of politicians playing politics w/ guns, putting lives at risk b/c they’re scared of NRA. Guns are a health care issue.” The NRA got Senators to hurl the words back at him during a confirmation hearing, and seems to have convinced not just Republicans but some Democrats to vote against him. Now nobody is talking about bringing his nomination to the floor.

Let’s leave aside the issue of whether a Tweet should be the grounds for an opposition campaign, and of whether Murthy, best known for running an advocacy organization to support Obamacare’s launch, is the most qualified person for the job. If the question at hand is whether it’s partisan to believe that gun violence should be under the purview of the nation’s top doctor, it seems the answer is no. As Lucia Graves at National Journal chronicled last week, Ronald Reagan and George H.W. Bush’s surgeon generals, C. Everett Koop and Louis W. Sullivan, have professed the same view as Murthy without ruffling feathers. “Promoting reasonable gun policies does not make [public health professionals] ‘antigun’ any more than the Insurance Institute for Highway Safety is ‘anticar,’” wrote David Hemenway of the Harvard School of Public Health in his 2004 book Private Guns, Public Health.

Gun violence impacts health in all kinds of ways. There are the more obvious ones, like death and injury. As Olga Khazan pointed out at The Atlantic, suicide rates are higher in states where gun ownership is more common. In 2010, 19,392 people took their own lives with guns, while “justifiable homicides”—self-defense shootings that may have saved a life—numbered only 230. Over two-thirds of homicides and over half of successful suicides involve the use of a gun, and accidental gun deaths average about two a day. The U.S. spends $2 billion a year on medical care for victims of gun injuries; one out of three people hospitalized after shootings is uninsured, according to The Huffington Post.

Then there are the less obvious health effects of gun violence: Lead in the ground from ammunition. Loss of hearing from gunshots. Widespread PTSD that effects everyone from shooters, to victims, to bystanders. “Gun violence traumatizes whole communities,” Hemenway told me. This creates a cycle: “People with PTSD in inner cities often don’t have good access to mental health care, and it makes them more likely to be aggressive.”

Public health experts have a list of possible solutions that fall outside the most fractious debates over firearms. Stephen Teret, a public health expert at Johns Hopkins University, has pushed for the engineering of “smart guns,” which could only be fired by their owners: No more weapons finding their way into the black market, or becoming deadly playthings in the hands of children. (The NRA has fought the new technology.) Teret’s idea would address both intentional and accidental gun hazards, but there are lots of ways to approach the latter—from mandated child safety locks, to features that would make it more obvious if a weapon was loaded.

Hemenway also suggested changing the culture around some aspects of gun use, as a sustained campaign did for drunk driving in the 20th century. “One of the social norms should be that it’s your responsibility, if you’re a gun owner, to make sure your gun is not stolen,” he said.

The power of the surgeon general lies mostly in the ability to shape public conversation, and to do so he or she needs to maintain a high degree of trust, on both ends of the political spectrum. But sometimes advocating for public health means wading into controversial issues, like AIDS or smoking, because people’s lives are at stake. That means a surgeon general must be ready and willing to speak out on all kinds of hazards, even ones with powerful constituencies behind them. Those can include carcinogens from cigarettes, poisons from pollution, and, yes, bullets from guns.

 

By: Nora Caplan-Bricker, The New Republic, April 3, 2014

April 4, 2014 Posted by | Gun Violence, Guns, Public Health | , , , , , , | 2 Comments

   

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