Gun violence as a public health crisis : Consider This from NPR : NPR
Gun violence as a public health crisis : Consider This from NPR The surgeon general's office has declared gun violence a national public health crisis.

It's the first time the body has ever issued a public health advisory about firearms, and for Surgeon General Vivek Murthy, it's a step in reframing the conversation about death by gunfire.

According to the CDC, more than 48,000 Americans were killed by gun violence in 2021, and over half of those deaths were by suicide.

Gun violence is getting worse. Can a shift in perspective be the solution?

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JUANA SUMMERS, HOST:

A heads up that this story is about gun violence in all its forms. It may not be appropriate for everyone, so please take care. Gun violence is a national public health crisis. That's the message this week from U.S. Surgeon General Vivek Murthy. It's the first time the Surgeon General's Office has ever issued a public health advisory about firearms. Murthy says his goal is to reframe the conversation about death by gunfire.

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VIVEK MURTHY: I lay out a series of strategies in this advisory that we can take to address the scourge of gun violence.

SUMMERS: That's Murthy speaking on NPR's Here & Now earlier this week. The scourge of gun violence he's referring to has a number. More than 48,000 Americans were killed by guns in 2021, that's according to the CDC's most recent annual data. Over half those gun deaths were by suicide.

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MURTHY: And what we got to recognize is the toll that it's taking on us. The most - the highest price we're paying are the lives lost, nearly 50,000 a year. But for every one person who loses their life to gun violence, there are two who are injured and who survive, but with mental and physical consequences.

SUMMERS: Eryk Brown is a survivor. He and a friend were both shot outside their car in Chicago a couple of years ago, waiting for a takeout order at a vegan restaurant. They each recovered from their physical injuries. But not long after the shooting, Brown told me about the mental toll of that experience.

ERYK BROWN: And I'd like to remember during that time is just, like, saying in my head, like, when is this going to be over? When is this going to be over? Like, just praying that it's going to be over and that I don't get hit nowhere that it will just, like, permanently make me disabled or, like, even kill me.

SUMMERS: That summer, Brown had relocated to Chicago for a summer internship, but it's actually the city where he grew up. That fear of gun violence was inescapable when he was young.

BROWN: When I was growing up, I was like, I hope I never get shot. That's something that I never want to experience. So I made sure that I avoid every way possible to not get shot.

SUMMERS: Brown chose to go out of state to college to the University of Wisconsin. He says he made that decision in part to escape the gun violence in his hometown.

BROWN: I don't have to, like, lean towards the streets and be involved in nonsense that I don't see myself being a part of. I never thought I was going to be a victim of gun violence.

SUMMERS: Even with everything he did, Brown could not avoid becoming a victim of gun violence, and that is an increasing reality here in the U.S. CONSIDER THIS - guns are killing Americans at a higher rate each year. Will calling the issue a public health crisis make a difference?

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SUMMERS: From NPR, I'm Juana Summers.

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SUMMERS: It's CONSIDER THIS FROM NPR. The issue of gun violence is a contentious political conversation in this country. But for years, doctors and health care officials have pushed to make it a conversation about public health as the surgeon general has done this week. Dr. Cedric Dark is one of those doctors, and he treats gunshot victims himself. He's an associate professor of emergency medicine at Baylor College of Medicine in Houston, Texas. Hi, Dr. Dark

CEDRIC DARK: Thanks for having me on.

SUMMERS: So the surgeon general's advisory says that it's meant to call the American people's attention to an urgent public health issue, but Americans are already quite well aware of the effects of gun violence. I mean, the report itself even says that more than half of Americans worry about a loved one being hurt or being killed by guns. So just to start in practical terms, what does a report like this accomplish?

DARK: The biggest thing that the surgeon general is doing is by putting focus and putting a direct spotlight on this public health issue, so no matter how much the public is talking about it or certainly politicians, the surgeon general's report is really important for focusing the public's viewpoint on what it should be looking at. Think about the surgeon general's report on smoking and tobacco. It changed the paradigm and, for the next couple generations after that, allowed us to tackle the tobacco industry. So this is something that I think allows us to look at the cures to gun violence, but instead of through a political lens, through a scientific lens and a public health lens.

SUMMERS: Because you brought it up, I do want to talk about that 1964 advisory on the health risks of smoking. And that report, as you point out, it did reframe the national conversation about smoking, but smoking cigarettes is not a constitutionally protected right in the same way that the right to bear arms is. So I wonder just how useful that comparison is, in fact.

DARK: Well, I think when I approach this from the bedside, you know, if we're talking about cigarettes, we have - as physicians have a responsibility to our patients to advise them as to what's the best thing for them, to tell them to stop smoking. And we also have that same responsibility when it comes to talking to our patients about firearms as well, whether they're here seeing me in the emergency department for a mental health crisis or for some other reason, maybe they have children visiting, making sure that their firearms are safely stored, locked and hopefully separate from ammunition. And it's not something that I would shy away from doing. It's my duty as a physician to approach the patient every time that I see something that might be harmful to their health. And so we should be doing the same thing, physicians, as well as the public health community, in talking to each other about firearms.

SUMMERS: The surgeon general has chosen to call attention this week to gun violence specifically, but as a physician, where does that fall among other sorts of public health crises that we're seeing?

DARK: I think the one thing that's really important to note is a study came out a couple of years ago, and in ooking at children and teenagers and specifically the No. 1 cause of death for them, for the longest time, it had been motor vehicles. And in the most recent years, that has actually been eclipsed by firearm violence. And that's, one, firearm violence increasing, but also because we've actually taken efforts to stop what was the No. 1 cause, which was motor vehicle collisions.

You know, we've done things like car seats, made sure that children are not sitting in the front seat of the car, and in other techniques through changing the manufacturing of cars have made cars safer. We can do the same sorts of things to firearms. And no one has gotten rid of cars. There's probably more than ever out there, but we've not done that same sort of pattern for firearms.

SUMMERS: Let's shift the conversation now to some of the policies that the surgeon general recommends, policies around guns themselves - things like requiring safe storage, universal background checks and a ban on assault weapons. What do you make of those types of recommendations?

DARK: So when I approach this report, and I specifically look at the policy portions of it, I like to think about it the same way public health professionals think about any other disease process, and that's primary, secondary and tertiary prevention. So when it comes to primary prevention, we can talk about things like background checks, which essentially are trying to make sure that guns don't wind up in the hands of people that aren't supposed to have them in the first place. We know that if we fix that, that lives will be saved.

From a secondary prevention process, we're talking about things like once a gun is in a home, how can we make that gun safer and so tragedy doesn't strike? And that's where safe storage comes into play. So if you do have a firearm at home, like I do, you can go ahead and lock it up, put on a trigger lock. You can put it in safe. And then third, we have tertiary prevention, things like violence intervention programs. So once someone's already been shot, how do you prevent that from happening again?

SUMMERS: I want to ask you a personal question because you are an emergency physician, but you are also a gun owner. So I'm hoping that you can talk a little bit about your decision to own a gun, but you are also advocating for some of these measures to prevent gun violence. Those are two things that some people may see as in conflict with one another.

DARK: Yeah, I don't see it as something that's in conflict. I live in Texas. Texas has a very strong gun culture here. My house was broken into when I first moved down here. My wife went to the store the next day and bought a couple of guns and brought them home. Until then, I had never actually owned a firearm myself. But what we did was be responsible about it. We decided to go ahead and take courses so that we actually know how to use them, and then once we had a child, to actually put those firearms away so that our child doesn't have access to them.

And I know a lot of people listening might have different opinions on that. It's not my job as a physician to tell you what to think or how to run your house, but it is my job to tell you about risk. And I think this is why it's really important the surgeon general is making this statement, so that people understand the true risks of having a firearm and they can decide what they want to do on their own.

SUMMERS: I know that you are not a politician, you are not an elected official, but I want to know from you, do you believe that a report like the one that the surgeon general has just issued has any hope of changing the political conversation about guns in a way that the mass shootings that we have seen in this country, like in Sandy Hook, like in Uvalde, like in so many communities across this country have not been able to?

DARK: I hope that it can. I think that when you talk about mass shootings and when we talk about things like assault weapons, which are mentioned in the report as well, there's something where I think certain people can disagree on. What I'm hoping, though, is that the surgeon general's report allows us to have these conversations and take the politics out of it so that we can approach things from a more evidence-informed manner and figure out what works and put forth laws to save the most lives that we can.

SUMMERS: That was Dr. Cedric Dark. He's an emergency physician at Baylor College of Medicine in Houston and author of an upcoming book called "Under The Gun." Dr. Dark, thank you.

BROWN: Thank you.

SUMMERS: This episode was produced by Kathryn Fink, Marc Rivers and Jonaki Mehta. It was edited by Jeanette Woods and Christopher Intagliata. Our executive producer is Sami Yenigun. If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline. And one more thing before we go. You can now enjoy the CONSIDER THIS newsletter. We still help you break down a major story of the day, but you'll also get to know our producers and hosts and some moments of joy from the ALL THINGS CONSIDERED team. You can sign up at npr.org/considerthisnewsletter.

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SUMMERS: It's CONSIDER THIS FROM NPR. I'm Juana Summers.

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