News at NCH
"Guns, Violence, and Public Health" by Allen Weiss, MD, MBA, President & CEO

Guns, Violence, and Public Health

February 15th, 2013 - The recent multiple tragedies involving gun violence has rekindled the concerns Americans have over the public health hazard of easy availability of guns. According to the Centers for Disease Control and Prevention firearms were used in more than two-thirds or the 16,799 homicides in 2010. But guns don’t just take their toll through citizen-against-citizen violence according to a recent editorial in Modern Healthcare. About half of the 38,364 people who killed themselves in 2010 used a gun. But very sadly, those committing suicide bring inexplicable mayhem and tragedy to those around them as happened in Newtown. Additionally, 70,000 shooting victims received medical treatment with a direct cost of two billion dollars.

On an average day in the United States, guns are used to kill almost eighty people, and to wound nearly three hundred more. If any other consumer product had this sort of disastrous effect, the public outcry would be deafening; yet when it comes to guns such facts are accepted as a natural consequence of supposedly high American rates of violence. These statistics are significant even when compared to smoking which caused 512,000 deaths in 2000 in the United States according to www.deathsfromsmoking.net.

Economic consequences from gun violence are significant and greatly underestimated when you consider the costs of prevention, managing risks, loss of quality of life and general stress. Gun Violence: the Real Costs, by Philip J. Cook and Jens Ludwig, estimates the actual cost of gun violence is 100 billion dollars per year, when all of the consequences are considered.

However, the emotional misery caused by sudden and unforeseen death and/or injury from guns is immeasurable. The real point is that with time, numerous activities of daily life are affected. Parents are concerned about school safety, necessitating secret family passwords and “locked down” schools. Court buildings have protection similar to airports. Shopping patterns and night activities have become more guarded. Domestic violence has heated up as two thirds of shelters’ victims with home guns have had those guns used against them. Gun violence has changed our culture.

Having a gun is obviously necessary but not sufficient for gun-related violence. A 2008 New England Journal of Medicine article relates that “passive” gun owners share a risk similar to “passive” smokers in that just being near a gun or a smoker increases the risk of injury or death. Homicide risk increases from 40 to 170% while suicide risk increases 90 to 460% in homes with newly acquired guns.

A public-health approach—which emphasizes prevention over punishment, and which has been so successful in reducing the rates of injury and death from infectious disease, car accidents, and tobacco consumption—can be applied to gun violence, according to noted fair-minded expert David Hemenway, a noted Professor of Public Policy at Harvard School of Public Health.

So much of what causes harm can be prevented. Why don’t we, as a country, concentrate on prevention? Eliminating gun violence would avoid untold misery for 100,000 victims and their families each year. We have essentially stopped polio, controlled tuberculosis, and have an on-going battle with tobacco use. Curbing gun violence should be added to our public health mission as a society. We are experiencing an epidemic which should be recognized, addressed and controlled.


 
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Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.