Some of our friends in the surgery and public health departments of the University of Massachusetts Medical School have just published an important editorial about gun violence asking whether we can do for gun violence what has recently been done for vaping and e-cigarettes. What they basically argue is that the 4-month ban on these products enacted in Massachusetts, a move that is apparently spreading to other states, creates a template for how we should be dealing with another threat to public health, namely, the threat posed by gun violence.
The authors of this well-reasoned piece point out that as of October 8, 2019 vaping products were responsible for the deaths of at least 26 young persons, with more than 1,200 hospitalizations as well. On the other hand, what thy refer to as the ‘epidemic’ of gun violence claimed nearly 40,000 lives in 2017, even though we have identified the agent which causes the problem (the gun) and we have developed “proven means” to reduce this particular health threat.
The editorial calls for a “temporary ban on the future sale of guns and assault rifles in the United States while we more systematically study gun safety,” a rather novel idea for dealing with gun violence which copies the temporary ban on vaping products going into effect in Massachusetts and possibly other states.
With all due respect to the co-authors of this editorial (in the interests of full disclosure, as they say, I should state that one of the authors, Dr. Michael Hirsh, co-directs with me the Wood Foundation which sponsors multi-city gun buybacks every year) I would like very much to know exactly what means have been proven to reduce gun violence, because such means certainly haven’t been put into effect. In 1999, the national gun-violence rate was 9.89. It bounced around until 2011 and has been steadily climbing ever since. It was at 11.69 in 2017, and if the open-source reports used by the Gun Violence Archive are at all reliable, the last several years have certainly not seen any decline in gun violence rates at all.
But the purpose of this column is not to nit-pick this word or that word with the authors of what is really a strong and commendable editorial on moving forward with some kind of serious gun-violence reduction plan. Rather, I want to address a much more fundamental issue which arises from the idea that we find ourselves in the midst of an epidemic of gun violence, a perspective which is shared by virtually all the researchers and advocacy groups dealing with this problem today.
When we use the word ‘epidemic,’ we usually refer to a medical problem which arises without warning, often for reasons that initially we do not understand, and requires a comprehensive effort to both cure the victims of the disease as well as to protect populations which have not yet been infected by the threat. This was exactly how the public health community responded in 2014-2016 to Ebola, which ended up infecting 28,000 and killing roughly 11,000 people in West Africa but was contained almost wholly within that geographic zone.
The United States isn’t suffering from an epidemic of gun violence. We are suffering from a threat to health which is endemic to certain locations and certain populations within the United States. Not only does gun violence occur virtually every day in certain, clearly-identified locales involving clearly-identified populations, but this medical threat has been going on in these same locations for what is now a century or more. All fine and well that public health has discovered the existence of this problem since Columbine and Sandy Hook. It’s hardly new news to residents of cities like Philadelphia, Baltimore, St. Louis and Detroit.
Sorry Thomas Abt, you don’t end gun violence by going into the ghetto, planting trees and cutting the grass. You get rid of gun violence by getting rid of the guns that are used to commit gun violence.
This still needs to be said?