Last week I wrote a column raising concerns about the so-called ‘consensus-based’ approach to gun violence being promoted by physicians and public health researchers, many of whom seem to be convinced that as long as they claim to ‘respect’ the 2^nd Amendment, that Gun-nut Nation will be more amenable to support all those ’reasonable’ gun laws, one such law having just been blocked by the Virginia State Senate.

This idea of not being opposed to the 2^nd Amendment is a riff on another idea which started to appear in the medical literature when doctors began talking about counseling patients who own guns, the riff being the importance of ‘respecting’ the ‘culture’ of people who own guns. Here’s a sample of this approach from several of our most dedicated and respected gun-violence researchers:  ”The provider’s attitude is critical. Patients are more open to firearm safety counseling when providers are not prescriptive but focus on well-being and safety—especially where children are concerned—and involve the family in respectful discussions. Conversations should acknowledge local cultural norms; be individualized; and, when possible, occur within a well-established clinician–patient relationship.”

Given the fact that most physicians aren’t gun owners themselves, exactly how should these clinicians gain the knowledge they need in order to counsel about guns while taking care not to make negative judgements about ‘local cultural norms?’ The only peer-reviewed resource which attempts to define the cultural ‘norms’ associated with gun ownership is the research published by our friend Bindu Kalesan, who asked 4,000 respondents to report on the degree to which their social activities were in some way or another connected to their ownership of guns. What she found was that roughly one-third of the gun owners reported some degree of social contact with other gun owners.

Based on this research, should physicians assume that a patient who owns guns may also feel somehow identified with the social activities that revolve around gun ownership and gun use; i.e., shooting range visits, hanging around a gun shop, joining a gun club? Sounds fair to me.

There’s only one little problem. What do all these social activities involving guns have to do with reducing gun violence? Nothing. Why do I say nothing? Because the guys who go to the shooting range to sight in their beloved shotgun before hunting season, or the guys who stop off at the gun shop to play around with the latest toys on display, or the guys wandering around the gun show munching on a donut because the wife doesn’t need the grass cut or the driveway cleared that weekend, aren’t the folks whose behavior or culture or whatever you want to call it creates 85% of the injuries that we define as ‘gun violence’ each year.

That’s right. Assuming that intentional, non-fatal gun injuries run around 75,000 – 80,000 a year, add that number to the 15,000 fatal intentional gun injuries in 2017, and divide it by that number plus the 20,000 suicides.  Sorry, it’s only 83%. Of course, we know that all this mayhem is created by legal gun owners, right? Yea, right.

The public health ‘threat’ known as gun violence happens to be the handiwork of young men, most of whom live in inner-city neighborhoods and start fooling around with guns by the time they are 14 years old. And by the way, these are also the kids who have overwhelmingly dropped out of school, even though school attendance is never (read: never) used as an indicator of gun risk by all my friends doing all that public health research designed to ‘inform’ policy-makers about the efficacy of various ‘reasonable’ gun laws.

Want to sample gun culture?  Try: https://www.youtube.com/watch?v=0ZGJcV19gRw. After you watch it, watch it again. Then talk to me about how we need to ‘respect’ the culture of gun owners, okay?

What I am saying is simply this: Either we begin to talk realistically about the causes of gun violence or we don’t. Right now, we don’t.