By Lee C. Rogers, DPM
In the United States, over 30,000 people die every year from a suicide or homicide caused by a gun. That’s nearly as many as die from pancreatic cancer or automobile accidents.
The gun policy debate has been brought to the front of the national discussion since last weekend when a massacre at an elementary school in Connecticut left 26 dead, of which 20 were children aged 6-7 years. The shooter, barely out of his teenage years himself, used a Bushmaster .223 assault rifle with large capacity magazines. The medical examiner reported that all the children were shot more than once, and in one case 11 times.
The American Academy of Pediatrics identified firearm-related injuries in children and adolescents as an ‘epidemic,’ releasing data highlighting it as one of the leading causes of death in that population. The CDC reported that US children under the age of 15 were 12 times more likely to die from a firearm than children in 25 other industrialized countries combined. The United States ranks eighth on a list of homicide rates by country, just behind Mexico.
Recently, an actuary calculated that gun violence collectively reduced the American life expectancy an average of 103.6 days. But that’s not equally distributed among the races or genders. The average life expectancy for African American males is reduced by 361.5 days as a result of gun violence. Additionally, gun violence costs the US about $100 billion annually, which is equates to the same amount of budget cuts that couldn’t be negotiated by the Congressional super-committee.
No one would argue a health provider’s role in rape prevention or domestic violence prevention. On every visit to my hospital, patients are asked if they feel safe at home. Doctors also discuss automobile safety and sports safety with patients as needed. But somehow providers have been sidelined during the debate on gun violence prevention. The National Rifle Association argues that doctors asking about gun ownership violates a patients’ Second Amendment rights. Some states have even passed laws to prevent doctors from asking about guns at home. The 2011 National Defense Authorization Act (NDAA) prevents military commanders from talking to service members about their personal weapons, even if they are suicidal.
Certainly mental illness is a component to mass murders, suicides and homicides. We need an action plan to better diagnose and treat of mental illness. But having policy to reduce access to deadly weapons is prudent, will save lives, and is a public health concern. Providers need to play a central role in preventing gun violence.
What can we do?
First is advocating for gun policy changes just as we have for smoking bans, helmet laws, and sports safety rules. A mass killing of 20 school children has caused enough public outrage to change the dialogue on gun control in the US.
Meaningful reforms start with a ban on assault weapons. No one needs an M-16 for self-protection or hunting. These are instruments of war. Just as we wouldn’t stand for landmines on our streets, we should not allow assault rifles in our neighborhoods. A ban on high capacity magazines will prevent a gunman from shooting 100 bullets without reloading. If we limit magazines to 10 bullets, which should be sufficient to protect yourself against a home invader or hunt a deer, we give people a fighting chance in future episodes of mass shootings.
Require 100% background checks on all gun transfers, commercial or private. This means closing the gun show loophole and requiring private sellers to use a broker or some other method to ensure the buyer can own a gun. As health care providers, we know that the severity of mental illnesses in a patient may wax and wane, but we need to create a federal definition of serious mental illness and exempt HIPAA compliance for reporting these to a national database.
During the treatment of mental illness, providers should ask about firearms in the house. We should counsel families to lock up the gun and trigger. In cases where a patient is at risk of performing self-harm, we should know where they can take the firearm to be deposited while their illness is being treated.
First person shooter video games are violent and desensitize individuals to killing. While a sane person knows fantasy from reality, a person with mental illness or children may not. We should advise caregivers not to allow these individuals to play these games.
I grew up in the Midwest where hunting and gun use was a part of our culture. If you haven’t been exposed to that, go sport shooting at a shooting range with an instructor so you can better understand gun safety and usage. You can place information about gun safety in your waiting room or on the wall in exam rooms.
Also, as a measure of personal safety, your clinic or hospital should have an action plan if faced with an individual with a gun. This is not an uncommon occurrence in hospitals. Assailants may be looking for drugs or to harm a provider or patient. You should have regular drills on what to do.
Health care providers do have a role in preventing gun violence, but it’s up to us if we choose to play that role. I argue that a trauma that cuts short the lives of 30,000 adults and children annually needs urgent action. While critics argue we’ll never be able to prevent all gun-related deaths, that is a poor excuse for not acting to prevent some of them.
Dr. Rogers is a podiatrist and health policy expert. He was a candidate for US Congress in 2012 in California. His SDN username is diabeticfootdr. The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions of The Student Doctor Network or Coastal Research Group.