Doctors target gun violence as a social disease

August 11, 2012 by MARILYNN MARCHIONE
In this Aug. 8, 2012 photo, Dr. Stephen W. Hargarten poses for a photo at Froedtert & Medical College of Wisconsin in Milwaukee. Hargarten helped many of the victims of Sunday's shooting at the Sikh Temple of Wisconsin. (AP Photo/Jeffrey Phelps)

(AP) — Is a gun like a virus, a car, tobacco or alcohol? Yes say public health experts, who in the wake of recent mass shootings in the U.S. are calling for a fresh look at gun violence as a social disease.

What is needed, they say, is a approach to the problem, like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago, even as the number of vehicles on the road rose.

One example: Guardrails are now curved to the ground instead of having sharp metal ends that stick out and pose a hazard in a crash.

"People used to spear themselves and we blamed the drivers for that," said Dr. Garen Wintemute, an emergency medicine professor who directs the Violence Prevention Research Program at the University of California, Davis.

It wasn't enough back then to curb deaths just by trying to make people better drivers, and it isn't enough now to tackle by focusing solely on the people doing the shooting, he and other doctors say.

They want a science-based, pragmatic approach based on the reality that we live in a society saturated with guns and need better ways of preventing harm from them.

The need for a new approach crystallized last Sunday for one of the nation's leading gun violence experts, Dr. Stephen Hargarten. He found himself treating victims of the Sikh temple shootings at the emergency department he heads in Milwaukee, Wisconsin. Seven people were killed, including the gunman, and three were seriously injured.

It happened two weeks after the shooting that killed 12 people and injured 58 at a movie theater in Colorado, and two days before a man pleaded guilty to killing six people and wounding 13, including then-U.S. Rep. Gabrielle Giffords, in Tucson, Arizona, last year.

"What I'm struggling with is, is this the new social norm? This is what we're going to have to live with if we have more personal access to firearms," said Hargarten, emergency medicine chief at Froedtert Hospital and director of the Injury Research Center at the Medical College of Wisconsin. "We have a public health issue to discuss. Do we wait for the next outbreak or is there something we can do to prevent it?"

About 260 million to 300 million firearms are owned by civilians in the United States; about one-third of American homes have one. Guns are used in two-thirds of homicides, according to the FBI. About 9 percent of all violent crimes involve a gun — roughly 338,000 cases each year.

In this Aug. 8, 2012 photo, Dr. Stephen W. Hargarten poses for a photo in a trauma room at Froedtert & Medical College of Wisconsin's emergency department in Milwaukee. Hargarten helped many of the victims of Sunday's shooting at the Sikh Temple of Wisconsin. (AP Photo/Jeffrey Phelps)

Mass shootings don't seem to be on the rise, but not all police agencies report details like the number of victims per shooting and reporting lags by more than a year, so recent trends are not known.

"The greater toll is not from these clusters but from endemic violence, the stuff that occurs every day and doesn't make the headlines," said Wintemute, the California researcher.

More than 73,000 emergency room visits in 2010 were for firearm-related injuries, the federal Centers for Disease Control and Prevention estimates.

Dr. David Satcher tried to make gun violence a public health issue when he became CDC director in 1993. Four years later, laws that allow the carrying of concealed weapons drew attention when two women were shot at an Indianapolis restaurant after a patron's gun fell out of his pocket and accidentally fired. Ironically, the victims were health educators in town for an American Public Health Association convention.

That same year, Hargarten won a federal grant to establish the nation's first Firearm Injury Center at the Medical College of Wisconsin.

"Unlike almost all other consumer products, there is no national product safety oversight of firearms," he wrote in the Wisconsin Medical Journal.

That's just one aspect of a public health approach. Other elements:

—"Host" factors: What makes someone more likely to shoot, or someone more likely to be a victim. One recent study found firearm owners were more likely than those with no firearms at home to binge drink or to drink and drive, and other research has tied alcohol and gun violence. That suggests that people with driving under the influence convictions should be barred from buying a gun, Wintemute said.

—Product features: Which firearms are most dangerous and why. Manufacturers could be pressured to fix design defects that let guns go off accidentally, and to add technology that allows only the owner of the gun to fire it (many police officers and others are shot with their own weapons). Bans on assault weapons and multiple magazines that allow rapid and repeat firing are other possible steps.

—"Environmental" risk factors: What conditions allow or contribute to shootings. Gun shops must do background checks and refuse to sell firearms to people convicted of felonies or domestic violence misdemeanors, but those convicted of other violent misdemeanors can buy whatever they want. The rules also don't apply to private sales, which one study estimates as 40 percent of the market.

—Disease patterns, observing how a problem spreads. Gun ownership — a precursor to gun violence — can spread "much like an infectious disease circulates," said Daniel Webster, a health policy expert and co-director of the Johns Hopkins Center for Gun Policy and Research in Baltimore.

"There's sort of a contagion phenomenon" after a shooting, where people feel they need to have a gun for protection or retaliation, he said.

That's already evident in the wake of the Colorado movie-theater shootings during a screening of the new Batman movie, "The Dark Knight Rises." Last week, reports popped up around the nation of people bringing guns to the "Batman" movie. Some of them said they did so for protection.


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1.7 / 5 (11) Aug 12, 2012
Progressives, only special progressives should have guns because guns are too dangerous, like large single servings of pop, large popcorn, or even baby formula. Just like only Al Gore should be able to drive monster cars, fly private jets, while the rest of us should ride bikes.

Yes another progressive idea.... gun free zones, that way only bad guys, you know the ones who don't follow rules, those that kill, will have a gun there.
Aug 12, 2012
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3.7 / 5 (3) Aug 12, 2012
I've noticed a relentless stream of 'anti right to bear arms' articles lately, especially in google news. The nannies must sit around on pins & needles waiting months or years for the next rare crazy person to pop his cork & bust some caps.
1.4 / 5 (10) Aug 12, 2012
Who will win in a rape, a 200lbs man vs 90lbs woman? Give the woman a gun who would win? Anti gunners hate women, the elderly, and the weak.

One interesting fact. If African Americans murder rate was the same as the white murder rate, US would have one of the lowest murder rate in the world. Would this idiot who wants to ban guns even dare suggest banning guns from Afican Americans?

RFW, the Killer that wants to kill will kill without a gun. Bombs are easy to make, gasoline is everywhere, so are knives
1.7 / 5 (11) Aug 12, 2012
In two of the shooting instances mentioned above, it was the health care professionals who FAILED in their moral and societal obligations, perhaps even their legal obligations.

In both cases the school mental health professionals knew they had someone on their hands who was a threat to others, notified their immediate circle of responsibility but FAILED to take the information they had to the local police. While I dont pretend to know the letter of the law, the overriding moral obligation, the safety of the general public, should have been a major concern in both the CO and AZ shootings and both cases should have had investigations launched by local law enforcement before the tragic events occurred. Whether they could have been stopped or not we will never know. What we do know is that the public health professionals FAILED to use the tools they did have, now they want more? Sounds just like those in public service who never have enough money and want more taxes.
1.4 / 5 (9) Aug 12, 2012
cont.... Its never their fault! Well this time it just might be.

To Dr. Hargarten, physician heal thy self! Demand better from your own community first and stop pointing to others, learn the lessons here and now!

Maybe its time we should all be demanding real teeth be added to laws that demand public health workers notify public law enforcement officials when they know someone is a danger to themselves and others, failure to do so should not only carry civil penalties but criminal penalties as well.

We cant stop them all but we do know by examination of the past, from Patrick Purdy in 1989, to Jared Loughner in 2010 and James Holmes in 2012, we could have, should have stopped the mentally unstable from either purchasing or keeping weapons. Officials in all those cases had enough information to act, but failed to do so. The results we all pay for.
1.8 / 5 (10) Aug 12, 2012
cont ...
In nearly all cases of mass shootings it is unarmed victims who pay the ultimate price. Its not at all their fault, but there is growing common sense and knowledge invading the inner thoughts of millions of Americans who can defend themselves and others in public and private places. They carry concealed firearms not because they have ego issues, but because they recognize the logic and responsibility of being able to defend themselves as well as protecting others. They should be commended for taking that step and Congress should extend reciprocity of those permits nation wide. Its also time to be rid of Gun Free zones which foster the unarmed victims sense of well being without a shred of reality.
3 / 5 (4) Aug 12, 2012
We don't allow guns in UK and don't really have this issue. You get the occasional person who makes their own gun or bought it illegally but its much easier to track down with insiders in the police.

If everyone had a gun its just impossible to know. I feel perfectly safe without a gun.

We do how ever have a knife crime issue, but i feel personally at least with a knife attack it won't create the killings you see in USA with the occasional nut job.

Also shooting back in self defence and killing some one can equally you traumatize you, so either situation with guns allowed its a problem. Most of Europe manage just find without guns.
5 / 5 (1) Aug 13, 2012
"They want a science-based, pragmatic approach based on the reality that we live in a society saturated with guns and need better ways of preventing harm from them"

I don't understand what the critics here have against this. Is it the word "science" that makes you hostile to the idea? Or is this some kind of Anyn Rand fantasy that all attempts at interference are evil? Then why bother with having cops?

"Most of Europe manage just fine without guns"

Aug 13, 2012
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