Under the gun- getting our heads out of the sand

head_sand_110731When Congress and the gun lobby can decide for the nation that an agency that studies and makes recommendations about public health issues should not study gun violence, we have a serious problem. One wonders why it has taken so long for this national disgrace to get the attention it deserves? Why have we let this happen? Because this stuff flies under the radar and the public does not know or understand the extent to which the gun lobby has gone to get its’ way.

After the Sandy Hook shooting in December of 2012, something changed in this country. The gun lobby has been under more well deserved scrutiny than ever before and that scrutiny is not complementary. I’m talking about the fear of retribution about even mentioning the idea that we should study the causes and effects of gun violence, of course.

An article from The Trace examined what is going on at the CDC ( Centers for Disease Control) and found some known and unknown facts that should concern us very much if we care about saving lives and preventing the devastation of gun violence. From the article:

“It was the leadership of CDC who stopped the agency from doing gun violence research,” Mark Rosenberg, a founder of the CDC’s National Center for Injury Prevention and Control, the division of the agency responsible for its work on the subject, tells The Trace. “Right now, there is nothing stopping them from addressing this life-and-death national problem.”

How much latitude the CDC has to pursue gun violence research is hardly an academic argument. The CDC is the nation’s leading public health agency, with a yearly budget of more than $11 billion. The failure of the CDC to invest in studies of gun violence has greatly inhibited the ability of social scientists, law enforcement agencies, and policymakers to understand the scope and causes of shootings — while also limiting understanding of interventions that might save lives.

How could this happen in a country that values research and being on the leading edge of solving public health problems?

The CDC was one of the first agencies to study gun violence as a public health issue. In 1992, Rosenberg and five colleagues launched the Division of Violence Prevention at the Injury Center, operating out of a converted men’s room with a yearly budget of around $260,000. Without any political impediments, they began to focus on identifying the root causes of firearm deaths and the best methods to prevent them.

One of the first studies that the division funded was “Gun Ownership as a Risk Factor for Homicide in the Home.” Published in the New England Journal of Medicine in 1993, the research found that the mere presence of a gun in a home increased the risk of a firearm-related death by 2.7 percent, and suicide fivefold — a “huge” increase, according to Rosenberg.

The NRA was furious about the findings, which it viewed as biased. The gun organization launched a campaign to shut down the Injury Center, an effort soon joined by two conservative groups led by pro-gun medical professionals,Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research. The latter famously called CDC investigators “liars masquerading in lab coats.” The NRA and the conservative doctors’ groups began pressuring members of Congress to stop the CDC’s gun violence research. By 1995, eight senators had signed on to the cause. The next year, 1996, Republican Representative Jay Dickey of Arkansas introduced the amendment bearing his name as a rider to an appropriations bill.

Notably, the Dickey Amendment did not immediately lead to a total stoppage of gun violence research by the CDC, as Satcher kept a few existing initiatives alive. But when Satcher left the CDC in 1998, Rosenberg says, his departure marked the end of substantive gun research at the agency. The new director, Jeffrey Koplan, had little interest in continuing the agency’s work on gun violence prevention, Rosenberg says.

 Ah. Now it makes sense. Or not. More…

In his 2017 budget request, President Obama requested $10 million specifically for gun violence research at the CDC — which works out to roughly 0.1 percent of the agency’s total funding allotment. Rosenberg believes that rather than waiting for a Republican-controlled Congress to grant Obama’s request, the CDC could immediately divert that sum from other programs to jumpstart new studies.

“They could do that in the blink of an eye,” he says.

Satcher, the CDC director who sought to shield gun research from cuts, says he understands Rosenberg’s viewpoint — but also knows firsthand how political realities can shape agency policy.

“I think it could be feasible, but the question is, how would it affect their budget?” he asks. “How would Congress punish the CDC for that? It would be easy for me to criticize the CDC, and I’m tempted to do that. But I also know the kind of risks they’re facing.”

Ok. Now we are getting at the truth of the matter. The CDC would be punished by Congress for using money in its’ budget for research into the causes and effects of gun violence.

Sigh.

So it’s a risk to study gun violence? And if the research shows that it’s a risk to have loaded guns lying around at home, what does that mean for the public health and safety? What does that mean for the corporate gun lobby and gun manufacturers? What does that mean for the American gun culture? And most important of all, what does that mean for saving lives? Hmmm.

Where is common sense? Why would one lobby group get to decide on vital national research into the causes of one of our nation’s most serious national public health epidemics. For what other cause takes the lives of 30,000 Americans and doesn’t get the attention and the concern it should have? And why is a lobby group so afraid of what the research would divulge if given a chance? What would be the result? Would Americans begin to take their heads out of the sand and see that guns in homes are an actual risk to their families and communities? How awful would that be? Perhaps only 20,000 Americans would lose their lives to bullets or suffer from fewer injuries that cost us all billions every year. Would that be so bad?

We already know that the gun lobby does not like Physicians talking to their patients about the risks of guns in the home. They have done in Florida what they would like to do everywhere- punish Physicians for doing their jobs. From the article:

When a Florida pediatrician asked the same question — “Do you have guns in the home?” — during a checkup in 2010, the reply from a mother of three was sharp: None of your business. She objected to the query as “very invasive,”complaining to her local newspaper, “Whether I have a gun has nothing to do with the health of my child.”

And so began what’s come to be known as the Docs vs. Glocks dispute. In 2011, after a lobbying push by the National Rifle Association, Florida passed the Firearm Owners’ Privacy Act, restricting physicians from asking about gun ownership and from counseling about gun safety in routine appointments. Potential penalties include fines, suspension and loss of a medical license. A federal judge blocked the law as an unconstitutional restriction of doctors’ speech. Then an appeals court panel overturned the ruling, emphasizing patients’ rights to own guns and to privacy.

This Florida case is just the latest example of how the politics of guns have affected physicians’ ability to bring science to bear on what experts can see plainly: That gun violence is a public health issue. The full U.S. Court of Appeals for the 11th Circuit is now preparing to hear the case, and legislators in at least 12 states have expressed interest in similar bills. So it’s worth correcting what lawmakers and the court panel misunderstand about the doctor-patient relationship and about the relevance of firearms to pediatric care — in a country where more than 2 million children live in homes with unsecured guns.

There are reasons for health care providers to discuss common safety and risk factors with their patients and patients’ families. More from the article ( written by a Pediatrician for the Washington Post):

But beyond responding to immediate warning signs, responsible doctors need to be able to counsel patients on matters that pose the greatest statistical risks to their health and well-being. Heart disease is the leading cause of death in Americans 65 years and older, so doctors talk to their elderly patients about healthy eating habits, regular exercise and smoking cessation. For children between the ages of 1 and 14, the leading cause of death is unintentional injury, a category that includes car accidents, suffocation, burns, drowning and gunshot wounds.

As pediatricians, we counsel parents about all of these issues. We explain how to properly install car seats. We caution against children playing with plastic bags. We teach about safe water temperature. We discuss safety around pools.

Gun safety is no different from any of these topics. Comprehensive numbers on gun accidents are hard to come by, in part because National Rifle Association lobbying and limited funding has deterred the Centers for Disease Control and Prevention from conducting firearm research. But outside research found that in 2015, children accidentally shot themselves or someone else at least 278 times, averaging more than five times a week. By some estimates, keeping guns locked up and unloaded could prevent 70 percent of unintentional shooting deaths among children.

Sometimes parents aren’t aware that their gun storage practices are unsafe. During one recent appointment at our clinic, a mother said she wasn’t sure if there were any guns in her home. Her father is a police officer, she said, and there might have been one or two in a closet. In a 2006 study published in the Archives of Pediatrics and Adolescent Medicine, nearly a quarter of parents who reported that their children had not handled a household gun were contradicted by their children.

Would it be so bad to recognize that suicide by gun takes more lives than homicide by gun? Would it be so bad to admit that too many self proclaimed “law abiding” gun owners are leaving guns out for children and teens to access, causing avoidable and totally senseless loss of life? Would that be so bad?

Until we make this one of our most important issues and the focus of attention and research, the devastation of gun violence will continue unabated. Until the corporate gun lobby comes forward to help do something about this public health and safety epidemic, they can’t be taken seriously when they claim that they teach safety with guns.

In case you haven’t noticed, it isn’t working. Kids are still getting their hands on guns and killing or injuring themselves and others. Domestic abusers are still gaining access to guns and shooting intimate partners on a regular basis. Teens and older males are still shooting themselves in suicides that don’t have to be but continue because of easy access to guns- the method most often used and most effective for the taking of one’s own life. Our military members will still be shooting themselves because of lack of services, PTSD, depression and battle wounds. In this article about the Minnesota National Guard and the high number of suicides, this quote says what we know but don’t talk about often enough:

Most have been men. The average age of victims was 26 — much younger than the middle-aged males in the general population who kill themselves. The most common cause of death — a self-inflicted gunshot.

Can we talk about this openly without fear of being attacked by the gun lobby? Lives depend on the answer.

Meanwhile, gangs will continue shooting at each other and often taking innocent lives in the process. Law enforcement will still shoot innocent people when it’s not necessary. Armed citizens will roam our streets with guns so law enforcement officers feel the need to protect themselves. People will still come up with ways to manufacture ever smaller, more concealable pistols for public use. The gun lobby will still convince elected leaders with their heads planted firmly in the sand and in the campaign money trough that guns should be carried everywhere we go. Researchers will still be fearful that if they dare consider the idea that we should have a better understanding of what causes most of our gun deaths and how we can prevent them, they will lose their funding or suffer from the offensive and vile vendettas against them from gun extremists.

And those of us who are publicly writing, speaking and taking actions against the gun violence that is so obviously a public health epidemic will still be called names and suffer from the hateful comments from the gun extremists.

But the majority of Americans are now on the side of common sense. That is little solace when their leaders refuse to act on behalf of victims and survivors and do the right thing. Elections are coming soon. Vote for #gunsense and make sure you know how your candidates stand on saving lives and supporting the public health and safety of their constituents. We can’t let the gun extremists win any longer. Threats of violence, fear of a minority of gun owners, attacking candidates who stand with the majority- not acceptable any more.

Take your heads out of the sand. Lives depend on it. We have had #Enough of this nonsense in the name of profit and power. Let’s get to work and demand the change our country deserves.