Another "Guns as a health issue" editorial

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Treat gun violence as a health problem

By David Hemenway
Originally published April 18, 2005

CITIZENS AND public officials in Baltimore face the perennial and politically contentious question of how to reduce a serious gun violence problem. At times it appears to be an insurmountable challenge to reduce the deaths and injuries caused by gunfire.

Politics is always at play when it comes to the gun issue - and the debate over solutions represents an emotional flashpoint that most elected officials would like to avoid.

There is, in fact, a different way to address gun violence: by approaching it is as the problem it is - a public health problem.

Compared with other high-income countries, the United States has similar levels of crime and violence (assault, robbery, burglary, bullying), but far higher rates of homicide, particularly firearm homicide. We have more private guns per capita, particularly handguns, than any other high-income nation and more-permissive firearm regulations.

What America needs is a scientific, sensible and comprehensive approach - a public health approach - to preventing firearm violence.

Gun violence in America is not only a criminal issue. The majority of gun fatalities, for example, are suicides, and a sizable minority of nonfatal gun injuries are due to accidents.

Fortunately, most of our firearm injuries are preventable. We need better parenting, better mental health care, better schools and a host of other things that would reduce the problem. We also need a systematic approach to reducing gun-related injuries that should include reasonable regulations concerning the production and distribution of firearms.

A systematic public health approach has been successful in ameliorating many of our nation's problems, including motor vehicle injuries. The United States has reduced motor vehicle fatalities, without banning most cars, by making the roads and vehicles safer (collapsible steering columns, air bags). Traffic fatalities per mile driven have fallen 80 percent since the 1950s, even though motorists do not seem to be driving any better.

Public health is about prevention - let's make things better. We can do more than focus only on the gun user. We should also have reasonable policies directed toward gun manufacturers, gun sellers and the environment in which guns are used.

Most motor vehicle deaths are the direct result of the willful and unlawful actions of motorists. But we have done much more than just increase the likelihood and severity of penalties for drunken driving, speeding, running red lights, etc. We also have made cars and roads safer.

Currently, we effectively ban certain motor vehicles, such as cars without seat belts or all-terrain vehicles with only three wheels. Such bans have been politically feasible because of the existence of established regulatory agencies concerned with promoting safety (such as the National Highway Traffic Safety Administration and the Consumer Product Safety Commission) and because the issues were discussed more on their merits than as attempts to take away the rights of vehicle owners.

A large number of sensible policies reduced motor vehicle fatalities; similarly, many sensible policies can begin to reduce the death toll from firearms. These include policies directed at manufacturers, such as safety standards for firearms and serial numbers that are difficult to obliterate; policies directed at the distribution system, such as background checks for all sales and one-gun-per-month laws to reduce gun-running; and policies directed at owners, such as training requirements.

A key to successful motor vehicle safety was a federal regulatory agency that could mandate that cars include passive restraints and collapsible steering columns and a comprehensive data system on motor vehicle injuries that has enabled us to determine which policies are effective.

Guns, like cars, will undoubtedly continue to be common consumer products in American society. Similar to the way we have successfully reduced motor vehicle injury, we should be considering a more comprehensive rather than a piecemeal approach to reducing firearm violence, an approach based more on science than partisanship or ideology.

It is as true for Baltimore and Maryland as it is for the rest of the nation.


David Hemenway, a professor of health policy at the Harvard School of Public Health, is the author of Private Guns, Public Health.

Partisanship or ideology? Naw, none of that here. Every time I read one of these "society and guns" articles I think that these folks have never even held a gun.
 
Epidemiology of Firearm Morbidity and Mortality

He has his head up where the sun don't shine. First, one has to separate gun morbidity and mortality and address each kind separately. Suicide don't bother, guns are just handy, in the UK instead of guns, people hang themselves, rate of suicide does not change.
Small child accidents, keep the guns and ammo under lock and key. You can't gun proof a 3 yr old, and even if you could, his or her playmates might not be.
This is a very small part of gun death.
Accidents and negligent discharges, again a very small part of gun injury and death, better training and social pressure. If your range or hunting companion acts carlessly, call them on it.
Columbine or Red Lake type incidents, terrible, but small numbers, stop these kids before they get that far, nobody ever seems surprised at who it is. There must be warnings, and teachers could carry.
Bad guy violence, go armed and shoot 'em.
Did I miss a category?
If you want to see research on these topics, Google MMWR and you will find the Gummint's Morbidity and Mortality Weekly Report, Similarly Entrez Pub Med is a library of abstracts of medical articles including firearm injuries.
 
Well the author got one thing right:

We need better parenting, better mental health care, better schools and a host of other things that would reduce the problem.


At least VPC's and the Brady bunches lies weren't regurgitated throughout the article.
 
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He has no suggestions on how to reduce the largest causes of death where a firearm is used.

He makes no real suggestions on how to reduce violent crime.

He makes no real suggestions on how to reduce suicide rates.

Guns in the hands of private citizens has proven to reduce violent crime. The numbers aren't staggering, but since only a small portion of the population take advantage of laws allowing them to carry a loaded firearm, you wouldn't expect a large decrease in violent crime.

Studies have not been able to find any evidence that gun control laws have reduced violent crime. In England, banning most private ownership of guns didn't reduce their violent crime rates, they actually increased. Guns don't commit violent crime, violent criminals commit those crimes.

As for suicide rates... They made private gun ownership extremely difficult in England, and the suicide rate didn't change significantly. The number of suicides with guns did go down, but not the overall suicide numbers. Guns don't cause people to commit suicides.

With automobiles you can demonstrate that requiring drivers to wear seatbelts can reduce fatalities and serious injuries from auto accidents.

You can show that air bags also help.

I suspect that there is evidence that drunk driving laws have had a significant effect on making our roadways safer.

Gun control has failed to be proven effective. Some of the most dangerous areas of the country have the strongest gun control laws. If anything the laws have proven to make the lives of the average citizen more dangerous.

This still leave us with the issue of safety features of the guns themselves.

There have been laws requiring numerous safety features, and they really haven't been shown to have any effect on accidental injuries.

Loaded chamber indicators. I think these are useless. Checking the chamber is the best way to determine the chamber is loaded or unloaded. Firearms differ in their features, and many of the accidents involve people without familiarity with the firearm they are using. It's simply too easy for someone to misinterpret something on a gun they aren't familiar with as showing the gun to be unloaded.

Unless you are very familiar with the firearm you are using the only way to determine it's unloaded is by visual inspection of the chamber. Since this way always works, it's most prudent to always use that method. That makes loaded chamber indicators useless.

Loaded chamber indicators are also one more thing that can break and interfere with the proper functioning on a firearm.

Drop safties. There are some guns where these are needed, other designs really don't require such a safety. Drop testing of firearms does seem reasonable, but it's really addressing an issue that really hasn't been demonstrated to be a significant issue.

Grip safeties. Some people like them, others hate them. I don't think they really do anything to make a handgun more safe, and I haven't seen any evidence to show they are needed. I don't think they should be required.

Manual safties. On a single action auto, they are needed. On a revolver or double action pistol they are not needed. If you use a well made holster that properly covers the trigger guard, and you keep your finger off the trigger unless you are on target and ready to shoot, there is no need for an extra manual safety on a double action handgun.

Redundant safeties, just like redundant safety procedures can add an extra layer of protection in the case where the user makes a stupid mistake due to carelessnes. However, a price is often paid in how quickly the gun can be made ready when it's needed, and when it's needed it's a matter of life and death.

Manual safeties are also another thing on a gun that can break. It's more parts and more complication without any real measurable benefit.

Internal safeties that prevent a gun from firing unless the trigger is pulled. This kind of safety is the most important in my mind. Guns should go bang when the trigger is pulled, but should not go off if the trigger is not pulled. That should be the basic test to see if a gun is defective or not.

If the trigger is pulled and the gun goes off, the gun is not defective, but the user might be.

The biggest way to prevent accidentaly injuries involving firearms is education. Educate kids along the lines of Eddie Eagle where kids learn that guns are not toys. They should never touch one unless under direct adult supervision. If they see an unattended gun, they should tell an adult.

Adults should learn basic firearm safety procedures, and practice them regularly.

I've seen to many occasional shooters sweep people with the muzzle of a gun, and I'm surprised how many don't know that they should always keep their finger out of the trigger guard until they are ready to shoot.

I don't believe it's possible to legislate good gun handling procedures. I'm concerned about the Brady Campaign's attempts to sue firearms manufacturers of well designed firearms when the firearms opperate as designed, it's the user that does something wrong.

When you pick up a gun you are accepting the responsibility to use it properly and accepting the consequences of using it improperly.
 
This is simple, really. It is all about research grants. If he treats gun problem as a "health" issue, he can write up proposals to get all these grants money.



-Pat
 
Currently, we effectively ban certain motor vehicles, such as cars without seat belts or all-terrain vehicles with only three wheels.

Is this Maryland specific? Three-wheelers certainly are not banned here and if your car was made before seatbelts were required then you might be asked to put in lap belts if a cop is particularly picky but otherwise, nada.
 
Doctors are a public health issue. There was a recent incident where a surgery victim was set on fire on the operating table and died. They should be banned.
 
Guns are a public health issue?

Fine as your newly appointed Surgeon General (with the cool uniform for picking up chicks), I do hereby order the following:

1. Mandatory firearms training in grades K-12;
2. Certificate of firearms proficiency before one is allowed to vote;
3. expenditure of vast sums of tax money for shooting ranges where firearms may be used safely;
4. abolition of all gun control laws.

I will issue orders in the future as needed to combat this public health crisis. In the meantime, remain calm, clean your guns and go take a kid to the range. That is all.
 
Sounds like the same ole stuff. Throw money at our school and more social services, yeah that'll fix it.

How about we look at the health ramifications of BS!
 
CITIZENS AND public officials in Baltimore face the perennial and politically contentious question of how to reduce a serious gun violence problem.

Maybe they should try to crack down on the root cause of so-called "gun violence:" armed criminals.

Wait. Sorry. Baltimore. Well, maybe we could all chip in to buy those poor dunces a clue.
 
Hemenway again.

I posted my take on Hemenway and his "Public Health" Prevention-model cronies (no, not preventing public health). They encourage this because that model requires government action on whatever the Prevention planners say should be done. Given that the Public Health Prevention world (be it disease prevention, accident prevention, etc) is staffed with people who tend to think just like Dr. Hemenway, can anyone guess which direction the activist policy will be pushed?

I recently attended an anti-gun extravaganza featuring Dr. Hemenway. I wrote it up in a local rkba listserv and one of the members posted it to Free Republic...

http://www.freerepublic.com/focus/f-news/1349260/posts

Dr. Dave is trying to bring his plan to fruition.

Rick
 
AZRickD has precisely the correct analysis started.

The Public Health Model is essentially a Political Action model for there is NO behavior of a group that cannot be analyzed for "benefit."

The attack on this model must begin with a good look at the a priori assumptions. Fundamentally, the argument is that anything that is good for the collective should be done--

Is it beginning to look familiar?
 
Baltimore has a big pile of problems, gun violence being the most indirect symptom. There is a small strip of non-ghetto where the universities, businesses and museums are, surrounded by the most horrible and scary ghetto you have ever seen in your life, stretching out for miles in every direction. And I grew up in NYC (and lived through the Koch and Dinkins years), so I have seen real ghetto at its worst. Baltimore was worse. And it wasnt a bad first impression. I lived there for nearly 6 years.

The best thing Baltimore could do is sell a used police revolver to every person who wanted to pay 150 bucks and pass a background check. They would make a pretty penny, and maybe the right people would get shot for a change.
 
Perhaps they should treat the culture of violence that pervades most of Baltimore as a public health problem......the mind sets of materialism, drug use and power trips are the disease while the use of firearms is just a symptom of the larger problem.

There was an article in The Sun the other day that lamented the continuing loss of population from the Baltimore City limits. Apparently, there is concern that the public housing isn't nice enough and people are opting to move to the suburbs. Mayor O'Malley is afraid of losing potential voters....
 
An update from the op/ed page this morning......thanks to Mr. Stefano for picking up Maryland'ers (including my own) slack for not taking the Sun to task for this:


Baltimore Sun, April 23, 2005

Treat gun violence as a criminal issue

Here we go again: Another "let's get creative" approach to attacking the problem of gun-related violence ("Treat gun violence as a health problem," Opinion
* Commentary, April 18).

The author, at one point, seems to indicate a need for education, which is a good thing. However, when the National Rifle Association advocates for gun safety recognition courses in our schools, it is often excoriated for having sinister intent.

The author wants to tighten up on the gun sellers, the gun manufacturers and the environment in which guns are used.

There is nothing new here. However, one thing that is interesting by its absence is any mention whatsoever of the criminal who uses a gun. But that is standard procedure for the anti-Second Amendment people; everyone is responsible for gun violence - the manufacturer, the dealer, society, law-abiding gun owners - everyone but the criminal who pulls the trigger.

Gun manufacturers are making quality products; they are not making dangerously defective products. To extend their responsibility to the end use of their product is preposterous.

Similarly, if any gun dealer is willingly selling firearms to "straw" purchasers, or otherwise proscribed purchasers, that dealer should feel the full brunt of the law.

Until someone wakes up and gets serious about criminal behavior, and the fact that there must be consequences for criminal acts, not only gun violence but all violence will continue to be a problem.

Also, I wish people would stop trying to draw an analogy between guns and automobiles

Just to enlighten the author: Driving an automobile is a privilege bestowed on the licensee by society, it is not a right, and it can be regulated.

Owning a firearm is a right that is recognized in and guaranteed by the Constitution of the United States.


Bob Di Stefano
Abingdon
 
Small child accidents, keep the guns and ammo under lock and key.

I think most people would agree with this statement, even die-hard RKBA supporters. However, in another thread, there was a description of a dialogue between a doctor and a patient, and the doctor made this recommendation (to keep guns locked up and out of young hands). Most everyone who responded saw this as some plot by organized medicine to push an anti-gun agenda and even create a medical database of gun owners.
 
Leftists continually preach a doctrine of 'anything goes' without regard to personal responsibility or consequences then turn around and demand government intervene to 'correct the problem'. They are truly mentally deranged.
 
Guns are a public health issue?

Fine as your newly appointed Surgeon General (with the cool uniform for picking up chicks), I do hereby order the following:

1. Mandatory firearms training in grades K-12;
2. Certificate of firearms proficiency before one is allowed to vote;
3. expenditure of vast sums of tax money for shooting ranges where firearms may be used safely;
4. abolition of all gun control laws.

I will issue orders in the future as needed to combat this public health crisis. In the meantime, remain calm, clean your guns and go take a kid to the range. That is all.

El-Tejon-You stole my Thunder!!--Though I would have OSHA approved silencers in the schools, so as not to disturb other classes.

I would also require proof of proficiency with handgun (minimum) to be a school teacher.

I would also fire with extreem predjudice any American history teacher who fails to teach the (entire) BOR.

And speaking of teachers (OT) But lets get rid of tenure for the love of god.


Lone_Gunman-
However, in another thread, there was a description of a dialogue between a doctor and a patient, and the doctor made this recommendation (to keep guns locked up and out of young hands).

That is because in that thread they had doctors writing gun owning status in the childs medical records. That's pretty damn sneaky using kids as a method of tracking adults gun use. Kind of a back door gun registration.
 
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