If gun violence is an epidemic, then what is a doctor’s role?

Do doctors have the potential to stop gun violence?

The average American child is 13 times more likely to be murdered with a gun than children in other industrialized countries are, according to the Harvard School of Public Health. More than 900 children in the U.S. die in homicides each year, the majority of whom (51 per cent) is shot by a relative, according to an NBC News analysis of 25 years of homicide reports.

Medical professionals have grown increasingly vocal about guns in recent years. The American Medical Association, the American Academy of Family Practitioners and the American Academy of Paediatrics all released statements this year demanding federal action on firearms. And in 2016, over 100 medical and public health organizations penned a letter to Congress calling on the Centres for Disease Control and Prevention (CDC) to directly fund research on the causes of gun violence.

An epidemic, as defined by Oxford Dictionaries, is ‘a widespread occurrence of an infectious disease in a community at a particular time’. With little thought, both health care professionals and the public alike can draw distinct parallels between this definition and the 38,658 deaths reported by the CDC's National Centre for Injury Prevention and Control to be caused by firearms in 2016 in the United States alone. This figure does not account for the 116,414 injuries caused by firearms in the same year, nor does it account for the 13,222 deaths in 2018 that have been, also, been caused by firearms. Data from the Gun Violence Archive reveals there is a mass shooting – defined as four or more people shot in one incident, not including the shooter – nine out of every 10 days on average.

Groups such as the National Rifle Association (NRA) are notorious for routinely resisting suggestions of change surrounding the current gun laws in place in the United States. Their influence, both politically and socially, is huge. If you add together all of the NRA’s contributions to candidates, parties and leadership political action committees between 1998 and 2016, it comes to more than $13 million, according to calculations from the Centre for Responsive Politics’ database. If we take into account the entirety of the NRA’s outside spending - candidate and party contributions, independent expenditures, and lobbying - the NRA has spent $203.2 million on political activities since 1998. Yet recently, the NRA took to Twitter to call out 'anti-gun doctors', telling them to “stay in their lane”. This prompted the rise of #ThisIsMyLane, which led to doctors and clinical staff from all around the States posting heart-breaking, and often incredibly graphic, images of the blood of gun violence victims on their surgical scrubs.

The involvement of the medical field has steered the long standing debate surrounding gun control into new waters. Approaching gun violence as an epidemic could be seen as one of the first steps in treating from a perspective of public health. Funding is being generated to advance research related to gun violence. Yet sometimes changing behavioural norms is far more effective than simply giving people information. To change behaviour, credible messengers are essential. Jack McDevitt, a professor and director of North-eastern University's Institute on Race and Justice, recently said that “having another voice of a doctor who's respected who says, 'You know, maybe you want to get the gun out of the house temporarily?' Or, 'Maybe you want to think about this differently?' Or, 'Here's a program you might want to go to.' I think there's nothing wrong with that," he said. "They can't compel anyone to do anything, but they can sometimes put it in the framework of, 'I'm concerned for your health' as opposed to, 'I want to take your guns away.' " While asking patients about guns might be uncomfortable, the organisation Scrubs Addressing the Firearm Epidemic (SAFE) doesn't believe doctors are imposing a partisan agenda in doing so. "We ask patients invasive questions all the time and we're supposed to," one member said. "It's just a logical extension to get medical students and doctors of all ages comfortable with asking about weapons."

Neither SAFE nor any other medical organisations are claiming that doctors can prevent all gun violence. But with epidemics where prevention is arguably more important than the treatment itself, it seems rather clear that medics have a strong position in the future of gun control.

Carol VII