gun violence Archives - Screening for Better Health

Supreme Court Ruling Suggests Data can Prevent Gun Deaths

July 3, 2016 by drjaffer

With the recent 6-2 ruling upholding the federal law banning people with misdemeanor domestic violence convictions from owning guns, the Supreme Court has sent a clear message regarding gun violence: when we have good data about how to prevent gun deaths, the federal government has a constitutional right to act.

For decades we’ve known there was a strong link between domestic violence and gun homicides, and in 1996 an amendment was passed barring people convicted of domestic violence misdemeanors from owning handguns. Research shows that abused women are five times more likely to be killed by a domestic violence partner if that person owns a firearm, and that two-thirds of women who had been domestically abused in homes with a firearm had been threatened at some point with that firearm. It’s also been shown that laws that prevent domestic abusers from owning guns are associated with reduced rates of domestic gun homicides.

The recent Supreme Court ruling gives hope to groups that are pushing for better funding for research into gun violence statistics – especially in light of recent events such as the Orlando nightclub shooting, with opposing factions arguing about whether or not restricting gun ownership rights to certain individuals could prevent mass shooting. It sends a clear message that, given strong data on how to save lives, the government has the authority to pass laws that restrict gun ownership for select groups of high-risk citizens.

The problem, of course, is that we still only have limited data on who commits gun crimes and why. The CDC is still hampered by restrictions on research funding, and doctors are still restricted from collecting data on gun ownership and risk. But at least for now we have assurance from the courts that what limited information we do have can be used for the greater good.

Terror Watch Lists aren’t a Solution to Gun Violence

June 26, 2016 by drjaffer

In the aftermath of the Orlando Pulse nightclub shooting that left 50 people dead and 53 wounded, many have called for increased restrictions to obtain firearms for people on government terrorist watch lists. As we struggle to untangle the shooter’s motives, his possible links to organized terror groups has strengthened fears in many Americans and reignited calls to keep guns out of suspected terrorists’ hands.

But in the midst of this understandable panic, it’s important to realize that the vast majority of firearms deaths in the United States have no links to terrorism – and the numbers aren’t even close.

In 2013, the latest year for which we have comprehensive data available, according to the CDC 33,169 people died from illegal gun violence in the US alone. This was 1.3% of the total deaths in the country! Even if we discounted suicides by gun, which numbered 21,175, we still end up with approximately 12,000 deaths from homicides and accidents. That’s approximately 33 people killed per day.

Contrast this with terrorism: in all of 2013, 21 Americans lost their lives to international terrorism.

These numbers just don’t add up. Even if every single terror attack on a US citizen was made possible due to ownership of a gun (which we know it isn’t: the September 11 attack was carried out with box cutters for weapons), and even if we could stop every single potential terrorist from acquiring a gun (which we couldn’t, even if we expanded our watch lists and criteria) we would, at best, stop somewhere around 25 or 30 murders in an average year.

Which is less than one-quarter of one percent.

Now don’t get me wrong – any decrease in gun deaths is a goal worth investigating. But targeted watch-lists are never going to be perfect, and they’re never going to stop all potential terrorists from obtaining guns, and most importantly they’re going to do almost nothing to dent our gun violence problem that is largely committed by average Americans living normal American lives.

What we do need is more research, more understanding of why people commit gun violence and how to stop it before it happens. Many doctors are already trying to help with this, but unfortunately there are laws in place keeping us from collecting data to better understand the problem. Rather than focus on flawed watch lists that target a tiny percentage of gun violence cases, we should look at those laws preventing better research and find a way to change them.

Why We Don’t Fund Gun Violence Research

May 19, 2016 by drjaffer

Original Title: 19 front 27b_5x — CDC Headquarters in Atlanta

Whether or not guns themselves are a problem in our society may be a matter opinion, but one thing that we should all agree on is that we should have good data on how and why gun violence is committed (as well as the who, what, where, and when). Both private citizens and law enforcement deserve to know when they might be at risk and what they can do to protect themselves, while doctors would better understand how to identify high-risk patients with mental health issues that might predispose them to violence. This should make sense regardless of political affiliation or how you feel about gun ownership.

And yet we have very little data. In fact, we perform almost no research at all on gun violence in our country. And the reason is entirely political – provisions in the annual appropriations bill (which directs federal funds toward research) prevents any money from being spent on gun control… and for decades, the NRA has been successful at branding “gun violence prevention research” as a sub-category of “gun control”.

It was 1996 when we passed legislation intended to strip the CDC of the ability to fund gun control research. The law was taken a step further, however, and the CDC essentially stopped performing any gun violence research at all. Since then, this ruling has also been applied to the National Institute of Health (NIC). As a result, for the past 20 years the United States has collected virtually no data on gun violence that could be used to curb or head off future incidences before they happen. And the result is that we have only limited private studies to look at when trying to figure out what to do about gun violence outbreaks, leaving our law officers and doctors mostly powerless. Even the senator who wrote the bill expresses deep regret at the results of his actions, stating that the law has been over-interpreted and resulted in unnecessary loss of life.

On top of all this, the NRA has fought in recent years to restrict doctors from asking their patients questions related to gun violence prevention. While they have been unsuccessful in preventing doctors from doing their jobs, they still have managed to force language into the Affordable Care Act and other provisions preventing the collection of data. They have managed to keep medical professionals from treating gun violence deaths as a “preventable disease”, despite similar causes of death being treated as such.

While there have been efforts to reverse these restrictive laws and open up the field of research for the public good, so far these attempts have amounted to nothing. The NRA and legislative allies have decided that public knowledge is a threat to the 2nd amendment, despite the fact that most Americans support gun ownership. The most recent attempt to end the ban on gun violence research is likely to go nowhere, at least until public opinion changes on the matter enough to pressure congress into taking action.

For now, we’re firing in the dark.

The Many Faces of Gun Violence

May 14, 2016 by drjaffer

Gun violence is not always a mental health issue.

Gun violence is not always an anger issue.

Gun violence is not even always intentional.

Gun violence has many faces, and it is impossible to identify them all in time to prevent it completely. Tragedies can spring from many sources: the disenfranchised loner with a score to settle, the mentally unstable man or woman on a mission, the road rage incident gone too far, the radicalized militant, or even the child who accidentally discharges his mother’s pistol in the back of the car.

There is no single profile for a person likely to commit gun violence. Even mental health issues is not a particularly good indicator of someone likely to commit violence. There are, however, a number of warning signs that we can use to paint a better picture. It is for this reason that doctors have started screening individual patients to determine whether they – or their family members – are at risk of committing, or being targeted by, gun violence.

Some good red-flag questions to ask yourself that may indicate an increased risk:

Does your household contain unlocked guns that can be accessed by someone, such as a child or visitor, or are kept readily at hand to be quickly retrieved in an emotional moment, such as rage?
Do members of your household threaten each other with violence, either verbally or physically?
Has a member of your household ever pointed a gun, loaded or not, at another member of the household?
Does someone with mental health issues in your household have access to firearms? If so, do these particular mental health issues suggest an increased risk?

An important thing to note is that these questions largely focus on the behaviors of the people in proximity or possession of the guns, as well as how the guns are stored and accessed. Stopping gun violence is not so easy as focusing on a broad group of people – even those with mental health issues – but must instead start with looking at the individual’s relationship with guns and violence in general.

Obamacare and Gun Screening

May 12, 2016 by drjaffer

The Affordable Care Act, more commonly known as Obamacare, was originally planned to contain a provision regarding gun violence screening and reporting by doctors. This was dropped, under pressure, from the act that was ultimately passed. In fact, language was specifically added, in a section called Title X, that specifically outlines restrictions on doctors to prevent them from recording and tracking gun violence statistics and the results of gun violence screening. Title X also states that healthcare programs may not require gun violence screening questions, and that patients may not be forced to answer gun violence screening questions.

Nevertheless, since the passage of the act, there have been a number of attention-grabbing headlines and chain e-mails of doctors demanding patients answer gun screening questions. Never mind the fact that your doctor cannot force you to answer anything, or that insurance companies cannot restrict their policies based on gun ownership or the likelihood of gun violence (it’s right there in the Affordable Care Act!).

Are these doctors overstepping their bounds? Are they breaking the law?

In a word: No. None of the provisions in Title X can stop a physician or a patient wanting to discuss firearms violence or ask questions about threats of gun violence. Doctors are doing so because they believe it can save lives. We can’t write it down, and we can’t share the data, but we can work with an individual patient to determine if they are at risk and what steps they could take to protect themselves and the people they love.

Everyone seems to agree that mental health is an issue with regards to gun violence. We are trying to directly address this problem. We are not violating your rights, and anyone that tells you we are doing so is lying to you to fulfill their own agendas. When you go to a medical professional, our job is to determine the risks – ALL of the risks – that you might be facing to your life and well-being. For years, patients have been speaking to their doctors about their fear of gun violence in their homes – doctors have simply started asking in advance, because many patients are not aware this is something we can help them with.

When guns are present, people are more likely to die as a result of violence. Simply having a gun in the home makes homicide or suicide more likely. Americans have always owned guns, and likely will continue to do so. The only way for us to reduce gun violence is to look to the source: people who are at risk.