On the Matter of "Gun Violence"
On the Matter of "Gun Violence"
What works, what doesn't work, and what else we can do.
About the Author
is a Marriage and Family Therapist, a National Certified Counselor and the Owner/operator of Zephyr Wellness. His full bio appears at the end of this post.This article was originally published on the author’s Substack:
. Brief editorial and formatting modifications were made for this republication.Surgeon General Vivek Murthy recently published a report on firearm violence. No, I do not agree in thinking that inanimate objects can be violent, and I would prefer something more precise like “violence perpetrated by firearm” but the term is in use, so I will use it, obtuse, clumsy, and politically charged as it is.
Anyway, Dr. Murthy called this a matter of public health.
Nay, a crisis.
I work heavily in the firearm injury prevention arena and agree we need to do more, but declaring it a public health crisis seems to lack the requisite evidence for such a claim. So let’s address each of these topics; the “doing more” as well as the “public health” angle.
A crisis as defined by…what, exactly?
In most matters of public health where tons of resources are allocated (e.g., cigarettes and cancer, lead exposure and brain damage, post-menopause and calcium deficiency, teen social media use and subsequent mental illness), a tight correlation exists. The R-value is solid enough to warrant such an effort. But I don't see that here. In fact, I can't find it anywhere.
In the report, here’s what I do see:
- infographics playing fast and loose with data (people are "children" through age 19)
- weak surveys that present dubious results (17% of Americans have witnessed a shooting with an N of 1271
- meaningless comparisons (US gun deaths vs international)
- spurious conclusions ("mass shooting incidents cause outsized collective trauma on society")
- single-cause attribution (mothers who witness a shooting are more likely to be depressed)
- calls for more funding for research on subjects that are already more than well researched
What I don't see:
- R-values of any kind
- quantifiable, time-limited goals
What should be presented is a tight correlation between firearm exposure/access and firearm injury/death. Certainly we have loosely correlated data based on incidents, particularly suicides, in areas of higher firearm prevalence, but that's common sense. The increased presence of pools also leads to more pool-related injuries, but is it a matter of public health? We simply don't know, statistically speaking, because we lack definitional value for the term. In fact, in recent years the “matter of public health” langauge has in some cases become a blunt instrument through which the authorities deliver top-down command and control upon the citizens. After all, if you dare argue, you might get branded an “enemy of public health” or some such thing.
Everyone has an opinion, but no one that I've met wants any unintentional negative outcomes with firearms. However, if we are to be scientific about this and call it a crisis of public health, then we need strategy, not fear mongering. The report makes multiple references to people’s general psychological welfare being negatively impacted by gun-related violence. However, I contend that the poor mental health results not from gun deaths themselves, but from the media coverage of them.
The implied presumption around “gun violence” is that gun fatalities - including suicides - are preventable, so let’s do a comparison to another category of seemingly preventable deaths.
Firearms take approximately 48,500 lives annually, about 60% of which are self-inflicted in the form of suicide. Medical errors take about 250,000 lives annually, none of which are self-inflicted. Yet our media apparati cover gun deaths liberally and in some cases gratuitously, while deaths-by-medical error are covered…not at all. (In fact, those 60% that are suicides are also completely not covered in the media except to augment the homicides.)
Certainly a fatality number five times the gun death total would warrant both media coverage and a public health emergency, yes? No one seems to be afraid of surgeries or ER visits though, so perhaps even the Surgeon General’s advisory itself is contributing to the irrational fear about guns.
But I digress.
“Someone Must Do Something”
I favor education over restriction. Lots of education, everywhere, including (or rather, especially) in the K-12 setting. I also favor care access over stigma that pushes gun owners away. And I definitely favor root-cause mitigation and long-term planning over short-term feelgood efforts that do little, if any good.
For six years, Walk the Talk America has offered many innovative solutions that cost almost nothing and which are based on already-published research. Very little information about why people die or get injured by firearms has yet to be uncovered; we know nearly all the angles and causes, and WTTA is very much “doing something” about most of them.
But what is the goal, less death? Fewer injuries? Of course. But how will we know when those are achieved? How can that be quantified to the point where we all declare the crisis over? (What constitutes a crisis, anyway? And why now and not 1993? Was 40,000 the magic number? If so, why?) That requires a debate about how much death and/or injury is acceptable, which would be zero, but as Megan Ranney once said, “part of the public-health approach is also saying that we’re not going to get to zero.” So that is off the table. But what is the goal?
Instead of putting millions more dollars into programs that don’t work, and in fact cause harm, or more money into research we do not need, I suggest that we put those valuable resources into education. And then, track those efforts with clear eyes and open minds. If this is indeed a public health matter - the a priori declaration with which I disagree, but will concede the point for now - then let’s do what we did for the other public health matters.
Let’s educate the populace properly. Let’s reject restrictions and stop costing the taxpayers money in lawsuits that just wind up overturning unconstitutional legislation. We healthcare professionals need to work hand-in-hand with elected officials and appointed/hired public health professionals, along with the firearm community, which includes manufacturers, wholesalers, retailers, ranges, enthusiasts, and influencers, to get proper messaging out. The three entities cannot be doing this in a vacuum, they must work together. Mike Sodini has said that the gun community has to stop being made out to be the bad guy. We have to ask military veterans and cops what they want, not just pretend their fear of rights restriction is artificial.
We also must remove politics from this conversation. No matter what your opinion is, firearm ownership is a human right, a civil right, protected by the US Constitution. Restriction cannot be an option. It is just too off-putting to too many people - people whose support is necessary for this effort. Even if we waved a magic wand and all the guns disappeared, we would still have violence; it would just be perpetrated with a different inanimate object. To wit, in every state that has an Extreme Risk Protection Order (Red Flag) Law in place, if firearm suicide has declined, overall suicide has not, or it has increased. Every. Single. State. Admittedly, this is my own research so I don’t have a hyperlink; apparently no one wants to acknowledge it because I couldn’t find anything comprehensive.
The bottom line is that restrictions don’t work, but education and care access however, usually do.
Truly walking the talk
Literally everything that Walk the Talk America is doing could be done on a public health scale if we had the funding and network. Kids to Kings is in inner city schools teaching about complex trauma and firearm safety. Free and anonymous mental health screenings are available and flyers are disseminated in product packaging and at ranges and shops. Gun culture competence courses are available for free for healthcare practitioners. We have a 2A-friendly directory of healthcare providers for patients who want clinicians who understand the culture without negative bias. We also offer mental health videos for firearms instructors whose states require such curricula for concealed carry certification. And so much more.
Let’s not reinvent the wheel. Let’s pull together and fund what we already have, which is already supported by the gun community and healthcare professionals alike.
We can do this, we just have to be intentional, take the long view, and work cooperatively.
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