Why Public Health Needs a New Gun Doctrine :: 09/13/2014

I am a public health professional, educated at the vaunted Johns Hopkins University Bloomberg School of Hygiene and Public Health. I like guns, and I believe the Second Amendment clearly secures the rights of individuals to own firearms.

You read that correctly. I am a public health professional.

And I like guns.

This make me a heretic in American public health, where embracing firearms and the rights of gun owners is a gross violation of orthodoxy.

As a society, our focus on guns and not gun users derives from the shock of mass killings, such as those in Newtown, CT, Aurora, CO, Virginia Tech, and Norway, which has some of the strictest gun control laws on the planet. Mass killings, however tragic, get distorted by saturation media hysterics and 24-hour political grandstanding. What gun opponents refuse to discuss is the precipitous fall in violent crime and deaths by firearms over the past 20 years, and how it coincides with an equally dramatic increase of guns in circulation in the US.

While that isn't cause and effect, the association is certainly curious.

In 2013, the Institute of Medicine, at the behest of the Centers for Disease Control, produced a report on firearms violence that has been ignored by the mainstream media. The upshot: defensive use of firearms occurs much more frequently than is recognized, "can be an important crime deterrent," and unauthorized  possession (read: by someone other than the lawful owner) of a firearm is a crucial driver of firearms violence.

That report went away for political reasons. Translation. Nobody wanted to talk about it because it raised more questions than it answered.

The tragic mass murders in Virginia, Colorado, Norway, Connecticut, and most recently California, showcase the failure of the healthcare system, including potential abuse of prescription drugs, and families where parents either checked out or were willfully oblivious to what their children are doing.  They are also outcomes of popular, feel-good movements, such as deinstitutionalization of the mentally ill, colliding with communities that had no means to deal with the consequences. Adam Lanza, Anders Breivik, Seung Hui Cho, James Holmes, and Elliot Rodger all needed  treatment, and, if necessary, involuntary commitment, with due process for both admission to a facility and subsequent release.

My public health approach to the problem of gun violence starts with the assumption that every gun owner is not a raving, irresponsible nut, but in fact a person of some seriousness who has a legal right to choose to own a firearm.

My next assumption is that the most egregious gun violence happens in communities that are broken, such as inner city Baltimore and St. Louis.

Again, a topic that is not to be spoken.

Gun control will not fix schools, restore neighborhoods, stabilize disintegrating (wealthy or poor) families, employ people, heal mental illness, rejuvenate local economies, or help create self respect. I support gun courts and mandatory, no-parole sentencing for people who commit gun crimes, with a massive public education campaign to back it up.

Public education works and is central to many public health issues, from highway safety to tobacco use reduction, but for some reason, when it comes to guns, the public health establishment's histrionic reflex is not to educate but to control and confiscate. According to the FBI, in 2012 there were 8,855 firearms homicides, down 7% since 2008. By contrast, 33,516 people died on the nation's highways in 2012, and alcohol abuse claimed 88,000 lives.

Where's the clamor to control and confiscate cars, cellphones (deadly when used while driving), and booze?

Before buying a firearm, I took a gun safety class and got advice from experienced friends.

I choose to store my guns in accordance with commonly promoted safety guidelines. My son (10) can pick up each shotgun and ensure that both the magazine and chamber are empty. He can check the safety, point it correctly, and place it safely in a case. He also knows how to hold and hand it to an adult. In a state where guns are ubiquitous, this is an essential skill in case he is ever in the presence of child who thinks that his family's carelessly unsecured guns are toys, not lethal weapons. Of course, he also knows to exit that room and get an adult.

Gun owners should not, however, get their hopes up that the public health community will ever take them seriously. Public health students are taught early on that guns are evil, that the people who think otherwise are an ignorant, backward, Jerry Springer watching lot and that there are some questions you don't ask: at least not if you want to pass the class.

This says more about the public health community than it does anything else.

More about that one in a future essay. I think you'll enjoy it.

Ironically, public health academics happily assert that there is a clear Constitutional right to privacy, even as they vilify a right that is actually expressed in the document, and they merrily condescend to its adherents, whom they regard as pathetic rubes. Here is how gun owners can thwart the push to have doctors ask about the presence of guns in a home during a routine history and physical: refuse to answer on the grounds of the much heralded penumbra-emanating right to privacy.

As for the claim that gun rights proponents oppose the conduct of legitimate research, consider this. Many years ago, I asked a very powerful anti-gun academic the following questions: What proportion of gun crimes are committed by the lawful owner of a legally purchased firearm, and what percentage of lawful gun owners use their firearm in commission of a crime?  He said that he did not know, and that he would oppose conduct of the research to answer both questions.

The answer was no surprise, and neither should my rejoinder be: molon labe.

Vik Khanna is THCB's Editor-At-Large for Wellness. He is also author of THCB's next e-book, Your Personal Affordable Care Act: Making Yourself Scarce in the Dysfunctional U.S. Healthcare Industry. Click on the link for a free download of the prologue.

http://thehealthcareblog.com/blog/2014/09/11/why-public-health-needs-a-new-gun-doctrine/