The recent tragedies in Colorado and Connecticut highlight the need for focused attention on the all-too-often unacknowledged public health concern of violence, particularly gun violence. These tragedies, and those that sadly preceded them, highlight the need for action to counter the devastating toll of gun violence on our nation. It is time for our nation to have an honest and frank discussion on reducing both the tendency and capacity for violence in our society.
My hospital — Children’s Hospital Colorado — has served as a treatment center for wounded children after two of the most horrific shootings in our nation’s history: the Columbine High School massacre in 1999 and the more recent attack at a movie theater in Aurora, Colo. Twelve students and one teacher were murdered at Columbine, and 12 people were killed in the theater shooting. Seventy-nine others were wounded in the two incidents combined.
Children from my practice, as well as children of my friends and practice partners — were at the theater on that horrible night in July.
It’s time that we, as a country, recognize gun violence as a major public health issue. According to the CDC, more than 32,000 Americans were killed with firearms in 2011, rivaling the number of those who died in traffic accidents. That number has been rising each year since 1999. The number of Americans killed by guns in one year on U.S. soil is more than four times the total of U.S. deaths from the wars in Iraq and Afghanistan combined. Equally devastating, the number of people injured by guns — most through interpersonal violence — was more than 78,000 in 2008.
The causes of this problem are complex, and there is no simple solution. As family physicians, we focus daily on prevention to improve the health of our patients. Today, we need to help our country focus on prevention that addresses all of the causes of violence in our communities.
Our country needs better mental health care, including improved access to care, substance abuse counseling and coordination with primary care. We must identify ways we can improve mental health services and we must provide access to those services in our health care system. Family physicians, through new delivery models such as the patient-centered medical home, are well positioned to help in enhancing access to mental health services.
We need to address violence in media — from television and movies to video games and music videos. Studies have shown that children exposed to media violence are more likely to cause harm to others.
We also must address firearm safety. Guns are not the only source of violence, but gun safety clearly needs to be part of the conversation and part of the solution. The American Academy of Family Physicians has long standing policy — endorsed and upheld by our Congress of Delegates — supporting legislation requiring trigger locks and safe storage of firearms, as well as policy opposing private ownership of assault weapons.
Family physicians must be able to have appropriate medical conversations with our patients about gun safety, and researchers need the ability to study gun safety. Currently, state and federal laws restrict their ability to do so.
Recently, the White House asked the AAFP for input, and we shared with them our policies related to violence, including media violence, gun safety and improving mental health care.
As nation, we have strong feelings on both sides of the gun violence discussion. Yet, all family physicians are advocates for decreasing violence in our communities. It’s a complicated issue, with multiple causes. But now is the time to begin addressing them and coming to a solution that preserves individual rights while it promotes safety for all.
Jeffrey Cain, MD, is President, American Academy of Family Physicians.