The Las Vegas Shooting: A Public Health Crisis
Earlier this year, for its health tracking poll, the Kaiser Family Foundation surveyed more than 1,200 adults on a number of issues, including about what kept them up at night. Forty-two percent of respondents said they were either somewhat worried or very worried about being the victim of gun violence. That’s a higher share than those who were worried about losing their jobs, or being able to pay their rent or mortgage, or being the victim of a terrorist attack.
As high as that percentage might seem to some, the results mirror those of other years in the Kaiser tracking poll. (In 2013, the same share of Americans—42%—expressed concerns over personally being a gunshot casualty.)
In the wake of the unforgivable and senseless killings in Las Vegas on Sunday night, the deep and widespread fear of gun violence will, no doubt, grow even deeper and more widespread. It will rise, perhaps, even to the level of our sorrow. That’s because when a “Las Vegas” (or an “Orlando,” or a “Virginia Tech,” or a “Sandy Hook”) happens, we cannot leave ourselves out of the story, says Dr. Garen Wintemute, an emergency room physician and professor at the University of California, Davis, who runs that school’s Violence Prevention Research Program. “Public mass shootings happen at concerts, they happen at movie theaters, and malls, and places of worship. They happen at the places we go to—which means all of us have to wonder if they could happen to me.”
And yet, as painful as such events are, and as much as they seem to increasingly define America’s uniquely violent profile among developed nations, they account for just 1-2% of all gun-related deaths in the U.S. “We lose upwards of 90 people a day on average to firearm violence, to suicide and homicide,” says Wintemute. “The vast majority of those events never make the news, but that’s where the problem is.”
The good doctor has spent much of the past 35 years reframing our national epidemic of gun violence as though it were any other epidemic—that is to say, as a public health problem. Or make that a national health crisis.
The effort hasn’t been easy. Since 1996, under a provision called the Dickey Amendment, Congress has prevented agencies in the U.S. Health and Human Services administration from using funds “to advocate or promote gun control.” The CDC, says Wintemute, has incorrectly “interpreted that as a mandate not to do research” on the public health dangers of guns and the epidemiology of gun violence.
But Wintemute, for his part, has steadily pressed on. When much of his traditional government funding dried up, he began financing his own program’s research in part with his savings—kicking in $300,000 a year. (“I’m an ER doc,” he says. “I live a simple life. I don’t need the money.”) By the end of 2017, Wintemute, who is 65 and who has no plans of retiring soon, will have self-funded his research program to the tune of $2.1 million. He has also gotten funding recently from the National Institute of Justice and from some private foundations.
A second challenging (and nonsensical) barrier to stemming this firearm-health crisis, he says, is the widely propagated myth that physicians can’t, or shouldn’t, talk to their patients about the safety risks of guns—a belief reinforced by a misunderstanding of a provision in the Affordable Care Act. That’s not the case at all, says Wintemute. (The law merely prevents health providers from collecting or demanding information from their patients regarding gun use.) “The language of the ACA really doesn’t apply to what doctors do,” he says.
As much as those who fear any kind of measured gun control try to stop the brave Wintemutes of the world, however, there is good news too. In June 2016, the state of California passed legislation that publicly funds the University of California Firearm Violence Research Center. Wintemute’s research program will see its first funding from that this month.