In recent years, gun violence has become an extremely prominent issue at the forefront of many policy discussions. The United States Congress and the American public are divided on the debate between gun control and gun rights (Wu). 36,252 persons in the U.S. died as a result of firearms in 2012. This number represents nearly 17% of injury-related deaths documented that year. Additionally, a recent study showed that U.S. gun homicide rates were 25 times higher than peer nations (Galambos). The National Rifle Association claims that guns play a role in helping reduce crime rates. If this were true, among all industrialized nations, the U.S. would have the lowest homicide -- and by a wide margin (Donohue). Each year, more than 33,000 deaths, an average of 93 deaths a day, occur as a result of firearm-related violence (Hill-Evans). While devastating, these statistics continue to undermine the extent this violence has on victims. For the tens of thousands of people killed per year, more than two times as many people suffer nonfatal gunshot wounds (Hills-Evans). The injuries that do not lead to death oftentimes result in mental health problems, like posttraumatic stress disorder, and long-term physical disabilities (Hills-Evans). Because Congress refuses to take action when addressing gun violence as a political issue, I propose we change the discourse of the matter to a health issue instead.
“Who could have imagined that Columbine, CO, USA (15 died) in 1999 would fail to be an anomaly, and initiate a series of shootings at such schools as Red Lake High School, MN, USA (10 died), Virginia Tech, VA, USA (33 died), Chardon High School, OH, USA (3 died), and Amish School, Lancaster, PA, USA (6 died)” (Rubens and Shehadeh). The government was and is not doing enough to combat the problem, so civilians themselves worked to raise awareness. A student-led movement that assisted in planning massive marches around the globe, succeeding in the horrifying school shootings in Parkland, Florida on Valentine's Day 2018 (Rahamim). Back in 2013, President Obama issued an executive order for the Centers for Disease Control and Prevention (CDC) to resume research in 'the causes of gun violence and how to prevent it' in the wake of the Sandy Hook Elementary School shooting in Newtown, Connecticut (Galambos). Despite the extensive public outcry following recent mass shootings, such as the school shooting at Marjory Stoneman Douglas High School in Parkland, Florida, or the Orlando nightclub massacre, Congress still does not act on calls to reverse the freeze CDC implemented on funding (Galambos).
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While the government has taken steps toward making gun ownership increasingly difficult for the population, the decisions made in the Supreme Court with cases regarding gun violence take the conservative approach. For example, the District of Columbia’s city council passed the Firearms Control Regulations Act in 1975 which banned individual gun ownership in the District of Columbia (DC). District of Columbia residents could have handguns but exceptions were made for police officers and security guards. The individual needed a license to have a firearm, which was to be disassembled, unloaded, or fitted with a trigger lock, at home. However, this act was repealed as a result of the District of Columbia vs Heller case in 2008. They ruled that citizens had the individual right to bear arms for self-defense (Long). Antonin Scalia wrote for the five-justice majority. His argument to take the originalist approach to the issue was that he found no evidence in legislative history showing that the Founding Fathers intended to limit gun ownership solely for militia purposes. Furthermore, after Scalia’s death, Obama announced executive action to strengthen gun laws (Long), but even then Congress did not take action. Something in common with these relevant cases and laws is the language they use when arguing against gun control. They constantly mention that it was a given right to American citizens, and therefore should be kept instead of seeing the horrible outcomes that are occurring as a result of it. The government passing acts like the Firearms Control Regulations Act appear to serve the sole purpose of gaining approval from the people instead of inducing change.
The government must make obtaining a gun more difficult than it currently is, taking into account how easily a mentally ill individual can get one. A way this can be accomplished is with more in-depth background checks. Under present law, “Health Insurance Portability and Accountability Act (HIPAA) only permits covered entities (e.g., state mental health agencies) to disclose such information to the NICS in limited circumstances: when the entity is a ‘hybrid’ entity under HIPAA (and the Privacy Rule does not apply to these functions) or when state law otherwise requires disclosure, and thus disclosure is permitted under HIPAA’s ‘required by law’ category ('HHS Issues Final Rule”). Currently, the federal government has no law requiring state agencies to report information to the National Instant Criminal Background Check System (NICS)” ('HHS Issues Final Rule').
Back in 2016, Obama said, “We’ve created a system in which dangerous people are allowed to play by a different set of rules.” According to the 2015 Bureau of Alcohol, Tobacco, Firearms, and Explosives Report (ATF), there are over 55,000 licensed gun dealers in the United States. This includes sporting goods stores, small privately-owned gun shops, and big chain stores (Fieldstadt). Additionally, the ATF claims there are over 8,000 pawn shops licensed to sell guns. It is a federal law that both pawn shops and licensed gun dealers administer background checks when selling guns. However, according to the Law Center to Prevent Gun Violence, sellers who are not licensed are not required to perform background checks and not all people who buy guns go the traditional route of going into a gun store. The Brady Campaign to Prevent Gun Violence released that 40 percent of guns sold in the U.S. are still sold with “no questions asked.”
Although the issue may arise between how far background checks can go until it is invasive of one’s privacy, we must still remember the factor this places in the health of the public. To have those who are mentally ill hold weapons like guns with the potential of ruining or even ending innocent lives goes against protecting American citizens.
The current discourse when an instance of gun violence occurs ranges from mentioning the American citizen’s second amendment rights given to them by the founding fathers or taking to social media to offer their condolences. The phrase “thoughts and prayers” is floating around Twitter endlessly as one shooting happens after another. Users post some variation of this phrase to show they are acknowledging what happened. Even though it is good that the public is becoming more aware of these violent instances, it does not encourage change nearly as much as taking action collectively to the government would. Their perspective is limited because of the lack of research available on the shootings. With federally funded research and Congress allowing the research to contain the proper language to accurately portray the statistics and harmful impacts of gun violence, the public would be able to see the strong correlation between the number of mass shootings and weak gun laws. Having this research would make people take these occurrences more seriously and fight for action instead of sitting behind their phones and posting their condolences without all the information. For those who are against gun control, the language they use consistently revolves around “rights.” They entirely miss that this right, which was made to protect citizens, is doing the opposite.
Society desperately needs peer-reviewed and evidence-based research to address even basic questions about firearm violence registration and licensing of guns to perpetrators of gun violence. In the 1990s, CDC-funded research showed that having a gun in the home was associated with increased risks of homicide and suicide. In response, the National Rifle Association lobbied Congress to end this line of research. In 1996, Congressman Jay Dickey of Arkansas included language in an appropriations bill stating that no CDC funds for injury prevention and control “may be used to advocate or promote gun control” (Hills-Evans). In 1993, an article published in the New England Journal of Medicine reported the findings of a study funded by the CDC (Kellermann et al., 1993). In an analytic review of 1,860 homicides, Kellerman and colleagues found that the presence of a gun in the home was a strong and independent risk factor for homicide, controlling for illicit drug use, prior arrests, and domestic violence (see also Kellermann, Somes, Rivara, Lee, & Banton, 1998). The researchers concluded that, rather than being an effective means of protection, guns instead posed a substantial threat to household members (Galambos). These pronouncements from a federally-funded agency prompted the National Rifle Association (NRA) to support the development of language in Congress’s 1996 Omnibus Consolidated Appropriations Act (Jamieson, 2013). This act mandated a prohibition on any funding by the National Institutes of Health (NIH) that might pose a “restriction on any legal consumer product, including its sales or marketing, including but not limited to the advocacy or promotion of gun control” (Hills-Evans). The Consolidated Appropriations Act of 2012 used similarly restrictive language about funding from the National Institutes of Health (NIH). While not outlawing gun violence research explicitly, this language had the intended effect: since 1996, federal funding for research dedicated to gun violence has plummeted (Hills-Evans).
However, there have been reports of impactful analyses despite the unavailability of federal support. For instance, research looking at the relationship between gun ownership and firearm homicide rates in the U.S. using publicly available databases essentially replicated findings from the 1990s that demonstrated increased rates of firearm homicide increased rates of gun ownership (Galambos). Additionally, the American Academy of Pediatrics supports the funding of research on surveillance of firearm injuries, evaluation of healthcare screening and intervention, and identifying and disseminating violence prevention resources (Rubens and Shehadeh). According to research conducted by the Los Angeles Times, at least 59% of the 185 public mass shootings that took place in the United States from 1900 through 2017 were carried out by people who had either been diagnosed with a mental disorder or demonstrated signs of serious mental illness before the attack (Duwe and Rocque). Mother Jones found a similarly high rate of potential mental health problems among perpetrators of mass shootings — 61% — when the magazine examined 62 cases in 2012 (Duwe and Rocque). With more than half of past shooters displaying these signs, it seems illogical to not allow background checks to place restrictions on those who suffer similar illnesses from owning a gun.
Since our attempts at getting aid from the government in support of gun control have not been successful, changing the discourse of the topic from a political issue to a health issue instead would help both sides see a perspective outside of gun ownership as a right given by the Second Amendment. A way this could be done is to work in close alliance with social workers. These people work as close analogs to potential mass shooters. However, in terms of clinical preparation of social workers for addressing youth violence, reports from the most recently available studies suggest that very few social workers (5%) received violence prevention training in their graduate programs, yet many express a desire for such training (Galambos).
Although it is uncommon for the public to hear from social workers themselves when instances of violence occur from guns, they still hold opinions on the issue. A social justice brief about gun violence was released in 2017 which on the whole promotes gun violence prevention laws, regulations, and policies (Arp et al., 2017). On their website, the National Association of Social Workers (NASW) has also praised specific actions, such as the executive actions President Barack Obama announced in January of 2016 (NASW, 2016a), and issued statements following mass shootings, such as the nightclub massacre in Orlando in June of 2016 (NASW, 2016b). Beyond these supportive statements regarding laws, regulations, and policies, the NASW has not yet elaborated clear and detailed guidelines on policy, practice, and research toward preventing and controlling gun violence (Galambos). I believe that social workers should place more emphasis on developing policies for their patients who show signs of similar mental illnesses held by previous shooters. For example, they could implement a guideline where when a patient shows a high percentage of similar symptoms held by previous shooters, it is added to their record so if they ever choose to try to purchase a gun it would be more difficult. To combat the backlash that this guideline would invade the privacy of the individual, we can start by placing some sort of symbol indicating the potential they have to use a firearm for mass violence instead of displaying the specific symptoms the patient is undergoing.
Research that directly impacts the micro practice role of social workers is particularly needed given the fact that social workers provide more direct mental health services to individuals than any other mental health professional (Galambos). Unfortunately, such research on preventing gun violence has lagged in social work (Galambos). A systematic review found that there has been very little evidence-based knowledge produced by the field since 1980, and concluded that this is a “neglected social work research agenda” (Galambos). Another review of clinician attitudes, screening practices, and firearm injury reduction interventions in the US found that the current literature in this area is not particularly high quality, and recommended more large-scale and adequately funded research. They do not have enough money to do proper research to academically prove claims. I suggest that NASW claims the provided federal funds for research under the health category to use for the safety of the public. When conceived as a health issue it is harder for the NRA to ban the use of the funds.
It is important to look at this issue from the perspective of social workers. In their perspective, the focus is on the mental health of the past and potential shooters as well as the health of the public. In regards to mental health, Rubens and Shehadeh state that violence occurred more frequently with individuals with a history of being socially ostracized, exhibiting poor anger management, a fascination with violence, and possessing a strong attraction and easy access to guns. From the public health perspective, the issue of gun violence could be evaluated based on the theoretical framework of the Social Ecological Model (SEM) by the Centers for Disease Control and Prevention (CDC). The SEM uses four levels of influence to describe a framework that identifies factors that either place a person at risk for or guard them against being subjected to or causing a health problem such as violence (Rubens and Shehadeh). Because public mass shootings happen in places like movie theaters, concerts, malls, and places of worship, we are all always wondering if it could happen to us (Wintemute). More people fear being the victim of gun violence than ever before – the Kaiser Family Foundation discovered that of 1,200 individuals surveyed, 42 percent said they were somewhat or very worried about being impacted by gun violence. This number is higher than those afraid of losing their jobs or being the victim of a terrorist attack (Wintemute).
One of the first steps for public health professionals is to work toward supporting, participating in, and even spearheading research efforts correlating with gun violence. These can include studying the health and safety risks through epidemiology or researching the impact on local communities from a community health worker role (Wintemute). Health educators, in particular, can play a vital role in stemming gun violence in their own and other communities. This is especially true in lower-income and high-crime areas where gun incidents take place on a more frequent and visible basis. Community health workers are in a unique position wherein they can educate individuals about the risks of gun violence, while also emphasizing storage and other safe practices (Wintemute). Because much of the gun violence spotlight revolves around mass shootings, public health professionals shouldn’t be afraid to speak about incidents and help educate the community. One survivor of the Las Vegas shooting noted that having a plan ahead of time made all the difference – Nick Perez, a security professional attending the concert with his girlfriend, examined the venue’s layout before the event so that he knew where entrances and exits were located. In addition to education, health professionals can support other’s research and prevention efforts in their local communities, placing a public health point of view and lending unique expertise to an important issue (Wintemute).
Gun violence is complex and deeply rooted in our culture, which is why we must take a public health approach to ensure our families and communities are safe (Wintemute). Despite the widespread nature of this issue, there is a serious lack of funding when it comes to supporting research and prevention efforts, contributing to overall inequity within public health (Wintemute). Social workers are in an excellent position to encourage gun safety with some of the most at-risk populations (Galambos). For this reason, scientific research should be conducted within their field itself because of the proximity they have to past and potential mass shooters. Unfortunately, the lack of federal funds to support research has stymied efforts to contextualize gun violence (Galambos). Because Congress refuses to allow funds to go into any research that would or could potentially show signs of support for gun control, we must change the discourse. By making health the domain of this discussion, the discourse is likely to move away from rights and commodities and more towards keeping a close eye on the mental health of gun buyers and ensuring that public health is taken as a priority.
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