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| In this Aug. 8, 2012 photo, Dr. Stephen W. Hargarten poses for a photo in a trauma room at Froedtert & Medical College of Wisconsin's emergency department in Milwaukee. Hargarten helped many of the victims of Sunday's shooting at the Sikh Temple of Wisconsin. (AP Photo/Jeffrey Phelps) |
MILWAUKEE
(AP) — Is a gun like a virus, a car, tobacco or alcohol? Yes say public health
experts, who in the wake of recent mass shootings are calling for a fresh look
at gun violence as a social disease.
What we
need, they say, is a public health approach to the problem, like the highway
safety measures, product changes and driving laws that slashed deaths from car
crashes decades ago, even as the number of vehicles on the road rose.
One
example: Guardrails are now curved to the ground instead of having sharp metal
ends that stick out and pose a hazard in a crash.
"People
used to spear themselves and we blamed the drivers for that," said Dr.
Garen Wintemute, an emergency medicine professor who directs the Violence
Prevention Research Program at the University of California, Davis.
It wasn't
enough back then to curb deaths just by trying to make people better drivers,
and it isn't enough now to tackle gun violence by focusing solely on the people
doing the shooting, he and other doctors say.
They want a
science-based, pragmatic approach based on the reality that we live in a
society saturated with guns and need better ways of preventing harm from them.
The need for
a new approach crystallized last Sunday for one of the nation's leading gun
violence experts, Dr. Stephen Hargarten. He found himself treating victims of
the Sikh temple shootings at the emergency department he heads in Milwaukee.
Seven people were killed, including the gunman, and three were seriously
injured.
It happened
two weeks after the shooting that killed 12 people and injured 58 at a movie
theater in Colorado, and two days before a man pleaded guilty to killing six
people and wounding 13, including then-Rep. Gabrielle Giffords, in Tucson,
Ariz., last year.
"What
I'm struggling with is, is this the new social norm? This is what we're going
to have to live with if we have more personal access to firearms," said
Hargarten, emergency medicine chief at Froedtert Hospital and director of the
Injury Research Center at the Medical College of Wisconsin. "We have a
public health issue to discuss. Do we wait for the next outbreak or is there
something we can do to prevent it?"
About 260
million to 300 million firearms are owned by civilians in the United States;
about one-third of American homes have one. Guns are used in two-thirds of
homicides, according to the FBI. About 9 percent of all violent crimes involve
a gun — roughly 338,000 cases each year.
Mass
shootings don't seem to be on the rise, but not all police agencies report
details like the number of victims per shooting and reporting lags by more than
a year, so recent trends are not known.
"The
greater toll is not from these clusters but from endemic violence, the stuff
that occurs every day and doesn't make the headlines," said Wintemute, the
California researcher.
More than
73,000 emergency room visits in 2010 were for firearm-related injuries, the
Centers for Disease Control and Prevention estimates.
Dr. David
Satcher tried to make gun violence a public health issue when he became CDC
director in 1993. Four years later, laws that allow the carrying of concealed
weapons drew attention when two women were shot at an Indianapolis restaurant
after a patron's gun fell out of his pocket and accidentally fired. Ironically,
the victims were health educators in town for an American Public Health
Association convention.
That same
year, Hargarten won a federal grant to establish the nation's first Firearm
Injury Center at the Medical College of Wisconsin.
"Unlike
almost all other consumer products, there is no national product safety
oversight of firearms," he wrote in the Wisconsin Medical Journal.
That's just
one aspect of a public health approach. Other elements:
—"Host"
factors: What makes someone more likely to shoot, or someone more likely to be
a victim. One recent study found firearm owners were more likely than those
with no firearms at home to binge drink or to drink and drive, and other
research has tied alcohol and gun violence. That suggests that people with
driving under the influence convictions should be barred from buying a gun,
Wintemute said.
—Product
features: Which firearms are most dangerous and why. Manufacturers could be
pressured to fix design defects that let guns go off accidentally, and to add
technology that allows only the owner of the gun to fire it (many police
officers and others are shot with their own weapons). Bans on assault weapons
and multiple magazines that allow rapid and repeat firing are other possible
steps.
—"Environmental"
risk factors: What conditions allow or contribute to shootings. Gun shops must
do background checks and refuse to sell firearms to people convicted of
felonies or domestic violence misdemeanors, but those convicted of other
violent misdemeanors can buy whatever they want. The rules also don't apply to
private sales, which one study estimates as 40 percent of the market.
—Disease
patterns, observing how a problem spreads. Gun ownership — a precursor to gun
violence — can spread "much like an infectious disease circulates,"
said Daniel Webster, a health policy expert and co-director of the Johns
Hopkins Center for Gun Policy and Research in Baltimore.
"There's
sort of a contagion phenomenon" after a shooting, where people feel they
need to have a gun for protection or retaliation, he said.
That's
already evident in the wake of the Colorado movie-theater shootings. Last week,
reports popped up around the nation of people bringing guns to
"Batman" movies. Some of them said they did so for protection.
Associated
Press writer Pete Yost in Washington contributed to this report.
Online:
- Violence prevention research: http://www.ucdmc.ucdavis.edu/vprp
- CDC injury prevention: http://www.cdc.gov/violenceprevention/nvdrs/
Follow
Marilynn Marchione's coverage at http://twitter.com/MMarchioneAP
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