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Guns in America: a Public Health Crisis

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Americans have an amazing killing ability – every year, about 85,000 Americans are shot by a firearm, and 11,000 of these die.  The death rate from guns in our country is far, far higher than any other developed nation.  Compare the 11,000 number to some other national totals last year, including the U.K. (41), France (35), Japan (11), and Norway (2).  Michael Moore got it right when he said:  “Guns don’t kill people— Americans kill people.”

This month, 26 year old Chris Harper-Mercer killed 9 people and wounded 9 at Umpqua Community College in Oregon.  He had a total of 14 weapons, all purchased from a federally licensed dealer by him or his relatives.  If you use the low end cost of a weapon at $500, one has to ask how he/they came up with some $7000.00 to buy guns?  President Obama went to Oregon to meet with the families of those killed, and fully armed gun supporters protested carrying rude signs against our president.  Since President Obama was elected there have been 933 mass shootings in this country, with almost 300 in this year.

On October 3rd, U. S. forces shot up the hospital, in Kunduz, Afghanistan, run by Doctors Without Borders, killing 12 staff and 7 patients.

What is it that the U. S. does not understand about the name of the organization: Doctors Without Borders. It means no exceptions – the organization treats all who show up at their hospitals for medical care.  It’s that simple.

It was that simple in the 1960s at Detroit Receiving Hospital. (Now called Detroit General.) where, fFrom about 1962 until 1970, I served at that hospital as a medical student, intern and resident   We treated all-comers: all races, men, women, poor, rich, sane, crazy, pimps, hookers, addicts and non-addicts.  Everyone got medical care.  There were no exceptions, no borders.

The U. S. military prides itself that their personnel can remotely direct drones or planes to kill whatever target they want to hit thousands of miles away.

A friend commented on the large protective force when Pope Francis was in the USD. C.  That’s because this Man of Peace was in a dangerous area, and required Secret Service agents to run alongside his vehicle.  Photos of the Pope in Cuba and South America show him walking with out heavy garments. I inquired of a friend, a former Jesuit, if he thought the Pope was wearing protective armor while in the US.  He said he did  not know for sure, but probably.

Recently on three occasions, the Washington Post carried a 20-page advertisement for hunting equipment, that includes a full page of 14 handguns, selling for between $339.99 and $845.99.  There is a second page of “firearms” that look remarkably like military weapons. Ammunition was relatively inexpensive.

Think about this area of northern Virginia, within biking distance of our nation’s capital.  Fairfax County has a population of about 1,131,000 as of 2013, which is about twice that of the entire state of Wyoming.  So where in this area can you shoot a gun and not cause harm?  Certainly not Washington, D. C., our capital.

In response to the Oregon College shooting, President Obama said “it is a political choice that we make, to allow this to happen every few months in America.” He added: “Each time this happens, I am going to say that we can actually do something about it but we’re going to have to change our laws.”

The President called for news organizations to compare the number of Americans killed by terrorism over the past decade with the number who died from gun violence. He noted that the US spends trillions of dollars and has passed myriad laws to protect people from terrorism.  “Yet we have a Congress that explicitly blocks us from even collecting data on how to reduce potential gun deaths. How can that be?” he asked.

Am I a stranger to shooting? – Not quite.  As a teenager, our neighbor brought out his 22-rifle, and his son and I shot at tin cans lined up on the shore of Lake Ontario.  The next encounter was when I was an intern at Detroit Receiving Hospital (now called Detroit General Hospital.)  A girl had been accidently shot in the chest by a classmate who had taken a gun from home and put it in his jacket pocket.  She had blue eyes and dark hair and was the same age as my daughter.  We could not save her.  In absolute distress, I threw up in the sink, and the chief resident sent me home – driven there in a police car.  Though I lived and worked in downtown Detroit, from 1960-1988, I never thought of having a gun.

In the U. S. certain people are more likely to be killed by a firearm.  These include young persons (89% are under 50 years old), blacks (the death rate is 3 times higher than for Hispanics, and 11 times higher than Caucasians), and males (5.5 more likely than females).

Medical costs to treat those killed or wounded are astronomical.  But there are much greater costs than just medical care.  Far greater is the loss of young persons who will not be able to make a contribution to society over their lifetimes and the ongoing costs of personal, family, and relational losses suffered by those who are left behind..

How are we in the U. S. to deal with this major public health problem, whose cost exceeds $229 Billion?  That money could buy a lot of food and housing for families, pay medical costs for those uninsured, and educate thousands of underserved students.

The good first step would be to reduce the number of firearms in the nation.  For every 100 residents in the U.S., there are 88.9 firearms, for with a total of nearly 300 million firearms.  Again, the U.S. exceeds all other developed nations in firearms per 100 residents, including Italy (11.9), Spain (10.4), the U.K. (6.6), Netherlands (3.9), and Japan (0.6).  Fewer guns mean fewer shootings.  And prevention is everything in public health; in principle, educating people to reduce the number of guns is akin to  – no different than educating smokers to cease tobacco use in order to reduce lung disease and various cancers.

Second, some U. S. states have laws that prohibit physicians from asking patients if they possess a firearm.  Similar “blinder laws” prohibit funding for research into the firearms frenzy.  This muzzling block by the arms industry represents a public health intervention hazard that must be challenged and changed if we are to even know the number and circumstances of those cut down by firearms.

If terrorists caused nearly 40,000 deaths and injuries annually, we would demand action.  But we don’t demand action.  We keep electing the same people who support guns, and we don’t limit or even document the amount of money given to candidates by gun supporters.

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Janette D. Sherman, M. D. is the author of Life’s Delicate Balance: Causes and Prevention of Breast Cancer and Chemical Exposure and Disease, and is a specialist in internal medicine and toxicology. She edited the book Chernobyl: Consequences of the Catastrophe for People and Nature, written by A. V. Yablokov, V. B., Nesterenko and A. V. Nesterenko, published by the New York Academy of Sciences in 2009.  Her primary interest is the prevention of illness through public education.  She can be reached at:  toxdoc.js@verizon.netand www.janettesherman.com

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