Published by: Sean Palfrey on 2/14/2013 10:50:07 AM
This blog is part of a month-long series from NAPH members addressing the relationship between gun violence and health care. Look for more posts this month covering issues from California to New York.
As a pediatrician, parents look to me to help them raise their children to be as healthy and happy as possible and prevent them from getting ill or hurt. The practice of medicine has changed a great deal in my lifetime. I no longer have to worry so much about the pathogens of the past -- deadly infectious diseases, such as meningitis and pneumonia -- because medical science has developed effective vaccines to prevent many of these illnesses and medications to treat them if they occur. Every day, scientists come up with new approaches, medicines and surgical procedures to treat cancers, heart disease, asthma and diabetes.
In my urban practice, though, almost every day I mourn tragedies my patients and their families have suffered. These days, accidents kill more children than anything else. Because car accidents kill thousands of children, we have extensively studied ways to prevent them. As a nation, we have legally required safer vehicle ownership and use by instituting strict training and licensure, speed limits, car seats, air bags, and laws against drunk driving and texting while driving.
Gun-related injuries are the next most common cause of death in children. In 2010, 6,570 children and young people ages newborn to 24 were killed by guns, amounting to roughly 18 per day. That number is twice as many as were killed by cancers, five times more than those killed by heart diseases, and 15 times more than those killed by infectious diseases, according to the Centers for Disease Control and Prevention (CDC).
Gun violence is a major “pathogen” of today. But unlike our approach to car accidents, we have not even begun to study or legislate ways to prevent firearm-related injuries and death.
Physicians and other professionals rely on accurate data to develop medical treatments and effective public health policies. But in the recent past, the funding, research, collection and evaluation of data about gun violence has been blocked, as noted in a recent Journal of the American Medical Association article.
The CDC, the National Institutes of Health, and the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) are some of the most knowledgeable and experienced organizations in the world at performing these functions. Our country has an urgent obligation to empower them to collect and evaluate the necessary information. Then, together we can develop evidence-based, commonsense health and safety programs and policies to reduce firearm injuries and save thousands of lives each year.
How Things Have Changed
As an American growing up in the 1950s and 1960s, and as the great grandson of Theodore Roosevelt, I grew up with guns, loved hunting stories and knew an incredible amount of natural history. I owned a BB gun at age 6 and a .22 rifle at age 10. I was a member of the NRA, and I was a very accurate target shooter at one time. However, weapons and attitudes have changed, not just since TR’s time, when his biggest gun was used to shoot elephants, but since the founding of our country, when communities faced physical threats by a real enemy at their doors.
In the past hundred years, we have developed weapons able to shoot hundreds of rounds a minute, rockets, biological weapons and powerful bombs. These new weapons are for war, sad as that is, to be used by our highly trained military forces or by our law enforcement professionals under extraordinary circumstances. It seems clear to me that while personal and family discipline alone might be enough for safe ownership and use of limited weapons, stronger regulation is clearly needed to mitigate harm caused by weapons designed for much wider destruction.
The American Academy of Pediatrics published its most recent policy statement on firearms in October 2012 and concluded, “The absence of guns from homes and communities is the most effective measure to prevent suicide, homicide, and unintentional injuries to children and adolescents.” Putting more guns in homes, schools and streets creates more danger and sends the wrong message: that violence is acceptable. As with many parents, my wife’s and my goal has been to eliminate as much violence in our children’s lives as possible.
Our Constitution and Bill of Rights give U.S. citizens amazing privileges: freedom of speech, freedom to bear arms, freedom of religion. But the greater the potential for harm or abuse by exercising a right, the greater the responsibility for each of us to keep our country strong and our people safe, happy, and free. This conversation we are finally beginning is not about rights, but about responsibilities, open dialog, research, mental health resources, friendship, common values, and reprioritizing our goals for this country and its children.
As pediatricians, we need to have the best possible data, ask the most important questions, and enter the most important discussions, even if they are awkward or sensitive.
As a country, we must act to make our communities and citizens safer, do the research that needs to be done to inform “best practices,” and establish common safety rules and even laws where necessary.
Equally important is the culture shift necessary to make all children and youth safe from firearm-related injury and death. Gun owners and gun-control advocates alike need to acknowledge that rights such as those granted by the Second Amendment come with enormous responsibilities. We have obviously not yet shouldered these responsibilities adequately, or the New Town tragedy would not have happened.
The challenges of acting on these responsibilities will increase with the invention of ever more lethal weapons. We need to establish data-gathering systems and “best practice” policies to be ahead of these dangers, not behind and reactive to them. We are learning more and more about developmental risks and mental health psychopathology, and must establish routines and build resources to ensure that children, families, communities and our country can be kept healthy and safe from harm from modern “pathogens.”
Sean Palfrey, MD, FAAP
Professor of Pediatrics and Public Health
Boston University and Boston Medical Center