Surgeon General declares gun violence a public health crisis

US Surgeon General Dr. Vivek Murthy on Tuesday declared gun violence in America a public health crisis, recommending a series of preventative measures that he likened to previous anti-smoking and road safety campaigns.

The step follows years of calls from health officials, including four of Dr. Murthy's predecessors, to view gun deaths through the lens of health rather than politics.

The National Rifle Association vigorously opposed this approach and pushed legislation that effectively eliminated federal funding for gun violence research for a quarter century.

Dr. Murthy's 32-page advisory calls for increased funding for gun violence prevention research; advises health care providers to discuss firearm storage with patients during routine doctor visits; and recommends safe storage laws, universal background checks, “red flag” laws, and an assault weapons ban, among other measures.

“I have long believed this is a public health issue,” he said in an interview. “This issue has been politicized, it has been polarized over time. But I think when we understand that this is a public health issue, we will have the opportunity to take it out of the realm of politics and put it into the realm of public health.”

Gun rights organizations have been scathing of the new advisory, deriding it, sometimes in unprintable language, as a justification for limiting the rights of law-abiding gun owners. An NRA spokesperson called it “an extension of the Biden administration's war on law-abiding gun owners.”

“America has a crime problem caused by criminals,” said Randy Kozuch, the organization's top lobbyist. “The reluctance of President Biden and many of his allies to prosecute and punish criminals is a major cause. This is a fact”.

Public health-based gun reform has been an uphill battle in the United States, whose political parties are deadlocked over many of the measures recommended by the report, including bans on assault weapons and background checks on purchasers. of weapons.

For decades, opposition from gun rights groups had a chilling effect on scientists, who feared that Congress would cut their budgets if they were accused of conducting “gun-supporting research,” Andrew Morral said, a senior behavioral scientist at RAND.

But that barrier is falling, as the Centers for Disease Control and Prevention has resumed funding for gun violence research. “There is a surge of interest,” said Dr. Morral, RAND's Greenwald Family Chair in Gun Policy. “There's a sense that this is a low-hanging fruit that hasn't been studied.”

He said he was confident that, as in the areas of tobacco and climate change, public opinion on gun violence would respond to “a slow and ultimately insurmountable body of evidence.”

Dr Murthy said he was moved to act by the growing number of deaths caused by firearms, especially among children. In 2020, gunshot wounds surpassed car crashes as the leading cause of death for children and adolescents in the United States.

Recent years have brought a surge in gun ownership and, with it, an alarming increase in gun suicides among young people. In cases where children and teenagers died from unintentional gunshot wounds, about three-quarters of the firearms used were stored loaded and open, the Centers for Disease Control and Prevention found.

“We need to look at this now for what it is, which is a children's issue,” Dr Murthy said. Traveling around the country, he said, he had regularly heard from students who were afraid of getting shot in their neighborhood or at school.

“As a country, we're actually more united than I think we can understand,” he said.

Dr. Murthy's warning on gun violence was his second dramatic move in two weeks, coming on the heels of his announcement that he would push for a warning label on social media platforms, alerting parents that the use of platforms could harm the mental health of adolescents.

The surgeon general's position functions largely as a bully pulpit, charged with communicating scientific findings to the public. Occasionally, the surgeon general's warnings have succeeded in shifting the national conversation, as in a landmark 1964 report on the health risks of smoking.

After that announcement, Congress voted to require a health warning to be printed on cigarette packages, and smoking began a 50-year decline. In 1964, approximately 42 percent of adults smoked daily; by 2021, 11.5% have done so.

Dr. Murthy said he sees a public health campaign against gun violence as a similar challenge, requiring a combination of education and awareness campaigns, cultural changes and policies. “There hasn't been a single strategy that has ultimately worked with tobacco,” he said. “That's what I think too here.”

Jonathan M. Metzl, a professor of sociology and psychiatry at Vanderbilt University in Nashville, argued in a recent book that public health strategies resulting from “tobacco wars, seat belt wars, or other conflicts between profits and people last century” were wrong. -fitting the national firearms debate that is so deeply rooted in identity politics.

Dr. Metzl said he interviewed thousands of gun owners while researching his book, “What We Have Become: Living and Dying in a Gun Country,” and concluded that they viewed guns not as a risk to health, but as a form of protection.

“Guns are not just a health problem, they are a problem of democracy, race and pluralism,” he said. “The public health framework does not address this issue. The framework is too limited for the problem we are facing.”

Dr. Mark Rosenberg, a gun violence researcher who helped create the CDC's National Center for Injury Prevention and Control, said he consulted with Dr. Murthy about the notice and welcomed it. Dr. Rosenberg said he was fired in the late 1990s under pressure from Republicans who opposed the center's research.

“Was I disappointed that it took 40 years to bring this idea forward? Yes, I was disappointed,” said Dr. Rosenberg, chair emeritus of the Task for Global Health.

But he added that it often takes a long time for scientific work to be translated into policy; Two centuries passed before preventative treatments for scurvy and smallpox were widespread among the population, eradicating those diseases, she said.

“I am pleased that the surgeon general was able to release this report,” he said. To translate the recommendations into law, he added, “we have a huge battle ahead of us.”

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