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Gun Violence as a Public Health Problem

Kennedy, Maureen Shawn MA, RN, FAAN

AJN The American Journal of Nursing: February 2016 - Volume 116 - Issue 2 - p 7
doi: 10.1097/01.NAJ.0000480475.12266.22
Editorial

When will our outrage lead to action?

AJN Editor-in-Chief E-mail: shawn.kennedy@wolterskluwer.com

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Before last December, many people probably hadn't heard of San Bernardino, California. That changed when a couple opened fire in a county facility for adults with disabilities, killing 14 people. Nor had many of us heard of Newtown, Connecticut, before December 14, 2012, when a young gunman entered Sandy Hook Elementary School and killed 26 people—20 of them children. The names of these towns have joined the list of others we've come to recognize: Littleton, Colorado (site of the 1999 Columbine High School shootings); Aurora, Colorado (site of the 2012 Century 16 movie theater shootings); and Blacksburg, Virginia (site of the 2007 shootings at Virginia Polytechnic Institute). Casualties at these three sites totaled 57 deaths and 75 wounded. And last year? Complete data aren't in as I write this, but according to the Washington Post’s Wonkblog, by October 1, there had already been 294 “mass shootings,” which it defined as four or more people killed or wounded by gunfire.

Mass shootings are horrific and prompt much outrage, but they're responsible for only a small percentage of U.S. firearm deaths. An FBI report on 160 “active shooter” events between 2000 and 2013 noted that just 64 involved the killing of three or more people. During the same time span, according to the Centers for Disease Control and Prevention (CDC), firearms accounted for 417,583 deaths— 253,638 suicides and 163,945 homicides.

Research indicates that U.S. firearm fatalities far outstrip those in other countries, which points to our appalling ineptness at addressing gun violence. A study comparing U.S. firearm death rates in 2003 with those in 22 other countries found that the overall U.S. rate was more than seven times higher. The U.S. firearm homicide rate was 19 times higher, while firearm suicide and unintentional death rates were each over five times higher. Fully 80% of all firearm deaths in the 23 countries that year occurred here.

Many people found the Sandy Hook shootings especially heartbreaking, and hoped this might spur changes in U.S. gun control laws. While a few states passed laws prohibiting the sale of some assault weapons and limiting ammunition purchases, federal laws have changed little, mainly because of the influence bought by gun rights proponents. This faction claims that tighter controls on legal gun purchases won't affect criminal behavior because criminals obtain their guns illegally. Yet a recent investigation by the New York Times revealed that most of the guns used in recent mass killings were bought legally. It seems obvious that longer wait times and more extensive background checks could prevent some potential shooters from buying guns.

But the National Rifle Association (NRA) has blocked research on gun violence for years, making it hard to determine what might work to reduce firearm deaths. It's disheartening, though unsurprising, that some presidential candidates and other public figures continue to further the NRA's message. For example, days after the San Bernardino killings, Senator Ted Cruz (R–TX) told a crowd, “You don't stop bad guys by taking away our guns, you stop bad guys by using our guns.” One wonders how many more unintentional shootings will occur as more people arm themselves. And gun manufacturers are meeting the increased demand. According to the Bureau of Alcohol, Tobacco, Firearms and Explosives, in 2010, there were 5.5 million firearms manufactured in the United States; another 2.8 million were imported. By 2013 those numbers had nearly doubled, to 10.9 million and 5.5 million, respectively.

After the Sandy Hook shootings, the NRA missed a huge opportunity to lead the development of reasonable reforms. It could have followed the example set by the automobile industry, which, when research showed that seat belts and air bags saved lives, modified its vehicles to decrease fatalities. The NRA could have, but it didn't. And despite polls showing that most Americans favor stricter gun control laws, many in Congress continue to pander to the NRA.

The American Nurses Association has called for gun control reforms, along with improved access to mental health services. As nurses concerned with the public's health, we must support measures to reestablish funding for research on gun violence and its prevention. Another Sandy Hook must not be allowed to happen.

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