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Is Gun Violence a Public Health Issue?

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President Obama has nominated Dr. Vivek Murthy, a Harvard and Yale pedigreed physician, to be the country's next surgeon general. The NRA has mounted a campaign against his nomination because of his support of modest gun control measures based on his experience of treating gunshot victims in the ER.

In full disclosure, Dr. Vivek Murthy, is a personal friend of mine who I find to be an individual of high personal integrity and unwavering commitment to the public good. Putting aside the political waywardness of having the NRA choose our next surgeon general, I wanted to discuss the issue of whether gun violence can be considered a legitimate public health issue.

But first what does it matter whether gun violence is considered a public health issue or not? Well plenty. In 1996, Congress forbade the CDC from allocating $2.6 million (a paltry sum) toward research that advocated or promoted gun control. That 17 year ban on federally-funded gun violence research was lifted by President Obama under an act of executive authority after the Sandy Hook massacre.

For gun control advocates, more funding for research seems like a humble pie-kind-of-policy-proposal. But in fact, more data collection about the facts of gun violence could go a long way toward making gun ownership more safe in America. Finding meaningful and credible data about gun violence is difficult and one of the reasons this is so is a lack of government will to compel companies and organizations to collect the data. David Hemenway who directs Harvard's Injury Control Research Center says that we know more about each fatal car accident than we do about each gun death in America. That's because in 1966, the predecessor to the National Highway Traffic Safety Administration began to record 100 data points for each fatal accident including type of car, the speed of the crash, use of seatbelts, etc. All of this data has helped make driving so much safer than what it used to be. Data makes a difference.

Gun rights advocates will argue that guns cannot be considered a disease vector. They argue that there are millions of law abiding gun owners in America who never shoot innocents, accidentally or otherwise. This is also true of tobacco, high-fat, high-sugar foods, and pharmaceutical drugs. There are millions of Americans who consume these products who never develop lung cancer, Type 2 diabetes, or overdose. Just because millions of Americans don't or haven not yet had a problem with these products doesn't mean government cannot or should not use its regulatory prerogative to shape how these products are consumed. Laws can help shape consumer behavior so that fewer people die and the American taxpayer is not left picking up the bill for the consequences of these products being misused or abused.

Given the scale of the health care costs related to gun injuries, it does seems like a public health issue. Our country spends $2 billion a year in hospital charges to treat victims of firearms-related injuries. One out of three patients hospitalized for gun injuries is uninsured.

The CDC reports that about 31,000 people die every year of gun shots. Only one-tenth that number dies of food poisoning and we have a multi-billion dollar federal agency making sure these outbreaks are prevented.

Most of us never register the scale of gun deaths in America. But doctors like Vivek Murthy who are often on the front line of our country's social problems know this scale all to well.