Consider This from NPR - Treating Gun Violence As A 'Serious Public Health Threat'

Episode Date: February 5, 2022

Firearm-related injuries are among the 5 leading causes of death for people ages 1-64 in the United States, according to the CDC. In 2019, there were 39,707 firearm-related deaths in the United States. That's an average of 109 deaths per day. Firearm-related injuries are harder to quantify, but the Gun Violence Archive reports that there were over 40,000 last year. CDC Director Dr. Rochelle Walensky has called gun violence a "serious public health threat." She's the first CDC Director to make strong public statements about gun violence since 1999. For decades, gun violence research received no federal funding. That's in large part because of pressure from the NRA. Once again, the United States is investing in a public health approach to stemming gun violence. Dr. Mark Rosenberg, founding director of CDC's National Center for Injury Prevention and Control, explains what this means. Additional reporting in this episode from NPR's Eric Westervelt.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Everyone that experiences, you know, that type of threat to your life at gunpoint goes through a state of shock. Washington, D.C. resident Nate Fleming, a lawyer and community activist, is speaking from experience. I was coming to get into the car and I noticed a van, a red vehicle, pull up beside me. They jumped out of the car, one directly in my face, pointing a gun with an extended magazine at me. It happened at a gas station in the middle of the day at a busy intersection blocks from where Fleming grew up and still lives. I backed up and threw my keys over the assailant's head towards my car, and they sped off. Nate Fleming is angry, but not just because this happened to him. More and more residents are being touched by violence, whether that's themselves personally,

whether that's family members, someone that's related to someone that's been a perpetrator of violence. It's impacting people throughout the community in deeply personal ways. Gun violence in all of its forms is a national epidemic. We have 4.6 million children who live in a home where a gun is kept loaded and unlocked. That is why we have 27,000 emergency room admissions for accidental shootings every year in this country. That's Sam Liccardo. He's the mayor of San Jose, California.

Last year, his city was devastated by a mass shooting at a rail yard when an employee killed nine people and then himself. Over the next 13 days, we had eight more people in my city who were victimized again by gunfire. And in addition, there was a witness who witnessed that horrible tragedy, who then turned the gun on himself. News of horrific mass shootings or accounts of brazen, violent gun crimes grab the headlines. But there's a daily toll of injury and death by guns that's often overlooked, but it's just as devastating. This is about the much larger ocean of harm out there. It's not simply about the coastline, what we see

on the headlines. Consider this. Since 2019, the toll of gun violence, always high in this country, is rising to new levels. Taken together, injuries, homicides, suicides, and accidental deaths are skyrocketing. For decades, professionals from across disciplines have agreed that treating gun violence like a public health crisis, and just a crime problem could reduce injuries and deaths. But that idea has never been fully embraced as a national strategy. Now, though, thanks to an unexpected alliance, the country could finally be ready to try. That's coming up. From NPR, I'm Michelle Martin.

It's Saturday, February 5th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com.

T's and C's apply. It's Consider This from NPR. Every day we turn on the news and there are more young people dying. This summer, while the nation continued to reel from COVID, CDC Director Dr. Rochelle Walensky went on CNN to highlight another crisis, gun violence. I swore to the president and to this country that I would protect your health. This is clearly one of those moments, one of those issues that is harming America's health. Dr. Walensky called gun violence a, quote, serious public health threat, unquote. It was an extraordinary moment. It may not have sounded like it. It shouldn't be a surprise

that the public figure charged with caring for the nation's health should be concerned about a spike in injuries and death by whatever cause, but it was. That's because it had been decades since a CDC director has spoken so strongly and publicly about gun violence. But Dr. Walensky was careful to make one thing very clear. I'm not here about gun control. I'm here about preventing gun violence and gun death. Gun control, those two words and how they have been politicized, have had an enormous impact on our country's ability to address gun violence. Here's why. In 1996, the NRA and their congressional allies helped pass the Dickey Amendment. It was named after its sponsor, Republican Congressman Jay Dickey from Arkansas. The amendment barred the use of federal funds

to, quote, advocate or promote gun control, unquote. It was a good strategy for the NRA, but it was a devastating strategy for the country. That's Dr. Mark Rosenberg. He helped found the CDC's National Center for Injury Prevention and Control in 1992, became its first director, He helped found the CDC's National Center for Injury Prevention and Control in 1992, became its first director, and oversaw the organization's gun violence research.

That is, until the NRA stepped in. In a three-year period, the Dickey Amendment passed and the CDC's funding was slashed. The amount of research CDC was doing on gun violence prevention fell by more than 90 percent. It effectually came to a halt. Then Dr. Rosenberg was fired. But that didn't stop him from advocating for a science-based approach to gun violence prevention. And he found himself working with an unlikely partner. Jay Dickey and I started out as mortal enemies. Yes, that same Jay Dickey, the Republican congressman whose amendment had essentially ended all CDC research on gun violence. I was told not to have anything

to do with Mark Rosenberg. He was the point man for the other side. But one afternoon, Dr. Rosenberg found himself in Dickey's office, and they started to talk. I saw Mark's sincerity, and I thought this might be worthwhile. It might be worthwhile to talk to a person who I was, I thought, destined to dislike. Over time, we developed a friendship. Jay Dickey taught me that it's so important to let people know that one of the objectives of the research is to find ways of reducing gun violence that won't infringe upon the rights of law-abiding gun owners. And he learned from me that science could find ways to reduce gun violence without taking guns

away through our public health approach. So he changed his mind. And together, until Jay Dickey passed away in 2017, he and Dr. Rosenberg helped Congress change their minds. In December 2019, Congress approved $25 million to be split between the National Institutes of Health and Centers for Disease Control and Prevention. After nearly two decades without government funding for gun violence research, it's a start. Coming up, Dr. Mark Rosenberg explains what this moment could mean for the future of gun violence prevention in this country. Now that federal funds are available to support research into gun violence prevention

based on a public health approach, we wanted to break down what that means in practice. I asked the founding director of the National Center for Injury Prevention and Control, Dr. Mark Rosenberg, to explain. A public health approach has three parts, three important parts. The first is that it's based on science. The second is it's focused on prevention. And the third is that it's collaborative by nature.

Let me tell you a little what we mean by based on science. That means we're going to ask and answer four questions, simple questions. The first question is, what's the problem? Who gets killed? Where are they killed? How are they shot? With what kind of weapons? Where does the gun come from? What, why, when, how, where? The second question is, what are the causes? What's the role of drugs and alcohol? What's the role of domestic violence? What's the role of kids having too easy access to weapons in their home. The third question we ask in a scientific approach is what works? What works to prevent these shootings and these killings? And there's only one way to know what works. It's not what you think.

It's what you can demonstrate and prove. The fourth question science asks is, once you have an intervention that works in your test setting, how do you scale it up? How do you translate programs into policy and legislation? That's what science will bring. I think when a lot of people think about gun violence, their mind immediately goes to a homicide or a mass shooting. What I'm hearing you say is this encompasses all these things. I mean, it encompasses self-harm.

It encompasses a child playing with an adult's gun and then a terrible accident. Absolutely, and it's a very good point you're making. Most gun fatalities are not homicides. That's what people think of first. But probably 50 to 60 percent of all gun deaths are suicides and self-directed harm. If you add the homicides and the suicides, you're covering probably 94, 95 percent of all gun deaths. A small number are unintentional shootings, but I would say the scientific approach works for all types of shootings.

The situation is beginning to change. In December 2019, Congress approved $25 million for gun violence research to be split between the National Institutes of Health and the Centers for Disease Control and Prevention. And this summer, Dr. Rochelle Walensky became the first CDC director in decades to publicly describe gun violence as a, quote, serious public health threat. Now, to some people, this might not seem like a big deal. But what does it mean to you? It's a very, very big deal because it means we can now start looking for the answers to these questions. It also means that for the first time in a series of CDC directors starting in 1999, a CDC director is saying this is a reason a lot of Americans are losing their lives. These are deaths and injuries that can be prevented. And we're going to look at it.

I take it that your concern here isn't just that gun rights supporters like the NRA have taken this kind of, I don't want to see anything, I don't want to hear it, position on safety policies. But your concern is also that people on the left don't really know what to advocate either. I mean, it sounds to me like you're saying that even well-intended prescriptions might not work because we don't really know what would work. We absolutely don't know what would work. There's some indications for some things that they're likely to work, but before you can put them into place, you need evidence. You know, we are asking politicians to vote on policies and programs when they have no idea if what they're voting for will help or will hurt. And we can get them the answers. We shouldn't be putting them in that position.

So the past two years, the CDC has finally started funding these various projects again. I know you don't work there anymore and haven't for some time. Do you have a sense of what their research priorities are? And if not, what do you think they should be, if you're willing to give us an opinion about that? I do have a good sense. And the first objective is to find out the answer to what's the problem and what are the causes. Who are the shooters? What motivates them? The second big objective is what works?

What works to prevent these shootings? How can we prevent gun suicides? How can we prevent gun homicides? How can we prevent gun homicides? How can we prevent domestic violence shootings? So CDC is absolutely focused on the right questions. The question that I think is just as important, and I hope it will get a lot of attention, is what works not only to prevent the shootings, but what works to protect the rights of law-abiding American gun owners? And this is really, really important. This question is very polarized

because people were told that if you investigate, if you do the research, you'll lose all your guns. If we investigate who shouldn't have guns, how we can keep them out of their hands, we can keep people from getting killed, whether it's suicide or homicide by guns, without banning guns. You are an advocate and have been for decades of we have to know more before we know what to do. But gun violence is a crisis now. Is there something that could be happening now to address this crisis? I think there are things we can do right now because the odds that they will reduce gun violence without interfering with the rights of law-abiding gun owners are really high. One is universal background checks. That's designed to keep guns out of the hands of people who shouldn't have them, and it's designed to not interfere with the rights of law-abiding gun owners. We have red flag laws. There are people who are at very, very high risk of killing themselves with a gun

or killing someone else with a gun. And if we can, through a judicial process, identify those people at very high risk, we can probably save lives. And there is some suggestive evidence that these red flag laws will work. That was Dr. Mark Rosenberg. He is the founding director of the CDC's National Center for Injury Prevention and Control. Additional reporting in this episode came from NPR's Eric Westervelt. If you or someone you know may be considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-8255 or the Crisis Text Line by texting HOME to 741741. It's Consider This from NPR. I'm Michelle Martin.