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Tuesday Jan 08, 2013

Time for a National Conversation About Gun Violence

Growing up in the Pacific Northwest blessed me with a love, and respect, for the outdoors. I am an avid cyclist and experienced skier. I also grew up with guns, and I own sporting guns to this day.

At the same time, my hospital -- Children's Hospital Colorado -- has served as a treatment center for wounded kids after two of the most horrific shootings in our nation's history: the Columbine High School massacre in 1999 and the more recent attack at a movie theater in Aurora, Colo. Twelve students and one teacher were murdered at Columbine, and 12 people were killed in the theater shooting. Seventy-nine others were wounded in the two incidents combined.

Children from my practice, as well as children of my friends and practice partners -- were at the theater on that horrible night in July.

It's time that we, as a country, recognize gun violence as a major public health issue. According to the CDC, more than 31,000 Americans were killed with firearms(www.cdc.gov) in 2009, rivaling the number of those who died in traffic accidents. The number of Americans killed by guns in one year on U.S. soil is more than four times the total of U.S. deaths from the wars in Iraq and Afghanistan combined. 

Following the recent school shooting in Connecticut, the White House formed a task force to develop policy to prevent these tragedies and reduce gun violence. On Jan. 3, I participated in the first of a series of stakeholder meetings when HHS Secretary Kathleen Sebelius, White House staff members and others met with representatives from groups representing health care professionals and public health organizations.

The causes of this problem are complex, and there is no simple solution. The White House and HHS are expected to meet with a wide variety of those involved in the issue, including mental health experts, law enforcement, gun owner groups and youth advocacy organizations, to listen to their analyses and recommendations.

As family physicians, we focus daily on prevention to improve the health of our patients. Today, we need to help our country focus on prevention that addresses all of the causes of violence in our communities.

Our country needs better mental health care, including improved access to care, substance abuse counseling and coordination with primary care. These points were made loud and clear during the Jan. 3 meeting.

The need to address violence in media -- from television and movies to video games and music videos -- also was part of our discussion. Studies have shown that children exposed to media violence are more likely to cause harm to others. The Academy has a position paper on that topic 

We also talked about firearm safety. Guns are not the only source of violence, but gun safety clearly needs to be part of the conversation and part of the solution. Our Academy has long standing policy -- endorsed and upheld by our Congress of Delegates -- supporting legislation requiring trigger locks and safe storage of firearms, as well as policy opposing ownership of assault weapons.

Family physicians need to be able to have appropriate medical conversations with our patients about gun safety, and researchers need the ability to study gun safety. Currently, state and federal laws restrict their ability to do so(jama.jamanetwork.com)

The White House has asked the Academy for input, and we shared with them our policies related to violence, including media violence, gun safety and improving mental health care.

I recognize the diversity of our membership and the fact that there are strong feelings on both sides of the issue when it comes to guns. Yet, all family physicians are advocates for decreasing violence in our communities. This is an opportunity for family physicians to be heard as strong advocates of prevention during the development of national policy that will affect the health and safety of our patients.

Jeff Cain, M.D., is the president of the AAFP.

Posted at 12:19PM Jan 08, 2013 by Jeffrey Cain, M.D.

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