How the public health approach can solve gun violence | Megan Ranney | TEDxProvidence

Early in my career I cared for a young man who changed my life. I received a call on the radio on a warm summer afternoon saying that EMS was arriving with a gunshot wound. I prepared the trauma room like I usually do when the ambulance arrives. The man had been shot in the head. My team did everything they could but we couldn't save him and that was horrible, but honestly, it's not particularly surprising. You see, we don't save many gunshot wounds. What was memorable to me was how and why he died he had shot himself with his father's gun and seeing his father at the bedside was something I will never forget.

That case led me to start asking a lot of tough questions: How did this kid get his father's gun? he changed that and saved his life, why didn't he know that people commit suicide with guns? How many do it each year? And if this death was preventable, what about all the other gunshots that come into my emergency room? What are we doing as

health

professionals? This now, like every other doctor, nurse, and social worker in this country, I have hundreds of stories of people we have treated with gunshot wounds, children killed in tragic mistakes, young people caught in the crossfire, and people who are my own colleagues. like dr.

Tamra O'Neal, an ER doctor who was shot and killed by her fiancé as she left her ER job last fall. Now stories matter because they are memorable because they motivate us, but stories alone are not enough, they matter when they are used. to create change that moves us toward the truth and that young man, he pushed me to realize that much of what I thought I knew about gun

violence

was actually a myth and taught me to strive to do better. We, as a country, have spent too much time. If progress is not being made on gun

violence

, depending on your perspective, you might think this is an issue of criminals, the law, or mental

health

, but the truth is, while that is what the common discussion focuses on, gun violence armed is none of that, what it really is. a

public

health epidemic now, making it an epidemic according to the CDC it is very clear that it is an epidemic because the numbers are increasing every year.

Now I'm a mother of two and I'll be honest every morning when I put my kids through it. bus I say a little prayer that today is not the day a gunman comes to your school, we all live in fear of mass shootings and that's what most of us think about epidemics, but in reality more than a hundred die people and more than 200 Every day there are injuries across the country due to gunshots and less than 1% of them are mass shootings. 2/3 of those deaths are suicides, and while mental health is obviously a part of suicide, the truth is that mental health plays a minuscule role in our lives.

General Epidemic Another thing that may surprise you about this epidemic: You might think it's an urban problem, but the truth is that gun death rates are almost the same in urban and rural areas. In fact, the highest mortality rates occur in states such as Alaska, Alabama, Montana, and Louisiana. and Missouri, another thing about this epidemic, young minority men are disproportionately affected by gun violence, but the fact is that almost two-thirds of gun deaths in our country are actually white men and veterans are at greater risk, plus this epidemic is everywhere, chances are almost every one of you in the audience knows someone who has been affected and here's a really important fact: there are approximately 330 million guns in circulation In the United States, there were about 40,000 deaths last year, that's 40,000 too many deaths, but if they do something really simple arithmetic you'll see that that means almost every gun that exists is not used to cause harm and when we demonize guns or the owners of them we will not progress.

Here's a story. This is a colleague and friend of mine, Dr. Christopher bar Soddy is an ER doctor like me, he is also a gun owner and 4 hour rifle safety instructor. He views gun ownership as an inheritance of honor and a personal responsibility. He is also the founding CEO of a research company, the country's only nonprofit organization dedicated to solving problems. gun violence through the

public

health

approach

, he and I work together not as gun owners and non-gun owners, but as people committed to finding the truth and implementing real solutions that can make a difference for our communities across this country and when we take this. public health

approach

when we address gun violence as an epidemic, then we can create real solutions based on real facts.

Now I cared for that young man in my emergency room just after finishing many years of training as a physician, public health practitioner, and researcher. I won't bore you with all the epidemiology and biostatistics, let's say there is a four-step approach that we have used over and over again throughout history to

solve

public health epidemics, first we count how many people are dying or being injured, then we say what puts them at risk. and why we then create solutions that work and ultimately spread those solutions to communities across the country. When we take this approach, we are successful.

I'm going to share stories of three epidemics here, car accidents, hiv/aids, and gun violence, so in this graphic. You will see that the yellow line is car accidents. Deaths from car accidents peaked in the late 1960s. We have now decreased death rates from car accidents by about 70 percent, not by taking cars off the roads. In reality, there are more cars, more millions of miles driven than ever before. What we did was use that four-step public health approach. We found things like 3-point seat belts keep you safer than a lap belt. We created car seats and got parents to use them.

We educate people on how to drive while intoxicated. Another example is HIV/AIDS. the red line now we discovered HIV in the 80's and it quickly peaked. Since then we have decreased the mortality rate by almost 90% again, not by banning sex, we know that doesn't work, instead we used science, we found out that the virus created drugs with education. people about safe sex and reduce the stigma to allow people to create opportunities and hope for change now compare that to firearms that orange line, you all already know that firearm death rates are increasing and have been increasing inexorably since the early 2000s, why?

Not surprisingly, that is the time when the so-called Dickey amendment was passed, which effectively shut down federal funding for this public health approach to firearm injuries. In this graph, the gray line shows that for most illnesses and injuries the amount of federal funding is basically proportional to the number of people who die but gun violence falls outside the curve. Overall federal funding for gun violence research is less than 2% of what would be predicted based on the number of people who die each year. Imagine if I told you that there has been virtually no research on cancer, heart disease, or even car accidents since 1996.

You would be horrified and unsurprised if I told you that death rates are increasing. The same goes for gun violence. I'm not naive. and if you'll excuse the pun, I know there is no magic bullet to fix this gun violence, like any other illness or injury, it is complex and will require complex solutions, but using that four-step Public Health approach will work and allow us Taking into account our unique American context now, when we take this public health approach, we create the possibility of change. I have spent the last 10 years since I cared for that young man working with people all over this country, first doctors and nurses, now the general public. create a movement for change to address this as a public health issue;

When we do, we will create the potential to move beyond the old gun control versus gun rights debate and toward a new prevention narrative, a place where we can implement promising solutions like working with gun stores to promote safe storage or training. to health professionals to help their patients at risk or talk about shooting while intoxicated, which really exists. If we had had this approach ten years ago, I could have saved that young man from coming in. My emergency department could have saved the lives of those children at Sandy Hook and Parkland and the lives of the hundred people who died and the 200 who were injured yesterday. and the 100 more who will die and the 200 more who will be injured tomorrow, but I can't.

I can't do this alone. My network can't do this alone. It takes all of us, so I asked us to do three things. First, learn and share the facts. Things like what I said today. Two-thirds of gun deaths in this country are suicide there are modifiable risk factors and the public health approach works ii share your stories join me and my colleagues in bringing this epidemic out of the shadows and into the light where we have than to talk about it and find real change feel free to contact me as a third party Join us to take action Join us in this movement to talk about and change gun violence as a public health issue.

When we do, we can create unity, we can create real solutions based on facts, stories and evidence, and we can create hope for my children and yours thank you