196: Gun Violence and Public Health

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Thursday, June 9th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

Every day, public health professionals work to protect and promote good health in the communities they serve—but what's their role in the drive to stop gun violence? A recent spate of shootings that have left dozens dead and even more injured across the U.S.

It's a topic that Vermont health commissioner Dr. Mark Levine has been thinking about for several years. He tells us how public health ought to respond in today's morning conversation.

As a public health official, what are the public health elements of this crisis in your view?

MARK LEVINE:

Well, you know, public health's role always is to protect and promote best health for everyone and to preserve life by decreasing preventable injury and deaths. So, broadly speaking, in this topic it means making sure guns don't end up in the wrong hands, conducting traditional public health surveillance, identifying risk factors and protective factors, and then what I like to call reframing potentially polarizing gun ownership regulations as true public health issues.

And this latter is really particularly important. So, one can apply media education and taxation strategies similar to what we do with tobacco. One can apply safety lessons from strategies similar to those used to prevent unintentional poisoning—like safe storage—and motor vehicle safety—like inspection, passive-inactive protections, licensing, and age requirements—investment in gun safety technology.

And then lastly, particularly focusing on schools, but also community-based prevention, establishing resources for schools like access to mental health services, programs addressing bullying, things of that sort.

JOHNSON:

What advice would you have for your public health colleagues as to how they might approach this issue in their jurisdictions?

LEVINE:

Yeah. So, whether you're at a state or a congressional level, I think it's really critical that public health be able to provide testimony and provide that reframing that I've described during this conversation.

I think using time-honored public health reliance on using the data and being evidence-based is critical: looking at the mass shooting data, providing that data in context with the far more common but equally tragic data on suicide by firearm—because prevention works for both crises and they are both concomitant crises, for sure—and then on proven safety standards and practices around responsible gun ownership.

And I think in public health we're always worried about our credibility, so being candid about where the evidence is strong but also where it's weak and also where it is still evolving—because we all know that there's been a lack of research funding as a consequence of the Dickey Amendment in past years. But certainly noting that there's still abundant great work that can be done that has scientific support.

JOHNSON:

You wrote an article about this topic two years ago. You were thinking about it then—what do you hope you'll be thinking about it two years from now?

LEVINE:

I'll be thinking about being able to use the data over this two-year period you're postulating and saying, "Have we made a difference?" What do we know now about the impact on suicide? What do we know about the impact of mass shooting events? What do we know about the impact on responsible gun ownership and has it actually had any negative consequences for those who feel they're responsible gun owners and want their rights protected? Using the data like we do public health all the time.

JOHNSON:

There's really no time to waste.

LEVINE:

Oh, the two years already that has gone by is wasted. I just hate to see any more time to waste.

We hear promising remarks from those in the Senate saying that they think they can arrive at some kind of negotiated agreement. I certainly hope they can have that and it be a meaningful agreement.

JOHNSON:

A new lifeline offering assistance to people considering suicide will launch next month and organizers want public health professionals to help get the word out.

Meighan Haupt with the National Association of State Mental Health Program Directors explains how the new 988 line will work.

MEIGHAN HAUPT:

For 988, when somebody calls they're actually getting immediate help. They're talking through an issue. It's more of a response system. If somebody needs a higher level of care after talking, then a mobile crisis response might be called upon. From there, a smaller percentage of people might need some crisis stabilization. But most of the calls can be resolved by simply talking it through by the initial call.

JOHNSON:

The line goes live July 16, but Haupt says it'll take some time to work out the bugs.

HAUPT:

Just because July 16 comes doesn't mean there's a light switch and that it's all perfect and all is glory. There's going to be a lot of work after that. So, we want to make sure that once it's operationalized, we make the changes that are needed. We look at what is needed in terms of is there anything missing? We need to give states time to really establish 988 and build out their systems.

So, it's going to be awhile before you're going to see public service announcements for 988 or marketing for 988.  

JOHNSON:

Even so, Haupt says public health agencies can help raise awareness that the line is coming soon.

HAUPT:

We would say it would be great for public health professionals to reach out to their state behavioral health leadership, and really have a coordinated effort with behavioral health leadership to ensure all stakeholders are aware of 988 and to ensure consistent messaging.

JOHNSON:

Haupt says her organization has created several implementation playbooks offering guidance to different groups involved with the 988 project. There's a link to the webpage in the show notes.

Finally this morning, ASTHO has a special event planned to honor Juneteenth. It features Ms. Opal Lee, known as the grandmother of Juneteenth. She'll be part of a webinar exploring the journey to equity scheduled for Thursday, June 16. Panelists will examine the impact of racism on public health.

The event starts at 1:30 p.m. Eastern time. Don't miss this unique opportunity to celebrate and contemplate the meaning of Juneteenth. Sign up using the link in the show notes.

That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.