Public Health Report: Gun Violence as a Public Health Issue
By Rainaclare Sibal
Within the first half of 2023, there have been more mass shooting events, to be exact 198 as of May 7th, than days passed in the year, with the number likely having climbed by the time this story is released (Gun Violence Archive, 2023).
The definition of “mass shooting” differs depending on the agency defining it. The Gun Violence Archive defines “mass shooting” as an incident where at least four people are shot, injured, or killed, not including the shooter (Gun Violence Archive, 2023). Alternatively, the Federal Bureau of Investigation uses the definition for mass shooting as an incident where at least four people, including the shooter, are killed (Tiderman et al., 2023). The amount of lives lost and endangered no matter what definition “mass shooting” takes on leads to devastation that spreads beyond loved ones of victims, and at an accelerating rate that the American public is barely equipped to keep up with.
Mass shootings became the American phenomenon they are today after the shooting massacre in Columbine High School in 1999 (O'Rourke, 2023). A similar pattern plays out each time this occurs: media coverage leading to shock, outrage, thoughts, and prayers, according to O’ Rourke et al. with the University of Illinois at Urbana-Champaign (2022). This is followed by a push from loved ones and gun control advocates to do more, with prayers not being enough to answer the problem (O'Rourke, 2023). At the same time, anti-gun control proponents and pro-gun legislators defend the right to the Second Amendment (O'Rourke, 2023), with more discussion but little progress to actually address mass gun violence.
In 2023, a string of shooting events stand out. On January 6th, a 6-year old student shot his kindergarten teacher in his classroom in Virginia. On January 21st, at least 11 people were killed and 10 others were injured by a gunman in a dance studio near a Lunar New Year celebration in Monterey Park, California. Two days later on January 23rd, a former employee of a Northern California farming community killed at least 7 people and left several others severely injured in two sites in Half Moon Bay, California. The following month on February 13th, a shooter killed 3 people and injured 5 more on the Michigan State University East Lansing Campus. This was followed by another shooting at a private school in Nashville Tennessee on March 27th, when a former student killed 3 children and 3 staff members. On April 10th, 5 were killed and 8 were wounded by a former bank employee in Louisville, Kentucky. Less than 1 week later, 4 were killed and 28 were injured at a birthday party in Dadeville, Alabama. Recently, on May 6th in the second-deadliest mass shooting of 2023, a shooter descended on a shopping mall in Allen, Texas, where 8 were killed and 7 were injured (Gahan et al., 2023).
This list does not even begin to cover all of the mass shooting incidents reported in the Gun Violence Archive. The feelings of shock, worry, and grief with any mass shooting are so familiar to the American public because of the possibility of a mass shooting occuring at any time or place. This is why mass shootings must be taken seriously as a public health issue.
Dr. Georges Benjamin, executive director of the American Public Health Association, has stated, “We talk about gun violence but you have to think of guns as an epidemic of injury by firearms. That is the more practical way to think about this” (O’Rourke, 2023). A 2023 article from the American Journal of Health Education proposes an upstream-downstream model in addressing mass shooting events through a public health lens (O'Rourke, 2023). This article considers the similarities between mass shooting events to other public health emergencies by considering statistics illustrating the impacts on health. For example, the number of deaths related to firearms rose by 15% in 2020, reaching the highest number of deaths since the CDC started recording this data in the 60’s (O'Rourke, 2023). Consider the fact that the US outranks other countries with the highest rate of homicide by firearm among the highly-developed nations that have populations larger than 10 million people (O'Rourke, 2023). A particularly important result from a study conducted by the non-profit organization, Everytown for Gun Safety, found that the estimated annual lifetime cost related to gun violence was 280 billion dollars, all at the expense of survivors, families, taxpayers, and the community regardless of gun ownership status, according to O’Rourke et al (2023).
Furthermore, a recent publication by The Commonwealth Fund reported that black individuals make up the majority of people admitted to the hospital as a result of firearm injury, the group accounting for the largest percentage of hospital costs for this injury type (Gumas et al., 2023). They also addressed the fact that the South exhibits the most inpatient hospital stays, and overall largest percentage of hospital costs due to injuries by firearm over any other region in the US (Gumas, et al., 2023).
The downstream interventions to address mass shooting events are often targeted at healing the individuals who were impacted by seeing or experiencing the violence. But upstream intervention falls short in stopping many sources of mass violence. Since 1996, federal legislation has been in place that states the National Center for Injury Prevention and Control at the CDC must not use funding that is designated for injury prevention and control on advocacy or promotion of firearm control (Katsiyannis et al., 2023). Without the proper allocation of funds, there is a question about what exactly the federal government is doing to fund and crack down on mass shooting events, especially school shootings for which there is limited research. Important considerations taken from the dataset on Everytown’s Gunfire on School Grounds in 2021 showed that 58% of perpetrators were connected to the school in some way, 70% of the perpetrators were white males, between 70% and 80% received their weapons through their home or people they knew such as relatives or friends, 100% of perpetrators displayed warning signs or concerning behavior, and 77% of the shootings involved at least one person from the school knowing that the perpetrator planned the shooting in advance (Katsiyannis et al., 2023).
A 2022 study focused on the degree of acceptance of 114 parents on different types of interventions to prevent school shootings (Carter et al., 2022). There was a positive correlation in parental preference between the interventions of Threat Assessment, which consists of a team trained on various types of threats and appropriately responding to them, and Peer Evaluation and Response, also known as PEAR, Groups, which meet weekly to provide
recommendations to school administration about peers that may be undergoing issues in their lives or showing warning signs of violent behavior (Carter et al., 2022). This suggested an overall tendency for parents in the study to prefer mental health-related options as interventions to school shootings (Carter et al., 2022). If the CDC has restrictions on using funds for injury prevention and control on addressing gun violence in schools, there must be further action to use such funds to better equip schools with the resources to address mental health issues that can be a precursor to mass shooting events. This study also addressed the value in having parents involved in the decision-making process for school protection plans, especially in being able to call out weak spots that school decision-makers may not consider (Carter et al., 2022). Involving more than just administrators and politicians to the decision-making process is the crucial kind of collaboration needed in treating mass shooting events as the public health issue that they are.
The looming threat of gun violence and mass shooting events impacts everyone. Like any other public-health risk, intervention to combat gun violence starts with willingness to sacrifice political agendas to prioritize the preservation of lives and the improvement of community health.
This has been the Public Health Report. Thank you for listening.
References:
Carter, S. L., Crews, C., Lee, J., Li, X., & Noble, N. (2022). Acceptability of school shooting prevention procedures among parents. Journal of Prevention (2022), 43(3), 359–374. https://doi.org/10.1007/s10935-022-00671-6
Gumas, E. D., Gunja, M. Z., & Williams II, R. D. (2023, April 20). The health costs of gun violence: How the U. S. compares to other countries. The Commonwealth Fund. https://doi.org/10.26099/a2at-gy62
Gahan, M. B., Goldman, A., Tumin, R., Fahy, C., & McCarthy, L. (2023, May 6). At least 9 dead, including gunman, in shooting at texas mall. The New York Times. https://www.nytimes.com/2023/05/06/us/allen-mall-texas-shooting.html
Katsiyannis, A., Rapa, L. J., Whitford, D. K., & Scott, S. N. (2023). An examination of us school mass shootings, 2017–2022: Findings and implications. Advances in Neurodevelopmental Disorders, 7(1), 66–76.
O’Rourke, T. W. (2023). Reducing gun violence: Using an upstream/downstream incremental and public opinion approach. American Journal of Health Education, 54(1), 1–9. https://doi.org/10.1080/19325037.2022.2142707
Tiderman, L., Dongmo, N. F., Munteanu, K., Kirschenbaum, M., & Kerns, L. (2023). Analyzing the impact of state gun laws on mass shootings in the United States from 2013 to 2021. Public Health, 215, 100–105. https://doi.org/10.1016/j.puhe.2022.12.001