Use public health models to reduce gun violence

Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.
-World Health Organization

When I was a child, I loved riding my purple bike up and down the street of my neighborhood. Boundaries were set as to how far and where I could go on my sidewalk excursions, the distance of about 3 city blocks. Boredom came quickly with the well-known landscape so late one summer afternoon, I ventured around a forbidden corner on my bike with a friend.

We were there just a few minutes when two teenage boys approached us and in a flashing moment one of them pulled out a gun, pointed it directly toward us and said “you’re gonna have to give me your bike.” In a haze, I defiantly said, “no” while tears streamed down my face.  He threatened to shoot us, but his panicked friend objected quickly and a conversation ensued between them about sticking to their original plan. We pleaded for our lives.  After some taunting, he took my bike and then both of them walked off.  I ran home, put on my pajamas and got in the bed.  A few minutes later my friend and her mom showed up at our house, informed my grandparents of the situation and then the police came.  We drove around the neighborhood in a patrol car, but we were unable to find the teenage boys who we had never seen before around our neighborhood.

It was my first time around the corner.  I lost my bike to a sense of vulnerability. The dangers that were alarming to my grandparents during the evening news showed up in our lives. Beyond bickering and street fights among older teens along with neighborly feuds from time to time the threat of harm and danger never seemed imminent to me at the time. I was more afraid of the very active beehive in our backyard.  My family and our neighbors helped us pull through; we all had conversations and then moved on with play throughout the summer. A few months after I got a new bike, but it could not replace what I had lost. The incident didn’t affect my sense of community or have a great impact my ability to thrive, but it’s a story that has remained with me.

Psychiatrist Carl Bell talks about “What Makes a Shooter Snap?” in a discussion on the recent violent rampage at the movie theater in Colorado. He affirms the need for inclusive communities as well as for trained professionals because he says “the more we can have people who are a bit quirky or strange or different be brought into the society and be tolerant and connected … the more that we can have people express themselves verbally and have an output, a way to tell people, look, I’m feeling badly, the less people have to act out.”

I’m thankful that the young guy with the gun standing in front me had a friend with whom he could talk and that he didn’t snap that day. I also remember thinking that without that gun those guys would have had to fight me for my bike.

Many years later when I as a young adult, the book Fist, Stick, Knife, Gun by well-known educator Geoffrey Canada gave me a framework for understanding some of the social context as well as culture of prevalent violence within inner city neighborhoods, which persists. In New York City more than 1,000 people have been wounded and 156 have died from gun shot wounds this year.  Hand guns do the most harm. When we follow the bullets and guns to understand more about the root causes of violence, we can create safer and healthier communities.

Did you know that young, economically productive people are most often the victims of violence?  According to the World Health Organization for every young person killed by violence, an estimated 20–40 receive injuries that require hospital treatment. Furthermore, the health impact of such violence is not limited to physical injury. Beyond personal disability, unsafe communities become immobilized, but like other forms violence, gun violence is not inevitable it is preventable. Dr. Gary Slutkin an internal medicine physician trained in epidemiology has applied an infectious disease model to stop the violence ( infection) at its source. In an award-winning provocative documentary “The Interrupters” you can see a public health model for treating “violence as a disease” and disarming fear in the streets. In Wrong Place, Wrong Time public health policy expert Dr. John Rich offers a lens to examine more closely the complexity of inner city violence through the stories of young black men who have survived incidents, it’s a primer for understanding more about the root causes of persistent, intractable violence one story at a time.

“Victory Over Violence” launched by faith and community leadership with public, private and media partnerships in the neighborhood where I grew up is now offering incentives to take guns off the streets. This effort also builds public awareness with the aim for reducing the potential for harm. What works in one place may not apply in another, but models are needed to address the rapid increase of gun violence rampant in our streets, homes, work places, grocery stores, movie theaters, house of worship, schools and on college campuses — exhausting 911, police and medical centers. The violence is devastating families and communities. Individual and organizational efforts will and should vary, but all the senseless bloodshed should move us to find out more about the triggers as well as to put an end to violence.

Katherine Ellington is a medical student who blogs at World House Medicine.

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