Gun Violence
A Public Health Crisis

Having worked in mental health and public health, I have seen the decay of both these fields in terms of prevention of mental illness. This is not to blame these fields, merely to point out that when politicians say mass shooting can’t be prevented nor predicted-I shake my head in disgust.
I have been trying to build a network of colleagues and professionals since the Aurora Theater Massacre. I was told that if I wanted to help, I could donate money to a Victims fundraising site.
Sad to say, we are all culpable for these mass shootings and violence in our society. This is going to take more than gun control laws. This is going to take a cultural paradigm shift. Everyone has been stretched to their limits, doing more with less for years. We have all become caught up in the rat-race of life. What is convenient for us, is not healthy for us.

Unfortunately, violence and mass shootings has become a solution for some. It has become a way to demonstrate power, act out rage and obtain fame and recognition. Media and social media are the avenues in which people can publicly one-up each other for all the wrong reasons.

Not to detract from the tragedies of rampage shootings, but I wonder if, from, a public health perspective, they are the right place to focus. My understanding is that gun violence as a whole is increasing and only an extremely small fraction is attributable to mass killings or rampages. Outliers are usually outliers for a reason and I am not sure they will have enough commonalities to make them a viable target for prevention. Does it make more sense to develop strategies and policies to target the outlier events or the more common but less notorious forms/causes/outcomes of gun violence? Are there realistically implementable strategies or polices which would meaningfully impact both the common forms of gun violence and the rare events?

China doesn’t allow private ownership of guns and the gun violence is very rare! Could there be a lesson?

Azevedo Fernandes, Jr.; MPH, PhD Research Fellow

COMMENTS – STATEMENTS

Not the guns kill people, not the weapons but rather the intention and the will power of our mind. Gun control will probably reduce in the number of incidences and their gravity but definitely will not stop. Weapons can be purchased as drugs are. Furthermore, they can be manufactured, improvised.

Education and row model – What we are actually facing its also an echo effect of humanity international armed conflict, a reverberation of the world wide violence under the label of war. Wars create public insecurity and a general distrust.
Violence in the movies – perpetuates human violence by feeding youngster’s brains from cartoons to the so call action movies.

Financial economy and money making – War means profits for the arms oriented financial interests. Guns and bullets mean income and profits. Public health means profits to health industry. The conflict of interest is very high. A small difference it makes in the moment when the family member of a major stockholder becomes the victim of such anthropogenic economy, but that is just a tiny noisy for a short time.

Solution: Observing the Bioeconomic principles and their gradual introduction into the economy, the adaptation of the financial economy to the natural economy that been around before mankind.

Questions:

1) What is your opinion, how do you see the above statements in relation to the public violence and the tragedies that our society at large is exposed due to our very own generalized misconduct?
2) Do you really believe that “gun control” will eradicate killings?
3) Who is responsible for such mental disorders that conduct to mass killings, the high suicidal rate and heavy alcohol and drugs consumption in the USA as well as worldwide?

Greetings to the entire The Forum at Harvard School of Public Health team !

Adrian Toader-Williams, PhD,
USA – ROMANIA – Full active member of the
International Academy of Science, Russian Section,
Moscow, Russian Federation

Where is Steven Pinker? Why is he not a participant? Violence is a straw man.

Gun violence is a symptom of a society that is addicted to quick fixes. Gun violence and really all violence is what people resort to, to solve their emotional pain. We are all part of the problem and will have to be part of the solution.

Not the guns kill people, not the weapons but rather the intention and the will power of our mind. Gun control will probably reduce in the number of incidences and their gravity but definitely will not stop. Weapons can be purchased as drugs are. Furthermore, they can be manufactured, improvised.
What we are actually facing it’s also an echo effect of humanity international armed conflict, a reverberation of the world wide violence under the label of war. Wars create public insecurity and a general distrust.
Violence in the movies – perpetuates human violence by feeding youngster’s brains from cartoons to the so call action movies.
War means profits for the arms oriented financial interests. Guns and bullets mean income and profits. Public health means profits to health industry. The conflict of interest is very high. A small difference it makes in the moment when the family member of a major stockholder becomes the victim of such anthropogenic economy, but that is just a tiny noisy for a short time.
We need to observe the Bioeconomic principles and their gradual introduction into the economy, the adaptation of the financial economy to the natural economy that been around before mankind.

Who is responsible for such mental disorders that conduct to mass killings, the high suicidal rate and heavy alcohol and drugs consumption in the USA as well as worldwide?

Adrian Toader-Williams, PhD,
USA – ROMANIA – Full active member of the
International Academy of Science, Russian Section,
Moscow, Russian Federation

EMAIL RECEIVED FROM ONLINE AUDIENCE MEMBER
Would each panelist identify gun control policies that pass these two tests:
1) They would make the United States safer;
2) They would be politically practicable, in the sense that the President can implement them himself by executive order, or they could realistically get through the current Congress?

Thank you very much. I look forward to the forum.

Rita Goldberg

EMAIL RECEIVED FROM ONLINE AUDIENCE MEMBER
Sirs:
I have three questions:
1. Where can one find reliable data on the circumstances surrounding deaths from guns? Specific examples would include
a. What fraction of deaths occurs between acquaintances? Between partners in domestic disputes? During the course of committing another crime? Suicide? Accident?
b. What fraction are committed by people with no prior criminal history (i.e. by “law abiding” citizens)?

2. What has the Supreme Court actually ruled with respect to gun laws?

3. What conceivable arguments are there for possessing large capacity firearms, like assault rifles or multi shot handguns?
Thank you.

Jim Butler, Dept. Env. Health, HSPH

what is the purpose of guns?
what are the positive and negative effect of guns?

Academic discussions of gun violence begin from the premise that more gun control laws are necessary. Rarely do speakers address current federal or state firearms laws. At what point will academics begin addressing gun law enforcement issues state-by-state rather than advocating new laws?

Why should the public health community play any role whatsoever in creation and enforcement of gun laws? If the public health community does assume a role in creation and enforcement of gun control laws, how will the community cope with those who will reject not just its gun control policies, but by extension *all* public health policies advocated by the community? I.e., what are the relative consequences indirectly associated with a public health gun control mandate?

I am a HEALTH teacher of DOMINICAN INTERNATIONAL SCHOOL, Taipei Taiwan. I thank you and Reuters for this opportunity to hear and watch this forum about gun policy. Restructuring US gun laws/ policies means a lot, the same way as promoting mental health. The public awareness about these strengthens the whole society to be vigilant and to take action against all forms of violence.

Are there legal impediments to bringing the cost of gun violence to the manufacturers and distributors of weapons? It seems crazy that pediatricians have to carry malpractice insurance but gun dealers don’t. Could we please sue Walmart for selling weapons of mass destruction that have been used to destroy lives.

As a RN that works in the emergency department in case management, the amount of violence from guns has become a common occurance. It is not a TV program that you can turn off and turn away… these are real kids, adults who are using deadly weapons they need not have. I believe that through well developed mental health assessements that I as a nurse or a social worker in the ED can perform with the patient or family and highlight pertinent questions related to the social functioning in the home including the housing and use of guns. This will at least help on the front end of healthcare along with providing a notification system to a larger database that can house potential patients that have mental personality disorders and access to guns and assault weapons. It is a pity that we must own guns at all. There are no excuses or reasons that can convince me they promote positive outcomes. They do nothing but kill.

I’m hopeful educated and informed authorities experienced with behavioral/mental health, active shooter, federal/state laws and firearms facilitate this webinar while providing valid and valuable information/data. Shall we focus and concentrate on the real problem and possible solutions? DRUNK DRIVING: We provide education, awareness and strict consequences for this behavior. We do not ban vehicles. WRITING: We provide education, awareness, reveiw and spellcheck. We do not ban pencils. A one-sided emotional discussion and reaction will only provoke alienation. One decision or rule/guidence will not be beneficial for all U.S. communities. Perhaps each community should be encouraged to form coalitions within their jurisdictions. Local, State and Federal Government can assist this effort through resources and legal authority to plan, train and respond how they believe is most applicable for their area

It occurs to me some “gun control” often means discouraging gun ownership (see some comments here, such as taxing bullets). This is reflected in some “strict” states laws and policies (e.g. MA increased licensing fees to $100, some local law enforcement licensing officials require doctor’s notes, others have application processing times that well exceed the 40 days in statutes. The list could go on).

Do you think this kind of legislation is effective in reducing gun violence and is the aim really to reduce gun ownership? I think the focus should be on public safety and reducing violence, not reducing individual ownership of firearms. Or would you agree with me that the latter focus has “fired up” gun ownership supporters and actually resulted in resistance to sensible public safety and legislation around guns?

I can tell you the focus on “reducing gun ownership for law abiding citizens” has upset me as a matter of public policy. The focus should be on keeping guns out of the hands of criminals, those with violent tendancies, irresponsible owners, and the mentally ill. I think we can achieve that if both sides of the debate came to the table with this focus and without the focus of eliminating gun ownership.

For reasonable consensus, I see two important concessions are necessary:
(1) PRO-GUN side needs to be open to sensible restrictions, background checks and gun tracing schemes that keep guns out of the hands of criminals and mentally ill
(2) ANTI-GUN side needs to (a) support the second amendment meaning an individual’s right to keep and bear arms (no fingers crossed behind the back) (b) agree to end abitrary (and often capricious) licensing policies used in the “strict gun control states” and especially large cities (= support “shall issue” policies) (c) to protect in statute that tracing schemes will not be used to confiscate law abiding citizens’ guns

What about a stronger focus on early childhood and mental health? Are there early childhood social and emotional learning programs or mental health screening and assessment tools that could be used/utilized in schools to help behavioral development early on to identify children who could benefit from mental health support?

Also, thinking more along the lines of school climate, what is the current and future role of bullying prevention programs in preventing school violence at the early childhood, middle and high school levels?

Let me get a bit more legal. First, we know from Heller that Scalia believes the second Amendment is not without limits. We also know that Scalia, Thomas and their ilk on the Court are strict constructionists—that the words of the constitution mean what they say when they were penned. Given this as background, has anyone looked at what the Second Amendment means when it says, “the right to keep and bear arms shall not be infringed”. The key here is the very last word, infringed. If anyone on this chat is a wordsmith, the infringed is meant to abolish, to destroy, to take away; it never was meant at the time to be inconvenienced, as we look to it now-a-days when speaking about having background checks, limiting magazine sizes, etc. Thus, even if we cede the argument to gun right advocates that the Second Amendment allows those outside the militia to have firearms, where is it that we can bear them but without some reasonable inconveniences?

Let’s face it. In 2008 and 2010 the Supreme Court, showed complete lack of responsibility to the American people, and succumbed to the NRA pressure (money) to let stand an outdated (222 year old) amendment without adding any sorely needed relevance for our modern society. In doing so, they ignored public safety and empowered the the NRA and others to make “meaningful” recommendations to curb gun violence by arming EVERYONE.

I am not a fan of guns; however, I respect the 2nd amendment and the reason for its existence. People should have the right to defend themselves. While we could limit the kinds of guns sold and to whom they are sold – as well as ammunition, I do not believe that making guns illegal or even drastically changing our gun laws will contribute to less violence. It may, instead, disarm the good citizens and embolden the criminals. To make real change in our incidence of violence with guns or otherwise, we must return to traditional family units with strong moral values. Homes need to include a mother and a father. There has to be discipline and children need to have a sense of purpose. That purpose comes with responsibility. Too many children are growing up without the presence of fathers, without good role models and without guidance. It’s a basic breakdown in our society that has spread its roots to many, many areas and impacted them negatively.

I am anti gun control and pro 2nd amendment. The words “shall not infringe” mean nothing to politicians though. It’s not gun violence! It’s just “violence” and the only epidemic is the News Media’s selected coverage of only violence where a gun is involved. How about this… Instead of gun control why don’t we remove the glamorization of gun violence on television, movies, and video games? Why not work on reducing single parent families? Why not teach gun safety in schools? Why not get rid of all the toy guns off the shelves of family department stores? Because this isn’t an issue of removing violence from our society. They don’t want to get to the heart of the matter. They want to remove our rights, and disarm our citizens only. That’s the real underlying issue. Without guns, we go from citizens living in a democracy to subjects living under tyranny.

Regarding Dr. Fenton Earls comment that violence is “learned” and does not orginate in the brain, I would respectfully disagree to the extent that current research shows the issue of aggression & propensity for violence is more complex than any binary reductionist explanation.

In fact, multiple streams of evidence show that the link between aggression & violence can arise from interactions among a child’s early environment, quality of maternal care, genetic endowment and even epigenetic changes after conception and birth as the below summary article of some recent research into this topic shows.

Respectfully,

–Patrick Brady

Portland VAMC/Portland State University
Portland, Ore.

Childhood Trauma Directly Linked to Adult Aggression
Pam Harrison

Jan 17, 2013

Stressful experiences in early life are associated with higher rates of increased long-term aggression, a new animal study suggests.

Investigators from the Ecole Polytechnique Federale de Lausanne (EPFL), Switzerland, found that male rats that were submitted to fear-inducing experiences during the peripubertal period exhibited high and sustained rates of increased aggression in adulthood, even against unthreatening rodents.

Peripubertally-stressed rats also showed hyperactivity in the amygdala, a region of the brain involved in emotional reaction.

In contrast, the same rats exhibited little activation in the orbitofrontal cortex.

Previous research examining the brains of violent individuals has shown the same deficit in orbitofrontal activation and the same corresponding reduced inhibition of aggressive impulses.

“In a challenging social situation, the orbitofrontal cortex of a healthy individual is activated in order to inhibit aggressive impulses and to maintain normal interactions,” states Carmen Sandi, PhD, head of the EPFL’s Laboratory of Behavioral Genetics, in a release.

“But in the rats we studied, we noticed that there was very little activation of the orbitofrontal cortex. This, in turn, reduces their ability to moderate negative impulses.”

The study was published online January 15 in Translational Psychiatry.

Consequences of Abuse

It is known that violent adults often have a history of childhood trauma, but a direct link between early trauma and neurologic changes has not been demonstrated before.

Using a protocol researchers had developed in their own laboratory, 43 rats were repeatedly exposed to fear-inducing procedures during a developmental period resembling the interval between childhood and puberty in humans.

This period was specifically chosen because it is a time when significant maturational processes occur in regions of the brain important for emotion and cognition.

When the rats reached adulthood, researchers investigated brain activity along with brain region–specific changes in the expression of the MAOA and 5HTT genes, variants of which genetically predispose humans to aggressive behaviors.

“We found that the level of MAOA gene expression increased in the prefrontal cortex,” said Dr. Sandi.

Alterations in gene expression were also linked to epigenetic change — in other words, exposure to fear-inducing procedures during the peripubertal period caused long-term modification of expression of the MAOA gene.

The study group also found that treating the same peripubertally-stressed rats with an MAOA inhibitor in adulthood reversed stress-induced antisocial behaviors.

“This research shows that people exposed to trauma in childhood don’t only suffer psychologically but their brain also gets altered,” said Dr. Sandi.

“This adds an additional dimension to the consequences of abuse and obviously has scientific, therapeutic, and social implications.”

The authors have disclosed no relevant financial relationships.

Transl Psychiatry. Published online January 15, 2013. Full article

While I am usually no fan of Justice Antonin Scalia, I think it appropriate that we all be clear on his position. In the Heller case he stated in his opinion:

“Although we do not undertake an exhaustive historical analysis today of the full scope of the Second Amendment , nothing in our opinion should be taken to cast doubt on longstanding prohibitions on the possession of firearms by felons and the mentally ill, or laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, or laws imposing conditions and qualifications on the commercial sale of arms.

We also recognize another important limitation on the right to keep and carry arms. Miller said, as we have explained, that the sorts of weapons protected were those “in common use at the time.” We think that limitation is fairly supported by the historical tradition of prohibiting the carrying of “dangerous and unusual weapons.”

It may be objected that if weapons that are most useful in military service—M-16 rifles and the like—may be banned, then the Second Amendment right is completely detached from the prefatory clause. But as we have said, the conception of the militia at the time of the Second Amendment ’s ratification was the body of all citizens capable of military service, who would bring the sorts of lawful weapons that they possessed at home to militia duty. It may well be true today that a militia, to be as effective as militias in the 18th century, would require sophisticated arms that are highly unusual in society at large. Indeed, it may be true that no amount of small arms could be useful against modern-day bombers and tanks. But the fact that modern developments have limited the degree of fit between the prefatory clause and the protected right cannot change our interpretation of the right.”

Thus, the most conservative justice on the highest bench in the land sees no infringement to the 2nd Amendment in taking steps to keep criminals and the mentally ill from obtaining them, nor does he see limiting civilians from having access to military level weapons which are currently being marketed to civilians.

Madam and Gentle Folk Here Today:

To address the current tone of the discussion here as you have so generously done for us, it may be quite necessary to correct our course before we get off point and run afoul.

Setting the foundation of the discussion here is the key to intelligently discussing the matter at hand. Proceeding upon a supposition without a proper review of relevant points does not stand the house squarely upon the foundation. This obvious analogy here is that the lean to the left or the right will not assist us in a proper discussion, our point of reference is skewed and thus our persuasion, however though out may not be on point. And just like a house the skew will be obvious if not corrected and result in the collapse of the house. After all, it is not our individual agenda we discuss her but how our understanding and our ability to reasonably address the matter that is of value if we indeed think to do the right thing.

On the point of Justice Scalia’s reference to “arms in common use at the time” I must say this. Miller was addressing a challenge to the National Firearms Act. Justice Scalia borrowed the phrase for the Miller Court’s comments in this consideration alone. The justices at the bench referenced militia statutes that mandated individual members come to drill and muster prepared to repel an instant threat to security. As every infantryman was equipped in the regular army, so the militia member was to be equipped. This was the bare minimum required to report to muster with, thus the fine if the member failed to report, missed the drill or the muster or failed to report with a proper “kit”. Failure to report with the prescribed equipment is still an offense punishable under and “Article 15” non judicial punishment pursuant the Uniform Code of Military Justice. The charge is “failure to repair”. Pleas note: the ordinary solder does not drag along a canon or other heavy equipment when required to report for duty, even today.

Miller was attempting to address the question of what a militia type weapon was. The challenger of the NFA, Miller, stated as a defense that a shotgun regulated under the NFA was a proper militia weapon and thus exempt from the provisions of the NFA. The courts rationale in determining the validity of Miller’s proposition was to consider arms in common use by the militia at the time, thus the phrase used by Justice Scalia. Unfortunately Miller did not complete his challenge, the attorney did not present any showing to support the defense’s position and the Court ruled that “absent a showing that a sawed off shotgun was a militia type weapon the NFA would prevail. In short the decision was based upon a default. What Miller did not address and Justice Scalia failed to research, exhaustively, is that citizens, of the colonies at the outset of the Revolution, possessed field artillery. I know that this fact may be shocking to the conscious but we must examine the truth here in it entirety of become one of the many agenda driven irrational voices which seem so prevalent today.

Minute Man Park has on display a 3 Pound canon with the inscription describing the ownership of the gun, who it belonged to and the Order of the United States Government returning the gun to its owners “several citizens of Boston. The inscription goes further to describe its fellows “captured by the enemy” belonging to the Government of Massachusetts. Such a distinction was carved upon the gun and its brother, the Adams and the Hancock as they are named, in order to pay tribute to those citizens who bought with their own money a fierce weapon of war and furnish it to the militia.

The United States Maritime Museum sponsors a site and the site describes the efforts of a civilian navy during the Revolution. The Continental Navy had a compliment of 64 ships equipped with around 1200 mounted canon and swivel guns. The civilian navy with privately owned and armed ships numbered in excess of 2000 with a gun compliment of over 14,000 canon and swivel guns. These men upon the armed ships of private individual citizens harassed the British shipping and naval vessels keeping our supply lines open and the British Navy otherwise occupied until the land forces could be marshaled and defenses could be made as well as they could. Obviously the sheer number of canon aboard these vessels would astound the civilian population today but at the time they were ordinary equipment aboard ships. Those who do not have such a sense of our historical roots and the facts as they are may sometimes swayed by incomplete supposition and allusions to reason which are, shall we say, constructed in a vacuum. But the truth is and it must be always observed else we are swayed by unreasonable suggestions and smoky rationale.

As for the use and possession of “military type weapons” I may add that in each and every militia statute, the weapon required of the militia man was of the equal or better quality as the military and in some of the statutes, such as that of Ohio in 1788, required the militia man to have a bayonet with their other military equipment when they mustered or were called into service. In addition if the civilians were to be relegated to having less proficient arms that that of the military would they not be limited to bows and arrows???? Indeed the militias in the Civil War that were called to duty did not all show up with muzzle loading weapons and when the technology changed, so did their weapons that used complete cartridges and breach loading technology. I dare say that the National Guard, the current “organized militia” is not directed to use muzzle loaders or black powder weapons.

Of course one may take “dangerous and unusual weapons” out of context. But headsman’s axes have no more use in a military operation, or simple self defense for that matter, than a sledge hammer. Unwieldy, heavy and cumbersome they were a symbol of certain death by tyrants committed upon bound and helpless victims. One would be hard pressed indeed to press an offense against a militiaman armed with a musket or rifle and bayonet. Indeed Washington chose a militia unit to cover his retreat from New York because the militia unit all had bayonets, whereas the newly formed Continental Army did not. However, yes there were regulations concerning what was dangerous and unusual but no one carries those types of things in public to disturb the peace intentionally. At least I have not seen anyone carrying a headsman’s ax recently. I too would think it unusual. In deference to the Heller decision we need to remind ourselves of one thing. The Court does not give advisory opinions. Comments about what a person keeps at home for personal protection was the question before the Court, not military type weapons. It is not permissible to for young clerks to use opinion and dicta in citing a “decision” by a court. The comments of the court are irrelevant and immaterial in this matter. While the comments are sometimes used for persuasion, it is usually considered bad form to quote a comment out of context and of course there is no “stare decisis” president created.

The militia unit was “well regulated”, they were well practiced in drill and maneuver, force-which is the correct and historical meaning of well regulated. They are not the type of weapon to carry into the field and would have been equally disdained by proficient infantrymen in open warfare. To say that rocket launchers, machineguns, mortars and the like are unusual in modern societies is to disregard the fact that civilians possess them in other parts of the world. Civilians also possess them in this country, although they are heavily regulated. There are operational tanks, grenade launchers, field artillery and even armed helicopters owned by civilians. There are reenactment done in this country that use amphibious equipment artillery and automatic weapons fire recreating the Normandy Invasion. So the unreasonable reaction that disregards fact and the “scientific” resort to empirical evidence as proof is just that, unreasonable.

So you see resorts to popular sentiment and appeals to authority and emotion are as fallacious in Aristotle’s time as they are in the present. Indeed time may change but as we ascertain by observation, human nature has not. The crux of the matter may be as easy as educating our young people about the sanctity of life for every living thing and not to callously disregard an action before you consider the effect upon ourselves and the people we interact with. There is too much anger in society. Those who foment the emotion and stir action based upon anger and hate are as culpable as those who commit the act. The FBI reports that more murders are committed with everyday items than firearms. Firearms are not the cause or the affliction. The firearm does not point itself or discharge unless there is a human to direct it. The issue is human error not that of the inanimate object. Let us cure the disease not mere address one symptom out of the many. The failure to see ourselves in the other person’s position or consider their life as ours is the failure of the whole of society, not a piece of metal. We all, I hope, wish to live in peace. Let us not throw peace to the wind for some irrational reasoning and emotional bent. Let us see the common ground here, not devise a war between us.

I thank you all for your time and your and good manners in allowing me to comment here today. I hope that I have not offended any one. My reason for commenting is to present a correct and well founded position from which to discuss a matter that all of us are concerned with. Grave differences of opinion often create divisiveness when we all should be united. Terrible events like those which occurred at Sandy Hook should be unifying calls to action. We can certainly accomplish more with communicating our ideas and suggestions than attempting to gain the moral high ground based upon questionable premises.

Kindest Regards,

Dennis Jackson, B.S. LS, LMT,
P.O. Box 81272
Fairbanks, Alaska 99708
drjackson253@hotmail.com

It should be a criminal offense to disarm your workforce like they did at the Naval Yard. This shooting, by one account, took thirty minutes to conclude! In the first few seconds you have panic and shock, but after that someone should have been able to do something! We should be able to prepare for it, and then react when it happens. I even just read a book on it, Fight, Flight, or Hide, by John Forsythe, but I’m sure there’s lots of resources out there that would be just as helpful.