Guns & Weapons Do Not Belong in a Health Book -- Why are they here?

The Public Health Approach to Gun Control, by Bradley J. Foster, 11/6/98, gives and inside view on how this anti-gun anti-weapons approach has worked its way into our society.

SOURCE: http://mcrgo.org/mcrgo/doc_pdf/politics_public_health.pdf

EXCERPT:

On November 6th, 1998, I attended an all-day conference entitled "Guns and Kids: Shaping Public Policy, Protecting Public Health". This conference was sponsored by several groups, led by the Michigan Partnership to Prevent Gun Violence (MPPGV), the leading gun control organization in our state. The conference was a real eye-opener for me. It helped me to better understand the perspectives of some of the participants, highlighted a number of emerging threats to our gun rights, and suggested to me that we can be very effective in countering these threats if we go about it properly.

The conference attendees were primarily members of the professions of law, medicine, and public health. The unifying theme of the conference was the movement to view "gun violence" as a public health issue, and to address it through the application of traditional public health mechanisms. This approach is no accident. The public health approach has three advantages for anti-gunners: First and foremost, it cloaks civilian disarmament initiatives in a new mantle of respectability. Well-meaning but misinformed medical professionals, concerned mainly with preventing injury, lend their reputations and professional status to the misguided, ineffective, and destructive ends of the anti-gunners.

Secondly, the medical and public health establishments wield a substantial amount of political power. Doctors’ opinions on medical issues are naturally respected by political decision makers. Public health authorities may impose quarantines or ban foods or other substances based on threats of disease or other public health hazards. If "gun violence" comes to be viewed as primarily a public health issue, these people will be in a position to substantially influence or even completely bypass the normal political process with respect to firearms regulation. This is a dangerous state of affairs.

The third and most important advantage of this approach for disarmament activists is that it shifts the terms of debate from a philosophical and political issue based on individual rights into a series of technical cost-benefit analyses based on medical and public health considerations. I believe that even on these terms, proper analysis of responsibly gathered data will show that the benefits of civilian firearms ownership far outweigh the costs. We have seen the data to support this view in several works by Prof. Gary Kleck and Prof. John Lott. Nonetheless, it is critically important to remember that whatever the outcome of this sort of cost/benefit analysis, the issue of civilian ownership and use of firearms is primarily an issue of individual rights. We must never lose sight of this fact, nor allow our elected representatives to forget it. We hold the moral high ground in this debate. The disarmament activists know this, so they are simply trying to achieve their ends by other means.

In the remainder of this article, I will discuss my understanding of this movement and its participants, some of the specific threats it poses, and some possible courses of action we can take to minimize its negative impact on gunowners’ rights.

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The Public Health Approach

One of the speakers (Professor Stephen Hargarten, MD, of the Medical College of Wisconsin) outlined the "Public Health Triad", which seems to be a commonly-used model for understanding disease. The three parts of this triad are the host, the agent (or vehicle) and the environment. If you draw these as points on a triangle, you will have a schematic model of the way a medical professional approaches a disease. To treat the disease, one looks at the way these three factors interact, and finds ways to intervene to prevent the disease.

If we were speaking of a real disease, the host would be a person, the agent or vehicle would be the germ, and the environment the home, office, or wherever. To treat the disease, one might try to kill the germ directly with drugs, or one might try to alter the environment (say, by filtering the water or cleaning up filth), or one might try to make the host more immune (say, by exercise or vaccination).

In the case of "gun violence", they see the host as the person who is affected (this includes both the shooter and the person shot), the agent or vehicle as the gun and ammunition, and the environment as the home, school, or wherever the person is located. Because they view the world using this public health triad, they see it as perfectly justifiable to address any of these elements of the triad in their campaign to eradicate the "disease". The question of whether or not they have the moral right to interfere with these aspects of people’s lives simply does not enter into their thinking - they simply assume they have the right to intervene, and proceed to do so.

Just as we have seen radical changes in automobiles and driving habits over the past thirty years due to safety and environmental concerns, the participants in this movement aim to cause substantial changes in firearms and firearms usage, in the name of eradicating the "disease" of "gun violence". They view this as a "public health emergency", and will certainly use all the power at their disposal to effect the changes which they believe to be necessary. As part of his discussion, Dr. Hargarten spoke of the "public health approach" to dealing with public health issues. This involves four phases or steps:

1) Surveillance - Gathering data about the problem
2) Risk Factor Identification - Isolating specific causal or contributing factors
3) Intervention Evaluation - Figuring out what to do
4) Implementation - Doing it

A number of specific instances were given of how this can work in the context of "gun violence". For example, the data gathered by surveillance may be analyzed to show that a high number of 15-to-24-year-old males are shot on the street with small-caliber revolvers having barrels of 4 inches or less. With these "risk factors" identified, they may then evaluate the effectiveness and political feasibility of intervention at different points in the triad (educating the host, eliminating the agent, modifying the environment). In this case, they might attempt to get laws passed restricting ownership or production of revolvers with barrels shorter than 4 inches.

I know that we can all find the flaws in the reasoning in this scenario, and I do not intend to address them here. I merely include it to serve as a very real, concrete example of the results obtained by this mode of thinking. We can expect to see much more of it.

The other major speaker at the conference was Dr. C. William Schwab, Director of the Trauma Center at the University of Pennsylvania. His presentation consisted of a combination of heavily emotional appeal featuring descriptions of dead kids and pictures of bullets, and a variety of statistics designed to promote the view of "gun violence" as a public health emergency. His approach was to encourage medical professionals to view themselves as advocates within their communities, with the purpose of reducing the "epidemic of gun violence". I will not take the time or space here to try to detail his injury and death statistics, especially as I have only partial notes.

Three things about Dr. Schwab’s presentation bear repeating here, however. One is his focus on the cost of care for non-fatal firearms injuries. He placed this figure at $47M over a two year period in his city, with over 80% of that money being public funds. This cost can be a powerful lever for disarmament activists to use to influence politicians and justify government intervention, and that is exactly how they intend to use it. Another interesting fact was that he suggested that handguns should be the primary focus, as rifles and shotguns seem to have little impact on the numbers. Finally, he outlined a number of specific recommendations for policies, laws, and further actions, which I will cover in the "Specific Threats" section.

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