Gun violence can be reduced through public health policy [column] | Local voices

Like many, I followed the heartbreaking news from Buffalo, New York, and Uvalde, Texas. You can’t browse gunviolencearchive.org without getting overwhelmed. Mass shootings – many apparently motivated by anger and hatred and noteworthy not just because they were committed using semi-automatic weapons – are now an epidemic.

A writer of a letter to the editor made a comment that struck me: we can do nothing about anger and hatred. Presumably this writer is speaking from a place of exasperation that are not heard and understood.

I observe frustration in friends and colleagues and in patients I see as a family doctor. What we offer to each other is this: we can and should cry. We need to reach out to those we love and also to those we don’t yet know.

Hate arises from fear, and to dispel it we must try to understand one another.

And to find solutions, we also need to be objective. About 21,000 Americans died in 2021 from gun violence (excluding suicides). In 2019, about 1,600 Pennsylvania citizens died from gun-related violence. For comparison, around 1,000 Pennsylvanians died in a car accident that year.

While some say guns aren’t necessarily the problem, a 2017 systematic review identified 34 studies evaluating the effects of firearms laws on gun-related killings; concluded that national and state laws imposing background checks and requiring a permit to purchase a firearm were associated with decreased mortality.

Therefore, I implore and welcome legislative action to promote public security and common defense.

We should therefore consider what we are already doing that works best. One needs an initial physique to drive a car in Pennsylvania and an annual physicist to drive a bus or commercial vehicle. Therefore, completing an annual examination and filling out a form is a regular process to ensure that our buses are safe on public roads. Shouldn’t we keep those who buy a gun or ammunition on the same level as those who take our children to school?

There is a precedent. Some covert transportation laws and the Pennsylvania State Police Lethal Weapons Training Act require those serving in public defense to have a psychological exam before carrying a semi-automatic rifle. As a family physician in the Air Force, I have grown accustomed to completing these federal assessments as well.

In both the civilian and military spheres, psychological exams help ensure that anyone carrying a weapon, loading a payload, or otherwise working with our country’s or state’s defense arsenal is stable and safe to carry out the own work. This not only keeps colleagues and civilians safe, but ensures that appropriate treatment can be expedited when needed. Shouldn’t we give everyone, anywhere, whoever carries a gun the same opportunity we give to someone who wears a uniform?

Gun violence is a public health problem and therefore access to health care should be part of the answer. Therefore, those wishing or needing to purchase weapons and ammunition, especially semi-automatic weapons and magazines, should not face obstacles to the screening assessment.

The evaluation of people should be considered a public service and therefore facilitated as much as possible. Not only would this effectively help trigger red flag problems, but annual screenings would provide a first opportunity to identify people with mental health disorders who need assistance.

Finally, running background checks is currently discouraged; they are time-consuming and present the risk of losing business if potential problems are discovered. Why not flip that script? We recognize the trust we place in arms distributors and replace the role they play in our public safety.

A practical opportunity to balance this cost would be to eliminate federal excise exemptions on firearms and ammunition; Current exemptions from this sales tax include being a gun sales rep who sells less than 50 guns a year.

Are we not all willing, when we buy weapons for personal defense, to contribute also to the common defense?

Health services cannot eliminate anger and fear, but we can all try to listen and understand, and mental health services can address stress to help support our community. So patients need to have access to mental health services. Certainly, any intervention to curb gun violence could save lives, and we all agree that it would be priceless.

Dr Corey Fogleman is a local GP and Vice President of the Lancaster City Board of Health.

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