Recognizing Gun Violence as a Public Health Issue

Posted by Chetan Muram on May 21, 2015

On April 22, 2015 Dr. Vivek Murthy was officially sworn in as the 19th Surgeon General of the United States. At 37, Murthy is the youngest person appointed to the position. Despite his young age, Murthy’s impressive credentials are unmatched. Graduating magna cum laude from Harvard University, Murthy earned a joint medical and business degree from Yale University. Murthy soon took on a position as a physician at Brigham and Women’s Hospital in Boston, USA and as a faculty member at Harvard Medical School.

As a student and a professional, Murthy has devoted much of his energy towards public health initiatives. He was a founding member of Swasthya Community Health Partnership, an initiative to train rural Indian women as healthcare educators and providers, the founder and president of VISIONS Worldwide, an American non-profit organization aimed at HIV/AIDS education, and the co-founder and president of Doctors for America, an organization of physicians and medical students advocating to ensure quality, affordable healthcare is accessible to all Americans. Armed with this impressive resume, Murthy seemed practically tailor-made to be the Surgeon General, the doctor of America.

Despite his notable accomplishments, Murthy’s nomination faced serious opposition due to his stance on gun control in the United States. In 2013, as president of Doctors for America, Murthy co-authored a letter advocating for immediately enacting stricter gun regulations in the US, framing the matter as a public health issue. Overwhelming evidence points to the extremely high rates of preventable gun violence in the United States. Each year more than 32,000 American die from gun violence, more than 2600 of whom are children. Drawing analogies to the successful public health approaches adopted that significantly reduced deaths from motor vehicle accidents, fire and drowning, Murthy’s letter argued that the issue of gun violence should be addressed in a similar manner. Adopting a public health approach involves recognizing the threat that guns pose to the health and safety of the American people, and introducing policies, programs and educational initiatives to combat this. For example, Murthy argued that universal background checks should be introduced to ensure guns and ammunition are kept out of the hands of dangerous individuals. Murthy has continually affirmed his position on gun control, recently stating “whenever large numbers of people are dying for preventable reasons, that’s a public health issue”.

The most vocal opponent of Murthy’s nomination was the National Rifle Association (NRA). The powerful pro-gun lobbyist unsuccessfully sought to have Murthy’s nomination blocked. The NRA has long opposed stricter gun control measures that limit access to firearms, holding that such measures do not address the real concerns such as the broken mental health system or the failure to prosecute criminals. The NRA objected to Murthy largely because they said the Surgeon General should promote health initiatives based on empirical, scientific evidence, as opposed to personal ideological convictions.

By advocating for stricter gun control, Murthy is acting just as the NRA says a Surgeon General should act. Empirical evidence supports Murthy’s position that stricter gun regulation will help to reduce the extremely high gun-related homicide rates in the United States. In certain US cities, the homicide rates are comparable to some of the most violent countries in the world, such as Honduras, El Salvador and Guatemala. According to Daniel Webster, director of the Center for Gun Policy and Research at Johns Hopkins University, lax gun laws may be “the most important determinant” of unusually high homicide rates in the US, since rates of non-lethal violent crime, adolescent fighting and mental illness in the US are comparable to those of other developed countries.

The NRA has also argued that the stricter gun control measures would lead to the confiscation of firearms from law-abiding citizens. Despite what the NRA and other pro-gun advocates suggest, Murthy is not seeking the outright prohibition of gun ownership. Rather, Murthy believes it is possible to strike a balance between addressing the public health concern that gun violence poses, while also respecting the legal and constitutional rights of Americans to possess firearms. Murthy proposes strengthening safety measures and regulations surrounding the purchase, transfer and operation of guns to ensure that they do not fall into the hands of people who could be of grave danger to themselves and others. Such an approach would introduce universal background checks on all people purchasing guns or ammunition, mandatory waiting periods for the purchase of firearms, limits on the purchase of ammunition and improved policing of areas with high levels of gun violence. Murthy is not alone in this matter. In his 2004 book Private Guns, Public Health, economist David Hemenway tackled the issue of gun violence by framing it as a preventable disease afflicting the United States. Hemenway, similar to Murthy, argued that stricter gun control laws are not meant to be anti-gun, in the same way that introducing motor vehicle safety regulations are not meant to be anti-car.  Checks and controls should be introduced to ensure that guns are used and distributed in the safest manner possible, mitigating the fatal violence for which they are too often responsible.

Lenient gun control laws are so deeply entrenched in the United States that introducing regulations of any kind will undoubtedly be an uphill battle. Murthy has said that while issues such as obesity and related chronic diseases will be his major focus, the issue of gun violence will not be taken off his agenda. A Surgeon General willing to address the epidemic of gun violence as a matter of public health is certainly a positive step towards reducing the thousands of preventable deaths caused by guns in the United States each year.

Chetan Muram is an intern at Lawyers Collective and JD Candidate at the University of Toronto.