Reducing gun violence through public health policy is possible [column] | Local voices

Like many, I followed the heartbreaking news from Buffalo, New York, and Uvalde, Texas. Can’t scroll without being overwhelmed. Mass shootings – many of which appear to be motivated by anger and hatred, and newsworthy not just because they are committed with semi-automatic weapons – are now an epidemic.

One letter-to-the-editor commented that stung me: We can’t do anything about anger and hate. Presumably this writer speaks from a place of exasperation that they are not heard and understood.

I witness frustration in friends and colleagues, and in patients I see as a family doctor. What we offer each other is this: we can and must grieve. We need to reach out to those we love and even those we don’t know yet.

Hate comes from fear, and to dispel it, you have to try to understand yourself.

And to find solutions, you also have to be objective. About 21,000 Americans died in 2021 from gun violence (excluding suicides). In 2019, approximately 1,600 Pennsylvanians died from gun violence. By comparison, about 1,000 Pennsylvanians died in car crashes that year.

Although some say guns are not necessarily the problem, a 2017 systematic review identified 34 studies assessing the effects of gun laws on gun-related homicides; he concluded that national and state laws mandating background checks and requiring a license to purchase a firearm were associated with decreased mortality.

Thus, I implore and welcome the legislative actions intended to promote public security and common defence.

We should then consider what we are already doing that works better. An initial medical exam is required to drive a car in Pennsylvania and an annual medical exam is required to drive a bus or utility vehicle. Thus, having an annual exam and filling out a form is a regular process to ensure that our buses are safe on public roads. Shouldn’t we hold those who buy a gun or ammunition at the same level as those who drive our children to school?

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

In the civilian and military spheres, psychological examinations help ensure that anyone carrying a weapon, loading a payload, or otherwise working with our nation’s or state’s defense arsenal is stable and safe to perform their job. Not only does this keep colleagues and civilians safe, but it ensures that proper treatment can be expedited if necessary. Shouldn’t we be giving anyone, anywhere who wears a gun the same opportunity we give those who wear a uniform?

Gun violence is a public health problem and therefore access to health care should be part of the response. Thus, those who want or need to purchase firearms and ammunition – especially semi-automatic weapons and magazines – should face no obstacles to pre-evaluation.

Individual assessments should be considered a public service, and therefore facilitated as much as possible. Not only would this help to effectively trigger concerns, but annual screenings would provide an early opportunity to identify people with mental disorders who need help.

Finally, conducting background checks is currently discouraged; they take time and carry the risk of losing customers if potential problems are discovered. Why not return this script? Let’s recognize the trust we place in arms distributors and supplement the role they play in our public safety.

A practical possibility of balancing this cost would be to eliminate federal excise tax exemptions on firearms and ammunition; current exemptions from this sales tax include being a firearms sales representative who sells fewer than 50 firearms per year.

Aren’t we all prepared, when we buy weapons for our personal defence, to also contribute to the common defence?

Health care services cannot eliminate anger and fear, but we can all try to listen and understand, and mental health services can manage stress to help support our community. Thus, patients must have access to mental health services. Certainly, any intervention to reduce gun violence could save lives, which we all agree would be invaluable.

Dr. Corey Fogleman is a local family physician and vice chairman of the Lancaster City Board of Health.

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