Bioethics Forum Essay
Treating Gun Violence as a Public Health Threat: Not Exactly What We Meant
This week, the United States saw two momentous public health events. The first was the official recording of one million deaths attributed to Covid. The second was the 198th mass shooting of the year, in Buffalo, N.Y., by an 18-year-old white male.
Both the pandemic and gun shootings are threats to public health. Individual approaches to these problems are unlikely to be effective for very long. Many writers, including myself, have suggested that the answer to gun violence is to take a public health approach.
I raised this issue, in large part, because I had cause this week to review an article that I wrote after the 2012 Sandy Hook school shooting, in which 20-year-old Adam Lanza shot and killed 26 people, including his mother, and then killed himself. Like many writers and organizations, I considered mass gun shootings as a public health threat. However, a recent reading of my 10-year-old essay stopped me short:
“If there were an infectious disease that could be prevented with a side-effect-free vaccine, we would look askance at anyone who did not get the inoculation. In fact, if that disease could lead to the death of other people, then under public health law, one might be required to be vaccinated.”
I could not have been more wrong.
The idea of gun violence as public health threat or an epidemic has a different meaning today than it did in 2012, since we are in the third year of a viral pandemic. As I write, the U.S. faces another surge of Covid cases. With one million recorded deaths, only 77.7% of Americans have gotten a single dose of a Covid vaccine, in a time when fourth shots are recommended for many. Only two-thirds (66.5%) of us are fully vaccinated, fewer than half have received their first booster (46.4%). Whether we look askance at anyone who did not get vaccinated depends on our politics: liberals and Democrats are likely to see this as irresponsible whereas conservatives and Republicans are more likely to see refusal to be vaccinated as an exercise of freedom.
Last month, the 9th Circuit Court of Appeals—known as the most liberal court—turned down a mandate for prison staff in California to be vaccinated against Covid. New York City reached a high-alert level of Covid transmission this week and yet is only recommending indoor mask wearing instead of mandating it, which was the response earlier in the pandemic.
The reality is that we have treated gun violence as a viral pandemic. But rather than coming together as a nation and using the power of government to protect the public’s health, which is what I had thought would happen in a disease outbreak, we have treated Covid-19 the same way we treat gun violence—with thoughts and prayers.
Public health in the U.S. has been severely broken in the 21st century through funding cuts, workplace violence and threats against public health workers, and the politicization of collective action. Efforts to combat the Covid pandemic and gun violence have been anemic. The result is an “on our own” approach. People are left to decide for themselves which precautions to take, if any, against Covid. And it is up to individuals to protect themselves against gun violence. Children participate in active shooter drills, and bulletproof backpacks are part of back-to-school shopping. In both cases, rather than taking an upstream, public health approach, the U.S. puts the burden on the individual, which usually means that the most vulnerable (children, immunocompromised, lower socioeconomic status, disabled, elderly) are sacrificed.
The call for treating gun violence as a public health issue has been answered, just not in the way anyone suspected or hoped that it would be.
Craig Klugman, PhD, is the Vincent de Paul Professor of Bioethics and Health Humanities at DePaul University. @CraigKlugman