The Unspoken Others: Reframing the Gun Violence Debate in Terms of Public Health

JEAN PHILLIP SHAMI—Framing is critical.

In the aftermath of the shooting at Marjory Stoneman Douglas High School, Americans across the country of differing views expressed their thoughts, prayers, and opinions concerning the shooting. Millions across the country joined together to march for more gun control in the United States.And with the emotions and advocacy came the numbers. 1 shooter—Nikolas Cruz. 1 gun—an AR-15 rifle. 17 victims—both students and employees. 18 school shootings nationally—just in 2018.

But one number went missing, and still continues to go missing when we talk about school shootings (or any shootings for that matter): the number of people who survived and were affected by the shooting, not just killed during the shooting.

Why does this number matter? Because it more specifically reflects the impact that one person with one gun can have on a community. It helps us better understand how impactful one gun can be in creating public health emergencies. It reflects the public health impact of unfettered access to guns and major shootings.

Consider Marjory Stoneman Douglas High School, a school of a little over 3,000 students and over 200 employees. That is 3,200 individuals alone. The students range in age from 14 to 19. These students and employees have siblings, parents, families, friends, and a community. If each of the 3,200 individuals connected to Marjory Stoneman Douglas High School are connected to two more people, that is over 6,400 individuals affected by the shooting. And that number is likely an underestimation.

6,400 individuals affected. Just from one shooting. Just from one gun. Just from one person.

Many of these people were fortunately left unscathed physically by the shooting, but their mental health, emotional state, and social functioning likely were not, whether temporarily or chronically. The trauma may result in major health implications and coststhat, if left unaddressed, will only compound over time. It could lead to lost productivity, increased mental health issues, and potentially more devastating acts (another gun shooting, for example).

In essence, one shooting quickly creates public health emergencies that are hugely expensive for individuals, communities, and society as a whole. In Florida alone, the cost of gun violence annually is estimated at $14.1 billion, a number that cannot be ignored. Some individuals will have the money and the ability to seek the needed care to recover from such a traumatic experience. Others will not. Some will go a lifetime untreated, left to cope with the emotions, pain, and trauma on their own.

The Secretary of the Department of Health and Human Services, through Section 319 of the Public Health Service Act, has the ability and arguably the duty to direct resources to confront and resolve known public health emergencies. The combined economic, social, and psychological effects of school gun violence alone urgently suggest that “a public health emergency . . . otherwise exists” with respect to gun violence in the United States. It is a public health emergency when 6,400 people could potentially go untreated. It is also a public health emergency when 3,000 children are traumatized at such a formative age. Its cause? One shooting led by one person with a gun affecting at least 6,400 people.

This is more than simply an issue of a school shooting, or gun control, or the Second Amendment. This is about the health, safety, and security of our communities, large and small. The schools we send our children to, the families we grow with, the social groups we associate with, and the communities we live in cannot properly function in fear of the danger of gun violence. This is about the protection of our future: our children.Congress—and the American people—can no longer sit passively, succumbing to the pressures of politics, personal motives, and harmful lobbying efforts. In the present climate, it makes public health sense to pursue gun control reform.

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