Firearm violence is being targeted as primary public health concern


From the epidemiologists who track death rates to battle-weary emergency room doctors and nurses who patch up wounded children, there is a growing movement to push new legislative, educational and political strategies to end gun violence.

The newly appointed head of the U.S. Centers for Disease Control and Prevention recently targeted violence as one of the major public health issues of the decade. In the past few months, several different groups have declared that they will campaign to attack violence with some of the same strategies that persuaded people to quit smoking and to buckle up.

The main goal is to get the guns out of homes and the hands of children. Among the strategies being considered are new taxes and laws to restrict access to guns or to ban certain types of guns and bullets.

Those strategies are likely to face tough opposition from the gun lobby, led the National Rifle Association, just as anti-smoking laws have been fought by the tobacco lobby.

"The goal is an ultimate ban on all guns, but we also have to take a step at a time and go for limited access first," said Joyner Sims, deputy commissioner in charge of injury control for the Florida State Health Department.

"Lawmakers are scared to death of this issue. If we create anger and outrage on a national level, it would really help the local folks."

Just as seat belts and air bags have saved lives without the need to improve anyone's driving skills, researchers say that making guns less plentiful and accessible would immediately cut the death and injury rate without the need to wait for solutions to the underlying causes of violence.

"Anything we can do to get guns out of the hands of children and out of homes would reduce the fatality rate," said Dr. David Satcher, who was named head of the CDC by President Clinton in August.

Across the nation, organizations and activists are taking up the cause to recast guns and violence as a public health issue.

Among them:

* A nationwide group of more than 100 associations -- universities, state health departments and the American Bar Association among them -- held its inaugural meeting in Chicago in October. The group, called the HELP Network of Concerned Professionals, is organized around a single issue: "to reduce the handgun epidemic by addressing it as a public health problem," according to its founder, Dr. Katherine Kaufer Christoffel of Children's Memorial Hospital in Chicago.

* Physicians for a Violence-Free Society was founded in January in San Francisco as a nonprofit organization dedicated to developing techniques that doctors and communities can use to prevent violence.

* The American Academy of Pediatrics has made the prevention of firearm injuries a priority. It has adopted a strong gun-control policy designed to keep guns out of the hands of children and to require that guns have trigger locks and an indicator that signals when the gun is loaded.

Activists also are taking lessons from the successes in the war against tobacco use.

Although information about the dangers of smoking helped reduce the percentage of adults who smoke to 26 percent in 1991 from 40 percent in 1965, it was the federal clean air laws that allowed nonsmokers to avoid second-hand smoke and finally made it so inconvenient to smoke that many people quit.

"Education is good, but it takes a long time, and it is very slow to show an impact," said Mr. Sims, of the Florida Health Department. "We need legislation."

Some legal experts believe that personal injury and product liability laws could be used to battle the gun industry.

For example, with sufficient research to determine the relative risks and benefits of owning guns, companies might some day be sued for false advertising if they marketed a gun for protection when research showed guns made homes more dangerous, some legal experts say.

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