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Is gun bill a vital step or a nuisance? For: It's time to look at the cost to society and treat gun violence as an epidemic that needs a public-health approach.


SEVERAL YEARS ago, improperly cooked hamburger killed a child. It was a national news story. As a result, the public demanded action, and E. Coli, the bacteria responsible, slipped into our lexicon.

When an outbreak of a life-threatening illness occurs, citizens demand the public health system take action to protect our communities. Yet, when a child is shot because a firearm was not locked up properly at home, or a child is injured by a stray bullet, we sigh and say how unlucky that child was to be at the wrong place at the wrong time.

Although the gun culture maintains deep, mainstream appeal in our society, we must acknowledge that the number of firearm-related injuries and deaths is not just an issue of getting guns out of the hands of criminals, but also is a preventable public health disaster. The act of settling a conflict with the use of a firearm is socially unacceptable, but occurs even while society talks about teaching children and adults how to channel their anger and resolve conflicts without resorting to violence. Weighing the demand for access to firearms against the need to protect communities from the serious health menace they pose takes political strength and a greater public understanding of what is at stake.

Children and guns

Consider these facts:

* 1. From October 1993 through September 1994, 87 Maryland children were admitted to and released from Maryland hospitals for treatment of unintentional firearm-related injuries.

* 2. A 1990 study by the federal Centers for Disease Control and Prevention found nearly 20 percent of all students in grade 9-12 had carried a weapon at least once during the 30 days preceding the survey. Of those who carried a weapon, one out of 20 students carried a firearm.

* 3. Maryland has the third highest homicide rate in the nation for males under age 19.

* 4. In 1994, gunshot wounds killed 44 of our children under age 18, nearly four children a month. During the same period, 216 children were hospitalized with firearm wounds.

* 5. Firearms are used in more than 80 percent of the homicides in which teens are victims.

If we substituted E. coli bacteria or motor vehicle crashes for the words relating to firearms in the sentences above, the public outcry would be deafening.

Health care costs

When health care reform was at the forefront of our national agenda, much was written about the cost of violence to our health care system. The idea of health care reform on the federal level may have withered on the vine, but health care costs related to gun violence continue to cost each and every one of us.

Nationally, the cost of direct medical spending, emergency services and claims processing for victims of gun violence totaled approximately $3 billion, in 1992. In Maryland, the direct medical costs are estimated to exceed $40 million annually.

In Maryland, $40 million could completely immunize 75,000 children, provide all the women who deliver babies with enhanced prenatal care including home visits and still have money left over.

Nationally, lost wages cost approximately $34 billion. According to the U.S. General Accounting Office (GAO), approximately 80 percent of patients who suffer injuries from violence are uninsured or eligible for government medical care cost assistance. That means we all pay in the form of higher taxes and higher rates for care. Individual trauma centers lose millions of dollars annually, treating gunshot wound patients, threatening their viability and ultimately the availability of that level of care.

Lifetime medical costs for the average child hospitalized with a nonfatal gunshot wound exceed $27,000. Medical costs for some paralyzed or brain-injured victims exceed $1 million. The national annual costs of gunshot wounds of children ages 15-19 are nearly $19 billion.

In Maryland, firearm injury-related hospital in-patient costs alone from October 1993 through September 1994 cost public funds nearly $7.5 million. That is $7.5 million out of your pocket and mine.

Protection is the reason most people buy guns for their homes, and why most children carry guns. In turning to weapons for safety, we unwittingly put ourselves in greater danger. Firearm injury, like heart disease or cancer, has identifiable high-risk groups.

A gun in the home is 43 times more likely to kill a family member or friend than it is to be used in self-defense. Almost twice as many people are murdered during arguments as during robberies. Approximately 18 percent of the murders in Maryland take place during arguments. In 1994, approximately 36 percent of murder victims were killed by someone they knew. More women are killed by their partners than men are killed by their wives. The presence of a gun in an abusive relationship appears to increase the chance of death for both partners.

If those deaths were caused by an illness, wouldn't our leaders be at fault for failing to develop a prevention strategy to insure the public's safety?

Public health solutions

For the past 30 years, public health initiatives have changed our behavior to achieve better health. For example, we no longer accept drinking and driving and we have learned the value of wearing seat belts. Today, we have laws to enforce those common-sense injury prevention steps. We must do the same for firearms and the injuries caused by them.

Gov. Parris N. Glendening's legislative proposals would reduce the number of illegal firearms, educate our communities about ,, gun-related violence, and take guns out of the hands of criminals.

Mr. Glendening's proposals for reducing firearm violence have begun the public process necessary to make our communities safer and healthier. Marylanders can no longer afford to ignore the public health epidemic of lives lost and futures ruined. We have had enough.

Georges C. Benjamin, M.D., is Deputy Secretary for Public Health Services for the Maryland Department of Health and Mental Hygiene.

On Monday, 1,000 gun rights activists held a demonstration in Annapolis to protest Gov. Parris N. Glendening's gun control bill. The demonstrators demanded that the state crack down on criminals instead of gun owners.

The key provisions of the bill would do the following:

* Require Marylanders to get a license to buy handguns and to pass a firearm safety course.

* Limit handgun purchases from stores to one per person per month.

* Require criminal background checks and fingerprinting of those who buy handguns privately.

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