Law enforcement officials in the Cleveland, Texas, neighborhood where a man allegedly shot five of his neighbors after they asked him to stop shooting in his backyard.
David J. Phillip/AP
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David J. Phillip/AP
Law enforcement officials in the Cleveland, Texas, neighborhood where a man allegedly shot five of his neighbors after they asked him to stop shooting in his backyard.
David J. Phillip/AP
More than four decades ago, Dr. Deborah Prothrow-Stith was working in an emergency room as a medical student when she realized that victims of violence were treated and released – unlike others patients – without any sort of preventative care.
“And one evening, at 3 a.m., a young man told me very specifically that he was going to go out and excise the guy who had injured him,” she says. “I thought it was not adequate. My response is not adequate. My profession’s response is not adequate.”
Prothrow-Stith played a key role in defining youth violence as a public health problem in the years that followed (her 1991 book Deadly consequences is considered a classic in the field). That means focusing on prevention efforts, not only in emergency rooms, but also in doctor’s offices and schools.
And guns are increasingly part of that conversation.
Prothrow-Stith, dean and professor of medicine at Charles R. Drew University of Medicine and Science in Los Angeles, remembers that when she started, stabbing was “the primary way that young men were killed” in Philadelphia. . The picture of violence has changed radically in just a few years.
“Guns in America play a huge role, especially as we begin to look at the availability of weapons of war and the mass shootings that are taking place,” Prothrow-Stith said. Morning editionIt’s Michel Martin.
The Centers for Disease Control and Prevention has recorded 48,830 U.S. cases. firearm deaths in 2021, latest year for which complete data are available. These include suicides – which have long accounted for the majority of gun deaths in the United States – as well as homicides.
Culturally, suicide is more common in white America and homicides more frequent in black America, notes Prothrow-Stith. But she emphasizes that violence in general is a learned behavior.
“You don’t come out of your mother’s womb ready to commit suicide or commit homicide,” she adds. “And I think as a culture, (we need) to understand that children who are hurt, hurt others or hurt themselves. And our job is not to give them a gun, but our job is to figure out how to help them heal.”
The role of guns in America, told by a doctor
Prothrow-Stith says it’s clear that guns turn “an everyday emotional situation” into fatal encounters.
“We know that sometimes people act differently when they have a gun in a situation, feeling invincible or escalating a situation they could otherwise deescalate,” she added.
And at least when it comes to adolescents, she says, there are some similarities in the contributing factors that can lead to homicide and suicide.
Most homicides are the result of arguments between people who know each other, whether they are family members, friends or romantic partners, she said.
“I remember some youth workers saying, ‘Well, it doesn’t surprise me that he killed someone because he didn’t care about himself, so why would he care about anyone? another one?’” says Prothrow-Stith. “If you think about it, not caring about yourself is a symptom of depression. It’s a symptom of a clinical illness and should be explored that way.”
What gun violence prevention could look like
How would prevention work from a public health perspective? Prothrow-Stith uses the analogy between smoking and lung cancer.
First there is primary prevention, which consists of informing the general public about the consequences of smoking. The second phase is to help smokers quit and the third is to treat people with lung cancer.
When it comes to gun violence, Prothrow-Stith says the first phase should be raising awareness and trying to increase safety.
The secondary phase involves understanding the risk factors. “How can we help children who are hurt, either because they are victims of violence or because they witness violence, particularly domestic violence or gang violence, on a regular basis?” she asks. “How can we help them heal from the anger, the guilt, the pain, but also give them the strategies to move forward?”
Programs like Big Brothers Big Sisters are a great example of secondary intervention because they provide children with distraction, purpose, and opportunity. Don’t underestimate the power of staying busy, Prothrow-Stith adds.
She tells the story of a high school student who, when asked how he stayed out of trouble, replied that he played football even though he didn’t particularly like it. Sports gave him an excuse to stay late and avoid late-night social events when necessary.
“He had developed his own strategies to deal with peer pressure,” she says. “These are things that are very, very important for kids ‘in the thick of it,’ if you will.”
Focus on what works: an assault weapons ban
Many people are accustomed to thinking of guns as a political issue rather than a public health issue. But Prothrow-Stith says a more productive way to talk about it would be to start where the United States has had success in the past: by banning assault weapons from 1994 to 2004.
Studies have shown a decrease in gun massacre deaths during the decade the federal ban was in effect — and an increase after it expired, which Prothrow-Stith attributes to the gun industry strategically “flooded the market” with assault weapons.
There are many more deaths in mass shootings when high-powered assault weapons are available, she adds.
“It’s like the movies and the sequel where more people are killed in the sequel than in the first movie with these assault weapons, these weapons of war,” she said. “We see more and more people killed every episode.”
In practice, guns are here to stay in the United States, Prothrow-Stith says.
“But we don’t need assault weapons,” she adds. “And I think we’re focused on that argument. And I think it’s a matter of time.”
Let’s return to the cigarette analogy. Prothrow-Stith remembers that smoking was ubiquitous and glamorous when she was a child, and it took about half a century after the first report of its health effects for the public to understand.
She is convinced that the United States will experience the same transformation with weapons. “It’s time again to address this epidemic, reduce our rates and move on,” she says. “We’ve done it before. We can do it again…just by making our children safer.”
Ben Abrams produced and Olivia Hampton edited the audio version of this interview.
