Parkland shooting – UAB Institute for Human Rights Blog

We Beretta Do Something: Gun Violence, Public Health & Their Discontents

doctor-gun. Source: spacecoastdaily.com, Creative Commons

Continuing the Institute for Human Rights’ blog series on gun violence, this contribution illuminates a public health lens, offering an evidence-based analysis and pragmatic solutions to the U.S. gun violence epidemic.

Following the February mass shooting at Marjory Stoneman Douglas High School (Parkland, FL) that resulted in 17 fatalities, mainstream fervor on U.S. gun violence has, once again, returned. Parkland Students have utilized their recent tragedy as a platform to demand an end to gun violence and mass shootings, stressing why their lives matter. According to Amnesty International, the world’s largest grassroots human rights organization, U.S. gun violence is a human rights crisis. Human rights are protected and enforced by international and national policy, and with the U.S. government marshalling many of these treaties and laws, it is, too, culpable of upholding such rights.

The nation’s leading science-based voice for the public health profession, the American Public Health Association (APHA), claims gun violence is one of the leading causes of premature death in the U.S., killing over 38,000 people and injuring nearly 85,000 annually. Gun violence can not only affect people of all backgrounds but disproportionately impacts young adults, men and racial/ethnic minority groups. Recently, Parkland Students teamed with students in Chicago to address inner-city gun violence, a phenomenon commonly overlooked by the media while addressing its threat on young lives. Though most gun violence is not an agent to mass shootings, the APHA claims, in 2017, there were 346 mass shootings in the U.S., killing 437 as well as injuring 1,802.

Furthermore, the American Medical Association (AMA), who leads innovation for improving the U.S. health care system, labeled gun violence “A Public Health Crisis”. At their 2016 Annual Meeting of House Delegates, the AMA actively lobbied Congress to overturn legislation that averts the Centers for Disease Control and Prevention (CDC) from researching gun violence. The CDC is one of the leading institutions of the Department of Health Human Services (DHHS), working 24/7 to protect Americans from foreign and native health threats, whether they be chronic, acute, curable or preventable, accidental or intentional. Ultimately, the CDC protects U.S. national security and critical science is imperative to addressing health threats.

According to the Union of Concerned Scientists, a 1993 CDC-funded study published by the New England Journal of Medicine found that firearms in the home increased the risk of homicide in the household, as opposed to home protection. This galvanized the National Rifle Association (NRA), a major force in U.S. gun rights and education, to campaign against the CDC and its “anti-gun propaganda”.

In response to this 1993 publication and the NRA’s support, Congress in 1996 passed an appropriations bill known as the Dickey Amendment, named after former Arkansas congressman and NRA member Jay Dickey, which states, “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Almost two decades and thousands of tragedies later, Dickey renounced these restrictions in 2015 by claiming, “Research could have been continued on gun violence without infringing on the rights of gun owners, in the same fashion that the highway industry continued research without eliminating the automobile.” Despite this humility, the Dickey Amendment persists, curtailing efforts to address gun violence in the U.S.

a picture of a Beretta handgun — Beretta 9000S. Source: James Case, Creative Commons

In the U.S., a common method to circumvent the argument that guns extrapolate acts of violence is to scapegoat people with mental illness. The American Psychiatric Association (APA), the leading voice and conscience of modern psychiatry in the U.S., recently published a book on gun violence and mental health. Specifically, they address the topic of mass shootings and mental illness.

Some popular misperceptions are:

Mass shootings by people with serious mental illness represent the most significant relationship between gun violence and mental illness.
People with serious mental illness should be considered dangerous.
Mass shooting will be effectively prevented with gun laws focusing on people with mental illness.
Gun laws focusing on people with mental illness, or a psychiatric diagnosis, are reasonable, even if they perpetuate current mental illness stigma.

On the other hand, it is evidence-based that:

Mass shootings by people with serious mental illness represent less than 1% of all annual gun-related homicides.
People with serious mental illness contribute to an overall 3% of violent crimes. An even smaller percentage of them are found to involve firearms.
Laws for reducing gun violence that focus on the previously mentioned 3% will be extremely low yield, ineffective, and wasteful of resources.
The myth that mental illness leads to violence is perpetuated by gun restriction laws focusing on people with mental illness, as well as the misunderstanding that gun violence and mental illness are strongly linked.

However, a significant caveat related to mental illness and gun violence is suicide. The American Foundation for Suicide Prevention (AFSP), who funds research and offers education on suicide, claims depression is one of the most treatable psychiatric illnesses yet is seen in over 50% of people who die by suicide. Suicide lays in the shadow of repetitive, media-frenzied mass shootings, while representing nearly two-thirds of gun-related deaths in the U.S. Harvard University T.H. Chan School of Public Health indicate a number of factors that define lethality of suicide methods, including inherent deadliness, ease of use, accessibility, ability to abort mid-attempt and acceptability — all attributable to gun ownership and usage, specifically in the U.S. To strengthen civil discourse on gun-related deaths and injuries, we must uphold a national platform for suicide prevention, too. If you or a loved one is experiencing a suicidal crisis or emotional distress, the National Suicide Prevention Lifeline is 1-800-273-8255 (available 24/7).

Last year, researchers at Johns Hopkins University School of Medicine analyzed data from the Nationwide Emergency Department (ER) sample between 2006-2014 and concluded the U.S. accumulates an annual $2.8 billion in hospitals bills from gunshot wounds, with an average ER cost of $5,254 and approximately $96,000 in follow up care per patient. This study was limited because data was only used for gunshot victims who arrived at the hospital alive; people who did not seek medical treatment or were dead on arrival were not counted. Furthermore, after accounting for lost earnings, rehabilitative treatment, security costs, investigations, funerals, etc., a 2015 Mother Jones report estimated gun violence cost Americans $229 billion annually.

The APHA insists gun violence is not inevitable but preventable, and suggests core public health activities are capable of interrupting the transmission of gun violence. Notable ways to curb gun violence are:

Better Surveillance
- Increased congressional funding of The National Violent Death Reporting System which is currently employed in 40 U.S. states, D.C. and Puerto Rico.
More Research
- Lifting restrictions on federal funding for research on gun violence. There is barely any credible evidence on the effect of right-to-carry laws.
Common-Sense Gun Policies
- Criminal background check on all firearms purchases. This includes gun show and internet purchases.
Expanded Access to Mental Health Services
- Funding for mental health services has declined, so increased financial support for the Substance Abuse and Mental Health Services Administration (SAMHSA) is advised.
Resources for School and Community-Based Prevention
- Intervention and preparedness programming to prevent gun violence and other emergencies in communities, namely schools.
Gun Safety Technology
- Innovation that prevents illegitimate gun access and misuse such as unintentional injuries.

If the above prescriptions are not followed, the tragedies will likely continue. So, it is imperative we support leaders who will encourage gun policy that protects public health and our right to life. Tomorrow, March 24, 2018, people across the world will March For Our Lives, demanding the lives of kids and families, amidst the controversy circling around gun violence, become prioritized.

A march for our lives, your life and mine is exactly what the doctor ordered.

The Responsibility to Protect, Revisited: Gun Ownership in the United States

Tennessee, Tennessee, Ain’t No Place I’d Rather Be

I grew up in rural Northeastern Tennessee, situated 30 minutes from both the Virginia and North Carolina state borders. In my hometown of Kingsport, itself a part of the Tri-Cities, I inherited many traditional Southern cultural mannerisms and beliefs as a growing kid. True to form, I can whip up banana pudding and biscuits and gravy, I sometimes use the word “ain’t”, and I will always hold the door open for others. Southern culture can be a simple one; try sitting on your front porch for the entire weekend – something we in Tennessee consider high entertainment. Tennessee made me a fan of great music (I’m an avid Bonnaroovian), a taste for delicious foods (ever tried Pal’s Sudden Service?), and a reverence of nature. My family, tried-and-true Southern kinsfolk, embody many Southern ideals. Most of these traditions, such as saying, “yes ma’am” and “no sir” are benign. These mannerisms just are – part of the charm of hailing from the South. Tradition is quintessentially Southern.

A photo of the author's family farm in Tennessee. — “Tennessee.” Photo by: Nicholas R. Sherwood

Part of a traditional Southern rearing is a respect for and knowledge of firearms. Almost all members of my extended family know how to operate these weapons using proper gun safety measures. I recall many afternoons as a child refining my marksmanship. This often involved setting up targets (nothing fancy, soda cans would do) across long pastures in the various farms my family owns. All the cousins and our parents would gather ‘round, grilling ribs, searing vegetables, and baking buttery breads. We swam in muddy ponds and hightailed across our properties in four-wheelers. All the while, the children, teenagers, and adults would take turns practice shooting a variety of revolvers, magnums, bolt-action rifles, and muzzleloaders.

This is a Sherwood tradition- we all know how to responsibly fire a weapon.

In my family, gun ownership is a serious endeavor. I vividly remember my uncle and my dad explaining to my sister and me that guns can and do often kill other human beings. To own and operate a gun is to have access to an awesome power, and we only used this power under the strict supervision of properly-trained adults. Firing a gun required two things: every person on the property was safely accounted for and our parents knew beyond the shadow of a doubt that we were mature enough to grapple with the destructive power in our still-growing hands. Today, I am thankful for being desensitized to firearms. I can watch someone shooting a gun and know if they have good or poor form, how to properly handle the weapon, and have the maturity to wield it. Most of the Sherwoods have taken at least one, if not several, Tennessee Hunter’s Safety Courses. This too was crucial to our firearm education. Additionally, many of us have Conceal & Carry permits. This is not to say the Sherwood clan only buys guns just to keep them; we have several avid hunters in our ranks. For us, hunting is a sacred tradition with specific rules we abide by. I was taught never to overhunt in an area – disrupting animal populations would wreck local ecosystems. Thankfully for us, East Tennessee has an overpopulation of deer, meaning local hunters can bag and tag a regulated amount of these animals without destroying the Tennessee natural ecology. In fact, by hunting excess deer, wild apex predators are kept in check and the vegetation deer overconsume is conserved. Descending from a long line of Cherokee Native Americans, instilled in every Sherwood is an understanding that we, like our ancestors, have a responsibility to care for the land around us. Hunting is part of that responsibility.

A Portrait of the Responsible Gun Owner

With this upbringing in mind, when acts of mass gun violence rip through the social fabric of America, I am thrust into a dissonant space. How do I reconcile my upbringing of responsible gun ownership with the dire need to regulate these weapons – for the safety of all Americans? Parsing through these issues, the Institute for Human Rights is currently running a series on gun control in response to the horrific massacres of school-children throughout the United States. It is my intention to show that responsible gun owners do exist, and they too must be a part of this conversation. Moving towards reconciliation of these two issues, public safety and private liberty, I have these questions:

What is responsible gun ownership?
Is it a regulatory process that educates the general population on gun safety protocols or an ethos of responsibility? Is it both?
Does gun control involve federal law, perhaps barring ownership from individuals with moderate to severe psychopathologies, histories of criminality, or a lack of maturity to handle weapons?
Is gun control a responsibility to protect the gun owner from his or her own mistakes in handling the weapon, or is gun control a responsibility to protect society at large from individuals with the sole intent to do as much damage in the least amount of time?
How do we reconcile the responsibility to protect the most defenseless members of society with the responsibility to protect freedom of thought and behavior?
What institutions bar authentic and transformative debates from occurring in the American public sphere and within global civil society at large?

What is undeniable is this: no productive and sustainable progress in gun control will take place without the inclusion of responsible gun owners within the conversation. And all gun owners must accept that governmental limitations on gun ownership is not an existential threat to one’s personal liberty. This limitation is a recognition that an individual’s participation in society requires a widening of responsibility to protect not only one’s immediate family and friends but also the protection of all members in a society. What we are facing here is a tension between individual liberty and the need for a cosmopolitan protection of all members within a society. To resolve this tension, we must first acknowledge that a solution is indeed possible, and that we already have the necessary tools to move towards successful resolution.

Towards this end, we must first define an oft-nebulous construct: responsible gun ownership. I propose a “responsible gun owner” possesses the following qualities:

a working knowledge of local, regional, and national laws that dictate the possession and usage of any and all types of firearms,
a vetting by official state authorities (such as the local police and / or military personnel) on said knowledge of gun possession and usage,
is of sound mental health (yes, this advocates for universal mental health background checks upon purchase of any firearm),
constant usage of a locked gun safe that prevents children and other unqualified persons from accessing firearms,
has undergone a rigorous criminal background check, with a waiting period before firearms can be purchased, requiring an utter absence of violent and harassment-based crimes, such as stalking and intimate partner violence,
an acceptance that gun ownership will always be a contested issue that must be resolved through constant dialogue between all invested parties with concessions on all sides,
a commitment to solution-focused resolution rather than a problem-focused resistance to negotiating gun ownership.

This last point is especially salient. Any meaningful conversation on gun control must arise from a negotiation between second amendment advocates and gun control advocates.

Too often (on both sides of the spectrum) the prevailing narrative of this discourse is a blanket denial of the rights, responsibilities, and needs of all involved parties.

Specific institutions promote this denial and antagonism, thereby promoting a particularly insidious form of structural violence and resistance to civil dialogue. I speak specifically of the National Rifle Association.

“NRA” by Bart, Creative Commons.

The National Rifle Association’s Culpability

In the aftermath of the massacre at Marjory Stoneman Douglas High School, the National Rifle Association (NRA) participated in a town hall on gun policy in America. In attendance were survivors from the high school, Senator Marco Rubio, local politicians, and the NRA’s spokeswoman, Dana Loesch. Ms. Loesch, a one-time contributor for Breitbart News and Glenn Beck’s The Blaze, relied heavily on her familiar stumping strategy: invoking the maternal instinct as an emotional appeal to advocate for gun ownership. She and other members of the NRA assert a broad dissemination of guns throughout American society (their opinion of who deserves such weaponry is inconsistent, to say the least) is one of the most promising methods to protect children and other marginalized groups in America from the “people who are crazy” who possess guns. Essentially, the NRA argues more guns in society increase the chances that “good guys with guns” will deter or kill the “bad guys with guns”. This is, of course, tautological.

Flooding the market with guns would increase the likelihood that these “crazy” people get ahold of a firearm. After all, the NRA has made no serious attempt to advocate for mental health reform in response to calls for tightened gun control. The ‘mental health’ argument has long been a smokescreen of the NRA, a method of distraction to bait the normally health-promoting left a fight on mental health care reform. This bait-and-switch technique is a political gambit used by an inherently political institution, and it does a disservice to responsible gun owners throughout the United States.

Furthermore, it duplicitously reduces individuals with mental health issues to be political pawns; this reduction is utterly dehumanizing and offers no solution to the massive structural issues facing access to mental health care in America.

These theatrics add to the antagonism on both sides of the issue. Of course, a critical question remains regarding why such controversy exists: who stands to benefit from these bitter feuds? The answer is overwhelmingly politicians.

Millions of dollars of contributions from the NRA have fundamentally altered how politicians are able to fundraise, which politicians receive adequate funding to mount serious campaigns, and (this is most concerning) when or if a given politician will advocate for common-sense, widely-supported gun control policies in the face of unspeakable tragedy. This puppeteering is, by its very nature, anti-democratic and antithetical of American ideals. This ability to openly buy politicians, including Presidents of the United States, is an existential threat to American democracy. Add in the suspected ties to Russia and the political jockeying on display during CNN’s Town Hall, and you have a political institution that effectively and openly operates as a site of political nepotism and deception. Topping it all, the National Rifle Association has been linked to white supremacy ideology and it’s spokeswoman, Ms. Loesch, accused of encouraging violence as an acceptable form of response for critiquing the NRA. This dimension of intentional structural violence transforms the NRA from an institution not only engaging in political bribery, but also one that reflects tendencies of homegrown terrorism.

In my opinion and personal experience as a responsibly-trained gun user, the National Rifle Association functions a terrorist organization stoking fear and tribalism, thereby driving responsible gun owners away from the debate table on this issue.

Support for the NRA is a moral failure to denounce election-buying, white nationalism, and foreign meddling in the American political system. This support is an abject failure to protect American society from treacherous forces undermining a functional society, and this failure is far beneath the maturity and discipline typically shouldered by responsible gun owners throughout their mastery of weapons capable of both indiscriminately murdering and responsibly nourishing.

Conclusion

As I have stated, responsible gun owners do exist. These individuals see the inherent danger and power in firearms and acknowledge that controlling this power requires specialized education, careful observation, and highly specific locations where guns may be appropriately used. Responsible gun owners must hold other gun owners responsible, whether leading by example or calling out inappropriate practices as they occur. This responsibility extends not only to other gun owners, but to the American public as well. The conversation on gun control requires an intentional suspension of disbelief from both camps in order to find a middle ground in the issue.

I assert responsible gun owners have the moral responsibility to inclusively and adroitly address the legitimate calls for disarmament in the face of such abject horrors and losses exemplified by the recent school shootings throughout America. Without genuine participation in this exchange, gun owners lose the opportunity to educate the public on successful encounters between liberty and responsibility, and they may well lose their firearms as a result. An unwillingness to come to the discussion table with open ears and clear heads will result in the marginalization of responsible gun owners unless they are willing to make strident concessions in the ongoing debate of gun control. Similarly, gun control advocates must accept that responsible gun owners do exist, and these individuals have a constitutional right to bear arms.

The only way the mayhem will stop, the only way lives can be saved, is if both sides accept the only way towards a meaningful and equitable solution for all involved parties will require an intentional partnership to confront and transform the meaningless violence that currently terrorizes the safety of many Americans – most notably schoolchildren.

The first step in this partnership must be a resounding denunciation and deconstruction of the practices and ideologies of the National Rifle Association. You are not a responsible gun owner if you support the NRA in its current form. Only once the NRA has been disbanded, its latent ideology of political radicalism reconciled, can authentic encounters between gun control advocates and responsible gun owners reshape the horrifying trends of gun violence currently annihilating the safety and wellbeing of schoolchildren and marginalized groups throughout the Unites States.

Where Do We Go From Here? An Event Recap

On Wednesday, February 28, the UAB Institute for Human Rights hosted Dr. Samantha Nutt, founder of War Child, to talk about her experiences working in war zones. During her conversation entitled “Where Do We Go from Here? Stories from the Frontlines of the World’s Major Crises”, Dr. Nutt covered topics from ranging from personal stories from her time in Somalia to gun violence statistics in the United States. You can read more about her background here.

The illicit and licit automatic weapons market is incredibly saturated in Somalia and the United States. In this post, I argue that this oversaturation and easy access creates a gateway for violence.

Dr. Samantha Nutt at the UAB Hill Student Center Ballroom — Dr. Samantha Nutt. Source: Tyler Goodwin, author.

Recap

The talk began with Dr. Nutt explaining how she began working in warzones – she was a volunteer doctor assigned to work in one of the world’s most dangerous countries, Somalia. She was contracted by an organization who was unable to pay her more than one dollar for her services, yet she decided to go anyway. To this day, Dr. Nutt carries with her the four quarters she received as payment.

Living in Somalia, Dr. Nutt met many people who considered this crisis area as their home. She told the story of a woman named Edith, who was a single mother who came to Dr. Nutt for medical assistance. The first time Dr. Nutt met with Edith, she was told of when Edith attempted to take her newborn child to the medical facility that was down the road. On the way there, she was ambushed by a group of boys armed with firearms who would not let her pass until she paid them a toll even though she possessed no money. As a result of being denied access to the medical facility, Edith’s child died due to malnutrition.

After suffering the loss of her child, Edith asked, “Do people where you are from know what is happening? Do they know what we go through?” Dr. Nutt replied with “I am afraid not.” On the international black market, an AR-15 can be purchased for ten dollars or less apiece; this happens in Somalia and many other states, according to Dr. Nutt. The AR-15s found in Somalia are commonly made in the United States. Upon further research, Dr. Nutt revealed that other women in surrounding villages were blockaded from accessing medical facilities by young men wielding guns as well.

Dr. Samantha Nutt giving her lecture with gun violence statistics in the background — Dr. Samantha Nutt with gun violence statistics. Source: Tyler Goodwin, author.

“Globally, we are currently spending about $249 per person on war; that is twelve times more than what we spend on humanitarian assistance across the world.”

Glancing at the statistics, one may assume that, globally, we prioritize the sale of guns and military weapons over the safety and welfare of humans. At home and abroad, we are quick to sell a rifle but question whether or not humanitarian action is necessary at every turn.

Dr. Nutt told of another visit by Edith, immediately after Edith was subjected to an act of violence. Dr. Nutt was in her office with her phone, laptop, water, and other items an average American would consider a necessity. Edith pointed Dr. Nutt’s possessions and said, “all of this is for you. We die for nothing.”

Addressing the faults of a failed state is necessary. Ignoring these issues perpetuates cycles of violence we see in war-torn Somalia, which causes Edith and countless other people to lose their families and threatens their very existence. Education provides the tools to combat issues that threaten peace. With knowledge of what is happening in Somalia, we are indirectly fighting for Edith and the other Somali citizens that say they “die for nothing.”

“We begin to tip the balance in favor of peace when we question the institutions that infringe upon it.”

Dr. Nutt also presented on the massacre in Parkland, Florida, where seventeen high school students were murdered. She mentioned the gun used in the Parkland shooting was the same grade as the ones commonly used in Somalia to block access to health facilities. Bangalore and Messerli of the American Journal of Medicine argue that the easier it is to access firearms, the higher the chances of violence are. With the average price of an AR-15 being about ten dollars on the black market, it is safe to say that these firearms are easily accessible.

In Dr. Nutt’s recent post on the Parkland shooting titled “The Kids are not Alright,” she calls for legislative action within the United States by citing other nations’ gun control legislation:

“…every developed nation that has imposed stricter gun control in the wake of mass shootings saw a precipitous decline in mass shootings and other gun related deaths. In Australia mass shootings dropped by 93% percent after a successful government gun ‘buy-back’ program following the 1996 Port Arthur massacre, which saw 35 people slaughtered. In the United Kingdom, after strict gun control measures were introduced in the wake of the Dunblane massacre of 15 kindergartners, there has not been another mass shooting in the 22 years since. Gun homicides have dropped to one third of their former levels. In Canada, a country with looser gun laws than the UK but tighter controls relative to the United States, gun related homicides are 8 times less per capita than the country’s southern neighbours.”

We have seen the Parkland shooting survivors gather support across the nation and assemble at our nation’s capital. By calling for change, they are calling for their form of peace. This is not to say that all gun owners disrupt that peace, but a military grade assault rifle should not be available for purchase on the black market for ten dollars and should not be available to purchase at your local Wal-Mart.

Dr. Nutt concludes by stating, “It does not matter how much you give, it matters how you give.” In her post mentioned above, she says, “Political candidates who openly advocate for gun control need financial and volunteer support. And those who resist gun control measures should be actively and consistently opposed, until NRA endorsements and contributions are seen as politically toxic.”

Human rights education gives us the tools to prevent acts of violence and teaches us how to fight against it when we see it. Like the students of Parkland, it is our duty to fight for our peace both at home and abroad. By fighting against the oversaturation of guns and regulating the market here in the United States, we can hope that the number of guns circulating through the black market, and ultimately Somalia, will decrease. As human rights activists, it is our duty to fight for peace. So, where do we go from here? We go toward peace.

Peace sign — peace. Source: Ken Swinson, Creative Commons

“Invest in peace, not war.”

To see more upcoming events hosted by the UAB Institute for Human Rights, please visit our events page here.

Disclaimer: emboldened quotations were provided by Dr. Samantha Nutt on the February 28, 2018 IHR Event.