The young man was a walking target, and he knew it. The police chief had just told him so. And so had the county prosecutor, the sheriff, a federal prosecutor, a reverend minister and one or two reformed ex-cons.
But as he walked out of an Akron courtroom on a summer afternoon last year, what was gnawing at the young man was not so much that the full force of law enforcement would descend on him if he made one false move. A bona-fide gang member, he knew, more or less, what came with that territory: the physical and emotional violence — the gun play, the knifings, the beatings, the threats to family and friends and prison — if he survived.
The newness in what he had heard that afternoon, the reality he hadn’t quite grasped until then, had to do with the health dimension of violence for those who survive his choice of recreation. Along with the law-enforcers, a retired ER physician had been present at the session that afternoon, explaining with clinical precision some of the common consequences of trauma — gunfire, specifically — on the human body. Patching up a body ripped by bullets comes with risks: infections… the progression of bed sores…paralysis and/or loss control of body functions… colostomy bags …. loss of independence. …
It was understanding the burden of a life thus diminished by violence that got through to him.
A slow dawning, we might say.
But the gangsta’s failure to comprehend is ours as well on a larger scale. As communities, we have been just as slow to comprehend fully the prevalence of violence and the burden it imposes as a public health challenge for everyone. Deaths and injuries stemming from violent behavior, whether it is directed at the self or others, cost billions of dollars a year in lost productivity and medical care. Many survive suicide and homicide attempts, domestic violence and child abuse, but their injuries continue to take a physical, mental and emotional toll often requiring extensive care. It is so much easier to understand an outbreak of chicken pox or mumps on a college campus, for instance, as a threat and a cost to public health.
Last month, the Senate derailed the nomination of Dr. Vivek H. Murthy to fill the vacant post of U.S. surgeon general. The opposition to Dr. Murthy, led by the National Rifle Association, argued the doctor was an ideological activist, who would use the authority of the office to push “radical gun control measures.” Such radicalism as proposing a federal ban on the sale of popular semi-automatic firearms and ammunitions; a buyback program of these firearms; and removing restrictions on gun-violence research and data collection by the Centers for Disease Control and Prevention.
“The American people deserve a surgeon general who will carry out the mission of the office unmotivated by political or ideological goals,” the NRA informed Senate leaders in a letter.
Incidentally, as early as 1979, the U.S. Surgeon General’s office issued a report in which it identified violence as a public health issue, one of 15 priority areas the nation ought to be concerned about. The following year, the Department of Health and Human Services set national goals to reduce violence, with a 1990 target date. The goals called for reductions in the number of privately owned handguns, deaths and injuries stemming from child abuse, suicides among young people, especially black males, between the ages of 15 and 24, and more reliable data on child abuse and family violence. Surgeon General C. Everett Koop, in 1985, made violence prevention a national focus, convening a Workshop on Violence and Public Health and issuing a call to action to public health professionals to address the issue.
During these 35 years, models have evolved that allow the incidence and prevalence of violence to be examined as public health questions: What causes violent behavior, who is at risk (as victim or perpetrator), how does it spread and why does it become “endemic” in some areas, what strategies work best to break or to prevent the cycle?
Firearms take up a big part of the discussion about violence because they are so lethal and the weapon of choice in so many situations. But the notion of violence as a public health concern encompasses deliberate actions that subject people to injury and death.
The American College of Physicians last week released a position paper in which it said physicians have “a special responsibility to speak out on firearm-related injuries and death,” just as they have on other public health issues.
How radical of them to rally to the call to prevent violence in the name of public health.
Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at firstname.lastname@example.org.