by Ashley Waddell
PhD Program in Nursing

Is reframing gun violence as a public health issue and strengthening the voice of health care providers in gun related policy discussions enough to shift the decades long National Rifle Association (NRA) induced gridlock funding gun violence research and common sense gun regulations?

The right to bear arms was among the first topics discussed in the third and final presidential debate.  As a nurse and a policy scholar this is a topic that holds specific importance to me.

Gun violence has an impact on individuals, families, communities and countries, and it has a secondary impact on the first responders and health care providers who confront the human suffering associated with such events.  According to the Brady Campaign to Prevent Gun Violence, on average 31 Americans are murdered with guns every day and 151 are treated for a gun assaults in an emergency rooms, this number essentially triples when suicides are included. This June, the United States endured the worst mass shooting in history, leaving 49 victims dead and another 53 injured at the Orlando Pulse nightclub. In a global context, the U.S. firearm homicide rate is 20 times higher than the combined rates of 22 other high-income countries. As a result, many health providers and public health experts began to reframe gun violence as a public health problem.

From a policy perspective, legislators are wondering what would work best to bend this curve of violence in our communities.  It’s a good question, and one that we have very little scientific information to inform. This is one of the significant ways in which the gun violence epidemic varies from other public health problems, because for the past 20 years the United States has not funded gun violence research. Since 1996, the Center for Disease Control, the primary public health organization in the United States, has not received any funding from Congress to support this line of research. This lack of a political will to support gun violence research is a remarkable success and reflection of the lobbying and political strength of the NRA. Working from a platform of a constitutional right to bear arms, the NRA has shutdown nearly all efforts to fund gun violence research and regulate gun purchases. However, the NRA’s positions and lobbying strength are not the problem here-I see the need for stronger counter positions, other groups rising up and providing pressure to end the unchecked power of the NRA.  Within the health care community, I believe we are starting to see evidence of this.

In 2013 President Obama nominated Dr. Vivek H. Murthy for Surgeon General. Dr. Murthy’s recommendation for common-sense gun laws to help curb what he described as a gun violence epidemic was enough to motivate the NRA to signal to congressional Republicans that their political careers were in jeopardy should they move forward with confirming Dr. Murthy resulting in a significant delay in his confirmation during the unfolding Ebola epidemic. However, the community of health care providers was in strong support of Dr. Murthy’s nomination, well recognized as an excellent candidate for the position, and spot on in his characterization of the impact of gun violence in society.

Days after the Orlando nightclub shooting the American Medical Association officially declared gun violence in the United States a public health crisis, committing to stand with the American College of Physicians and American College of Surgeons, in pushing for renewed gun violence research funding. The American Nurses Association also elevated its attention to this issue, asking all health care professionals, policymakers and the public to support meaningful gun control legislation at the state and federal levels. Members of these organizations, and of the professions that they represent should applaud the leaders of these organizations for taking a stand, and further join them in efforts to address the policy issues of gun violence research and gun regulations.

According to a December 2015 Gallup poll, nurses, pharmacists, and physicians were the top three most trusted professionals in the country, however this trust does not translate directly into political influence. Health care providers have direct experience handling the human devastation, pain, and loss experienced by individuals, families, and communities impacted by gun violence. When incorporated into policy discussions, such experiences can be a powerful way to inform decision makers, however health care providers must be willing to bring this information forward. We all stand to gain by shifting away from longstanding political realities related to gun regulation to a more balanced and comprehensive perspective–inclusive of the daily realities of the human devastation incurred by gun violence and the medical care that is needed to sustain and strengthen life after an injury. When joined with the voices of families and victims of gun violence, perhaps the political conversations on this topic can shift in congress, but it will take a sustained and united effort to counter the longstanding strength of the NRA.

During the debate the presidential candidates took distinctly different perspectives on the second amendment. Donald Trump wasted little time before acknowledging that he was proud be a strong supporter of one’s right to bear arms and to have the endorsement of the NRA. Whereas candidate Hillary Clinton stated that she also believes there is an individual right to bear arms, however she emphasized that this position was not in conflict with sensible, common sense gun regulations. During this critical election in U.S. history, all voters should consider the impact of gun violence in their communities and consider the candidate’s positions on these issues as they prepare to cast their ballots.

It remains to be seen if reframing gun violence as a public health issue will be a successful strategy is changing the political dynamics that have framed gun policy for decades. I argue that it has good potential, but will need the support and voice of health care providers, and community members alike.

Ashley Waddell, MS, RN is a doctoral candidate studying Nursing and Health Policy at the University of Massachusetts Boston. She is also a 2016-2018 Jonas Nurse Scholar and a lecturer at the university. Ashley has 15 years of experience working at Boston Children’s Hospital and has co-chaired the Government Affairs Committee for the Organization of Nurse Leaders for MA, RI, NH, & CT for the past four years.