FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

GUN VIOLENCE

Question: I am saddened, angered and enraged by the amount of gun violence that occurs in our country. The tragic death of the Florida teacher, Barry Grunow, is an example. My doctor doesn't know if I have guns in my house or not because he has never said anything to me about them. Shouldn't he and all doctors take a more active role in addressing the serious risks that firearms pose to our health?

Answer: Firearms do certainly pose a significant risk to our collective health. In 1997, the most recent year for which the Centers of Disease Control and Prevention have statistics available, there were 32,436 firearm-related deaths in the U.S. That averages out to about 89 deaths every day. Certainly the death of teacher Barry Grunow was tragic, but so were the other deaths. I think it is important to keep this senseless loss of life in perspective with other preventable causes of death. There are more than 40,000 deaths each year from motor vehicle accidents and also 20,000 each year from influenza.

We physicians almost never address motor vehicle safety, seatbelt use, or firearm safety during usual adult health-care visits, although we may ask about medically related preventive measures such as immunizations. There are a number of reasons this is so, but the most important is that the majority of us will die of disease -- most likely stroke, heart attack or cancer -- rather than from gunshot wounds or automobile accidents. Certainly, all of us would like to eliminate accidental deaths from firearms as well as purposeful murders. We physicians could take a more active role in educating our patients about these health risks. Many, and I hope most, pediatricians talk about firearms in the home when they speak with parents about safety issues for their children. This is important because individuals age 15-24 have a substantially greater risk of being killed by this form of violence. And, young black men have a 10-fold increased risk when compared to the general population. Obviously, lots of changes are needed to improve these dismal statistics.

I think there are several areas in which we physicians can help reduce the risks of firearm related deaths -- and I don't think any of them involve the current "feeding frenzy" of legislation proposed by the anti-gun politicians. What it involves is education. Physicians should tell their patients who own a firearm to keep it secured in a locked cabinet when it is not in use. This is not to simply protect children in the home, but also to reduce the risk of theft and subsequent use in crimes. It is best if the weapon is additionally made inoperable, if practical, to further reduce the risk of accident. As an example, the bolt from a rifle should be stored in a different locked cabinet from the rest of the weapon. In addition, the ammunition should not be stored with the gun.

Most gun-related injuries don't result from accidental discharge of a weapon. Instead, these injuries are inflicted as part of the commission of a crime. The most important preventive measure for this type of violence is vigorous prosecution of all those committing crimes with firearms. I think stiff sentences for first offenders -- regardless of age -- when no injury occurs, and life in prison for second offenders or any time there is personal injury would drastically reduce the problems with firearm violence.

Obviously, there are many social, cultural, economic and legal issues involved in gun-related violence. The ultimate success of any potential solution is dependent on taking all of these factors into consideration. Personally, I'm convinced that a solution can be found to this epidemic if we as citizens talk to one another and, if our prosecutors and legislators will debate this issue without resulting to the emotionally charged and highly polarizing rhetoric of the "must have" and "can't have" zealots.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.