Why Democrats are calling gun violence a 'public health crisis'

At the Democratic National Convention, Democrats have called gun violence a 'public health crisis.' What are the policy implications of reframing the issue this way?

It's no surprise that former Vermont governor and physician Howard Dean spoke of the importance of access to health care at this year's Democratic National Convention. Perhaps more telling was that Dr. Dean, who received the highest possible rating from the NRA during his tenure as governor, called gun violence "the ultimate public health crisis" in the United States.

Dean's framing of the issue as a public health crisis reflects a broader shift in US society as it attempts to deal with the prevalence of firearm deaths, as well as a shift in the Democratic party's willingness to make gun control a major political issue. 

"We're seeing a major shift in the Democratic party, and a real adoption of a public health language to talk about guns," Adam Winkler, professor of law at the University of California, Los Angeles, and author of Gunfight: The Battle over the Right to Bear Arms in America, tells The Christian Science Monitor.     

Gun violence: a public health issue? 

In June, the American Medical Association made headlines for calling gun violence in the US a public health crisis, an assessment that received criticism from conservatives. But some researchers say the classification can help change society's thought on how to go about addressing the issue. 

"Framing it as a public health crisis expands how you view the problem and, therefore, approach it," Daniel Webster, the director of the Center for Gun Policy and Research at Johns Hopkins University, tells the Monitor. 

Since gun violence represents "an epidemic," the classification is important, says Sandro Galea, the dean of Boston University's School of Public Health.

"It says that we as a society want to see gun violence as something we should act on for the sake of improving health, separate from the many public discussions around values that color this issue," he tells the Monitor.  

Gun violence, especially urban gun violence, mimics a contagious disease, Webster says. It follows the same patterns of contagious diseases, spreads across locations, and occurs in groups who have relationships with each other. The public health approaches also allow consideration of the overlaps between gun violence, substance abuse, and mental illness, using data "to drive our understanding of the people and places of greatest risk, of how to make changes that are geared toward prevention." 

One prevention-based public health strategy, for example, employs former felons to do outreach to gangs, encouraging them to resolve conflicts without guns, Webster says. 

However, the Centers for Disease Control and Prevention has not funded a study aimed at reducing gun violence since 2001. An amendment to legislation blocks research on gun violence by the Centers for Disease Control and Prevention if the studies "advocate or promote gun control," which has effectively stopped the CDC from gun research. The AMA has announced it plans to lobby Congress in hopes of changing the rule. 

"There are many things we need to do, but one of the most basic is to understand the causes, and protective measures we might adopt," Rep. David Price (D) of North Carolina, who has called for the CDC to research gun violence, tells the Monitor. "This is something the CDC most certainly should be researching."

Even if the CDC could research gun violence, Webster says the federal government would still not dedicate enough funding to adequately address the problem. An average of 297 people are shot every day in the United States, 89 of whom die, according to the Brady Campaign to Prevent Gun Violence. This adds up to over 108,000 people shot each year and 32,514 people who die from gun violence. 

A drawback, Webster says, is that the complexities of public health may make the approach harder to communicate to the public.

"For some people, it's a little less intuitive, to think about gun violence as a public health problem," he said. "People are used to thinking about it principally as a criminal matter, and public health is sort of a complex field. People don't really understand public health all that well."  

However, there are successful precedents for using public health and law enforcement approaches in tandem, such as the decrease in drunk driving fatalities. When it comes to gun solutions, the current system is too focused on law enforcement and incarceration, he says.  

"The public health approach is much more nuanced, realizing, more than anything, we're trying to change behaviors," Webster says. "You can change behaviors without putting people away for decades of their lives."  

Democratic Party's Evolution

The Democratic Party gathering in Philadelphia this week has a very different outlook on addressing gun violence than the Democratic party of the past. 

Many Democrats, including former President Bill Clinton, have seen the push for gun control as having played a major role in the large electoral loses in the 1994 midterm election. Democrats have worried that support for gun control could alienate swing-state gun owners in states such as Ohio, Pennsylvania, and Florida.

"For many years, the Democrats thought to be competitive in tight elections on election day meant supporting gun rights and minimizing discussion of gun control," Winkler says.  

Even President Barrack Obama, after his first year in office, received an F rating from the Brady Campaign. Democrats would often speak more about gun rights than gun control on the campaign trail, including President Obama during both of his campaigns, Winkler says.   

Rep. Price says a number of his Democratic colleagues have changed their view on gun control as they have realized it is "unconscionable to not do what we can do in the way of reasonable measures." 

"On the Democratic side, we have a more receptive attitude now across our entire party to reasonable gun violence prevention measures, and that has to do with the evolution of the issue," Rep. Price says. "The public opinion has become even more positive towards things like background checks." 

Winkler said the 2012 Sandy Hook Elementary School shooting "fundamentally changed" the party's attitude toward gun control as President Obama made it a top priority.

The Sandy Hook shooting and others contributed to the creation of well-funded gun-control lobbying groups, including Everytown for Gun Safety, which is largely funded by Michael Bloomberg. This provides a political counterweight to the NRA that Democrats can turn to.  

The party has also begun to prioritize motivating its base over appealing to independent voters, Winkler says, prompting it to look again at gun control, which is "really motivating" the Democratic base right now. 

"Overall, I think the Democratic party has picked up on this because the general public has picked up on this," Rep. Price says.