Enforcing gun control requires more than public health policy

Enforcing gun control requires more than public health policy

Things went according to a now-familiar script: On Sunday, April 22, 2018, a white man with a history of mental illness and previous run-ins with law enforcement drove into a Waffle House restaurant in southeast Nashville, Tennessee. , and opened a restaurant. He opened fire with an AR-15-style rifle, killing four people and injuring several others. Grieving families, activists, public health experts and mayors have called for gun reform. Instead, six and a half months later, Tennessee elected a pro-gun governor who overturned already lax gun laws, allowing almost anyone to carry a gun in public, including bars and near schools.

The results may seem like a paradox, but such is our gun politics, said psychiatrist and sociologist Jonathan Metzl, chair of the Department of Medicine, Health and Society at Vanderbilt University in Nashville. logic. Metzl, a long-time vocal supporter of public health policies aimed at reducing gun violence, writes in his new book, “What We Have Become: Life and Death in a Nation of Arms,” ​​that those who view guns as vectors of diseases that can only be cured Public health policymaking is missing a key political component. Blue state liberals who seek to curb gun violence view all American gun owners as pathological. Metzl said defining gun violence as a public health epidemic is a failure.

My interview with Metzl has been edited and condensed.

Can you explain what a public health framework on gun violence means?

Public health scholars, doctors, and activists have a long and proud history of developing health frameworks for deadly consumer products. This manual is very effective for cigarettes, car seat belt failures, or asbestos insulation. The idea is that if you can show a product’s negative impact on health, it will lead to corporate accountability and lead to regulations and health policies that improve health. Hygiene frameworks are very effective.

Starting in the 1980s and 1990s, we started applying this to firearms. We started tracking the health toll guns are taking on our country: how many people are injured and killed, the skyrocketing rates of gun suicides, gun homicides, accidental shootings. The idea is that these injuries and deaths can be addressed in the same way as cigarettes and seat belts—by emphasizing health impacts, developing health policies, and enacting corporate accountability and government oversight.

Jonathan Metzl, authorhamilton matthew masters

You write that this public health approach to gun violence has had disastrous consequences. how so?

Part of the problem is a failure to recognize that guns are deeply political, which seems obvious now but was not so obvious in the 1990s and early 2000s. We think people will certainly follow the government’s instructions. But we failed to realize that gun ownership has important intersections with the history of race, gender, and geography in the United States, and that our model does not take this into account. Another part is that gun rights advocates have always said gun control is biased against them. I am an advocate for public health. I’m a doctor. But as I began to trace this history, I began to notice assumptions about gun owners in public health models. I don’t think public health has recognized its politics yet. In other words, from the beginning, the framework was this: public health was common sense, and gun owners were seen as lacking common sense and irrational.

Case in point: We created all our policies in the wake of mass shootings, so many gun owners feel lumped in with mass shooters.

Deep assumptions about race are also part of different public health policies. For example, red flag laws require relatives to call police to remove guns from family members, but gun owners of color I interviewed distrusted police and did not want to invite authorities to evaluate their own relatives.

Do most mass shooters suffer from mental illness?

I’ve spent a lot of time deciphering the mental health narrative, and I hope my book will illustrate why it’s as grounded in reality as it is in myths and stereotypes. Yes, many mass shooters suffer from psychotic symptoms, but that is very different from mental illness causing them to commit murder. This stereotype encompasses many other factors—bad gun laws, substance abuse, misogyny, previous history of violence, access to guns, etc.—that are more central causal factors in almost every shooting, even if The person also suffers from mental illness.

The 1996 Dickey Amendment prohibits the Centers for Disease Control and Prevention from using its funds to “advocate or promote gun control.” This effectively blocks the collection of data on gun violence in the United States, you write, creating a divide between researchers and conservative gun owners. how so?

It has exacerbated divisions between red-state gun owners and blue-state researchers. Many of the universities that can fund gun research are in blue states. A lot of people who want to do gun research are liberals like me. Many gun owners do not believe that gun research represents their interests and are hostile to many of the recommendations made by those in the public health community. It creates a structural divide where blue state researchers and liberal researchers are setting policies and gun owners (conservative red staters) are required to comply. This is a very paternalistic assumption that is not obvious to many people. I’m part of it. For example, it is different from cigarettes, where everyone knows the person who smokes. Such geographic and ideological divisions do not exist in other public health campaigns.

Gun politics are also racial politics. You note that our cultural scripts encode white gun owners as patriots and black gun owners as threats. The gun industry has adapted to this and is profiting from it by pushing different messages to different groups. Is there a way to intervene in this profit-driven, fear-driven escalation of gun ownership?

After the police killing of George Floyd, gun companies directly advertised to Black Americans, telling them police wouldn’t protect them. And then they would advertise to white people and say, look, these black people are buying all the guns, you better buy more guns. This is a circuit. In the Sandy Hook case, gun manufacturers got into trouble over advertising. [Editor’s note: The families of the slain sued Remington for marketing their AR-15 rifle in ways that appealed to troubled men, in violation of Connecticut’s consumer protection laws.] Therefore, regulating advertising is promising. But there also needs to be a counter-narrative. Whenever a group is under attack, the gun industry’s saying is: Go buy a gun because you need them to protect yourself. It’s a very effective, powerful narrative. There needs to be a counter-narrative that illustrates the importance of community cohesion. The answer isn’t background checks or red flag laws. The answer is to build safe communities across divides. I believe in the importance of advocating for a broader agenda that combines public health with structural support for the security of public spaces and democratic institutions.

So what do you do? Gun reform advocates and gun owners alike care about public safety and protection. The problem is that they don’t agree on what public safety means.

In my ideal world we wouldn’t have to argue about this. There are ways to build consensus.

The Supreme Court has been striking down gun laws in blue states and cities. bren decidesThe bill ruled that the ability to carry a handgun in public is a constitutional right guaranteed by the Second Amendment, which has implications for Boston and surrounding areas, where police have historically had broad discretion in issuing permits to carry handguns. , but not anymore. How can we agree on acceptable gun policies across the country if we are so divided?

I think we have to overturn Bruin, we have to overturn these ridiculous public carry laws that are ridiculously permissive. But I don’t think we’re going to do that by building coalitions around background checks and red flag laws. In the five years that I’ve been writing this book, 27, now 28, states have passed open carry legislation and we’ve had over 500 million guns, and then Bruin happened. This shows that our alliance on this issue is not as large as it seems. It’s concentrated in places that have already voted for gun restrictions. I’m trying to imagine how we can build a broader coalition where people see gun safety as being in their self-interest.

Ieva Jusionyte is an associate professor at Brown University and the author of the forthcoming book, “Exiting the Wound: How America’s Guns Fuel Cross-Border Violence.”

Jonathan Metzl will discuss his new book tonight at 7pm at the Harvard Bookstore in Cambridge

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