Taking a Public Health Approach to Gun Violence

Northwestern Medicine
News February 26, 2013
Northwestern Medicine's Emergency ambulance entranceAs the national dialogue on gun violence grows louder, many medical experts are advocating for a public health approach similar to the campaign used against smoking decades ago. Among them is Marie Crandall, MD, MPH, a trauma surgeon at Northwestern Memorial Hospital and associate professor of surgery at Northwestern University Feinberg School of Medicine. Dr. Crandall has been integral in developing partnerships between Northwestern Memorial and community organizations, such as CeaseFire, that aim to prevent further injury to patients who have been shot. She was recently featured on PBS Newshour regarding the public health crisis in Chicago because of high rates of gun violence. You can view the video below, but we also asked Dr. Crandall to answer a couple of questions on the topic:

Q: Why should gun violence be framed as a public health issue? How does this approach work?

MC: Understanding gun violence as a public health issue, versus a criminal justice issue, has increased steadily since the 1980s and is now well-accepted.  Like many public health  issues, clean water, vaccinations, gun violence disproportionately affects children and the poor, and deep racial disparities exist with respect to risk and outcomes.  Also, it’s pervasive; nearly 40,000 people per year die of firearm injuries every year in the United States; it is the leading cause of death of young African American men. 

A public health approach to a problem first identifies the issue using epidemiologic methods, then define risk factors and protective factors, develop interventions, and finally implement and evaluate those interventions. These are interventions that are multi-tiered but ultimately have a population or community base. For gun violence, a combination of decreasing access to firearms, affording job and educational opportunities to disadvantaged communities, changing cultural norms regarding the acceptability of violence, and direct action and advocacy are needed to make a difference.  

Q: What programs are in place at Northwestern Memorial to address violence and aid in prevention?

MC: Our central partnership is with Ceasefire Illinois/Cure Violence.  We have partnered with CeaseFire to provide crisis intervention to all of our patients who have been injured by violence.  Their outreach workers are trained community members whose work has been shown to decrease the likelihood of retaliatory shootings or reinjury.  It is our version of beta-blockers after a heart attack or antibiotics after an admission for pneumonia; it prevents morbidity and mortality and is part of our care plan.  Case management and referrals are handled by CeaseFire and our southeast side community partner, Claretian Associates. In addition, with other community groups, such as La Rabida, the YMCA, and the Black United Fund of Illinois, we have an ongoing service provision and research agenda to help create sustainable pathways that offer opportunities for change for our patients and their families.

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