Some healthcare groups charge into fight for gun control as others lag behind

The aftermath of the mass shooting that last month killed 17 people at a high school in Parkland, Fla., has motivated some healthcare advocacy groups to enter a debate they'd previously avoided. The voices of young survivors of the shooting at Marjory Stoneman Douglas High School who are asking for a ban on assault rifles have been hard to ignore.

The Greater New York Hospital Association, the American College of Physicians, the American Academy of Nursing and the American Public Health Association last week wrote letters urging Congress to enact gun control legislation or take other actions.

Earlier this month, the Greater New York Hospital Association adopted a resolution asking for a ban on all assault-style rifles, enhanced firearm background checks, greater investments in mental healthcare resources and more federal gun research.

"If we in the healthcare community really believe that we're in preventive medicine, this is preventive medicine," said Kenneth Raske, CEO of the GNYHA. "We have an obligation as healthcare professionals to step up on public health issues."

Physician and nurse groups are taking action as well. "We are finally having the kind of national conversation that we should have had years ago," said Dr. Jack Ende, president of the American College of Physicians. The ACP sent letters to Congress urging lawmakers to take immediate action to reduce the number of firearm-related deaths in the U.S., which totaled more than 36,000 in 2015, according to the most recent data from the Centers for Disease Control and Prevention.

"I think we may be seeing a change in public sentiment," Ende said. While the protests and marches have not yet led to any broad legislation, policymakers on both sides of the aisle have admitted that something needs to change.

The American Medical Association, which in 2016 adopted a policy calling gun violence a public health crisis after the death of 49 people at a club in Orlando, Fla., said it maintains that pro gun-control policy.

"Now is an opportune time for those that are interested in this to come forward and be heard," AMA President Dr. David Barbe said.

In the days following the Parkland shooting, the American Academy of Nursing sent a letter to congressional leaders co-signed by 96 other organizations requesting they form a national commission on mass shootings. The group would identify strategies to strengthen laws that prohibit at-risk individuals from purchasing a firearm, while improving background checks and allowing health professionals to assume a greater role in helping prevent injuries from guns.

"It's not for us to decide who should get firearms," said Karen Cox, president of the academy. "But we see the results when a 4-year-old shoots and kills his older brother or sister." The physical damage caused by assault and automatic rifles has become a bigger challenge for providers to treat. Cox said the academy has offered free gun locks to patients for the past three years.

"Every moment has its time, and I think that the health community has always had this as an issue that it was concerned about," said Dr. Georges Benjamin, executive director of the American Public Health Association.

Last week the APHA announced it would make publicly available all documents related to firearms research that the American Journal of Public Health has ever published. The goal is that greater public access to research would lead to more evidence-based policies.

The American Hospital Association and America's Essential Hospitals, which were not included in the recent letters to Congress, cited other ways they were working to effect change.

AHA officials are framing gun violence as a serious public health problem; highlighting its Hospitals Against Violence initiative; advocating for access and funding of mental health services; promoting research and education to reduce violence in communities; and supporting state, regional and metropolitan hospital associations to designate hospitals as "safe zones."

Beth Feldpush, senior vice president of policy and advocacy for America's Essential Hospitals, said its members have launched programs that focus on the belief that improving gun safety and reducing violence ultimately benefit the nation's health. But she said the group is currently focused on ensuring strong Medicaid and Medicare funding for the nation's safety net, resisting attacks on the 340B drug discount program, and promoting federal recognition of social determinants of health.