As COVID-19 slowly retreats, another kind of public health pandemic is re-emerging, healthcare experts say.
The murders of 19 children in Uvalde, Texas, last week and 10 elderly patrons of Tops Friendly Market in Buffalo, N.Y., two weeks ago once again has shone a grim spotlight on what medical professionals call the ongoing public health crisis of gun violence across the U.S.
As debate rises again about gun policies, hospitals and healthcare researchers are racing to understand and enact more effective programs and measures in hopes of stopping the bloodshed.
Those include identifying and addressing mental health warning signs as early as possible and teaching young people to recognize and regulate their emotions.
Deaths from gunshot wounds are up more than 20 percent in the past five years, and preliminary reports suggest homicides and suicides by guns rose 10 percent throughout 2020. More than 100 people died by firearms each day that year. And guns are now the leading cause of death for children in the United States.
"We have to be more intentional about recognizing firearm violence as a public health crisis," said Justin Heinze, an assistant professor of health behavior and health education at the University of Michigan and co-principal investigator at the National Center for School Safety. "We have to analyze the touch points for the youth who are engaging in this behavior, those who are 12 to 25, and find ways to treat the risk."
Heinze said firearm violence prevention measures exist, but they are not coordinated. A 1996 federal law known as the Dickey Amendment has banned the use of government funds for gun control advocacy, which made research grants on public health and firearms dry up, though $25 million for injury prevention was appropriated in 2020.
Intervention efforts include those that occur in the emergency department when a victim of gun violence is admitted or during depression screening at primary care physician offices.
"We start a lot of these conversations with physicians and parents, but there's not a lot of cross-coordination," Heinze said. "Wouldn't it be great if hospitals could interact and warn counselors? We think there is opportunity for information sharing to have these conversations at a more community-wide level."
There are effective gun violence prevention measures in place across the U.S, including the Advance Peace program in Stockton, Calif., and the national Lock2Live program.
Advance Peace uses outreach to educate and counsel individuals at high risk for gun violence in their neighborhood and mediate conflict. Lock2Live use emergency-room doctors to educate suicide patients on safe gun storage to mitigate suicide attempts.
However, broad connection of efforts between hospitals and the community is more difficult because of privacy concerns and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) law that prevents the sharing of medical information, including mental health status, without patient consent.
The potential for an overreaction or potential misidentifying of a threat also holds consequences.
"You have to work to avoid biases on which student may or may not be a threat and shape a conversation around it," Heinze said. "This shouldn't result in a sheriff's officer knocking on your door. Or that method (should be) used sparingly. This has to be done in a restorative way and paired with prevention. The bridge between schools, community organizations and hospitals, to avoid experiencing or perpetrating violence is a worthy cause to pursue."