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Gun violence, public health and the missing piece

Cross posted from Pruning Shears.

The massacre in Newtown has once again opened up the discussion of firearms in America. We are getting the usual dumbassery about how this is a punishment from God or the fault of video games (which apparently are unavailable outside of the US) and the usual preemptive whining about how this is not the time to talk about firearm legislation because it would politicize the issue. This is the same spirit in which we refrained from discussing terrorism after 9/11 for fear of politicizing that issue.

It appears that the gun nuts are feeling a little defensive though. Unlike with previous gun massacres, this one has been accompanied by a real push on the role of our abysmal mental health care system. It’s actually a great point: we’ve basically outsourced mental health care to our prisons, with predictably disastrous results. We need to do a much better job of investing in mental health care, removing the shame that surrounds it, and making sure it is available to anyone who needs it.

That doesn’t mean it’s an either/or situation though. We can both improve mental health care and implement sensible policies to reduce gun violence. One obstacle to the latter is a certain air of resignation and fatalism (“I’m fresh out of ideas. Anybody?”) which – surprise! – is a stone’s throw from demands for a comprehensive legislative strategy for implementation. Because that is the only way to discuss any issue, and it also explains the absence of war, abortion, finance, inequality and gender policies from our national dialogue.

One of the emerging ideas is to treat gun violence as a public health issue much like we have with tobacco. Highlight the grisly costs of our gun worship, educate the public on the most hazardous aspects of the issue, and do everything we can to get people to think about it.

These suggestions are missing an absolutely crucial component, though: stigma. The public health campaign against smoking pushed information on the hazards of smoking into the public arena, but it also pushed back against the activity itself. Advertising for it was increasingly restricted, the glamorization of it by Hollywood was denounced, the areas where it was permitted narrowed, and in general the unmistakable message was: this is bad; don’t do it.

That’s what we need to do with firearms, because our gun culture has glamorized them for far too long. Any discussion of guns as a cultural marker usually begins as though we were still a late 18th century agrarian land recently liberated from a royal tyrant. That is not the world we live in, to put it mildly. The vast arsenals and enormous firepower of assault weapons bears no resemblance to the “to arms, men! Redcoats at the town square!” imagery of a musket-carrying citizen soldier often invoked when gun legislation is contemplated.

To say that these mass killings are unrepresentative of the gun owning public is as persuasive as the “few bad apples” argument after Abu Ghraib. In both cases they are produced by a systemic failure that goes all the way up the line. They are not freak aberrations, but the inevitable results of a terribly broken system.

It’s time to stop defending the violent gun culture or hedging arguments. It’s possible that there is some magical country where all the guns are kept safe, are never purchased illegally, and are always used for recreational purposes or self defense. We do not live in that country. We live in a country where 31,347 people were killed by guns in 2009 (the last year official numbers are available), where our thinking about firearms is based on mythology and not reality, and where the gun lobby and spineless officials block even the mildest reforms.

If we really are going to try to change all that with a public health campaign, stigmatizing gun ownership needs to be a part of it. And guess what? No political roadmap is needed. It can be done for handguns in urban areas and for semiautomatic weapons outside them. It’s something anyone can do, anywhere. Those who defend the status quo have blood on their hands, and we should say so plainly when the issue comes up. (For those concerned about telling people mean things see here.)

In some alternate reality maybe there’s an America where gun policy does not come at such an unconscionably murderous price. That’s not America circa 2012, though. When faced with the enormous damage of tobacco use, anti-smoking advocates didn’t mince words. They didn’t say, hey – a little smoking is probably fine; you probably won’t get lung cancer if you just have a couple a day. Faced with a public health catastrophe, they took an unambiguous stance. It’s time we did the same.

Photo by Jon Mallard under Creative Commons license.

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