Opinion | Surgeon General: Americans Have Accepted Fear of Gun Violence as ‘Normal’

In this exclusive video interview, MedPage Today‘s editor-in-chief Jeremy Faust, MD, sits down with U.S. Surgeon General Vivek Murthy, MD, MBA, to talk about his advisory on gun violence in America.

Watch the first part of this interview here, which examines social media and teen mental health, and the second part here, which discusses e-cigarettes for smoking cessation, medical misinformation, and masking.

The following is a transcript of their remarks:

Faust: I know we’re short on time, but I do want to touch on firearms because, again, very recently you did something that I think was anticipated and very much desired by the public health community, which was to issue a public health advisory on firearm violence. Looking through it, again, these are very fact-based documents that your team and you produce.

I’ll share some of them: 54% of U.S. adults report that they have either personally or know someone in their family who experienced a firearm-related incident and 21% [have been] threatened with a firearm. Two numbers really stuck out to me: 17% have witnessed someone being shot, but this one really shocked me in a different way, 4% have shot a firearm in self-defense.

And that actually really, in a way, bothered me. Not that a fact can really bother a person, it’s a piece of information. Elsewhere in your report, you talk about something that’s known to many of us, which is that a big, huge independent risk factor for unintentional accidents, especially with kids, is having a gun.

And so if 4% of our community feels that they had to use a gun to protect themselves, what does that tell us? What does that tell you? Because there are people who think the answer to this problem is more guns, and 4% of the people apparently agree. That number just really struck me.

Murthy: Yeah. I mean, there was so much that was striking to me in putting this report together. And I would say to your earlier point, I think numbers can bother a person, and many of these numbers bothered and worried me, again, not just as a doctor, but as a father as well.

I’ll tell you that in particular, seeing that more than 50% of our kids are worried about a shooting in their school, that bothers me. Seeing that 60% of Americans are worried about losing a loved one to gun violence, that bothers me too. And I would dare say, I think it should bother all of us.

Because I think one of the things that has happened, Jeremy, whether it’s looking at the 4% stat or the other broader stats around how people are experiencing firearm violence — that 54% of Americans — is that we have accepted as normal something that I don’t think is normal, which is that we live a fair amount of our life in fear, worried about normal activities that we should be able to undertake safely.

We should be able to go to the grocery store, go to the movies, go to church or synagogue or mosque or temple, go to school, take a walk in our neighborhood. We should be able to do these things without worrying that we are going to be shot and potentially lose our life, yet millions of Americans do not feel safe in that way.

I think Jeremy about a mom, actually a fellow physician, who was at a mass shooting event that took place just a few years ago, and she had to run with her children away from the shooter. She happened to be in flip flops that day, and it was hard to run in flip flops. And ever since then, whenever she leaves the house, she hesitates to wear flip flops because she doesn’t know if this is going to be another day when she encounters a shooter who she’s going to have to run away from.

Think about simple decisions like that. I think about the grandmother who told me her grandkid does not want to wear light up shoes — the kind of shoes where when you step on them, like a light flashes that a lot of kids wear — because he’s worried that he’ll be an easy target for a shooter if there’s a school shooting in his neighborhood.

Kids and parents should not be worrying about these things. And I worry that we’ve accepted this as somehow just normal, as the way things are, but it does not have to be the way things are.

The last thing I’ll point out is that we put in this advisory our international comparisons. The U.S. is an outlier here, and it’s not a close call. We have a dramatically higher rate of firearm-related death and violence compared to our economic peer countries. When you look at the other OECD [Organization for Economic Co-Operation and Development] countries — 28, 29 countries — we make up about 30% of the population, but we comprise more than 80% of the firearm-related deaths.

And so I laid out a series of strategies in this advisory that I think can help us to pull back from where we are to ultimately creating a safer community for all of us, but especially for our kids.

Faust: Just linking that to another topic we’ve discussed: mental health in kids. I worry, and many worry, that one response to this crisis has been active shooter drills at schools, which comes out of a really understandable place, but I worry, and many worry, that it’s just traumatizing and doesn’t add anything. What do you think about those kinds of endeavors?

Murthy: Well, I certainly understand where they’re coming from. We want our kids to know how to react in the case of such an emergency. But I also think that these kinds of trainings need to be designed in a trauma-informed way so they help create a feeling of safety and not actually create a sense of trauma and fear among kids.

And to do that means, frankly, that you’ve got to approach it with a trauma-informed mindset and you have to study the impact of different training strategies. I certainly don’t think we have done enough of that.

It’s one of the reasons I was certainly happy to see in 2022 the passage of the Bipartisan Safer Communities Act, which did put a lot of funds toward schools in particular. It was an important first step — or I should say an important step — toward addressing the gun violence in America, but certainly should not be a last step because there’s still a lot more we’ve got to do.

Fundamentally, we want our kids to be prepared for what could come, but we also want them to feel safe in their school environment.

We know for children to grow up and to thrive, they need to have safety in their relationships and safety in the spaces that they grow up in. Those two things are really vital. Kids spend a lot of time in school. If they’re not feeling safe in school because they’re worried constantly about school shootings, if they’re traumatized by the active shooter drills that they’re going through, that does not make school a safe space.

And that’s, again, one more reason why we’ve got to address gun violence in America with the urgency that it deserves. I don’t think that we have been approaching it, frankly, with the urgency that it requires.

This is something that all of us, whether you’re hospitals and healthcare systems, whether you’re policymakers, whether you’re community organizations that have a role to play here, we’ve all got to look seriously at what we can do and look at the steps that we’ve laid out in this advisory, because I think there’s something here for all of us to take part in.

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