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Friday, June 19, 2015

Public Health: Is Gun Violence a Public Health Issue?

I think this is the third time I have posted this article just in the last few months...Although I had considered writing my next article about parental leave, this is more appropriate for the time being.This incident sounds like something out of the 1950's.

How is public health defined, who decides what that definition is and on what information are they basing their decision? Who has a seat at the table while these topics are being discussed?

Recently, I found myself thinking; " How many people have to die before action is taken to decrease gun violence?" I suppose there is an argument for the fact that all societies are desensitized to their own failings.

Where then, must we go to gather together those that have the right thinking on the issues that hold us back from living up to the ideals of our society?

Although I don't recall the first time I thought about the idea of fostering discussion around gun violence as a public health issue, even a brief google search shows that this topic is already out there.

There's a lot to delve into here...

I do think that a civil society has an obligation to provide certain services to its citizens. Health care, being one of them. In order to move from talking about heady ideas and lofty goals to actually identifying what specific steps to take to create a better quality of life when it comes to access to health care, you have to get into economics.

An idea by itself is stagnant without the necessary resources and oversight to actually take action.

Rather than write this entire post from an editorial perspective, I think it will be more useful for me to give an overview of some of the voices that have chimed in to the discussion about whether or not gun violence is a public health issue.

No matter how you define it, public health only moves forward when facts are given pride of place over everything else.

If you google Public Health, the first entry that comes up is the Johns Hopkins Bloomberg School of Public Health. Other sources of information are the WHO (World Health Organization) and the APHA (American Public Health Association).

If you want to see a fact sheet on gun violence, the APHA has a resource titled, "Gun Violence Prevention." has an article that reviews several different perspectives on the topic of whether or not gun violence is a public health issue.

Diversity of thought  is necessary to yield any kind of forward thinking approach to improving our society; thus community activists, students, think tanks and colleges and universities should all have a role in shaping the discourse around gun violence and how best we can understand it and prevent it.

I spoke with Professor Jon Vernick, Co-Director of the Center for Gun Policy and Research  at the Johns Hopkins Bloomberg School of Public Health about the idea of framing gun violence as a public health issue.

"Guns claim more than 30,000 lives in the United States alone every year and another additional 70,000 or so non-fatal violent injuries are associated with guns. By thinking of it as a public health problem we can consider all aspects of the problem, not just gun deaths by homicide which are of interest to the criminal justice world, (but) we can also think about suicide and accidental gun deaths. We can consider upstream solutions. Whereas the criminal justice system thinks primarily, though not exclusively about punishment, public health thinks primarily about trying to keep people from getting hurt in the first place.

Public health also has a tradition of focusing on the vector of a particular cause. In this topic, the vector is the firearm. There is a history in public health about 'how we can modify the vector'; how to keep guns out of the hands of a violent person in the first place.

There is a history of success that public health has had in other areas such as motor vehicles.By thinking of guns as a public health problem maybe there is inspiration that can be drawn from other successes."

This quote brings to the surface the idea that there are multiple aspects to gun violence which, in my opinion, is an important point. In order to make progress it is necessary for the major media outlets to inform the public of the kinds of things that are taking away from our ideas and ideals as a nation. Moving forward, it is absolutely critical to have more in-depth conversations about preventative measures. These conversations, guided by a nuanced perspective of the topic(s), inform the voting public and the wheels of progress turn...or at least that's the idea.

Wednesday, June 10, 2015

Relationship Between Service Providers and the Populations They Work With

As I may have mentioned here before, I first wrote about public health around 2004 when I covered an event for an organization raising awareness about cervical cancer.

Around the same time that I covered this story, I went to a women's health clinic to get standard screenings for STD's and STI's and I also wanted a screening for HPV.

I  went into this with my new found awareness that a clear pap smear result does not always mean that there is no chance that you have HPV.* I remember a staffer saying something to me along the lines of, "we usually do a pap smear and if something shows up than we screen for HPV."

While I am aware that had I gone to a different doctor or health care provider at that same clinic I may have gotten a different answer. I also appreciate that she may have handled our interaction based on what she was trained or encouraged  to do by whomever decides what the standard of care is for basic STD, STI and any other gynecological screenings.

However, there must be women who have gone to that clinic and gotten similar information about HPV screenings and had no reason to think that they were not being given the full picture.

I remember making an attempt to get an HPV screening regardless of how the pap smear results came back. This was years ago before there was any notion of an HPV vaccine on the market and I do think that there is generally much more discussion around HPV.

What I take from that experience is the importance of educating myself about my health in order to have the best possible interaction with health care providers.

In some ways, I think of healthcare as being similar to any other service in that the best result comes out of having a trusting relationship between service providers and the populations they work with.

If you are part of a population where conversations about health are limited to yearly check ups, where can you find information to compliment those discussions?

In what settings do health care providers have opportunities to interact with the populations they work with outside of formal appointments?

While conversations about sexual and reproductive health rights are critical, it is also good to just get information and to ensure that a general awareness is supported in settings such as community centers, online communities, the social media space, colleges and universities etc...


*I am not a medical professional and this is just me recounting my own personal experience as I remember it.