Is a gun like a virus, a car, tobacco or alcohol? Yes say public health experts, who in the wake of recent mass shootings are calling for a fresh look at gun violence as a social disease.
What we need, they say, is a public health approach to the problem, like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago, even as the number of vehicles on the road rose.
One example: Guardrails are now curved to the ground instead of having sharp metal ends that stick out and pose a hazard in a crash.
"People used to spear themselves, and we blamed the drivers for that," said Dr. Garen Wintemute, an emergency medicine professor who directs the Violence Prevention Research Program at the University of California-Davis.
It wasn't enough back then to curb deaths just by trying to make people better drivers, and it isn't enough now to tackle gun violence by focusing solely on the people doing the shooting, he and other doctors say.
"What I'm struggling with is: Is this the new social norm? This is what we're going to have to live with if we have more personal access to firearms," said one of the nation's leading gun violence experts, Dr. Stephen Hargarten, emergency medicine chief at Froedtert Hospital and director of the Injury Research Center at the Medical College of Wisconsin. "We have a public health issue to discuss. Do we wait for the next outbreak or is there something we can do to prevent it?"
About 260 million to 300 million firearms are owned by civilians in the United States; about one-third of American homes have one. Mass shootings don't seem to be on the rise, but not all police agencies report details like the number of victims per shooting and reporting lags by more than a year, so recent trends are not known.
More than 73,000 emergency room visits in 2010 were for firearm-related injuries, the Centers for Disease Control and Prevention estimates.
At the same time, violent crime has been falling and the murder rate is less than half what it was two decades ago. And Gallup polls have shown support for stricter gun laws has been falling since 1990. Last year 55 percent of Americans said gun laws should remain the same or become more lenient.
Dr. David Satcher tried to make gun violence a public health issue when he became CDC director in 1993. Four years later, laws that allow the carrying of concealed weapons drew attention when two women were shot at an Indianapolis restaurant after a patron's gun fell out of his pocket and accidentally fired. Ironically, the victims were health educators in town for an American Public Health Association convention.
Violence prevention research: www.ucdmc.ucdavis.edu/vprp
CDC injury prevention: www.cdc.gov/violenceprevention/nvdrs