Pediatricians Judith S. Palfrey, M.D., and Sean Palfrey, M.D. express their concerns in this week’s New England Journal of Medicine:
Prevention is the core of pediatric work. We aim to protect children from all things that can harm them. Injuries are the biggest threat to U.S. children over 1 year of age. In 2010, gun-related injuries accounted for 6570 deaths of children and young people (1 to 24 years of age). That amounts to 7 deaths per day. Gun injuries cause twice as many deaths as cancer, 5 times as many as heart disease, and 15 times as many as infections.
They call the nation to action:
It is time to act for these families and for those who continue to lose children to gun violence. Newtown concentrated the horror in one place for one hour, but the same outrage occurs daily in U.S. cities, suburbs, and rural areas.
As a nation, we have it in our power to protect our children from gun injuries, as other countries have done. Doctors, teachers, city and state officials, gun owners, families, and young people must come together with a creative and meaningful commitment to improving our society.
Garen J. Wintemute, M.D., M.P.H. isn’t looking for a band-aid, either:
We pore over the details, searching for the clues that will bring order to chaos and help us predict and prevent the next one. But these catastrophes are all different. We have found to our dismay that prediction is somewhere between difficult and impossible. Tailored interventions, designed for specific circumstances, will have little effect. We need to take a broader approach.
Dr. Wintemute suggests specific interventions, including strengthening existing gun laws, and concludes:
This time, the circumstances are different. The outcome will be different only if we make it so. The interventions proposed here will not end firearm violence in the United States, but they will reduce it, and that’s a goal worth fighting for. If Sandy Hook, Aurora, and the others are what it takes for us finally to confront this challenge, they will still be terrible beyond description. We will still share responsibility for them. But it will be of some comfort to know that all those students, educators, moviegoers, and temple-goers did not die in vain.
John T. Walkup, M.D., and David H. Rubin, M.D. address the mental health problems:
An important dimension that has been less discussed is the question of social withdrawal and isolation, within and beyond the confines of mental illness. For the withdrawn and isolated and the angry and alienated, there are deep-seated barriers to care, and there may exist a small subgroup that is uniquely vulnerable to the seductive power of violence in our culture.
Drs. Walkup and Rubin don’t let the media off the hook:
What is missing from most related discussions is a focus on the seductive, powerful subculture that celebrates and advocates violent and antisocial behavior. Most people are not interested in and do not engage with this subculture, and most who do so are not seduced into action by antisocial themes and violence in films, video games, written materials, or interest groups. However, a very small minority of angry and alienated mentally ill persons may gain a sense of belonging and support from this subculture and may be particularly vulnerable to being seduced into action.
Read all three articles in the New England Journal of Medicine here.