By Jacqueline Lantsman
There is no question that gun violence is a public health crisis. It penetrates communities physically, taking loved ones abruptly, and retraumatizes victim families with persistence. Just yesterday, two young lives were taken and three wounded at Saugus High School in Santa Clarita, California, and every day, over 100 Americans are projected to die from gun violence. Gun violence incites fear, anger, and a sense of hopelessness, as Americans feel suffocated in their capacity to lead grassroots-change against the 5.2 million spent by the gun lobby, in 2017 alone. We are aware that structural change modeled after other public health interventions is the single way to move forward.
While recognition for public health interventions to violence is growing, days after the heinous hate crime committed in El Paso, Texas, using weapons of mass destruction took the lives of 22 people and wounded more than 26, leaders were more adamant about seeking death penalty against the admitted shooter, than deriving a strategy to provide government wrap-around support services, including but not limited to community-based, culturally relevant, individualized, strength-based, and family-centered services, to assist survivors and their families with physical and emotional ailments.
Operation H.O.P.E. co-founder, Patsy Gomez explained to NPR that the primary focus of survivors is grief and practical questions around making medical appointments, applying for disability benefits, accessing prescription medicine, all on top of other life demands, like paying rent and electric bills.
The Executive branch is imitating lawmakers in Texas– the Trump Administration urged the US Justice Department to respond to hate-crime mass-murders with capital punishment. The Administration’s proposal to sentence offenders of mass shootings and hate crimes to death row is reactive, antiquated, and proven consistently an ineffective method of deterrence. This response is antithetical to evidence-based policy and only reinforces brutality. We cannot turn to capital punishment — the same tool that across 13 states actively persists to target low-income populations and communities of color — as a resolution for mass shootings and hate crimes.
Before making policy decisions it is critical that lawmakers understand that capital punishment is not an effective intervention to gun violence nor hate crimes.
Capital punishment in the United States is the extension of racial prejudice and oppression. Researchers and attorneys have proven that capital punishment was the legal counterpart to publicly practiced lynchings. A report published by the Equal Justice Institute states, “Southern legislatures shifted to capital punishment so that legal and ostensibly unbiased court proceedings could serve the same purpose as vigilante violence: satisfying the lust for revenge.” A tactful judicial decision during the Jim Crow Era set a precedent of
false assurance that tough on crime policy protects and creates security
for Americans, when in reality no evidence proves that capital punishment deters crime. Yet, this delusion of security has fortified incentives by elected legal arbiters to support sentencing individuals to death.
We see this manifested in judicial elections. The Brennan Center published a report on the relationship between elections and criminal cases. Among the various researchers cited by Brennan, Paul Brace and Brent D. Boyea
analyzed data on Supreme Court tenure between 1995 to 1997 for all
states with capital punishment, whose judicial tenure is renewed through
elections. Their findings suggest that there is a “direct effect which
encourages judges to affirm lower court punishments where the public is
most supportive of capital punishment.”
The research concludes that during re-election appellate judges are more likely to uphold death sentences.
The conspiring between the judicial system and the violent racism of
lynching has manifested itself in capital punishment, which disproportionately confines and executes African American men. While Black Americans make up less than 13 percent of the nation’s population, black men consist of 42 percent of the death row population. When reviewing wrongful convictions and exonerations, the National Registry of Exonerations found that, “black people are seven times more likely to be wrongfully convicted of murder than white people and that African Americans imprisoned for murder are more likely to be innocent if they were convicted of killing white victims.”
Lawmakers, how is it that a judicial practice that preys on Black Americans is a sufficient intervention to hate crimes? How is it that a judicial practice deemed Unconstitutional across 21 states — on the grounds of racial bias, and insufficient proof of deterrence — is an adequate intervention to gun violence?
The roots of capital punishment alone should indicate that Government sanctioned executions will not protect marginalized communities, or any community for that matter, against hate crimes or weapons. Instead, we must refer to evidence-based, human-centered interventions to inform the systemic reform of gun access.
Evidence clearly shows that public health professionals possess the skills to be lead actors in this effort. They can begin by correcting the politicized assumption that mass shootings are caused by mental illness. Yale Psychiatry Professor Madelon Baranoski explained that when research on the matter is reviewed collectively, data shows the relationship between gun violence and mental health is unsubstantiated. The inflation of the two only further stigmatizes and alienates the community of individuals experiencing mental illness. Baranoski voices that, “The majority of gun deaths come from increased impulsivity, decreased judgement and affective disruptions and that isn’t necessarily mental illness… The message has to be that people with mental illness are actually suffering from the disorder and not perpetrating crimes against others.”
Public health professionals are also skilled in effective prevention, behavior change, norm change, and working with difficult-to-reach populations. Cities that integrate public health interventions in efforts to reduce violence find a substantial decrease in incidences. Attempting to address youth violence Minneapolis spent years relying on law enforcement strategy, consistently seeing limited results. Eventually, the Minneapolis health department became involved by first conducting an assessment of youth arrest and detention data, to understand what leads to such outcomes; and more importantly, what can prevent such outcomes. Once data were collected, a multi-sectoral community coalition was organized to assist in the interpretation of results and idea development for programming and interventions. The output was the development of employment programs, gang prevention and healthy youth development curriculum, and a neighborhood cleaning programming. Programming implemented in 20 neighborhoods across Minneapolis with the highest rates of violence, resulted in a decrease of 57% in the number of individuals younger than 18 years arrested or suspected in violent crimes. Further, fatalities among individuals younger than 24, fell by 76%.
End the Violence Epidemic, a movement of 500 individuals dedicated to activating the health and community response to violence, presents many examples across cities and towns where health-based violence prevention was instituted and saw positive outcomes. Refer to the map below:
In 2015 the city of Wilmington, Delaware leveraged public health data scientists in response to a 45% jump in shootings between 2011 and 2013. Epidemiologists from the Center for Disease Control and Prevention — professionals that use data surveillance to examine the causes of disease outbreaks in order to treat existing diseases and prevent future outbreaks — investigated 569 people charged with firearm crimes and looked for certain risk factors. Courtney Lenard, from the CDC explained,
“Our investigation was not focused on the mechanism of injury, but rather on understanding opportunities to intervene on more root causes of violence such as prior exposure to violence, family disruption, and limited educational attainment.”
While public health professionals are more directly focused on prevention, they are also uniquely entrenched in the consequences of hate and discrimination.
Nancy Krieger, a professor at the Harvard T.H. Chan School of Public Health, makes the poignant argument that while hate crimes result in “mortal violence, serious injuries, psychological terror, and the psychic and bodily toll of chronic threats and fear,” they are the symptom of White Supremacy — a mechanism that upholds racial disparities in health, negatively impacts quality of life for people of color, and is inseparably linked to violence that permeates US culture. The Anti-Defamation League reports that white supremacist activity has killed more people in recent years than any other type of domestic extremism. The systemic informs the individual experience, as explicitly shown in research that racism and discrimination can reduce the quality of life by raising the chances of developing depression, hypertension, cardiovascular disease, and even death.
Given these population-based outcomes, public health professionals have a stake in reforming structural racism and preventing hate crimes. While an opportune moment exists for public health intervention, traditional penal practices continue to be the immediate reactionary response.
To begin to diverge from this popular reliance on retribution, we can seize the opportunity to make the Centers for Disease Control and Prevention an active responder to future gun violence. This was attempted once before by members within the organization, however, when findings consistently revealed guns to be the common culprit to violence, the National Rifle Association (NRA) feared negative media and proceeded to lobby to eliminate research by the CDC “perceived as anti-gun efforts.” Led by Representative Jay Dickey of Arkansas, in 1996 the Federal spending bill would state “[n]one of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.” Due to this ban, since 2005 there have been no relevant studies published on access to guns and its association with suicide and homicide.
In recent years there has been confusion around the actual constraints of the Dickey Amendment. Multiple sources clarify that the Amendment prevented CDC advocacy, as opposed to gun-related research. However, while this might be the case, for over two decades the politicization of gun violence and the power of the gun lobby has created, “fear among some researchers that studying guns will make them political targets and threaten their future funding even for unrelated topics.” David Hemenway, director of the Harvard Injury Control Research Center explains that researchers are disincentivized from choosing gun violence as a research specialty. Given this, funding once allocated for the issue of gun violence was redistributed to other departments in the CDC.
A study conducted by the American Medical Association determined the amount of funding allocated to gun violence. While gun violence took the lives of as many individuals as sepsis, compared to research funding on sepsis (approximately 5 billion between 2004 and 2015), funding for gun violence research accounted for only 0.7% of sepsis funding, reaching approximately 35 million between 2004 and 2015.
However, relative to 1996, the year that the Dickey Amendment was passed, the urgency and regularity of gun violence has led to a shift in public opinion around gun regulation. In 2018 it was found that 57% of U.S. adults say gun laws should be more strict, reflecting the need for more research on evidence-based practices to limit gun access. Furthermore, while we are beginning to see support for gun control measures across party lines — 89% of Republicans and Democrats say people with mental illnesses should be prevented from buying guns — this is also clear evidence that public health education campaigns are imperative to dispelling the relationship of mental illness and committing gun violence. In doing so, public health practitioners will confront the gap between public knowledge and factual evidence found in research.
While the National Rifle Association (NRA) still holds influence over certain legislators, whose pockets are padded with favors from lobbyists, nationally and internationally it is clear that public support stands with changemakers and advocates in the gun violence reform movement.
Considering our political climate, public health research could offer formative information on the determinants of violence and trauma-informed restorative practices in response to violence. With formative research, public health officials can take a two-pronged approach. Given competency in working directly with community stakeholders at the local level, public health professionals can activate community to derive local interventions using a combination of community voice and evidence-based research. At the structural level, evidence could be used for legislative reform that would disrupt the historic pattern of using correctional brutality, like capital punishment, to achieve a false sense of deterrence and justice. It is time for lawmakers to stop relying on antiquated retaliatory tools like capital punishment to confront violence. It is time we move forward by responding to violence with trauma-informed restorative practices and wrap-around support services.
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Jacqueline Lantsman is currently receiving her Masters of Public Health, with a focus on health policy, at the George Washington University Milken School of Public Health. She takes a cross-sectoral approach to advancing quality of life. Her former experiences include policy research and programmatic work at the Brookings Institution, the Drug Policy Alliance, and the National Coalition to Abolish the Death Penalty.
