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Megan Ranney MD MPH @meganranney
, 25 tweets, 18 min read Read on Twitter
One week ago, #thisisourlane exploded on Twitter. At the request of may, here's a tweetatorial to address some of the most common questions and answers about the epidemic of #gunviolence - why it matters to docs - and what we can do about it:
***Q1: What are the patterns of #gunviolence injury and death in the US? ***

A: 100 people die and 200 are injured each day across the US. Most deaths (~2/3) are suicide; these are mostly white middle-aged men from rural areas.
Approximately 30% are homicides: mostly young minority men from inner cities. The rest are accidental and mass shootings.

#DomesticViolence deaths from firearm injury are estimated at ~50/month.

And firearm injury is the 2nd leading cause of death for American youth.
Rates of all types of firearm injury are increasing. cdc.gov/mmwr/volumes/6…
What about non-fatal firearm injury? Deaths are the tip of the iceberg. And most gun *injuries* are from assault. (A suicide attempt with a gun has a 90% fatality rate, so they never even make it to the hospital!)
* NB: Although other types of injuries are MORE COMMON, the fatality rate from guns is MUCH WORSE. (See picture below, from jamanetwork.com/journals/jama/…)
*NB again: There are MAJOR limitations with the data on firearm injury, but data is pretty consistent sources. The lack of good data is one of the reasons we need more #research funding. fivethirtyeight.com/features/the-c…
***Q2: If most injuries are from assault, isn't this just a criminal justice problem?***

A: No. This is about so much more. Sure, it’s about access to illegal guns and enforcement of laws; but some of the greatest work isn't about guns at all, but is about the underlying issues
FOR EXAMPLE: some great work that may decrease gun violence:
- Brief ED-based interventions that reduce fights. ncbi.nlm.nih.gov/pubmed/22614776 @StrohCunningham

- Greening vacant lots. pnas.org/content/115/12… @branas
- Counseling suicidal patients on temporarily decreasing access to lethal means @EmmyBetz

- Creating hospital-based violence intervention programs to reduce repeat firearm injuries nnhvip.org @KBFischer
Using the #publichealth approach, all of us who know that #ThisIsOurLane can CHANGE the patterns of the epidemic. slate.com/technology/201…

Yes laws need to be enforced. That's part of #publichealth. But that's not sufficient. (If it were, it would have worked already!) @ChaviKar
***Q3: What about [medical errors, heart attacks, diabetes, etc]?****

A: Those are all important. No one thinks we should talk about gun violence INSTEAD OF these other issues. Instead, we’re advocating for it to be talked about – and approached – the SAME. With science.
***Q4: Why don’t we “just” “ban guns”?****

A: Prohibition of alcohol didn’t work. American culture is such that prohibition of guns won’t work either. There are 330 million guns in circulation already (most of them, safely used). We need REAL solutions, not bans.
And we know that the #publichealth approach can and will work. We have decreased car crash deaths DESPITE there being more cars on the road, and more miles driven. We can do the same for #gunviolence.
***Q5: What is the Dickey amendment? Why does it stop good research?***

A: In 1996, AR Rep Jay Dickey passed an amendment that didn’t ban research per se – but resulted in, effectively, removing all funding from CDC (and, later the NIH) for firearm injury prevention.
Since 1996, there’s been virtually $0 appropriated from Congress for this issue. As a result, the science of firearm injury stalled. Without good funding, it's impossible to do good research.
This of course is the rationale behind the founding of @ResearchAffirm affirmresearch.org - with partnership of many including @AmerMedicalAssn @AmCollSurgeons @ACEPNow @MassMedical @AnnalsofIM @ACPinternists. Because we can't wait for "someone else" to make this work happen
***Q6: But the other side says [[[quote something you heard in the news]]****

A: We are smarter than this. Few Americans want their kids or their families at risk. And the movement has both gun owners and non-gun owners involved.
Examples include this paper (18/22 authors are firearm owners): facs.org/media/press-re…

And this amazing work, a collaboration between gun shop owners and public health professionals, to decrease gun suicides: nssf.org/safety/suicide…
We can and must move beyond the rhetoric, to real solutions. Our kids and our communities deserve better. See affirmresearch.org for more resources.
***Q8: So what can I DO?***

A: SO MUCH. Follow some of the amazing voices that have been working for years to make a difference for #ThisIsOurLane including @FACTS_Safety @WYCDinitiative @ResearchAffirm @JosephSakran @EmmyBetz @scrubbedin @ERdisasterdoc @StrohCunningham @njoshi8
3rd, for those of us who are healthcare professionals, take a minute to learn about what YOU can do today. A great resource is ucdmc.ucdavis.edu/vprp/WYCD.html @WYCDinitiative !
Finally, keep going. Help create private & public momentum towards a transformative #publichealth approach. Share #docs4gunsense @thisisourlane stories: talk about the human toll of #gunviolence at local & national level. Help us all create change.
TL/DR? Gun violence is a #publichealth epidemic. We can fix it the same way we've fixed other epidemics: through science-based solutions (it will take more than one). To help: Talk to patients, donate, get involved. It doesn't have to be this way. /fin
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