In Philadelphia, Gun Violence and Public Health Doesn’t Mix.
Last week the City Council of Philadelphia produced a 194-page report, ‘100 Shooting Review Committee Report,’ which claims to be an analysis of the ‘root causes’ of gun violence, along with recommendations to deal with the problem which appears to be out of control in the City of Brotherly Love, where 2,351 fatal and non-fatal shootings set a record in 2021.
The report, which you can download here, begins with the following statement: “Firearm violence in Philadelphia is a public health crisis.” I am assuming that when the report uses the term ‘public health,’ it is referring to what Charles-Edward Amory Winslow in 1920 called “the science and art of preventing disease.”
Disease is defined by Merriam-Webster as “an illness that affects a person, an animal or a plant.” And what is an ‘illness?’ The dictionary calls it an ‘unhealthy condition.’
In other words, at some point preventing disease has to involve the practice of medicine and the people that practice medicine whom we refer to as physicians. And yet, in this entire 194-page report on a public health ‘crisis,’ not one single physician or medical organization appears even once.
Actually, what I just said isn’t completely true. Because on Page 102 the report mentions a discussion led by “Dr. Ruth Abaya — Department of Public Health.” Except that Dr. Abaya happens to be Ruth Abaya, M.D., an attending physician in the Emergency Department of the Children’s Hospital of Philadelphia and has been a leader in the hospital’s Violence Prevention Initiative program since 2016.
Notwithstanding the slight involvement of Dr. Abaya in the activities which formed the basis of this report, the data is almost entirely drawn from Philadelphia Police Department (PPD) and focuses on how, when and where gun violence occurs, but also the police department’s strategies to reduce violence by concentrating their efforts on identifying, arresting, and otherwise controlling the city’s population which commits violence with the use of guns.
That’s all fine and well, except this document allegedly was created to draw attention to the ‘public health crisis’ involving the use of guns. And with all due respect to the tireless and difficult job that the PPD faces in trying to reduce gun violence, this report has nothing to do with public health at all.
The report (Page 183) lists 34 contacts that individuals who engaged in gun violence had with various city agencies, mostly courts and jails, but the most frequent connection with a health-based organization was the Department of Behavioral Health, both in-patient and out-patient visits and treatments, usually for addiction to alcohol and/or drugs.
If the City of Philadelphia believes that gun violence is a public health crisis, how come there is not one, single mention of any interaction between individuals who commit gun violence and a facility or organization which provides medical services? How come the basis for all public health initiatives, which is defining and dealing with community-wide illness, is left entirely unsaid and unexplained?
As far as I’m concerned, a report whose rationale and reason for being developed is to respond to a public health ‘crisis,’ without any involvement whatsoever with medical professionals is a report that shouldn’t have been published at all.
Want to do something about gun violence without any input from the professionals who have to deal with the physical and mental damage suffered by everyone who gets shot with a gun? Fine. Call gun violence a crisis in ‘policing,’ or a crisis in community ‘safety’ or something else.
But don’t kid yourself and the public into thinking that gun violence is a public health problem which can be solved by ignoring how public health is defined and works.
