Ready, aim, fire at gun disease

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Richmond (left) and Schwab see gun violence as a public health issue. Photo by Candace diCarlo

C. William Schwab and Therese S. Richmond want to take the political fire out of the firearm debate. Instead of looking at the issue in terms of politics, they want to reframe the discussion as a public health issue.

When we talk about firearm violence in the political world we are constantly polarized into are you pro-gun or are you anti-gun? Well, were not either, said Richmond, associate professor of trauma and critical care nursing in the School of Nursing. Were interested in decreasing the toll of firearm violence.

The Hospital of the University of Pennsylvania has treated one gunshot wound a day for the last 12 years, said Schwab, professor of surgery in the School of Medicine. Astronomical figures such as these led him and Richmond to co-establish the Firearm Injury Center at Penn. Founded in 1997, FICAP represents a unique collaboration between the School of Medicine and the School of Nursing.

To Richmond, it makes sense to think of gun violence as a public health issue. It may not be a disease where you have a germ in your body, but its a disease where you have a bullet in your body, she said. When youre shot, where are you brought? Youre brought to the hospital.

She and Schwab argue that the publics understanding of firearm violence needs expansion. All we have is truly the tip of the iceberg and whats interesting is that [the] part of the iceberg that is sticking out is so dominated by urban America that nobody has any idea of whats happening in suburbia and rural America, said Schwab.

Schwab and Richmond point out that an important area of firearm violence suicide is completely neglected in crime data reporting. And while the causes of suicide may be rooted in something other than guns, the two say firearms deserve a place in the discussion. There are root causes for violence, just as there are root causes for suicide, but when you enter the gun into the equation it increases the lethality so much. It makes it an irretrievable event, said Richmond. If you take guns out of the equation, salvaging peoples lives is that much more likely.

To put all forms of firearm violence on the nations radar screen, FICAP is pushing for a national violent-death reporting system, something which currently doesnt exist. Its not like an infectious disease where we could literally turn at any time to a Web site created by, supported by, and disseminated by the federal government that says last year we had x number of cases of measles and this is where they were. We dont have any of that [for firearm violence], said Schwab.

Schwab and Richmond believe that only with such a system in place can data-driven intervention then take place.

Richmond says that FICAPs research attempts to bypass politics and address one simple questionIs there a way, if you choose to live in a society with guns, that we can make it safer?