Karen Udoh and Caitlin Wessel

Schools, hospitals, movie theaters, workplaces, grocery stores, concerts, churches, neighborhoods…nowhere is safe from the increasing gun violence plaguing communities across the nation. In 2020 the Centers for Disease Control and Prevention reported an estimated 45,222 firearm-related deaths in the United States, including homicide, suicide, unintentional injuries, and law enforcement-involved shootings³. These numbers continue to rise at record paces as we are now seeing gun violence as the leading cause of death among U.S. children and adolescents³. It is ever so apparent that gun violence is a public health crisis that can no longer be ignored.

Unfortunately, Louisville, Kentucky is no exception to this. Homicides went up 63% in 2020, with 76% of the homicide victims being Black. The Black community of Louisville only makes up 24% of the population but makes up the majority of deaths seen in the city. When we look at youth firearm mortality, Black youths shoulder most of the burden with a firearm mortality rate 4.³ times higher and a firearm homicide rate 14 times higher than that of their white counterparts¹. We see some correlations on areas with the highest poverty level and also have the highest level of gun violence. West Louisville in particular, which is predominantly Black, has the highest rates of poverty, food insecurity, and gun related violence and fatalities in the city. In full display, these statistics emphasize the racial inequities when it comes to gun violence. This only touches the surface as we often overlook the long-term effects and cost this has on communities, especially those left behind with physical and invisible wounds from this violence¹,³,⁴.

More and more people are now living with life altering physical disabilities from gun violence to chronic mental health disorders. We cannot discount the constant fears many individuals have not knowing if their daily activities will put them at risk of being shot. This is no state of fear that anyone should live in. The actual cost of gun violence is striking. According to the National Institute on Criminal Justice reform on the cost of gun violence in Louisville, it is estimated that the total cost of an injury shooting is $1 million for two suspects and $1.8 million for a homicide shooting for two suspects. Factoring in the last 5 years, taxpayers in Louisville paid more than $104.4 million7. This cost broadly accounts for crime scene responses, hospital/rehabilitation, criminal justice, incarceration, victim support, and lost tax revenue. There is no denying how much the healthcare field plays a major role in the response and prevention of gun violence, from the system to the individual level. There must be a greater push to reduce gun violence and promote preventative strategies to mitigate the major effects gun violence has on our communities⁷.

With how extensive gun violence has infiltrated our society, the approach to address this issue must be multifactorial. Therefore, our physicians and healthcare workers have an obligation to speak out and develop initiatives to address this issue. These approaches are often divided into the framework of protecting those at greatest risk, addressing the physical and social characteristics of communities and implementing policies to enhance economic and household stability³,⁴.

Oftentimes medical providers are unsure about how they can use their role in healthcare to address issues like gun violence. A feasible place to start is by examining the needs of your patients, and then determining how best to advocate for those at greatest risk. As a provider, the way you advocate can take on many different forms and occur at many different levels

Patient Level

There are a handful of topics that can be challenging for physicians to talk about with their patients, one of which is gun ownership. Some gun owners are completely fine talking about the guns they own, and how they use and store them. Others can be quite hesitant, either out of mistrust or concern for their privacy. Either way, it is important to ensure that all our patients have easy access to quality information on gun safety and storage.

The Law Center to Prevent Gun Violence found a 23% drop in unintentional firearm deaths and an 8% drop in suicide among older children over a 4yr period when gun storage safety was implemented8. For example, any gun not in use should be unloaded, locked up with a locking device that has a key/combination inaccessible to children or any unauthorized users, and stored separately from ammunition6. It is important to emphasize to patients that just because a gun is out of sight, that does not mean that it is inaccessible to other people. When parents and children were independently asked about firearms in their homes, 40% of parents incorrectly assumed that their child didn’t know where their gun was stored⁶.

Safes are the most secure way to protect firearms from being stolen or used improperly, however lock boxes are oftentimes more affordable and work just as well⁸. Trigger locks are devices that can be inserted into the trigger guard that prevent the actual trigger from being pulled, even if a gun is cocked and loaded8. Safe storage devices are provided for free by the Arabian Federation of Martial Arts Academy (https://www.facebook.com/TheArabianKnightsandQueens/) here in Louisville¹¹, but can also be purchased at most gun retailer shops.

Alongside proper storage technique, any adult who owns a gun is obligated to know how to safely use it. The Rhinox Research Group (https://rhinoxresearchgroup.com/)is a veteran-owned gun education class founded by Louisville native Aaron McGahee¹⁰. McGahee offers classes year-round that are geared towards gun owners at all different levels.

Community Level

There are a handful of amazing programs here in Louisville that are working towards reducing the burden gun violence is placing on members of our community. We highly recommend supporting these organizations through volunteering, donations, or raising awareness about these programs to your patients.

Future Healers (https://uoflhealth.org/future-healers/) is a collaborative effort supported by ULSOM SNMA Chapter, UofL Health Trauma Institute, UofL Surgery Department, and Christopher 2X Game Changers. The goal of this program is to build “stronger bridges between the Louisville health care community and our city’s youth most impacted by gun violence.”⁵ Future Healers offers free interactive lessons and mentorship to children in Louisville impacted either directly or indirectly by gun violence.

Christopher 2x Game Changers (https://www.2xgamechangers.org/) is a nonprofit that “promotes early childhood education, parental involvement, mentoring, and community involvement to positively transform the lives of children….and make communities safer in the Louisville area.”² They partner with local organizations to support victims of gun violence through healing and education.

Pivot to Peace (https://louisvilleky.gov/government/office-safe-healthy-neighborhoods/pivot-peace) is a UofL Health program in collaboration with the Peace Education Program that assists victims of stabbing and gunshot injuries to address components of their lives that increase their risk of experiencing violence. Victims work with a team of case workers, peer support specialists, mental health professionals, and community resources throughout their recovery. This program has reported a 95% reduction in injury recidivism when compared to victims not enrolled in the program⁹.

Whitney Strong (https://www.whitneystrong.org/)is an organization that advocates for gun safety legislation founded by survivor Whitney Austin. The goal of Whitney Strong is to find “common ground to end gun violence through data-driven, responsible gun ownership solutions.”¹² Both leaders and volunteers take active roles in advocating for bipartisan gun safety laws in both Kentucky and Ohio.

Legislative Level

The Kentucky Medical Association (KMA) has resources to help physicians identify and directly contact local legislators, as well as information on the current state legislative agenda. The fee for KMA membership is waived for all past and present ULSOM medical students. This is a great resource for healthcare workers to have their voices heard on a county and state level.

The American Medical Association (AMA) is a national organization that helps American physicians advocate for a variety of topics on a national scale and creates a platform for discussion across the country. This is a great resource for healthcare workers to have their voices heard on a national level.

Call to action:

With the continuously growing burden of gun violence in Louisville, we challenge you to step outside of your comfort zone and try advocating for your patients in a different way!

If you would like to learn more, we recommend these additional resources below that can expand yours and your patient’s knowledge on gun violence prevention and gun ownership safety in U.S.

Doctors 4 Gun Safety: https://doctors4gunsafety.org/
BulletPoints: www.bulletpointsproject.org

Project Childsafe: https://projectchildsafe.org/
American Psychological Association’s Gun Violence Prevention https://www.apa.org/topics/gun-violence-crime/prevention
American Academy of Pediatrics Advocacy Toolkit https://www.aap.org/en/advocacy/gun-violence-prevention-advocacy-toolkit/
Gun Violence Trauma Resources: https://www.counseling.org/knowledge-center/mental-health-resources/gun-violence-trauma-resources
John Hopkins Center for Gun Violence Solutions: https://efsgv.org/learn/learn-more-about-gun-violence/mental-illness-and-gun-violence/
Future Healers: https://uoflhealth.org/future-healers/
Whitney Strong: https://www.whitneystrong.org/
Pivot to Peace: https://louisvilleky.gov/government/office-safe-healthy-neighborhoods/pivot-peace
https://www.peaceeducationprogram.org/pivot-to-peace/
Arabian Federation of Martial Arts Academy: https://www.facebook.com/TheArabianKnightsandQueens/
Christopher 2x Game Changers: https://www.2xgamechangers.org/
Rhinox Research Group": https://rhinoxresearchgroup.com/

Additional Resources:

Andrews, Annie L., et al. “Pediatric Firearm Injury Mortality Epidemiology.” American Academy of Pediatrics, American Academy of Pediatrics, 28 Feb. 2022.
“Christopher 2X Game Changers” Christopher 2X Game Changers, 2019.
“Fast Facts: Firearm Violence Prevention.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 May 2022.
“Firearm Deaths Grow, Disparities Widen.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 June 2022.
“Future Healers.” UofL Health, 24 May 2022.
Kravitz-Wirtz, et al. “Safe Storage.” BulletPoints Project, 24 May 2022.
“Office for Safe & Healthy Neighborhoods.” LouisvilleKY.gov, June 2022.
Person. “Gun Safety 101: How to Store Guns Safely in Your Home.” Garage Cabinets - Direct from the Manufacturer - Made in The USA, 12 Feb. 2021.
“Pivot to Peace.” LouisvilleKY.gov, 2022.
Rhinox Research Group, 3 June 2022
Sanders, Author: Ford. “'Things Can Happen in an Instant'; Local Groups Fighting Gun Violence Offer Free Gun Locks.” whas11.Com, 27 Apr. 2022.
“The WHITNEYSTRONG Organization.” The WhitneyStrong Organization, 2021.

This is Our Lane: Gun Violence Prevention

Additional Resources: