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Gun violence as a public health crisis

Northwell Health convenes forum, pledges $1M for research


Six bullets pierced Jessica Ghawi’s body on July 20, 2012. The “kill shot,” said her mother, Sandy Phillips, cut a five-inch hole in the side of her face. The aspiring sports reporter was one of 12 killed in the Aurora, Colo., movie theater massacre. Seventy were injured.

On Dec. 12, Phillips and her husband, Lonnie, sat before 170 physicians, hospital administrators and researchers from across the country at Northwell Health’s Gun Violence Prevention Forum, recounting the awful moments of their daughter’s death.

Ghawi had survived a mass shooting in Toronto in June 2012, only to be killed seven weeks later, they said.

The couple were among 26 speakers at the intense morning-long seminar in Manhattan, convened to gather support for a nationwide coalition of health care providers that will work to reduce gun violence. 

The Phillipses, who started the nonprofit foundation Survivors Empowered, held hands as they spoke plainly, deliberately.  They were there, they said, to advocate for the survivors of mass shootings.

“We see their pain,” Sandy said. “We see their daily struggles.”

Michael Dowling, Northwell’s president and chief executive officer, organized the forum in the hope of forming a working group of health professionals to take steps to end the nation’s epidemic of gun violence. Some 38,000 people are killed annually, two-thirds of them by suicide. 

“If we get involved as a collective,” Dowling said, “I think we can have more traction.”

Toward the end of the forum, two high school students, Payton Francis and Marisol Martinez, both survivors of the Parkland, Fla., massacre in February 2018, offered a stirring vocal performance of original works that addressed the suffering caused by gun violence. 

Dowling then announced that Northwell was pledging $1 million to fund research into the causes of gun violence and to seek evidence-based solutions to stop it. He also called on the country’s 50 to 60 other largest health systems to do so, and to sign a pledge to promote gun safety while preserving Second Amendment rights. 

Reframing the debate

Medical systems like Northwell, Dowling said, have a “special responsibility” to address a public health crisis such as gun violence, and they have influence in their communities. Northwell, he noted, is New York’s largest private employer, with 62,000 people on staff, giving it an outsized voice.

The key, Dowling said, is to “reframe” the narrative surrounding gun violence from a polarized political debate to a reasoned dialogue on public health, similar to  past discussions on car safety, smoking and HIV/AIDS.

“This is about families. This is about kids,” he said. “This is a moral issue.”

Dr. Tom McGinn, Northwell’s deputy physician-in-chief and senior vice president, said that gun violence must be thought of as a disease that has spread across the nation. He likened a bullet to a vector, which is any agent that carries a bacteria or virus, such as a mosquito or tick. 

Of the bullet, McGinn said, “We’ve got to prevent it from entering the body.”

Greater research is needed, he said, so proposed solutions are proven effective, according to science, before they are put into widespread practice.

Gun violence, McGinn said, disproportionately affects young men of color, and it is primarily centered in coastal cities. Beyond that, the causes of gun violence have not been widely studied, in large part because the federal government has provided relatively little funding for the research.

In April, the House of Representatives passed a $50 million spending bill to study gun violence, with $25 million for the Centers for Disease Control and Prevention and $25 million for the National Institutes of Health. A companion bill in the Senate was introduced last January, but never sent to committee for review and an eventual vote by the full chamber, and so the funding was never allocated.

The House bill was the first time that Congress had passed a measure to fund gun violence research in two decades. 

Caring for the victims of gun violence costs the nation $229 billion a year, a September congressional report found. 


Reducing the violence

Dr. Sheldon Teperman is the director of the trauma center at Jacobi Medical Center in the Bronx, a public hospital that is part of the New York City Health and Hospitals Corporation. As a trauma surgeon, he is on the front lines, fighting to save the victims of gun violence. 

Teperman has advocated for gun control for years, he said, working in 2003 with then U.S. Rep. Carolyn McCarthy, a Democrat from Mineola, in an attempt to renew the federal Assault Weapons Ban of 1994, which expired in 2004. It has not been reinstated since.

Beyond the deaths, more than 100,000 people are injured in shootings each year, Teperman noted. “I see a legion of young black men who are paralyzed,” he said.

On two large screens, he projected a photo of a woman who was late in her pregnancy, lying on a gurney with a bullet hole in the side of her abdomen. “The sound of that screaming baby . . . still haunts me,” Teperman said.

He grew particularly emotional speaking of 92-year-old Sadie Mitchell, who was struck by a stray bullet while sitting in her apartment in the Bronx in 2009. The 18-year-old who fired the shot called her death “an accident,” according to The Daily News.

Teperman operated on Mitchell and, distraught that he could not save her, collapsed on the surgical room floor, covered in blood, unable to stand, he recalled. 

When Mitchell died in his hands, Teperman said, he thought about his “failed advocacy” and his mother. In a Herald interview after the forum, he said, “At that moment, I just felt like it was never getting better,” referring to gun violence.

Reducing it, he said, is “not complicated,” and he offered a three-point plan:

• End the gun-show loophole, which allows buyers at gun shows to purchase weapons without having to pass a federal background check. 

• Ban assault weapons.

• Ban high-capacity magazines.

Pass these measures, Teperman said, “and we end the carnage.”

The Phillipses implored attendees to continue the discussion and their advocacy. “This is giving us hope,” Sandy said. “If you do nothing else, you have given us hope, so don’t stop here.”