The Public Health Approach to Firearm Violence "What is it, Why Do We Need It?The Public Health Approach to Firearm ViolenceWhat is it, Why Do We Need It?

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The Public Health Approach to Firearm Violence What is it, Why Do We Need It? Victor W. Sidel, MD Distinguished University Professor of Social Medicine Montefiore Medical Center & Albert Einstein College of Medicine Past President: American Public Health Association, Physician for Social Responsibility, International Physicians for the Prevention of Nuclear War IANSA Public Health Network Panel on “ Risk and Resilience: Understanding the Factors that Influence Small Arms Violence” United Nations Church Centre -- July 16, 2008

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On July 1, 1665, the lordmayor and aldermen of the city of London put into place a set of orders “concerning the infection of the plague,” which was then sweeping through the popula- tion. He intended that these actions would be “very expedient for preventing and avoiding of infection of sickness” (1). At that time, London faced a public health crisis, with an inade- quate scientific base in that the role of rats and their fleas in disease transmission was unknown. Nonetheless, this crisis was faced with good intentions by the top medical and political figures of the community. Daniel Defoe made an observation that could apply to many public health interventions then and today, “This shutting up of houses was at first counted a very cruel and unchristian method… but it was a public good that justi- fied a private mischief” (1). Then, just as today, a complex relationship existed between the science of public health and the practice of public health and politics. We address the relationship between science, public health, and politics, with a particular emphasis on infectious diseases. Science, public health, and politics are not only com- patible, but all three are necessary to improve the public’s health. The progress of each area of public health is relat- ed to the strength of the other areas. The effect of politics in public health becomes dangerous when policy is dictat- ed by ideology. Policy is also threatened when it is solely determined by science, devoid of considerations of social condition, culture, economics, and public will. When using the word “politics,” we refer not simply to partisan politics but to the broader set of policies and systems. Although ideology is used in many different ways, in this case, it refers to individual systems of belief that may color a person’s attitudes and actions and that are not nec- essarily based on scientific evidence (2). Public Health Achievements Science influences public health decisions and conclu- sions, and politics delivers its programs and messages. This pattern is obvious in many of public health’s greatest triumphs of the 20th century, 10 of which were chronicled in 1999 by the Centers for Disease Control and Prevention (CDC) as great public health achievements, and several of which are presented below as examples of policy affecting successes (3). These achievements remind us of what can be accomplished when innovation, persistence, and luck converge, along with political will and public policy. Vaccination Childhood vaccinations have largely eliminated once- common, terrible diseases, such as polio, diphtheria, measles, mumps, and pertussis (4). Polio is being eradicat- ed worldwide. The current collaboration between the World Health Organization, the United Nations Children’s Fund, CDC, and Rotary International is a political as well as biological “tour de force,” and eradication of polio in Nigeria has been threatened by local political struggles and decisions. ...

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The Public Health Approach to Firearm Violence "What is it, Why Do We Need It?The Public Health Approach to Firearm ViolenceWhat is it, Why Do We Need It?

1. The Public Health Approach to Firearm Violence What is it, Why Do We Need It? Victor W. Sidel, MD Distinguished University Professor of Social Medicine Montefiore Medical Center & Albert Einstein College of Medicine Past President: American Public Health Association, Physician for Social Responsibility, International Physicians for the Prevention of Nuclear War IANSA Public Health Network Panel on “ Risk and Resilience: Understanding the Factors that Influence Small Arms Violence” United Nations Church Centre -- July 16, 2008

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