NC pediatrician discusses tackling gun violence

By Anne Blythe

The anniversary of the Uvalde mass shooting was not far from the minds of many of the people on a Zoom call several weeks ago that drew health care providers and others interested in lifting Latino voices in discussions about gun violence prevention.

It was the Wednesday before Mother’s Day, and Brian Eichner, a pediatrician in Durham, was presenting sobering data and charts. Only four days earlier, a heavily armed gunman had killed eight people at a shopping mall in Allen, Texas, before a police officer shot him to death

“We’re coming up on the traumatic anniversary of the school shooting in Uvalde,” Eichner told members of LATIN-19, a North Carolina-based organization that came together, in part, because of the deadly mass shooting at a Walmart in El Paso, Texas, in late 2019.

Eichner recalled the violence at Uvalde’s Robb Elementary School in which a former student armed with an AR-15 style rifle killed 19 mostly Latino students and two teachers. “For a lot of families this is going to be the first Mother’s Day without their babies.”

While there were many calls for action amid the thoughts and prayers that spilled out after the third-deadliest school shooting in the United States — surpassed only by the 2007 shooting at Virginia Tech and the 2012 mass killing at Sandy Hook Elementary School — mass shootings have proliferated in 2023.

“We’re not making progress, so how are families supposed to think that we’re doing all we can?” Eichner asked.

There have been 238 shootings in this year alone (as of May 21) in which four or more people were injured or killed, according to Gun Violence Archive.

Additionally, 16,657 people have died this year in the U.S. from gun-related deaths, and 702 of those have been children younger than 18.

In 2021, Eichner said, 3,600 children died in the United States in firearm-related deaths. Until recently, North Carolina had pretty much paralleled the national trends. That has changed in the past three years, and not for the better.

“As a kid in North Carolina, you are 51 percent more likely to die as a result of a gun than you are if you lived in another average state in our country,” Eichner told his audience. “I’d like to challenge us. Unless we’re doing something about it as adults, we’re all complicit in this. … Our voices can’t all be silent.”

No single solution

LATIN-19, which started as a weekly meeting of a handful of health care providers and other interested advocates, has attracted nearly 1,000 participants since the start of the pandemic. It has become a group that many rely on to grapple with some of the thornier health care topics in North Carolina.

Clinicians at Duke University with family ties to Central and South America started the conversations when they were upset by the news that the gunman in the El Paso incident had driven some 600 miles from Dallas to target Hispanic people.

They met informally at first. Then, when the first COVID-19 case was reported in North Carolina in March 2020, they came together officially as the Latinx Advocacy Team and Interdisciplinary Network for COVID-19, or LATIN-19. Since then, they have elevated the voices of Latinos and other communities of color in the Triangle and beyond.

When Eichner was invited to speak to LATIN-19 about gun violence, Durham was wrestling with an uptick in shootings in 2023. In the first four months of the year, at least 11 of the victims were younger than 18.

These are numbers and incidents that health care providers do not want to see normalized. As daunting as it can be to take on gun violence prevention in a state where lawmakers are loosening firearm regulations, some of the participants on the LATIN-19 Zoom call wanted to know what actions they could take.

“The good news is that we can do better,” Eichner said.

Gun locks and safe storage procedures help, he said, as do violence intervention programs.

“Remember our approach to COVID? How we  kind of took the approach that we need to flatten our curve and we were going to use different techniques, whether it be masking or maintaining distance or hand washing and eventually vaccinations, altering work styles, things like that?” Eichner added. “So the same principles apply here. There’s not going to be a single cure. It’s like cancer. There’s not a single cure or prevention, but there’s going to be a step by step of things we need to do to help fight this epidemic.”

More violence researchers now

Making mental health care more readily available is another component of tackling the problem.

Eichner used a chart that showed more children in 2020 dying from gun-related violence than from motor vehicle crashes with a note of optimism in that grim news.

“Guns didn’t pass cars just because of a proliferation of guns,” Eichner said. “It’s because we’ve done better with cars. I think that cars are a good model.”

Researchers pored over data for nearly five decades to find out what features would make motor vehicles safer for children and then worked with policy makers and the car industry to make them more common.

Gun violence research of similar intensity will be important moving forward, Eichner added.

“For a long time, from the mid-90s until 2019, federal dollars couldn’t be spent on gun violence research. It’s something called the Dickey Amendment,” Eichner said. “As of 2015, there were only 20 senior investigators across the country that had research careers in firearm injury prevention.”

When he was starting out as a pediatrician, Eichner said, he was interested in pursuing gun violence research. But he was told that it would “pretty much be a dead end for my career because you weren’t going to be able to get federal funding to do it.”

“This is no longer the case,” he added. “There is an awesome group of young physicians, particularly pediatricians and other scientists, that are violence researchers now. They can inform us on what strategies work and which ones don’t. This is going to have a ripple effect. As these researchers mature, they’re going to have careers and they’re going to have mentees and they’re going to be able to motivate new researchers to study this topic.”

‘The lockdown generation’

In addition to research, pediatricians have become more accustomed to discussing firearm safety with their patients and their parents.

Conversations about guns in the home, especially when children are on playdates, should become as routine as parents sharing information about food allergies, said Jennifer DeCoste-Lopez, another pediatrician on the call.

Children born after 2000 are known in some circles as “the lockdown generation” because of the school lockdowns and lockdown drills that have become normal in their lives.

Gun deaths among children in North Carolina have risen to the level of a public health crisis. A recent North Carolina Child Fatality Task Force report noted that from 2012 through 2021, more than 600 children ages 17 and younger died from firearm-related injuries in North Carolina. 

“Most child deaths from guns still are outside the schools,” Eichner said, while acknowledging that just the mention of school shootings can spark a visceral reaction because so many like to think of schools as secure spaces for children. “It just resonates with all of us because we all think of school as … we really need it to be a safe place for our kids.”

“Part of why I think this is so overwhelming is that we all know the school shootings are just the tip of the iceberg,” Eichner added. “Beyond that, it’s suicides. It’s intimate-partner violence and all of the other things, as well.”

In March, Gov. Roy Cooper created the North Carolina Office of Violence Prevention with a goal of helping law enforcement and public health communities reduce violence in a coordinated way — through training efforts and organizational models that build upon successful community-based programs.

Research will drive solutions

People interested in reversing the gun violence trends can point to research, Eichner stressed, that can help direct policy and community conversations.

“We’ve learned through research that giving gun locks at the same time as we give safe storage education improves people’s gun hygiene, in other words the way that they store their guns, locked and unloaded with ammunition separate,” Eichner said. “Subsequently, some of the studies have built on this to show that if we did this universally, we could save at least 100 kids’ lives per year in our country.”

Research also can show what does not work.

“For instance, we know that giving just a coupon for gun locks doesn’t work,” Eichner said. “We actually have to be able to provide the lock. This is just an example, but it shows we can’t come up with ideas for how to fix this if we can’t do research.”

Beyond the research and debate over amending firearm laws and regulations, Eichner suggested that people can make individual choices that go a long way toward reducing gun violence.

“For those of us in the medical community, our responsibility is to produce data, to produce interventions and educate our communities and our leaders,” Eichner said. “As community members, our responsibilities go much deeper.”

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