On June 25, the U.S Surgeon General, Dr. Vivek Murthy, rightly declared gun violence a public health threat. Every day 117 Americans lose their lives to gunshot wounds, which are also the number one killer of children and adolescents, surpassing car accidents. With more guns than people in the U.S., this is an epidemic that is not waning.
At Hackensack Meridian Health, we agree with Dr. Murthy; we must address gun violence as a public health problem, not a political one. We need to embrace evidence-based solutions, robust public awareness campaigns and create cultural shifts. We owe it to our children and the countless families that are being destroyed every day to take action, starting at the bedside in emergency rooms.
Our New Jersey-based health network has aided 700 people over the last three years through Project HEAL (Help, Empower, and Lead) and our Trauma Injury and Prevention program. In addition to acute care, our teams provide counseling, intensive case management, job training, support navigating the legal system and other wraparound services to patients who present with violent injuries. The surgeon general noted that change could emanate from healthcare settings and at Hackensack Meridian our program and similar efforts nationally are proof that hospitals are a vital part of the solution.
There is not a one-sized-fits-all approach to addressing the unique needs of our patients. One man was shot five times in a Jersey shore town in front of his son, the victim of a love triangle gone bad. The victim didn't even know the man who left a bullet in his thigh. The program provided counseling and support for the man to obtain his commercial driver's license. For another patient, we purchased a bus ticket from Asbury Park, N.J. to Asheville, N.C. to help him avoid a retaliatory gang shooting and start a new life.
The cyclical nature of violence compounds this crisis. Studies show that up to 40% of those who present to the hospital with a violent injury return with another within five years. Even more alarming, up to 20% of these patients die from another violent injury in that same timeframe.
And remember, while 117 Americans die every day, another 200 on average visit emergency rooms for nonfatal firearm injuries and must endure lifelong consequences of those injuries. This epidemic is especially pronounced in communities of color. Young Black men and teens made up more than one-third of firearm homicide victims, according to the Centers for Disease Control and Prevention. It is also important to note that while gun violence conversations tend to focus on homicides, nearly six out of every 10 gun death in the U.S. are suicides. Health systems throughout the US also need to work diligently to address our mental health crisis by expanding access and better coordinating care and innovating treatment.
Our commitment to treating violence as a public health issue is part of a broader strategy to not only take into account patients' medical records but to consider other aspects of their lives to provide quality healthcare. Up to 80 percent of the factors that impact health are non-medical including stable housing, access to healthy food and transportation and personal safety. In the last two years, Hackensack Meridian has screened 1.5 million people for social determinants of health and provided 4.3 million referrals for community-based services our patients may not even know exist.
As a nation, we know public health campaigns can save lives. Each year, seat belts save more than 15,000 people. In 1964, when Congress ordered health warnings to appear on cigarette packs about 42 percent of Americans smoked. By 2021, the percentage had dropped to 11.5 percent. Let us be clear - our focus is on public health and safety so that we can see measurable progress against this epidemic.
The impact of violence – of the empty chair at the dinner table where a loved one used to sit – reminds us why we must intervene. Together, we can create a nationwide network of healthcare providers committed to treating violence as the public health emergency it is. Our communities deserve nothing less.
Robert C. Garrett, is CEO of Hackensack Meridian Health, New Jersey's largest health system.
Aakash Shah, MD, is medical director at Project HEAL and chief of Addiction Medicine, Department of Psychiatry and Behavioral Health at Jersey Shore University Medical Center.