Is a gun like a virus, a car, tobacco or alcohol? Yes say public
health experts, who in the wake of recent mass shootings are calling
for a fresh look at gun violence as a social disease.

By MARILYNN MARCHIONE
AP Chief Medical Writer

MILWAUKEE —
Is a gun like a virus, a car, tobacco or alcohol? Yes say public
health experts, who in the wake of recent mass shootings are calling
for a fresh look at gun violence as a social disease.

What we need, they say, is a public health approach to the problem,
like the highway safety measures, product changes and driving laws
that slashed deaths from car crashes decades ago, even as the number
of vehicles on the road rose.

One example: Guardrails are now curved to the ground instead of having
sharp metal ends that stick out and pose a hazard in a crash.

"People used to spear themselves and we blamed the drivers for that,"
said Dr. Garen Wintemute, an emergency medicine professor who directs
the Violence Prevention Research Program at the University of
California, Davis.

It wasn't enough back then to curb deaths just by trying to make
people better drivers, and it isn't enough now to tackle gun violence
by focusing solely on the people doing the shooting, he and other
doctors say.

They want a science-based, pragmatic approach based on the reality
that we live in a society saturated with guns and need better ways of
preventing harm from them.

The need for a new approach crystallized last Sunday for one of the
nation's leading gun violence experts, Dr. Stephen Hargarten. He found
himself treating victims of the Sikh temple shootings at the emergency
department he heads in Milwaukee. Seven people were killed, including
the gunman, and three were seriously injured.

It happened two weeks after the shooting that killed 12 people and
injured 58 at a movie theater in Colorado, and two days before a man
pleaded guilty to killing six people and wounding 13, including
then-Rep. Gabrielle Giffords, in Tucson, Ariz., last year.

"What I'm struggling with is, is this the new social norm? This is
what we're going to have to live with if we have more personal access
to firearms," said Hargarten, emergency medicine chief at Froedtert
Hospital and director of the Injury Research Center at the Medical
College of Wisconsin. "We have a public health issue to discuss. Do we
wait for the next outbreak or is there something we can do to prevent
it?"

About 260 million to 300 million firearms are owned by civilians in
the United States; about one-third of American homes have one. Guns
are used in two-thirds of homicides, according to the FBI. About 9
percent of all violent crimes involve a gun - roughly 338,000 cases
each year.

Mass shootings don't seem to be on the rise, but not all police
agencies report details like the number of victims per shooting and
reporting lags by more than a year, so recent trends are not known.

"The greater toll is not from these clusters but from endemic
violence, the stuff that occurs every day and doesn't make the
headlines," said Wintemute, the California researcher.

More than 73,000 emergency room visits in 2010 were for
firearm-related injuries, the Centers for Disease Control and
Prevention estimates.

Dr. David Satcher tried to make gun violence a public health issue
when he became CDC director in 1993. Four years later, laws that allow
the carrying of concealed weapons drew attention when two women were
shot at an Indianapolis restaurant after a patron's gun fell out of
his pocket and accidentally fired. Ironically, the victims were health
educators in town for an American Public Health Association
convention.

That same year, Hargarten won a federal grant to establish the
nation's first Firearm Injury Center at the Medical College of
Wisconsin.

"Unlike almost all other consumer products, there is no national
product safety oversight of firearms," he wrote in the Wisconsin
Medical Journal.

That's just one aspect of a public health approach. Other elements:

-"Host" factors: What makes someone more likely to shoot, or someone
more likely to be a victim. One recent study found firearm owners were
more likely than those with no firearms at home to binge drink or to
drink and drive, and other research has tied alcohol and gun violence.
That suggests that people with driving under the influence convictions
should be barred from buying a gun, Wintemute said.

-Product features: Which firearms are most dangerous and why.
Manufacturers could be pressured to fix design defects that let guns
go off accidentally, and to add technology that allows only the owner
of the gun to fire it (many police officers and others are shot with
their own weapons). Bans on assault weapons and multiple magazines
that allow rapid and repeat firing are other possible steps.

-"Environmental" risk factors: What conditions allow or contribute to
shootings. Gun shops must do background checks and refuse to sell
firearms to people convicted of felonies or domestic violence
misdemeanors, but those convicted of other violent misdemeanors can
buy whatever they want. The rules also don't apply to private sales,
which one study estimates as 40 percent of the market.

-Disease patterns, observing how a problem spreads. Gun ownership - a
precursor to gun violence - can spread "much like an infectious
disease circulates," said Daniel Webster, a health policy expert and
co-director of the Johns Hopkins Center for Gun Policy and Research in
Baltimore.

"There's sort of a contagion phenomenon" after a shooting, where
people feel they need to have a gun for protection or retaliation, he
said.

That's already evident in the wake of the Colorado movie-theater
shootings. Last week, reports popped up around the nation of people
bringing guns to "Batman" movies. Some of them said they did so for
protection.