Gun Violence Bleeds into Healthcare Reform

2022.06.10 El_Paso_shooting_memorial

The heart-wrenching mass shooting at Robb Elementary School in Uvalde, Texas, on May 24 has reawakened attention to firearm violence. 

Fixing U.S. Healthcare sees firearm violence as a public health issue. It identifies the dynamics opposing gun safety reform as similar to those opposing healthcare reform. It also sees similar messaging tactics employed by both, pitting special interests against the common good. And it sees the same path forward – examine the facts, confront the obfuscations, and dialogue across differences.

Firearm Violence Is a Public Health Issue

From 1996 to 2019, the so-called Dickey Amendment in effect barred the Centers for Disease Control from collecting data related to firearm injuries and deaths. Funding was restored in 2019, and research can now proceed to guide gun safety reform.

The CDC’s new data registered 45,222 gun-related fatalities in 2020, making firearms the eleventh leading cause of death in the U.S., ahead of car accidents, sepsis, and falls. Alarmingly, firearm injuries are among the top four causes for deaths under age 35.

Greed & Power

Fixing U.S. Healthcare has called out greed, corrupt power, and cronyism as the root of inaction on healthcare reform. We see the same dynamic underlying inaction of gun safety reform.

Multiple polls, including Gallup March 2018, show more than 80 percent of Americans support tightened background checks, raising gun purchase age to 21, screening for violent threats among students, as well as improved school security. The same poll showed 56 percent support for a complete ban of high-capacity assault weapons. After a bill to expand background checks was defeated in the Senate in 2013, 65 percent objected that the Senate should have passed the bill.

Gallup’s polling also reflects areas of disagreement, as well. For example, the same polls show that 52 percent want stricter gun control laws, 11 percent less strict, and 35 percent keeping laws as they are.

Money is a factor driving political inaction. Forbes reported annual gun and ammunition revenue of $17 billion for 2018. Forbes calculated an addition $13 billion in revenues from related “gun industry” sales such as security systems, guard training, and shooting ranges. Homeland Security has averaged another $65 billion annually in domestic security spending.

Forbes comments that these figures appear modest compared to, say, Amazon’s annual sales of $178 billion in 2017. But Open Secrets reports up to $30 million annually spent on lobbying Congress both pro and con gun control, putting it in the same league as business, pharma and healthcare lobbying. BBC reports $3 million spent by the NRA, but admits that PAC spending is not easily tracked and not included in that figure.

So, it also comes down to power, most notably in the U.S. Senate.  A 2017 Gallup poll showed that 24 percent of registered voters supported candidates based solely on the gun control issue (either pro or con), and another 61 percent indicated guns were an “important issue.”

Guns have a disproportionate impact as a wedge issue. Politicians either love NRA’s CEO Wayne LaPierre or hate him – no middle ground.

Solutions to gun safety and healthcare reform will not come from the greedy or the powerful, only from we-the-people.

“Dog-Whistle” Messaging

Like opponents to healthcare reform, some opponents of gun safety reform employ misleading messages or slogans with veiled race-tinged undertones. Their arguments superficially appear to be good-faith rational claims. But in fact they are, at least in part, bigoted tropes that tap into racial resentment. This rhetorical ploy clouds the issue of gun safety, fragments principled reform efforts, and subverts solutions that could benefit all.

Let’s look at examples of these obfuscations:

1. School shooters are the product of “disastrously falling apart” families, especially fatherless ones.

True meaning: “Others” are the problem, period.

Racist message: Non-whites — stereotyped as living in indignity — are uncivilized, disorderly, violent, morally depraved, and socially objectionable.

Ulterior motive: Distracts from the many factors contributing to gun violence, deflecting attention away from the gun industry’s complicity. Also serves certain politicians as a wedge issue and voter motivator by stoking fear and acrimony toward non-white groups.            

Kernel of truth:  Poverty, lack of family-friendly policies, and structural racism do contribute to civic, economic, and political disruption. Truth is, these – along with healthcare reform – should be addressed for their own sake and for the sake of family well-being, not just as a remedy for gun violence.

2. Texas Governor Greg Abbott says, “Anybody who shoots somebody else has a mental health challenge. Period.”

True meaning: Mentally ill “others” are the problem, “period.”

Racist message: See, Abbott can say, this is not a racist claim. It’s mentally ill persons of all races who are uncivilized, disorderly, violent, morally depraved, and socially objectionable.

Ulterior motive: Same as 1., except directing fear and acrimony at the mentally ill.

Fact check: A very small number of mentally ill persons are violent. Of these, a greater number, tragically, direct their violence against themselves than at others. Most acts of violence are committed by persons without mental illness, and most persons with mental illness do not commit acts of violence. Mentally ill persons are much more likely to be victims of violence and perpetrators of it, per a public health report.

Kernel of truth: Mental illness is a problem. Gov. Abbott should expand Medicaid to give access to mental health and general health care in his state. Doing so, in itself, will probably not reduce gun violence. Incidentally, 21 percent of adults in the U.S. experienced mental illness in 2020 – we all need care, not stigmatization.

3. Representative Mo Brooks (R-Alabama) says, “…if you’re talking about depriving people of their Second Amendment right to bear arms, well, first, it’s unconstitutional.”

True meaning: Vote for me based on this wedge issue alone – no debate, dialogue, or compromise.

Racist message: Several respected historians have interpreted the Second Amendment, adopted 1791, as protecting “well-regulated militias” (successors of slave patrols) to allow “free states” (in the South) to maintain “security” (against slave revolts, such Gabriel’s uprising in 1800, put down by then-Governor James Monroe using the Virginia state militia). These historians include Carl T. Bogus and Joseph Ellis in The Quartet (p. 206).

Ulterior motive: Vote for me based on this wedge issue alone.

Kernel of truth: Jurists, Constitutional scholars, politicians, and public policy experts do need to consider the prerogatives of law-abiding citizens to own guns and lawfully use them, as legislators seek a balanced approach to gun safety.

4. Gallup reports in November 2021, ”88% of U.S. gun owners, up from 67% in 2005, own for crime protection.”

True meaning: We fear crime and criminals

Racist message: We fear non-white crime and criminals.

Fact Check:

  • Some studies report that 25 million persons have used a gun in self-defense at least once in their lives, and that self-defense gun use occurs at least 65,000 times and perhaps as many as 3 million times per year. Others have claimed that these figures overstate self-defense use.
  • Skeptics counter that “claims about the benefits of gun ownership [for self-protection] are largely myths,” based on best available research.
  • What does the CDC say? “Given the wide variability in estimates, additional research is necessary to understand defensive gun use prevalence, frequency, circumstances, and outcomes.”

Kernel of truth: Crime is a problem. Crime in non-white communities is a disproportionate problem. There is reason to doubt that “the best protection from a bad guy with a gun is a good guy with a gun.” The 1968 Kerner Report would be a more comprehensive and fact-based starting place to address the problems of crime, civil unrest, and their underlying causes.

Racism is Not the Issue

We point out the race-based subtext of these arguments, not to condemn them or attack their authors but rather to help us separate true substance from confounding passion.

“There’s not a racist bone in my body!”  That’s correct. Racism is not in our “bones,” but rather hard-wired into our nervous systems. Humans are social, and that means we are all, in a sense, racist. Our survival on the primeval plains of Africa depended on our instincts to discern whom to trust and whom not to, who was our in-group and who was “other.”

Our survival now in complex, large, multi-ethnic societies – or at least our ability to thrive in these 21st century circumstances – now depends on ability to discern when to trust our primitive instincts (say, to react to real threats when Talking with Strangers) and when deliberately to override these instincts in order to dialog across differences or to synergize with “others.”

That’s a big challenge — a constant tension in every social interaction, including debates over gun safety and discussions of healthcare reform. But it need not deter reform.

What Works?

Putting aside passion – race-based and otherwise — let’s ask, What actually works? A 2018 comprehensive RAND Corporation review of existing evidence identifies the following measures that reduce violent crime, unintentional injuries, and suicides:

Strongest Evidence

  • Child access prevention laws
  • Waiting periods

Moderate Evidence

  • Background checks
  • “Red flag” authority in case of threatened domestic abuse
  • Stand-your-ground laws result in net increase in homicides

Limited Evidence

  • “Red flag” authority in case of mental-illness-associated homicidal or suicidal ideation
  • Licensing restrictions
  • Minimum age restrictions
  • Assault weapons ban
  • Concealed-carry laws


  • Gun-free zones
  • Armed personnel in K-12 schools
  • Lost firearm reporting
  • Firearm safety training
  • Firearm registration
  • Bans on low-quality handguns
  • “Red flag” laws (except domestic abuse and mental illness, above)
  • Surrender of firearms by prohibited possessors

Conclusion:  Individual Interests and the Common Good – “Let’s Talk”

In addition to the tension between us and “others,” here’s another obfuscation – the tension between the individual and the state, between libertarian freedom-from (“don’t tread on me”) and social-contract freedom-to (“form a more perfect union”) – see our Fuzzy Concepts blog post.

This is the tension between Ronald Reagan and Thomas Jefferson.  Reagan said, “Government is not the solution to the problem; government is the problem.” On the other hand, Thomas Jefferson declared that “to secure these Rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.” He went on to say that it is “the Right of the People to alter or to abolish it. . . laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.”

In other words, Jefferson insists that we must make Government give us solutions, ones to which we all compromise, consent, and ultimately agree to unify behind as the best way collectively to secure our rights. Political theorist Denise Allen explains in a succinct video.

Of course, government is not the only solution in our rich society. America is teeming with businesses large and small, civic associations, knowledge infrastructure, and shared history, creed, and community.

Jefferson’s compatriots in 1787 crafted a Constitution that struck a balance between the rights of individuals and the synergism of the Union. And they had the genius to build in mechanisms for future “alteration” and resilience counter-balanced against unalterable “inalienable” principles.

So, with Jefferson, let’s put aside passions. And let’s listen first, probe each other’s viewpoints, and then work to satisfy each other’s concerns. Maybe — even Reagan himself did this! — then compromise on areas of disagreement. Both on gun safety reform and on healthcare reform.

Take Action

Take action to advocate for gun safety reform and healthcare reform.

Image Credit

Title:  El Paso Shooting Memorial

By:  ruperto miller from panama, panama, via Wikimedia Commons


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2 thoughts on “Gun Violence Bleeds into Healthcare Reform

  1. Updates to this post:
    • On June 23, the Supreme Court invalidated at New York state law regulating concealed carry of firearms, declaring a Constitutional right to bear arms in public. [ ]
    • President Biden signed Congress’s Bipartisan Safer Communities Act on June 25. It provides incentives for states to expand “red flag” laws, closes the so-called ‘boyfriend loophole,” funds school safety, expands background check for purchasers between age 18 and 21, and funds more mental health services. [ ]
    • The “good guy with a gun” solution to mass shootings came under further dispute in a June 22 analysis by the New York Times of data from the ALERRT Center of the University of Texas. It showed that among 433 mass shooting events between 2000 and 2021, only 12 (2.7%) were ended by an armed civilian by-stander. [ ]
    • Journal of A.M.A. published two reviews of firearm violence during the pandemic, underscoring its public health importance and its correlation with poverty and race-based disparities. [ ] and [ ]


  2. RAND Corporation updated its research review in January 10, 2023 (available at link, above). RAND cites further strong evidence supporting child access prevention laws, but now also new strong evidence associating concealed-carry laws and stand-your-ground laws with increased firearm violence.


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