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Clinton, Doctors Push Gun Debate Into Public Health Arena

December 7, 1993

Undated (AP) _ By JILL LAWRENCE Associated Press Writer

WASHINGTON (AP) - Two dozen pediatricians listened intently the other day to a lecture on an epidemic that’s leaving their young patients dead, disabled and emotionally scarred.

″It’s a very serious disease, and it’s costing us,″ Dr. Cynthia Fishman told her colleagues. Then they learned how to lobby Congress for gun control and other bills that might relieve this particular plague: violence.

Many doctors recognized a decade ago that violence was a public health problem of the first magnitude. Now, despite the hold of the nation’s individualist tradition, the public too is starting to see guns as health hazards.

The most concrete signal yet of an impending social sea change came last week when President Clinton signed the Brady handgun control law. It finally passed after seven years, he said, because ″grassroots America has changed its mind.″

It wouldn’t be the first time.

People used to think smoking was cool, seat belts were nuisances and drunken driving was no big deal. In 10 years they may find it hard to believe that weapons were once easy to come by; that unlike toys, cars and other products, they were not regulated for safety; and thousands of kids toted guns to school each day.

″Most parents now feel guilty if they don’t put their child in seat restraints. I hope one day issues related to firearms will take on the same social aura,″ says Dr. Jerome Paulson of George Washington University, a pioneer researcher in the field.

Clinton and top administration officials are pushing bans on assault weapons and gun ownership by juveniles, as well as extra police officers and other steps to combat crime. In settings that range from churches to hospitals to hearing rooms, they’re also making the case that violence is a public health problem.

How extensive is it? Surgeon General Joycelyn Elders recently told a House committee that guns kill 14 children a day, that violent acts killed 50,000 people last year. By comparison, AIDS took 30,000 lives and drunken driving an additional 18,000.

″The human tragedy is the most important thing,″ Clinton said in October at a New Brunswick, N.J., trauma center.

But he also said gun violence is ″a huge economic problem″ that costs $4 billion a year - and 80 percent to 85 percent of the victims have no health insurance. ″You pay for them,″ Clinton told his listeners. ″The system pays for them. It’s part of the escalating costs of health care.″

Perhaps the most spectacular linkage of health and violence comes from Sen. Daniel Patrick Moynihan, D-N.Y. He wants to help pay for health care reform with a large tax hike on ammunition. Moynihan calls his bill ″The Real Cost of Handgun Ammunition Act.″

On another front, Rep. Patricia Schroeder, D-Colo., has proposed a national ″firearm fatality reporting system″ modeled on a federal database on motor-vehicle deaths. She says the information collected by that system has led to major improvements in vehicle safety and a decrease in fatalities.

Until recently the National Rifle Association dominated debate on gun bills. Questions from the budding pediatrician-lobbyists made clear they doubted their ability to compete with the clout of the NRA.

But the medical community believes it has found the way to be a potent countervailing force: by transforming the polarizing guns-and-violence debate into a less charged discussion of science and public health.

So doctors, nurses and public health professionals are being encouraged to speak up. And medical groups are spewing research that’s hard to ignore. In recent weeks:

-An association of children’s hospitals reported that it takes more than $14,000 to treat each child struck by gunfire.

-The federal Centers for Disease Control and Prevention found that gunshot wounds are the leading cause of death for black teen-age boys and the fifth leading cause of accidental death for all children under 14.

-The National Center for Clinical Infant Programs issued a report, filled with case studies, on how to care for children who have witnessed or experienced violence.

By January the Clinton administration is expected to have in hand the suggestions of a six-department study group looking at ways to prevent and cope with violence.

″I’ve never seen attention and support before at this level,″ said Mark Rosenberg, acting associate director of CDC’s National Center for Injury Prevention and Control. ″It’s not a question of do you do anything about guns and violence. Now it’s what do you do. That’s real different.″

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