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Journal Article

Citation

Woesner ME. Prev. Med. 2019; ePub(ePub): 105882.

Affiliation

Bronx Psychiatric Center, Bronx, NY, United States of America; Albert Einstein College of Medicine, Bronx, NY, United States of America. Electronic address: mary.woesner@omh.ny.gov.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ypmed.2019.105882

PMID

31697959

Abstract

... What, if anything, from the age of AIDS and Koop can inform a discussion of the American epidemic of gun violence? The epidemic had been proceeding apace for years, with a spike in the late 1980's and early 1990's corresponding to the crack epidemic in the inner cities. The murder rate in the United States reached its highest level in 1993, and while many attribute this increase solely to the rise of crack cocaine use and gangs, others point to an increase in handgun production and purchase. Like HIV, this wave of gun violence initially affected disenfranchised communities: the poor, the unemployed, and people of color in the inner cities.

Initially, in its efforts to reduce gun violence, the CDC was in step with society's support of gun control. The Gun Control Act was passed in 1968 and President Ford's Attorney General submitted a proposal to outlaw guns in high-crime areas. In 1979, Surgeon General Richmond released a report (“Healthy People”) identifying violence as a priority area to address in the coming decade. It called for a substantial reduction in the homicide rate in black males and in the number of privately owned handguns (https://profiles.nlm.nih.gov/ps/access/NNBBGK.pdf, n.d.). In 1985, one year prior to the release of the “Surgeon General's report on AIDS,” C. Everett Koop released the “Surgeon General's Workshop on Violence and Public Health Report,” recommending “there be a complete and universal federal ban on the manufacture, importation, sale, and possession of handguns (except for authorized police and military personnel)” (https://profiles.nlm.nih.gov/ps/access/NNBCFX.pdf, n.d.). The federal government, however, was in opposition. Ronald Reagan ran as a candidate and came into the presidency (1981–89) as a Second Amendment supporter opposed to gun control, stating in an early article: “In my opinion, proposals to outlaw or confiscate guns are simply unrealistic panacea.”

The CDC's goal of “substantial” reductions in handguns and handgun violence (particularly among black youth) was not achieved. According to its 2000 paper (“Healthy People 2000”) (https://www.cdc.gov/nchs/data/hp2000/hp2k01.pdf, n.d.), “Data from 1979 through 1993 indicate that the total homicide rate increased due to increases in firearm-related homicides.” As the 1990s progressed, most population groups saw a decrease in murder rates, except for young black men. Communities of color remained under assault.

In 1992, the CDC formed the National Center for Injury Prevention and Control but the Center soon came under attack. Studies funded by the Center - including one by Kellerman's group demonstrating the homicide risk increased in homes with a firearm (Kellermann et al., 1993) - angered gun owners and their political supporters. Lobbying efforts were made to eliminate the Center and, failing that, pushed for the “Dickey Amendment” to the 1996 Omnibus Consolidated Appropriations Bill. The amendment states that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” At the same time, funds for firearm injury research were cut, in total a $2.6 million-dollar budget cut that Congress diverted to traumatic brain injury research ...


Language: en

Keywords

Acquired immunodeficiency syndrome; Gun violence; HIV; History of medicine; Public health

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