Gun violence has become a crucial national problem that negatively affects health equity in the United States. The American Medical Association (AMA) has declared U.S. gun violence a public health crisis requiring a comprehensive public health response and solution. While we debate whether we need better gun control laws, or a more efficient way to implement current laws, Americans at large are affected by shootings whether it is at a mass shooting or an individual being shot. No other country has the gun violence statistics that the United States has acquired in these last years.
What is health equity? It is the right that every individual has to a fair opportunity to live a long and healthy life. The implication is that health should not be compromised or disadvantaged because of an individual’s or population group’s race, ethnicity, gender, income, sexual orientation, neighborhood or other social condition. Health equity depends on creating fair opportunities for health and eliminating gaps in health outcomes between different social groups. It also requires that public health professionals look for solutions outside of the health care system, such as in the transportation or housing sectors, to improve the opportunities for health in communities.
The ultimate goal is to reduce and eliminate disparities in health and achieve the highest possible standard of health for all people while providing special attention to the needs of those at greatest risk of poor health, based on social conditions.
The three main components of health equity identified by the World Health Organization are social determinants of health, health disparities and social justice. Gun violence is a problem that affects each component and creates negative health outcomes nationwide.
Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries, states, cities and communities.
A disproportionate number of gun homicides occur in urban areas. By contrast, a disproportionate number of firearm suicides occur in rural areas. Although highly publicized, less than two percent of the homicides of children occur in schools.
Health disparity is a particular type of health difference that is closely linked with economic, social or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age or mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location or other characteristics historically linked to discrimination or exclusion.
Gun-related homicides take the lives of Black men with appalling consistency. Every day in the United States, more than 15 Black men are killed by guns. Almost 81,000 Black men were murdered with firearms between 2001 and 2014 – compared to 29,000 non-Hispanic White men – without including those shot by police.
Social justice is the equal distribution of resources and opportunities, and outside factors that categorize people are irrelevant. Social justice demands that we not only seek to avoid future tragedies on behalf of potential victims, but also on behalf of potential perpetrators. Social justice is to prevent mentally unstable individuals from acquiring a gun, avoiding the means to commit a crime and earn just punishment when they, in fact, need medical care. It is protecting citizens from violence that creates a physical and mental burden, and perhaps even an early death.
What can we do to respond to the shootings in Florida and other states? We can learn about the current gun- control laws and decide what we believe in. Do we need to change the present laws, or a more efficient way to implement them?
We can take actions that make our communities safer. Let’s pay attention to our loved ones, neighbors and coworkers and watch for signs that they might be at risk of harming somebody or being harmed by guns. Let’s protect people who are vulnerable to discrimination because of their racial or ethnic group, religion, sexual orientation or gender identification.
The Robert Wood Johnson Foundation’s “Culture of Health” initiative aims for a society in which “every person has an equal opportunity to live the healthiest life they can.” Every American can live by this motto and pursue not only their own happiness and good health, but ensure that as a society we provide health equity among all.
Dr. Diana Lee is Director of the Odessa Chambliss Center for Health Equity at Bethune-Cookman University.