memorial candles
February 22, 2018

SPH Dean Boris Lushniak and faculty members Dr. Amy Sapkota, Dr. Stephen Thomas and Dr. Woody Kessel will lead a conversation on gun violence and how we can respond. Join this urgent dialogue on Friday, February 23, 12:00 pm Friedgen Student Lounge, Rm 2236. 

Amy Sapkota
Associate Professor, Applied Environmental Health
Director, CONSERVE: A Center of Excellence at the Nexus of Sustainable Water Reuse, Food, and Health

I am infuriated, frustrated and heartbroken, as we continue again and again to face the carnage experienced by the students of Marjory Stoneman Douglas this past week. From my perspective, we are in the midst of a gun violence epidemic in the United States. To date, we, as a country, have tallied over 2,000 gun-related deaths this year alone, not even two months into the new year. The deaths continue to rise, we know the cause, and yet Congress continues to support the status quo with perverse inaction. 

In contrast, in the early 2000’s we began to see spikes in the number and severity of food borne outbreaks. Outbreaks associated with the consumption of contaminated spinach, contaminated peanut butter, contaminated tomatoes. In 2006, three deaths occurred as a result of an E. coli O157:H7 outbreak attributed to spinach consumption and after this outbreak we finally saw a turning point in federal legislation resulting in Congress enacting the monumental bipartisan Food Safety Modernization Act (under the Obama Administration), the first broad sweeping, major piece of food safety-related legislation since 1938. 

To address gun violence, we have bold models from the Australians: bans on all semi-automatic rifles and semi-automatic shotguns, along with tough background checks on all gun purchases. These policies WORK, and yet, here in the land of the free, we are too afraid to boldly act to protect our children, our spouses, our friends and our parents. We need to move forward with such policies here in the U.S. Enough is enough!

Apparently our elected officials can’t stomach deaths caused by spinach or peanut butter, but deaths due to gun violence are just fine. This MUST change. The time for action is NOW.

Stephen Thomas
Professor, Health Services Administration and Director, Maryland Center for Health Equity

 “There is no greater agony than bearing an untold story inside of you” --Maya Angelou

The students from Stoneman Douglas High School are bearing witness in the aftermath of 17 fellow students murdered by a 19-year-old former student who came into their school armed with his AR-15 assault rifle and opened fire on students, teachers and staff who were fleeing the building in response to a fire alarm. 
Easy access to handguns and weapons of war are responsible for needless death and suffering, a fact that would be easy to ignore were it not so well documented. The United States is the only developed nation in the world that allows easy access to guns as a right of citizenship, a right that is killing our children.
Thoughts and prayers for the children who were killed at Stoneman Douglass High School must now yield … Yield to all of us standing up with these students to demand meaningful action on common sense gun control. 
So, where do we go from here? I recommend we support advocacy organizations like MOMS Demand Action for Gun Sense in America, Inc. and Every Town for Gun Safety, Inc. Both groups recommend the following:
1. DEFENDING life-saving gun safety laws and regulations through our Second Amendment practice.
2. CHALLENGING dangerous gun-lobby sponsored laws that conflict with constitutional or other legal limitations.
3. ADVOCATING on behalf of individuals injured or killed because of dangerous, negligent or illegal actions by gun manufacturers or gun dealers.
4. ENFORCING gun safety laws on the books, including where responsible officials are failing to implement them.
5. ADVISING local and state government officials facing legal challenges or seeking assistance in their efforts to advance gun safety in their communities.
Finally, we must work with survivors of gun violence in lawsuits against the gun industry and with local and state governments facing Second Amendment challenges to gun safety laws.
Recommended reading:

Jie Chen
Associate Professor, Health Services Administration 

Karoline Mortensen
Associate Professor, Health Management & Policy, University of Miami Business School 

Another school shooting, another heartbreaking, preventable tragedy. According to the Washington Post, more than 150,000 students attending at least 170 primary or secondary schools have experienced a shooting on campus since the Columbine High School massacre in 1999. There were so many opportunities to prevent these tragedies from happening.  

The nation has identified two main drivers of these tragic events: access to guns, and lack of access to mental health treatment. If there were signs of mental illness of the shooter, why didn’t the community act upon it? Where there opportunities for us to have intervened and prevented this from happening? This is the critical time to let people know the truth: there is a mental health crisis in this nation. This is the critical time to advocate for public health’s role in promoting mental health of the nation. This is the critical time to act and fix a broken system and make sure such tragedy never happens again.

These tragedies are not a time to stigmatize mental health, but to work together to improve access to appropriate treatment. Untreated mental illness is associated with high mortality rates, increased risks of developing major chronic diseases, and higher rates of committing assaults and violent crime. Over 44 million (1 in 5) Americans aged 18 or older experience mental illness. People with mental illness face substantial stigmatization in seeking and receiving treatment. However, the current mental health care system works in a silo.
Public health agencies and local health departments (LHDs) serve as a bridge between federal/state and community organizations. They can improve population mental health by providing critical resources to people with limited health care access, coordinating and integrating the various mental health resources that are available in the community. LHDs assume more responsibilities in underserved areas, providing health care access to uninsured populations and targeting stigmatization and other negative beliefs about mental disorders in their communities. They are a safety net of last resort for vulnerable populations. Recent studies have shown the cost effectiveness of local health departments, and we need to learn how to better integrate them into their communities. 
Effectively treating mental illness and the associated conditions will depend on a comprehensive approach that crosses health systems, communities, and policies to target “Population Health” and emphasize the value of social determinants of health. If there is clear evidence of improving population mental health through a public health-integrated health care system, why can’t we work together to promote public health’s role? 

Washington Post: No, there haven’t been 18 school shootings in 2018. That number is flat wrong.

National Health Expenditures 2016 Highlights

Chen J, Novak P, Barath D, Goldman H, Mortenson K. Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. Medical Care. 2018;56(2):153-161.

Chen J, Bloodworth R, Novak P, Cook B, Goldman H, Rendall M, Thomas S, and Reynolds C. Reducing Preventable Hospitalization and Disparity: Association with LHD Mental Health Promotion Activities. American Journal of Preventive Medicine. 2018;54(1):103-112.

Related People
Stephen B. Thomas, Amy R. Sapkota, Samuel (Woodie) Kessel, Jie Chen, Boris Lushniak