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Catholic health leaders are voicing support for the U.S. Surgeon General's advisory on firearm violence released earlier this summer, noting that they also have long believed the issue is a public health crisis.

"I think it's a thoughtful report, and a very, very important topic of discussion," said Mike Slubowski, president and CEO of Trinity Health. "One of the questions is: Is anything going to change as a result of it?"

U.S. Surgeon General Dr. Vivek Murthy's advisory, "Firearm Violence: A Public Health Crisis in America," was released June 25. It came less than a month before the assassination attempt July 13 that wounded former President Donald Trump and left the nation in shock. The attack at a rally for Trump killed one spectator and wounded two others. Authorities say it was committed by a 20-year-old with a rifle.

Murthy's advisory explained that since 2020 firearm-related injury has been the leading cause of death for American children and adolescents ages 1-19, even surpassing motor vehicle crashes, cancer, and drug overdose and poisoning.

The problem is growing: The advisory says that in 2022, 48,204 people died from firearm-related injuries, over 8,000 more deaths than in 2019 and over 16,000 more than in 2010. Those deaths include suicides, homicides and unintentional deaths.

It's a problem particularly prevalent in the United States: In 2015, the overall firearm-related death rate was 11.4 times higher in the U.S. compared to 28 other high-income nations.

"Firearm violence is an urgent public health crisis that has led to loss of life, unimaginable pain, and profound grief for far too many Americans," said Murthy in a statement. "We don't have to continue down this path, and we don't have to subject our children to the ongoing horror of firearm violence in America. All Americans deserve to live their lives free from firearm violence, as well as from the fear and devastation that it brings. It will take the collective commitment of our nation to turn the tide on firearm violence."

The advisory argues that a public health approach must be applied to change the conditions and circumstances that lead to a higher risk of firearm violence and its mental health and emotional impacts. Past public health approaches have contributed to a more than 70% decline in cigarette smoking in adults and improved motor vehicle safety over decades, according to the advisory.

"Taking such an approach to firearm violence prevention has the potential to curb the alarming trends of firearm-related injury and death in America and the resulting health impacts," the report says.

The advisory is the first publication from the Office of the Surgeon General dedicated to the issue.

Catholic health care support
In policy briefs, CHA has called for supporting safer communities by requiring background checks for the sale or transfer of all firearms, including gun show and online sales; banning the purchase and sale of assault-style weapons; temporarily prohibiting an individual from purchasing or possessing firearms when deemed by a judge to a pose a danger to self or others; and banning the purchase and sale of high-capacity ammunition magazines.

“We must also hold our elected officials accountable, and demand action on sensible gun policies. The issue of stopping gun violence is something all people of goodwill should agree upon.” — Sr. Mary Haddad

"As Americans, we need to balance individual rights with our responsibility to promote the common good, which includes the safety and security of our communities," said Sr. Mary Haddad, RSM, president and CEO of CHA. "We must also hold our elected officials accountable, and demand action on sensible gun policies. The issue of stopping gun violence is something all people of goodwill should agree upon."

Slubowski pointed out that regardless of their views on gun rights issues, everyone can rally around some of the concepts addressed in the advisory, such as the concerns about the impact of gun violence on mental health.

Among the steps Trinity Health has implemented to detect and deter potential gun violence is using a tool called the Broset Violence Checklist, which can help clinicians determine a patient's potential for imminent violent behavior. The system also supports the  "Doesn't Kill to Ask" campaign in which clinicians ask families at pediatric visits whether weapons are in the house. Slubowski wants that question to be a part of screenings for all patients.

In response to gun violence, he noted, the system has enhanced security at facilities, discussed the issue with politicians in Washington and partnered with Hartford Communities That Care in New England to help gunshot victims and their families.

Slubowski pointed out that while Trinity Health can only deal with what it can control, his view is that as a Catholic system it has a responsibility to address the wider problem of gun violence.

"Catholic social teaching is about the common good, and you can't speak to the common good unless you can talk about physical and psychological safety from gun violence," he said. "I do think Catholic providers have a unique role in speaking out on these issues and advocating on these issues as a public health crisis. The common good does speak to the responsibility we have for public health."

In Baltimore, several Mercy Medical Center programs address domestic violence, sexual assault and human trafficking, which are often linked to gun violence and coercion. The hospital's Blue Dot Human Trafficking Initiative was recognized in 2023 by the White House with a presidential award for helping human trafficking victims and survivors. Its forensic nursing program provides services for sexual assault and trafficking victims and works with criminal justice agencies and other Baltimore agencies addressing violence.

"Mercy strongly endorses the Surgeon General's declaration of gun violence as a major public health crisis in the United States. For too long, gun violence in American cities has been underrecognized and unaddressed by failing to enact common sense policy solutions," Ryan O'Doherty, senior vice president, external affairs, Mercy Medical Center, said in a statement. "Here in Baltimore, we are keenly aware of the devastating impact that gun violence has had in many of our neighborhoods for decades."

Mental health impacts
The Surgeon General's advisory notes that mental health alone isn't a good predictor of whether someone will resort to violence, but the advisory does point to repeated studies that say gun violence has mental health impacts, even among those not physically injured.

One study looked at emergency department admissions in parts of Philadelphia between 2014 and 2018 and found that children and adolescents who lived within two or three blocks of a shooting were 50% more likely to use an emergency room for mental health reasons during the 30 days after the shooting than other children and adolescents. Another study showed family members of survivors of firearm violence had a 68% increase in psychiatric disorders compared to a control group.

As for suicide, the advisory says the rate of firearm-related suicide increased by more than 20% from 2012 to 2022, with a "staggering" increase among younger populations during the same decade. The rate increased 43% among 25- to 34-year-olds, 45% for 15- to 24-year-olds and 68% for children aged 10-14.

Dr. Arpan Waghray is the chief executive officer of Providence's Well Being Trust, which works to improve the mental health and well-being of communities within the system footprint and advance the work nationally. He recently joined Murthy at a panel for middle and high school students from the Renton, Washington, School District, located just south of Seattle, about normalizing conversations about mental health and self-care.

Waghray said the gun violence advisory is a great resource to start a conversation about gun violence and answer its call to bring in more research.

"(Business theorist) W. Edwards Deming said it beautifully. He said, 'In God we trust, all others must bring data.' And what I think the advisory does is it forces us to look at some objective data that's available," Waghray said.

He said Catholic health leaders have a unique role in the conversation about gun violence.

"The idea that we believe health is a human right and everybody has the right to reach their fullest potential is inherent in what we do every day," he said. "We have a moral responsibility to make sure that we are doing more, and I think what we need to be doing is make sure that we're bringing the best science forward to really help people and drive change."

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