Report from Heartland Coalition Against Gun Violence conference

Gun Violence: A Public Health Issue – October 12, 2015, Brigid McCauley

The conference was put on by the Heartland Coalition Against Gun Violence, which is made up of 36 groups with 12,000 members.


The event was held in the Kaufman Conference Center, a beautiful new facility with ample free and landscaped parking, and breakout rooms in various sizes and arrangements surrounding a large room where all could assemble. Members of the sponsoring Kansas City coalition wore orange t-shirts and helped others navigate, giving the meeting an overall feeling of welcome and good organization.


The keynote address, “Treating Violence like a Contagious Disease,” was given by Dr. Rex Archer, M.D., Director of Health for Kansas City MO.  He likened gun violence to a contagious disease and led us through a brief history of how contagious diseases like plague, typhus, cholera, etc., were understood and “treated” in the past, under now-discredited theories.  We know now how to stop and reverse epidemics, and recognize that violence behaves like a contagious disease—and that treating violence like an epidemic gets results in communities where it is rampant.  He said that, holding all other factors constant, the best predictor of violence is exposure to violence.

He then outlined the steps used in public health to deal with epidemics:  1) interrupt transmission, in this context, for example, by diverting thoughts of retaliation.  2) prevent future spread of violence by helping those at high risk to learn different coping techniques.  3) change group norms: the decline of smoking was frequently cited—and the way entire groups now turn and stare at anyone who lights up: everyone looking at you is very effective.

Dr. Archer suggested that interrupting those inclined to violent activities, if the interrupter is a person who has or can win the confidence of a potential shooter, is an effective technique.  People who are asked by community members with credibility why they think violent behavior will make things better can stop, think, and come to a different understanding of the effects of rash acts; reframing, buying time, diversion, all actually contribute to rewiring the brain.  Practitioners of efforts to modify behavior need to be aware that the various parts of the brain are still maturing in the late teens and early 20’s: the amygdala (hot) is mature by 18; the prefrontal cortex (cool) is not mature until 24-25.

Victim presentation:  State Representative Stacey Newman introduced the parents of a young woman murdered in the shooting at a Colorado movie theatre, who spoke next.  They were obviously deeply hurt, and had recently lost a lawsuit against an ammunition manufacturer only to learn that, under Colorado law, they were liable for the legal expenses of the manufacturer—more than $200,000 for essentially one motion to dismiss.  This was a reminder of how difficult the environment for making changes is currently.

Breakout Sessions:

Policy Recommendations  was the topic addressed by State Representatives Judy Morgan, from the Missouri side, and Barbara Bollier, a retired physician, from Kansas.  Both states have legislatures that are currently dominated by elected officials whose primary concern is protecting gun ownership (and both states received a grade of F last year from the Law Center to Prevent Gun Violence).  The fact that gun owners have been more generous contributors to political candidates was cited as a factor in the make-up of our legislatures, and we conference attendees were urged to let our representatives hear from us (and get letters to editors printed) on the importance of issues like background checks and ending the ability to avoid such checks by buying and selling guns privately and at gun shows.

Support for these measures shows up in polls but is less apparent when legislators read their mail or meet constituents.  Being anti “gun violence” rather than for “gun control” was suggested as an important way to frame the issues—and take control of the vocabulary!

Pew Research looked into the polling data in depth and found an exact parallel with “Obamacare” as an issue: Democrats like Obamacare and are consistently in favor of gun regulation; Republicans absolutely HATE both, but when asked issue by issue love every individual piece of the whole…hate the very idea but love the particulars, in numbers almost identical to those of Democrats.

Another possible tactic for dealing with state legislators: Kansas now allows guns on campus, and we were encouraged to talk to parents of high school kids and also legislators about a growing concern possibly leading to students avoiding State U if there will be guns present.  Drinking, guns, and amygdala/prefrontal cortex issues can definitely combine to produce a health issue.

Effect of Exposure to Violence on Children by Dr. Denise Dowd, Pediatric Emergency Medicine physician at Children’s Mercy Hospital:  This was a horrifying talk.  Briefly: adverse childhood experiences are cumulative, and lead to brain damage, many chronic diseases in both childhood and adult life, and early death.  There’s a positive level of stress that we use to stay alive, the fight-or-flight response, but we don’t encounter many bears these days; witnessing or suffering physical abuse and violence leads to toxic stress, brain architecture disruption, and other physical damage; chronic cortisol produces inability to calm or cope.  Exposure to guns and gun violence produces chronic fear, which produces brain changes which lead to increased risk for both victimization and perpetration of violence.

Risk Factors that Lead to Gun Violence were addressed by psychologist Dr. Jean McCabe.  She reported that a very small fraction of firearm homicides involve the mentally ill and that most fatalities in this category are suicides rather than homicides. She outlined factors that could lead to suicide and made the point that, while people who tried to use pills to kill themselves could be rescued (and often went on to happier lives), guns were such effective killing machines that they did not often allow a depressed person a second chance at life.   Suicide is the leading cause of death among gun purchasers.   Background checks could be useful in this context.  An extensive report by the American Psychological Association (Feb 2013) was cited.

Children and Gun Safety:  Dr. Kimberly Randell, Pediatric Emergency Medicine physician at Children’s Mercy Hospital presented a fascinating set of facts and statistics showing correlations between guns and deaths and injuries in homes, particularly among children, who often find hidden guns, and are capable of firing them as toddlers—well before they understood the danger guns present.  Keeping guns under lock and key, separate from ammunition (also locked), was stressed, as was the desirability of asking parents of playmates whether there are guns in their house, and how safely they are stored, before allowing a child to visit.  Asking Saves Kids (A.S.K.) helps families keep kids safe: the ASK campaign, which Dr. Randell closed with, stresses that “one question could save your child’s life.”

We have a copy of Dr. Randell’s slide set, which I can forward; we’re supposed to receive slides from other talks, but so far none have come.

Large group sessions

The Mayor of Kansas City, Sly James, spoke to us at lunch, giving reduction of gun violence his strong support.  At the end of the day we heard from a panel on Local Initiatives, starting with a sergeant in the Kansas City police working with NoVA, a program that involves interaction with at-risk youth, helping them get out of their violent networks and stay safe, alive, and out of prison.  He was joined by leaders of two Kansas City groups, Aim4Peace and AdHoc, also trying to stop the violence.  Interruptors with street cred can help prevent retaliation for violent incidents, change the norm, and stop the killing—violence is a learned behavior and they’re offering a set of replacement behaviors—anger management, academic help, staying out of prison and avoiding the collateral damage incarceration brings in the lives of prisoners and their families. Each man described his group’s efforts, making it clear that the problem of violence among young people has the attention of community leaders.