Yale School of Public Health Dean Megan L. Ranney, MD, testified before the U.S. Senate Judiciary Committee Tuesday, urging Congress to support a public health approach to the nation’s gun violence crisis.
An emergency physician by training, Ranney recounted the first time she treated a young man who had shot himself with his parents’ firearm. Although she was unable to save him, the incident changed her perspective on gun violence.
“His death led me to question why we didn’t think about gunshot wounds the same way we think about drunk driving or heart disease, as something we can and should prevent,” Ranney told the committee.
“It is because I have had a front row seat to our nation’s growing firearm injury epidemic that I have worked to define and implement a public health approach to this crisis,” she said.
Watch Dean Ranney’s testimony here.
Watch Dean Ranney's response to Sen. Kennedy's question here.
She explained to the committee how a public health approach to addressing the national firearm injury crisis would work.
“First, we gather data on the problem, how common it is and who is affected,” Ranney said. “Second, we define risk and protective factors, what increases or decreases the chance of someone being hurt or dying. Third, we figure out programs that work to change those patterns to avert injury, hospitalization, or death. Finally, we scale what works.”
Ranney said she has “example after example of how this four-step approach, when applied systematically, can improve human health without abrogating rights.”
Similar approaches, she said, have been used previously to reduce car crash deaths by more than 70% despite more cars being on the road – quantifying the problem, identifying the risk factors, developing multi-faceted solutions ranging from reducing drunk driving to putting air bags in cars, and then scaling what works.
“Unfortunately, we have not yet consistently applied this approach to firearm injury,” Ranney said. “As a result, we are facing a growing epidemic.”
America’s total number of gun deaths is the highest on record. Firearm deaths have surpassed breast cancer deaths in America. Firearms are now the leading cause of death for American children ages 1-19. Although mass shootings get the most media attention, Ranney said, two thirds of firearm deaths are preventable suicide averaged over the past decade. The remainder are mostly due to community violence and to a lesser extent, domestic violence, she said.
“Although there are clear risk factors and disparities, it is a problem that affects all of us,” Ranney said. “More than half of American adults say they or a family member have been involved in a shooting, more than three-fourths say that the fear of gun violence has led them to change something in their lives.”
Ranney said the effects of the epidemic are “wide and long,” ranging from immediate medical costs estimated by the government accountability office at $1 billion a year to long-term mental health, economic, and educational impacts. Families and first responders may experience anxiety, depression, and post-traumatic stress after a shooting, she said.
“These dismal statistics aside, as an ER doc and public health dean, I have confidence we can turn the tide,” Ranney said.
She cited four things that are needed to do so – improved data, improved research funding, improved training of health care and public health professionals and community members to help recognize and act on risks, and “most of all” improved collaboration with the most affected communities whether rural or urban.
Improved data will allow Americans to better measure, predict, and evaluate the firearm injury crisis. Ranney said Congress could help by supporting funding for data modernization at the CDC and by removing barriers to data sharing among state, territorial, and local partners as Utah has done.
She also urged Congress to sustain, and ideally increase, appropriations to the National Institutes of Health and CDC in support of research to develop and evaluate potential solutions to the firearm injury crisis. She also urged support of increased training for people on the public health programs and interventions that work.
“And finally,” Ranney said, “help our country have hope by demonstrating collaborative action as you have done before.
“We are turning into a nation of traumatized survivors,” Ranney said. “But I have story after story of public health collaborations between gun owners and non-gun owners, hospital workers and community violence interrupters, faith leaders and survivors. We have shown we can reduce the risk of a shooting long before someone picks up a gun with intent to harm. Through your bipartisan commitment to this public health approach our country can reduce firearm injury and death for all.”
Tuesday’s hearing was titled, “The Gun Violence Epidemic: A Public Health Crisis.”
In addition to Ranney, those testifying Tuesday included Steven H. Cook, retired associate deputy attorney general at the Justice Department; Amy Swearer, senior legal fellow at the Edwin Meese III Center for Legal and Judicial Studies at the Heritage Foundation; Vaughn Bryant, executive director at Metropolitan Peace Initiatives; and Franklin N. Cosey-Gay, director of the University of Chicago Medicine’s Violence Recovery Program.
“Dealing with the constant drumbeat of gun violence has turned these public health officials into battlefield experts,” said Sen. Dick Durbin, D-Illinois, the committee’s chair. “Gun violence is a public health crisis, plain and simple.”
Durbin noted there were more than 48,000 gun-related deaths in the U.S. in 2022, which equates to 122 deaths a day.
An exchange between Ranney and Senator John Kennedy, R-Louisiana, during the question-and-answer period was widely replayed on social media Tuesday.
Kennedy asked Ranney whether gun violence in Chicago, which he described as “America’s largest outdoor shooting range,” was due to Chicago residents having guns in their homes for protection or hunting or because of “a finite group of criminals who have rap sheets as long as King Kong’s arm?”
Ranney pointed out in her response that Kennedy’s home state, as well as Mississippi and Missouri, have higher firearm death rates.
When pressed by Kennedy about Chicago specifically, Ranney said Chicago is not one of her primary areas of research. However, she continued, "I think there's easy access to firearms combined with environmental conditions, lack of great education. There have actually been studies showing that when you green vacant lots and repair abandoned buildings in urban neighborhoods, you see decreases in gunshots and violence, as well as in stress and depression in the neighborhoods around them."