Issue link: https://beckershealthcare.uberflip.com/i/644565
32 POPULATION HEALTH How Hospitals Need to Help Fight Gun Violence: 3 Experts Weigh in on Chicago's Pressing Public Health Problem By Emily Rappleye S ince 1985, only six cities have held the undesirable honor of "murder capital" of the U.S. for the highest number of homicides per 100,000 residents. ose cities are New Orleans, Washing- ton, D.C., Detroit, Flint, Mich., Richmond, Va., and Birmingham, Ala., according to a Pew Research analysis of the FBI's Uniform Crime Reporting Statistics. Not on that list once is Chicago, where 2,987 people were shot in 2015 and where most residents, at least in some parts of the city, would agree — the staccato of gunshots is all too frequent. is year, between Jan. 1 and Jan. 31 alone, 289 people were victims of a shooting. at's more than nine people every day. It's also nearly double the number of shoot- ings compared to January last year, according to e Chicago Tribune, which tracks all shootings — not just homicides — and updates the count several times per week. Chicago may not be murder capital of the U.S., but it undeniably has a gun problem. is is important because each shooting, fatal or nonfatal, has a profound ripple effect on the physical and mental health of the communities where it occurs. It also adds significant strain on health systems within those communities. e average emergency room visit for an individual gunshot victim cost hospitals $1,126 in 2010, according to data from the Urban Institute. e average inpatient stay for a gun shot victim was $23,497 in 2010. As the number of shootings grows, the cost to Chicago's residents and hospitals grows too. But the Windy City is not alone. Based on the "murder capital" rankings, Chicago comes in 21st among sizeable U.S. cities. Clearly, cities and towns across the nation face gun violence as a mounting public health issue, and law enforcement and government regulation alone have not proven a solution. So, the question is what can and should healthcare professionals across the country be doing about it? We asked those on the forefront of Chi- cago's trauma response: • Faran Bokhari, MD, chairman of the Cook County Trauma & Burn Unit at John H. Stroger Jr., Hospital, one of the first com- prehensive trauma units in the U.S., and now one of the country's largest, • Catherine Humikowski, MD, medical director of the Univer- sity of Chicago Medicine's pediatric intensive care unit, who re- cently penned an article in e Chicago Tribune about what it's like to care for children who have been victims of gun violence, and • Shannon Cosgrove, MPH, director of health innovation for Cure Violence, an organization that applies disease prevention models to violence, and was started in Chicago by Gary Slutkin, MD, under the name CeaseFire. Editor's note: Responses have been edited lightly for length and clarity. Question: Do you think gun violence is viewed through a health lens in Chicago, or is it viewed as more of a law enforcement issue? Dr. Faran Bokhari: It depends on who we are talking to and who is viewing it. Public health officials will look at it through a public health lens and law enforcement will look at it as a law enforcement issue. I think the answer is somewhere in the middle. Dr. Catherine Humikowski: In Chicago, it is viewed largely has a law enforcement issue. I suspect a lot of places think of it in this way. But here, in particular, gun violence is largely linked to criminality, and that's not true all over. For example, suicide is a big piece of gun deaths in the U.S. However, in our popula- tion, certainly where I work on the South Side, it really is linked mentally to gang ac- tivity and criminal behavior. A lot of people say, "is is a law enforcement issue. is is related to community-police relations. We need tougher sentences for gun criminals." All of that is very well true, but my perspec- tive is that it's one piece of a bigger issue. While we do tend to view it through the law enforcement and criminality lens in Chicago, we have to shi that debate to be more encompassing. is public health angle is another part, but it's not going to capture the entirety of the problem. It's not isolated to the "bad guys" on the South Side. It really is everybody's problem. Ms. Shannon Cosgrove: Chicago was the first city to implement the health ap- proach as Cure Violence knows it and sees it. at was in 2000. In that aspect, Chicago was very much ahead of the curve. Quite a few efforts are underway in Chicago that look at violence as a health issue, but it hasn't elevated to a place where healthcare professionals are seen as leaders in response to the epidemic. We really feel the health sector is underutilized and has a lot to bring to the table. When you think about the Ebola response, if there was even a threat of a case coming into the U.S., everyone was ready and had their policy programs and protocols in place to respond accordingly. Similarly, we want the same response for violence. Dr. Faran Bokhari Ms. Shannon Cosgrove Dr. Catherine Humikowski