RAY SUAREZ: We conclude our weeklong series on guns, violence and mental health concerns in the wake of the Connecticut shootings.
Tonight, we have a report from Chicago on how doctors and researchers there are trying to tackle the growing problem of gun violence as a public health issue.
Our story is part of the PBS “After Newtown” project and was filed by Elizabeth Brackett of WTTW Chicago.
ELIZABETH BRACKETT, WTTW Chicago: Not yet two months into 2013, and the death rate from gun violence in Chicago has exceeded what it was this time last year. And last year’s numbers were awful, 506 total murders in 2012, 16 percent higher than the previous year.
There was Shirley Chambers, who lost her fourth child to gun violence in January when a gunman opened fire on a van with her son inside. There was 15-year-old honor student Hadiya Pendleton, who had just returned from President Obama’s inauguration when she was gunned down just a few blocks from the president’s Hyde Park home. Her death brought the president to Chicago to talk about gun violence.
PRESIDENT BARACK OBAMA: What happened to Hadiya is not unique. It’s not unique to Chicago. It’s not unique to this country. Too many of our children are being taken away from us.
MAN: All right, let’s swing your legs over to the side here.
ELIZABETH BRACKETT: But death tolls don’t tell the whole story.
DR. MICHELLE GITTLER, Schwab Rehabilitation Hospital: You could slide under the desk with the prosthesis.
ELIZABETH BRACKETT: Dr. Michelle Gittler, who treats survivors of gun injury at Chicago’s Schwab Rehabilitation Hospital, says gun violence has become a public health crisis.
Like many big city medical professionals who see victims every day, Gittler welcomes the new attention lawmakers are giving the issue after 26 were killed at Connecticut’s Sandy Hook Elementary School.
MICHELLE GITTLER: That kind of tragedy, that’s not the problem that we’re really talking about. I mean, it’s catastrophic, but 31,000 people die every year of firearm violence.
ELIZABETH BRACKETT: An expert in spinal cord injury and paralysis, Gittler works with patients like this 17-year-old high school student who was shot multiple times while walking in his neighborhood. His mother doesn’t want us to show his face, for fear the shooter, who was never caught, may try to hurt him again.
MICHELLE GITTLER: The individuals that I deal with have a disability. The very first thing is, they have lived, so that’s good, but then they realize this isn’t going away.
So you try to enable them to resume as much independence as possible. It will be different, but really the hardest part is getting them back home, getting them right back to where the injury occurred in the first place. How do you get someone back into school if they don’t feel safe? And so then if they don’t go to school, what are they going to do for the rest of their life?
ELIZABETH BRACKETT: Gittler says the costs to the country’s health care system is enormous. She cites rehabilitation, Social Security disability, and emotional trauma.
The Centers for Disease Control, or CDC, estimated in 2010 that the medical and work loss costs from firearms death and injury came to more than $68 billion dollars.
MICHELLE GITTLER: It’s dollars we talk about what their earnings could be and what they are getting from SSDI, but, you know, I would think that as a public with a conscience, we care that individuals have disabilities that could be prevented.
WOMAN: A little bit higher.
ELIZABETH BRACKETT: Gittler wants the focus shifted to prevention and thinks a public health approach will do just that. She lauds President Obama’s recent executive order directing the CDC to research the causes and prevention of gun violence.
MICHELLE GITTLER: It’s like understanding any disease, whether we’re talking about diabetes that affects different populations, or breast cancer that affects different populations. Until we had the research that showed us how we addressed those populations, we didn’t understand how to treat the diseases.
ELIZABETH BRACKETT: In the mid-1990s, the CDC halted research on gun violence. That’s because gun rights advocates complained it was a way to push gun controls.
Shaun Kranish, who lives in Rockford, Ill., is an avid marksman and gun enthusiast. He sees Chicago’s violence as a huge problem, one that deserves attention and funding, but Kranish believes isolating guns is politically motivated.
SHAUN KRANISH, Gun Enthusiast: I really look at violence as violence no matter what object or tool or method is employed. And we do have a violence problem in this country, but it is a complex issue. And this whole discussion is really just centered around trying to bring some legitimacy to the idea of prohibiting guns, despite the fact that access to firearms is a guaranteed right as a free society.
ELIZABETH BRACKETT: Those who view gun violence as a public health issue focus as much or more on proactive intervention as they do on reactive treatment.
Dr. Marie Crandall is a trauma surgeon at Northwestern Memorial Hospital.
DR. MARIE CRANDALL, Northwestern Memorial Hospital: The people who come in after having been shot are some of the highest-risk folks. These are people who have been shot, who may have been shot before, and really without some intervention, without some life-changing moment, the trajectory’s either going to be jail or death.
ELIZABETH BRACKETT: Dr. Crandall wants to change that.
MARIE CRANDALL: I felt like patching people up and sending them back on the street was similar to taking care of someone after a heart attack without treating the underlying hypertension that led to their heart attack in the first place.
Unfortunately, there are no easy or quick solutions to violence, like a beta blocker for hypertension.
ELIZABETH BRACKETT: With Crandall’s help, the hospital’s trauma unit has recently developed a new protocol. Now, when a gun shot victim arrives at the hospital, community-based violence mediators are immediately called in. Crandall likens it to prescribing medication.
MARIE CRANDALL: We at Northwestern partnered with community organizations to help really bring care to our patients that would be similar to a beta blocker for heart disease.
ELIZABETH BRACKETT: It is a similar story for pediatrician Karen Sheehan at Chicago’s Lurie Children’s Hospital.
DR. KAREN SHEEHAN, Lurie Children’s Hospital: I became a pediatrician because I wanted children to reach their full potential so they could do whatever they wanted to be. But if you live in Chicago, that’s not going to happen for many of our children because of the amount of community violence we have.
Do you guys have a gun in the home?
ELIZABETH BRACKETT: Sheehan looks at health issues beyond just gunshot wounds.
KAREN SHEEHAN: We have not fully appreciated the effects of violence on the whole health of the population. It’s limiting just to think of it just from the injury point of view.
ELIZABETH BRACKETT: Many of her conversations with families center around healthy and safe lifestyle choices.
KAREN SHEEHAN: I think even more than the direct physical effects of violence, these people are experiencing the stress of living in these communities with high rates of violence. And so it changes their other behaviors. So now they’re afraid to exercise. It contributes for diabetes and heart disease and such, because it limits what you feel like you can do in your community.
ELIZABETH BRACKETT: The vast majority of Chicago’s gun-related homicides are concentrated in just a few neighborhoods on the city’s South and West sides. Gun violence is the leading cause of death for African-American males ages 15-24.
At Harper High School in the South Side neighborhood of Englewood, 27 current or former students were shot in 2012 alone. Eight died. Trying to make sense of why kids here are so vulnerable, academics from the University of Chicago’s Crime Lab are studying Harper’s students through the lens of public health.
MAN: You can relate to this, right, people saying you’re not going to make it or …
ELIZABETH BRACKETT: The researchers chose males with a high-risk index, poor grades and poor attendance records, and placed them in a clinical trial.
Jens Ludwig directed the trials.
JENS LUDWIG, University of Chicago Crime Lab: We identified 2,700 kids, and 2,700 boys grade 7-10 living in a variety of South and West Side Chicago neighborhoods. And, then, like in medicine, we randomly assigned some to get program services and some to be a control group.
ELIZABETH BRACKETT: The young men who were randomly assigned services were placed in this program called Becoming a Man or BAM.
The group is counseled about how to control dangerous impulse behaviors.
MAN: It can be very uncomfortable to do the right thing, but if we practice doing the right thing in this circle where it’s safe …
ELIZABETH BRACKETT: Results from the 2009-2010 clinical trials showed a dramatic difference in the students who received BAM counseling and students in the control group who didn’t.
JENS LUDWIG: One year of BAM participation reduces rate at which kids are arrested for violent crimes by fully 44 percent. That is an enormous reduction.
ELIZABETH BRACKETT: Ludwig says that this kind of empirical data is critical.
JENS LUDWIG: I think one of the key characteristics of the public health approach, besides its reliance on data and rigorous evaluation using clinical trials, like in medicine, is to try and be more preventive, to think, what can we do for kids who are on trajectories that might lead to some sort of bad outcome? What can we do to help them and divert them onto a more pro-social trajectory, before something really unfortunate happens?
ELIZABETH BRACKETT: For sophomore Levelle Morgan, the BAM program is about much more than statistics. It’s about life-and-death choices.
Do you worry about living until you’re 40?
LEVELLE MORGAN, Student: Yes, I would love to see that.
ELIZABETH BRACKETT: And what do you think the odds are?
LEVELLE MORGAN: That I will eventually get shot. But I try to stay as far as away from, you know, gangbanging as I can, but at some points, they will need me.
ELIZABETH BRACKETT: As lawmakers debate what to do about gun violence these next few months, the medical community here and across the country is likely to weigh in.
RAY SUAREZ: Online, we have a look at how some schools are teaching therapy and stress management. In Appalachian Ohio, educators say their students are learning to change the way they think about negative things in their lives before they turn to violence.
Our weeklong series wraps up tonight, but you can find links on our website to our previous stories. And we will be following the issues and debates closely in the months ahead.
PBS’ “After Newtown” series also concludes tonight with a “Need to Know” report on the continued impact of one school shooting 20 years later. And “Washington Week” also takes up the gun violence story this evening. Check your local listings for both programs.