“Gun violence” Doesn’t Fit the Public Health Model of Disease

"Gun violence" isn't a disease

courtesy npr.org

By Robert A. Margulies, MD

The oft chanted mantra that firearms are like viruses is patently untenable. Viruses are living organisms—they replicate and perform actions independently. To consider firearms alive, self-replicating and capable of independent action requires an absence of rationality.

Now, to the public health model. It is predicated on education about, then modification and eradication, of a problem. Study should begin with examining history, epidemiology, utility, and a cost benefit ratio.

Firearms are a tool designed to allow an organism to project power against another organism. That holds whether the tool-using organism(s) is a human against a predatory animal, or a group of people against another group of people. They are especially helpful for weaker organisms confronted by stronger ones. Firearms may be used appropriately or inappropriately, but that is based upon the user, not the tool.

Firearms are widely prevalent and that holds whether society accepts them or not. That is clear when we compare disparate regulations between cities within a country, or between countries. Some examples include Chicago and Baltimore in the United States, and criminal and terrorist use of firearms in countries with very strict anti-firearm regulations such as France, Mexico and Guatemala.

Firearms do exactly what they were designed to do, and they do it effectively and efficiently. For self-defense or anti-criminal use, firearms are the quintessential tool which allows a person, regardless of strength or physical ability, to defend against an individual or a group of criminals.

Individuals and groups who wish to see firearms removed from society frequently begin by proposing modifications. None of the modifications expounded by these groups would improve the utility and cost-benefit equation, or prevent criminals and terrorists from misusing them.

That leaves eradication. Those who propose eradication fail to understand human nature. Being human drives us to develop tools for specific purposes. Humankind went from being able to walk to using animals and then machinery to accomplish transportation. We went from charcoal scratchings on rock to print and electronics to accomplish communication. We went from running to throwing rocks to launching projectiles faster and farther to firearms.

Last but not least, the public health model has worked to some degree for automobile safety, and to reduce tobacco and alcohol use. But imperfectly, because the advocates fail to understand human nature. Compulsion goes only so far.

Society continues to struggling with the failure of seat-belt laws and mechanical safety devices, and the fact that people too often will not do what other people think is in their best interest. The public health model as applied to firearms issues has also been plagued by misuse of data and fraudulent science attempting to promote a predetermined end.

The American people trust the Constitution of the United States more than they trust esoteric statistics. Ultimately, the public health model fails because the proponents are ideologists, not scientists.

Robert A. Margulies, MD, MPH, FACEP, FACPM is an emergency medicine specialist, retired Navy Medical Corps captain, sworn peace officer, and firearm trainer with multiple certifications from the NRA and the Massad Ayoob Group.

This post originally appeared at drgo.us and is reprinted here with permission.

comments

  1. avatar Joe R. says:

    ““Gun violence” Doesn’t Fit the Public Health Model of Disease”

    WHERE DOES COMMUNISM FALL ON THE DISEASE CHART.

    CAN WE PLEASE DEVOTE MORE OF OUR ATTENTION TO STAMPING OUT COMMUNISM ???

    There are representatives in California that might benefit from being beaten half to death with a wet flip-flop BEFORE those representatives manage to go full-Venezuela on California, BUT NO ONE OWES THEM SUCH HELP.

  2. avatar jsled says:

    > The oft chanted mantra that firearms are like viruses is patently untenable.

    No one “oft chants” this. I’m not sure anyone serious claims this. This is a straw man, and a bad one at that. I’m glad, at least, Mr. Margulies put it as the first sentence to make it clear.

    The argument is that a subset of “gun violence” behaves in similar ways to infectious disease, and can be responded to effectively by adopting some of the same practices and models. It’s not necessarily “gun violence”, of course, but “normal” human violence that is made exceptionally lethal with the presence of firearms. It is the type of interpersonal, revenge-fueled, “honor” violence, often among competing social cliques and gangs.

    This post is overly simplistic, reductionist garbage that pollutes the discourse and makes it harder to realize one class of approaches – one, importantly, not grounded in useless gun control – to combating a large class of the “gun violence” we see in the US.

    1. avatar Anymouse says:

      This “bullet as pathogen” was published in JAMA by Alderson and cited by at least a dozen other papers, so there are academics who believe it. I’ve attended lectures where it was advocated.

    2. avatar BLoving says:

      Agreed. It is simplistic and targets only one class of gun bigot: the elitist, pseudo-scientist or researcher that claims to have “proof” that civil rights need to be curtailed and controlled.
      The problem is: there are several types of gun bigot – and only a few of the types we confront actually have the intellectual capacity to form such complex (but wrong) rationalizations against our civil rights. A significant number of the rank-and-file gun bigots care little for studies, statistics, and polls – they simply nod, hit the “like” button and then “share” and with that, they have “done something” about crime.
      Unfortunately, reaching out to that particular brand of bigot requires that they be confronted with hard data and perhaps personal experience at a gun range to persuade them to the side of truth; they simply can’t be bothered to learn because they don’t really care that much.
      🤠

  3. avatar C.S. says:

    Antigunner logic: let’s count suicides by gun as part of gun violence, but not count suicide prevention funding.

  4. avatar Slab Rankle says:

    I’m going to play devil’s advocate on this one.

    a) Gunshots injure and kill people.

    b) Diseases injure and kill people.

    c) Therefore, since A and B do the same thing, they should be treated the same way, which is by removing the disease vector, guns, and the people who wield them. No one has the right to spread Cholera. Gunshot wounds are no different.

    I, as devil’s advocate, challenge anyone to deny the ineluctable logic of the my statements.

    1. avatar Thomas says:

      Your argument doesn’t hold water because while diseases injure and kill people, you can’t use diseases to prevent injury and death. Guns are proven to be very effective in preventing injury and death when in proper hands.

      1. avatar ‘liljoe says:

        Not to be pedantic, but retroviruses for gene therapy and vaccines are two examples of diseases used to help heal and prevent injury. Penicillin from mold would be another example if you consider mold a pathogen.

        1. avatar JamesDThePharmD says:

          And that right there is an excellent point challenging the original statement. We do spread disease to help the well being of others. Guns may also do the same.

        2. avatar Roymond says:

          James, you beat me to it! That is an excellent point about the disease model.

    2. avatar C.S. says:

      Yeah, and getting rid of medical doctors would reduce doctor related medical deaths.

      1. avatar Sam I Am says:

        You are correct. And getting rid of laws would eliminate crime. Always wondered why more people do not see that.

        1. avatar TX_Lawyer says:

          Because they do see it and realize that the cure is worse than the disease? Or maybe they don’t see it because the cure is worse than the disease and therefore “unthinkable?” Just guesses.

    3. avatar AKM Sarah says:

      There is no logical or legal defensive use of cholera to address a credible, immediate deadly threat. Nice try. Cholera has no legitimate use, whereas firearms do.

    4. avatar Defens says:

      Your analogy is flawed, because you’re equating an action – “gunshots” – with an organism/object – “disease”. There are thousands, if not millions of species of various microorganisms, but only a handful are actually harmful to people. Those that are, we focus on their treatment and/or eradication.

      “Gunshots” in your analogy, relate more to the action of certain diseases. Elevating that to a human context, a mass shooter is more like a cholera germ. We should be focusing on reducing the threat from criminals (and germs) not by removing the processes by which they exist – which can be used for relative good or evil – but by removing the bad actors from the population. You don’t treat cholera by indiscriminately killing off all microbes, and you don’t treat “gun violence” by removing all guns from the population. You remove the criminal elements by inoculation and hygiene.

    5. avatar Scoutino says:

      How do you aim cholera? Can you carry cholera dormant and then use it in an instant to stop an attack on your health and life? How do you use cholera to get rid of government in case it turns tyrannical? Hunting with cholera would be a drag and plinking not much better.

    6. avatar DOWN WITH DOUBLE BUBBLE GUM! says:

      A true “Devil’s Advocate” would know the required logic to express his viewpoint (and counter other’s). Yours falls apart immediately, by assuming an equivalency between A and B. Since no equivalency is possible, only a similarity of final outcome, you could just as easily compared earthquakes, lightning strikes, satellites falling out of the sky, or anything else that causes injury or death.
      From a non-logical viewpoint, however, I agree with you.
      Go Figger.

    7. avatar Specialist38 says:

      The disease only needs to “ride” on the host. If it comes into contact with another host, it actively tries to colonize that host.

      The bullet does nothing on its own. The “host” uses the bullet to inflict damage on another person. Once in contact with the person, the bullet does not replicate and colonize.

      The bullet…..just sits there because it is not alive. The “host” that used the bullet is the plague.

  5. avatar WI Patriot says:

    ““Gun violence” Doesn’t Fit the Public Health Model of Disease”

    Of course it doesn’t, that’s because it’s NOT a “disease”…

    1. avatar Jim Bullock says:

      Yeah, citations aside, even as presented there, it’s a pretty crappy claim.

      People doing real science are all the time digging for the thing behind the obvious, that holds up more robustly. “People who sneeze spread disease.” is vaguely robust. And people who sneeze contaminate other people who then sneeze, so…

      Except sneezes and disease only works sometimes. People looking for answers go looking for a better model. With sneezing, the more robust model presumes active agents — pathogens — transmitted by sneezes sometimes. Because not everybody who sneezes is sick, not everybody who gets sneezed upon gets sick, and so on. Guns as pathogens would be refuted from the start if they use the same standards they use for … pathogens.

      Perhaps someone here recalls the name for the protocol for confirming that a particular bug causes a particular disease. It goes like this:

      — You can isolate it from someone with the disease, always. Plenty of violence with no guns to be found, so, no.

      — Introducing it to someone without the pathogen produces the disease. Plenty of people given guns don’t end up violent, so, no.

      — And when you find someone who became violent once you handed them a gun, you can re-isolate the gun, um, no. Not always.

      We can demonstrate that introducing guns to people causes them to have guns, consistently. That’s about it. Violence, however acts a lot more like a pathogen. Maybe pay attention to that. Some cultural things — specific behaviors, attitudes, ideas, approaches to problems — propagate kind similar to pathogens, sometimes.

      Interestingly, doing science, given “sometimes” you go look for something behind that that’s “always.” Drinking water doesn’t always make you sick. Sometimes it does. Drinking water with cholera in it always makes you sick. Or eating veggies “washed” in cholera water, then dried. Then, maybe see if the cholera bug is found in people with cholera. (Yes) If you can create cholera by introducing that bug to people, water or no. (Yes.) And if you can recover the cholera bug from people who showed cholera after you infected them. (Yes.)

      So, stay away from the cholera bug, and especially water with cholera in it. Because we’re dealing with the contrived anti-gun deliberate fake misunderstanding, I’ll lay it out. Guns are water. Tendency toward violence is cholera. If the anti’s had which was which right, their efforts would have been way more successful at reducing “gun violence.” (It’s almost like the goal is not getting rid of violence but getting rid of guns, no matter how many people that kills. If that’s the goal, the more violence continues, the better for their agenda.)

      Also, these “gun disease” people aren’t doing science. They’ve found a convenient cudgel, that’s all.

      We live in the Red Queen’s world: judgment first, trial after. “No guns for you!”, requires that guns be bad (since they’re not yet galactic overlords, they need an excuse), which requires that guns be causing the harm (so there’s an excuse to wee-wee up the proles), etc.

      This is how lawyers operate: outcome first, then build the case.

  6. avatar BierceAmbrose says:

    #tinfoilhattruth: “It’s almost like the goal is not getting rid of violence but getting rid of guns, no matter how many people that kills. If that’s the goal, the more violence continues, the better for their agenda.”

    #infectedbylawyers: “This is how lawyers operate: outcome first, then build the case.”

  7. avatar Macofjack says:

    The post sounds like a description of a liberal to me!

  8. avatar OmnivorousBeorn says:

    Viruses aren’t even technically alive, if I remember my bio class correctly. But he’s supposedly an “MD, MPH, FACEP, FACPM,” so whatever. Maybe it’s up for debate.

    1. avatar JamesDThePharmD says:

      You are correct, viruses are not considered life. Can’t expect someone with a psych degree to know a lot about actual science though.

      1. avatar OmnivorousBeorn says:

        Haha that’s not the greatest way start to a sermon, even if it’s to the half-asleep choir.

        1. avatar JamesDThePharmD says:

          Yea, I cringed at first for some reason but managed to make it through.

  9. avatar n64456 says:

    Firearms aren’t a virus… “Democrat values” are a virus… It destroys everything it contacts… Symptoms include (but aren’t limited to) Rape, robbery, narcotics, murder, welfare fraud, medicare fraud, Social Security fraud, identity theft, voter fraud, immigration fraud, theft, assault, larceny, and carjacking.

    Cure is: isolation from civilized society (containment) or eradication…. Other attempts haven’t proven successful…

    1. avatar OmnivorousBeorn says:

      Killing or imprisoning everybody who doesn’t agree with us is against the most basic conservative principles. Diversity of thought MUST be tolerated, because without it republics implode. Intolerance is perhaps the main characteristic of despotic governments. There’s a reason why the first amendment comes before the second.

      I apologize if you weren’t serious.

      1. avatar OmnivorousBeorn says:

        Just to clarify, I understand that diversity of opinion also kills republics. Yes, it is dangerous, but it is also vital.

        1. avatar LarryinTX says:

          Ah! I see! Like guns.

      2. avatar n64456 says:

        There is nothing wrong with eradicating dangerous, violent and uncivilized ideologies and behavior…. I didn’t say anything about people…. You misunderstood my absolutely serious remarks…. Isolate it by an amicable divorce between flyover America, and the socialist cesspools of the northeast and left coast. Just like the Berlin wall and flight corridors of the Cold War; a transit corridor for air traffic and walled highway from the northeast to the left coast will keep them from polluting the flyover areas. Violations will be considered an “Act of War”…

        1. avatar OmnivorousBeorn says:

          Sorry for misunderstanding you. I agree that dangerous people should be locked up. As far as ideologies, the line where it becomes unacceptable is pretty arbitrary, even with the same person.

          I don’t see, however, how it’s practical to isolate “socialist cesspools.” All real cities are liberal. If we force everyone to pick sides, we’ll be left with very few people and even less means of supporting ourselves. Although tempting to isolate ourselves, it’s not a good idea in my opinion and makes very little sense practically. YMMV.

        2. avatar n64456 says:

          OmniverousBoern

          Those liberal cities will collapse under their corrupt governments and welfare state policies…. It will be critical to ensure a large physical border wall to prevent mass migration when it finally collapses into anarchy (or martial law)… Anyone wanting to migrate to flyover country must present proof of voting registration to prevent leftist ideologies from crossing over… Flyover states will survive just fine; just as they always have.. To quote HW Jr; “A Country Boy (and girl) Can Survive”……. As long as those same cesspools insist on imposing their values and laws on middle America; there can be no compromise… They refuse to, why should flyover country?

        3. avatar OmnivorousBeorn says:

          So you’re telling me that a country made up of rural towns will be able to build and maintain a border wall? And hold it against millions of “refugees”? Honestly, I don’t see why these cities, if they collapse, wouldn’t go over to other countries, which isn’t good news for your country. There are not enough people in the right areas to make this utopia even remotely possible.

          Also, I think there’s a problem with thinking that eliminating differing opinions will be a good thing.

        4. avatar n64456 says:

          OB

          Well, since those Marxist-Socialists will be totally (and voluntarily) disarmed; stopping them from scaling the wall will be fairly easy for fully armed middle Americans especially if using natural dividing lines to augment walls (mountain ranges, rivers, etc…) Their armed masters won’t dare invade, because they will be divided; and wouldn’t have the stomach for a 2 front (east/west) assault on middle America… With larger M-A settlements near each border, a large massing of M-S troop on those borders would be met quickly with a mobilization of Middle Americans (within 24 hrs)…

        5. avatar OmnivorousBeorn says:

          Whatever man. I think we’ll have to, ironically, leave this at agreeing to disagree.

    2. avatar Roymond says:

      “Democrat values”… if only today’s Democrats were actually democrats!

      (And if only today’s Republicans were actually republicans.)

      1. avatar OmnivorousBeorn says:

        Democrats aren’t democrats in the sense that they’re redefining what democrat means to be far father left. Republicans aren’t republicans because they lack the resolve or political know-how to not be democrats.

        So what we’re left with is, well, America today. (Yes, I know, #CaptainObvious.)

        1. avatar MamaLiberty says:

          You folks seem to be missing the real basic problem. All political entities, and those who support them, have as their foundation the desire/compulsion to control the lives and property of other people. ALL politics are about nothing else in the long run, no matter what their names or supposed goals.

          The desire/compulsion to control the lives of others is the ROOT of all evil.

          The commitment and integrity to control oneself, and be responsible for the consequences of all of one’s actions and choices… in voluntary association with others… is the foundation of freedom, of individual liberty and justice.

      2. avatar OmnivorousBeorn says:

        @n64456 So you’re telling me that a “country” made up of rural folks will be able to build and maintain a border wall against tens of millions of refugees? They have to prove that they opposed your adversaries in order to live in your country? C’mon. There’s not enough people like you to even make that a hypothetical.

  10. avatar Roymond says:

    If guns were truly like a disease, then the way to stop “gun violence” would be simple: shatter a lot of guns (liquid nitrogen would work) and hand out the pieces to everyone. They would thus be innocculated against “gun violence”.

  11. avatar barnbwt says:

    LOL, it appears HIV & diabetes don’t fit the model of justified funding either *cough* what could that mean? *cough*

  12. avatar rswartze says:

    Based on the number, it’s still including suicide by gun. So even the non-starter chart is misleading of course. That’s mental health issue, not a physical health issue.

    I guess it may look better with the larger gap in funding when its shown with the higher death rate if the argument is against gun violence as a large issue. Even 2A folks should want it accurate though.

  13. avatar Justsomeguy says:

    I’m actually getting to where I like the disease analogy. Right now there is a black death outbreak in Africa. Nobody is trying to treat the disease in Oklahoma, because it isn’t there. Experts in the subject have all descended on the site of the outbreak and are attempting to eradicate it where it is. Just like there are centers for a disease outbreak there seam to be centers for violence. How bout we send people to where there are similar pods of violence and have them solve the problem where it is happening? Sending solutions to where the problem isn’t, doesn’t help anyone.

  14. avatar Kyle in Upstate NY says:

    Gun violence is not any public health issue. Public health deals with things that are known to be harmful to people without their control, such as pollutants, diseases, car safety, etc…gun violence by contrast is an issue of criminology. That certain people use guns to kill and/maim other people is not any issue of public health.

    One huge difference is in the study of the benefits and drawbacks of guns in a society. A criminologist will look into both of these. Whereas the public-health model doesn’t view guns as possibly being any positive at all. Rather, guns are taken from the get-go as being a net-negative for a society. The gun is viewed as a pollutant or disease. No one looks into the positive effects of Ebola or smallpox or typhoid in the population for example. No one looks into the positive effects of breathing exhaust fumes. Guns are viewed by the medical community as the equivalent of diseases and pollution, which is why they are fundamentally unsuited to study the issue in the first place.

    1. avatar TX_Lawyer says:

      That second paragraph is the best explanation of both why I don’t bother examining public health arguments about guns (they’re wrong), and why they’re wrong (the public health model is fundamentally unsuited for studying something with even direct and obvious benefits to society).

  15. avatar Wally1 says:

    So, I actually read this article and the comments. There is 10 minutes of my life I will never get back. What a ridiculous topic. If you argue with idiots, what does that make you.

    I will immediately get my guns out of the safe and get them vaccinated, therefore they will never harm anyone by passing on the “Gun Violence” virus. Problem solved. Yea, the argument is that stupid.

    1. avatar Martin B says:

      The only potentially “medical” issue around gun ownership is the possible “gun acquisition syndrome” which can afflict some individuals who find it impossible to pass up the latest and greatest example of the gunsmith’s art.

      And everyone here knows what I mean. It is not only a recalcitrant spouse who needs to be persuaded, wrestling with one’s own conscience is harder as bills remain unpaid, the lawn grows higher, and meals remain unbought.

      The struggle with hoplomania is a silent epidemic haunting the suburbs and rural towns of America. Much funding is needed for a major study.

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