Opinion piece by Joanne M. Conroy, MD, president and CEO of Dartmouth Health in New Hampshire and Keith J. Loud, MD, MSc, Dartmouth Health Children's physician-in-chief and chair of pediatrics, Geisel School of Medicine at Dartmouth.
The mass shooting in Lewiston, Maine, on October 25 shattered the false sense of security many of us in rural northern New England felt: that gun violence on such a scale could not happen in our backyard. It couldn’t happen in this bucolic setting, where someone who needs a hand gets it, and someone who can lend a hand usually gives it. But this mass shooting did happen, and it is painful and personal for those of us who live here and for the loved ones of those were injured and who died in Lewiston that day.
When a tragedy like this happens, we naturally ask ourselves, "What can be done to prevent this from happening again?" There is no simple solution, but we must do something—even if it seems like a tiny step.
While our small New England communities seem largely immune to it, gun violence still impacts us every day and many preventable, untimely deaths occur in part because of easy access to firearms. With deep traditions of hunting and sport shooting, Maine, New Hampshire and Vermont have among the highest rates of gun ownership in the United States. While we enjoy relatively low rates of firearm-related homicide, recent data from Every Town for Gun Safety demonstrate that our region experiences a higher-than-average rate of firearm-related suicides, causing the vast majority (more than eight in 10) of gun deaths in children and adolescents.
Nationwide, the death toll is mounting, especially for young people. Firearm-related injuries became the leading cause of death in those younger than 25 years of age in the United States in 2017, according to data from the Centers for Disease Control and Prevention (CDC), with a sharp increase noted in 2020. More than 120 people are killed with guns every day in the US, according to the CDC, with an unimaginable 22% of these deaths in children and teens in 2020. At the current trajectory, more than 10,000 young people will die by firearms each year—the equivalent of one full school bus every three days.
There is no doubt that the pandemic worsened a mental health crisis among adults and children, and easy access to guns exacerbates the problem, as demonstrated by the Lewiston shooter. According to the American Academy of Pediatrics, keeping a firearm in the home increases the risk of injury or suicide among adolescents independent of mental health diagnosis. Many are purely accidental. Most are impulsive acts, with no mental health warning signs in advance; although we now know there were significant warning signs in the case of the shooter in Lewiston.
While the data shows the share of American households with at least one gun has remained relatively steady since the 1970s, a 2018 survey published in the American Journal of Public Health found that more than half of U.S. gun owners did not safely store all their guns. That’s why Dartmouth Health Children’s primary care practices screen patients’ families about gun safety and give out free gun cable locks to those who keep guns in the home. We recognize such prevention programs would not have prevented the violence in Lewiston, but even if it has a chance to save one life, it’s worth the effort. Ultimately, it will not take one, simple solution to put an end to gun violence in America. It will take many, sometimes small solutions to link together a system that will make our kids and loved ones safe from a deadly bullet, whether they’re at home or enjoying a night at their local bowling alley.
Gun safety is not about challenging the Second Amendment to take guns away from responsible gun owners. Responsible gun owners are part of the solution. Their voices are critically important to the conversation about gun safety. One way to address gun violence as a public health crisis is to share information with responsible gun owners about how to store firearms safely: locked up and with the ammunition locked and stored separately, which research shows can reduce firearm injury and death.
But it will take more than responsible gun owners and health systems like Dartmouth Health to prevent the next tragedy, and sadly, we in northern New England have now been called to lend our voice to the chorus.
About Dartmouth Health
Dartmouth Health, New Hampshire's only academic health system and the state's largest private employer, serves patients across northern New England. Dartmouth Health provides access to more than 2,000 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH, as well as across its wide network of hospitals, clinics and care facilities. DHMC is consistently named the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, one of only 56 National Cancer Institute-designated Comprehensive Cancer Centers in the nation, and the only such center in northern New England; Dartmouth Health Children’s, which includes Children’s Hospital at Dartmouth Hitchcock Medical Center, the state’s only children’s hospital, and multiple clinic locations around the region; member hospitals in Lebanon, Keene and New London, NH, and Bennington and Windsor, VT; Visiting Nurse and Hospice for Vermont and New Hampshire; and more than 24 clinics that provide ambulatory services across New Hampshire and Vermont. Through its historical partnership with Dartmouth and the Geisel School of Medicine, Dartmouth Health trains nearly 400 medical residents and fellows annually, and performs cutting-edge research and clinical trials recognized across the globe with Geisel and the White River Junction VA Medical Center in White River Junction, VT. Dartmouth Health and its more than 13,000 employees are deeply committed to serving the healthcare needs of everyone in our communities, and to providing each of our patients with exceptional, personal care.