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国家枪支暴力疫情:佛蒙特州卫生部的应对措施。

The National Epidemic of Gun Violence: The Vermont Department of Health Response.

机构信息

Brody School of Medicine, Greenville, North Carolina (Dr Novick); Vermont Department of Health, Burlington, Vermont (Dr Levine); and Stamford, Connecticut (Ms Novick).

出版信息

J Public Health Manag Pract. 2020 Jan/Feb;26(1):32-38. doi: 10.1097/PHH.0000000000001103.

Abstract

This case study details a 2018 "near miss" school mass-shooting event in Vermont that involved a former student and occurred contemporaneously with the Parkland, Florida, tragedy. The situation "jolted" this rural state's governor, lending urgency to the need to enact sensible gun control laws. He comes to support a series of proactive bills already in the legislature and advocate for further preventive strategies. The state's commissioner of health plays public health's traditional role within state government as trusted health promotion and education resource to frame the issue in public health and public safety terms. He portrayed health data on firearm injuries and deaths and formed a public health strategy including surveillance, identification of risk factors, and resources for school- and community-based prevention. On April 11, 2018, Governor Phil Scott signed a package of gun-related legislation that included increasing the legal age for gun purchases, expanding background checks for private gun sales, banning high-capacity magazines and rapid-fire bump stocks, and extreme risk protection orders. The final results were examined from an evidence-based public health standpoint, acknowledging the lack of gun research by federal agencies since the 1996 enactment of the Dickey Amendment that prohibits the Centers for Disease Control and Prevention from conducting firearms-related research. The case study illustrates the paradox of moving forward on gun safety, where more research is needed, but research does not necessarily influence political leaders or policy. It also demonstrates how prevention of gun violence can be portrayed in a public health framework, drawing upon data and strategies used in upstream preventive efforts in areas such as early childhood development, mental health, and substance misuse.

摘要

本案例研究详细介绍了 2018 年佛蒙特州的一起“险些发生”的校园大规模枪击事件,该事件涉及一名前学生,与佛罗里达州帕克兰的悲剧同时发生。这一情况“震惊”了这个农村州的州长,促使他迫切需要制定明智的枪支管制法律。他转而支持立法机构中已经提出的一系列积极法案,并倡导采取进一步的预防策略。该州卫生专员在州政府内发挥着公共卫生的传统作用,作为值得信赖的健康促进和教育资源,从公共卫生和公共安全的角度来阐述这一问题。他展示了有关枪支伤害和死亡的健康数据,并制定了一项公共卫生战略,包括监测、识别风险因素,以及为学校和社区预防提供资源。2018 年 4 月 11 日,菲尔·斯科特(Phil Scott)州长签署了一揽子与枪支有关的立法,其中包括提高枪支购买的法定年龄、扩大私人枪支销售的背景调查、禁止大容量弹匣和快速射击的 bump 枪、以及极端风险保护令。从循证公共卫生的角度来看,最终的结果是值得关注的,因为自 1996 年《迪基修正案》(Dickey Amendment)颁布以来,联邦机构缺乏枪支研究,该修正案禁止疾病控制与预防中心进行与枪支有关的研究。该案例研究说明了在枪支安全方面取得进展的悖论,即在需要更多研究的情况下,研究并不一定会影响政治领导人或政策。它还展示了如何可以从公共卫生框架的角度来描述枪支暴力的预防,借鉴在幼儿发展、心理健康和药物滥用等领域的上游预防工作中使用的数据和策略。

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