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Dr. Kohar Jones: Gun violence is a public health problem

ContoriPowers cries for her 6-month-old cousshot 6500 Block S. MarylStreet Monday March 11 2013.  |  John H. White~Sun-Times

Contoria Powers, cries for her 6-month-old cousin, shot in 6500 Block of S. Maryland Street, Monday, March 11, 2013. | John H. White~Sun-Times

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Updated: April 17, 2013 6:08AM

On a recent Friday, a young man came to my outpatient clinic on Chicago’s South Side, struggling with deep grief and depression after having lost two members of his family in one day.

His sister had been killed in a drive-by shooting, and his distraught diabetic father had missed taking his insulin and slipped into a diabetic coma, never to wake up.

The health ramifications of our national epidemic of gun violence — with 100,000 people killed or injured by guns each year — extend beyond those who suffer from bullet wounds, encompassing their family, friends and communities. They struggle to cope with the needless loss of life from gun deaths, and their own sense of vulnerability in dangerous neighborhoods.

I think of my suicidal middle-aged patient who lost her second son to gun violence. She lost her sense of purpose in life at the same time. We struggled to find her ongoing mental health care in a budget-constrained environment to deal with her overwhelming feelings of loss and hopelessness.

I think of an optimistic 18-year-old who spends her weekdays not in school, nor working, but in taking her 2-year-old daughter to appointments with physical therapists and neurosurgeons, a year after the little girl was hit in the head by a stray bullet in a drive-by shooting.

I think of a beaten down elderly man, his son killed in a gang-style ambush on a freeway exit. (“Maybe you heard of it?” he asks. “The radios covered the traffic backup.”) When I advise him to walk a half hour every day for his health, he shakes his head no. “The people who killed my son still live in my neighborhood. I don’t feel safe on the streets.”

Gun violence is a terrible public health problem on Chicago’s South Side.

Dr. Doriane Miller, one of my colleagues in the Urban Health Initiative at the University of Chicago Medicine, born and raised on the South Side, leads Community Grand Rounds, an important series of evening meetings that bring together university and community experts to address health needs identified by the community. Gun violence (along with obesity) has emerged as the most common concerns.

Dr. Miller responded to neighborhood concerns about gun violence and the mental health of youth with the powerful play “It Shouldda Been Me,” exploring the responses of the best friend of a victim of gun violence, and how his family dealt with his depression.

How does a community respond to the overwhelming loss of life, and the terrible ripple effects on a family and community — depression, withdrawal, school failure, anger and revenge?

The sense of vulnerability and mistrust that neighbors have for each other erodes individual health in more subtle ways too. My patients are afraid to go outside to exercise, refusing to walk in their neighborhoods, further contributing to the epidemic of obesity. The stress of what amounts to low-intensity warfare, never knowing when bullets might fly, leads to an increased stress response that exacerbates asthma and heart disease.

We need stronger gun laws and improved mental health care. Responding to the mental health needs of those who witness violence, and the family and friends who are deeply affected by senseless loss, will help to stop violence. We need to make our streets safer, to create communities where neighbors can walk to the corner store to buy their fruits and vegetables, pursuing the habits that prevent the diseases of lifestyle that are making Americans die earlier than our counterparts around the globe.

Gun violence hurts more than the people who suffer the bullets in their bodies. It hurts the mental health of the family and friends of gun violence victims, and erodes the cohesion of healthy communities.

Gun violence is a public health problem, and we can support the public health measures that will create a healthier America.

Dr. Kohar Jones is a clinical assistant professor in the Department of Family Medicine at the University of Chicago Medical Center.

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