Population Health Blog

Population Health Blog

Why It Matters

Gun violence as a public health issue lacks scientific evidence, but needs to be addressed now

By Victor J. Dzau, M.D.

Gun violence in America is a public health crisis, and one that scientists have not been able to effectively study for too long. Our nation has been reluctant to address gun violence with lasting evidence-based policies, but it has never been more critical to address this epidemic head-on. Scientific research will not be able to support every policy that needs to change, but we as researchers can lead the way toward enacting common-sense gun control measures.

The National Research Council and the Institute of Medicine, in 2013, authored a report titled Priorities for Research to Reduce the Threat of Firearm-Related Violence that outlined a research agenda focused on illuminating the causes of, possible interventions, and strategies to minimize the burden of firearm-related violence. This research agenda includes areas that warrant further research and highlights current gaps in our understanding that are critical to making informed decisions in the future.

The increasing prevalence of gun violence is a complex and daunting crisis, but it is one that we can see abate in our lifetime. I authored three editorials recently on this topic — two with NAM member Dr. Alan Leshner, CEO emeritus of the American Association for the Advancement of Science and Committee Chair of Priorities for Research to Reduce the Threat of Firearm-Related Violence (Science and Annals of Internal Medicine), and one with NAM Member Dr. Mark Rosenberg, founding director of the National Center for Injury Prevention and Control at the CDC (The Washington Post). All three editorials highlighted the critical need for research to investigate the causes of gun violence, as well as allocated funding to support that research. Evidence-based policies will lead to safer schools, safer communities, and less unnecessary deaths, and do not have to infringe on the rights of law-abiding citizens. These policies are long overdue.

Victor J. Dzau, M.D., is president of the National Academy of Medicine. This commentary was originally published in the March 2018 edition of the National Academy of Medicine newsletter

Is loneliness among the elderly a population health problem for our time?

By Dennis Archambault

It’s not customary to read philosophy. Or, at least, few people I know tell me about the latest philosophy book or article they read.  Philosophers are thinkers and often have some pretty interesting things to say.

Kwame Anthony Appiah, a  philosopher in Ghana, wrote about a cautionary tale, “What will future generations condemn us for?”  Climate change is perhaps the best example of how various groups speak of our responsibility to the future and how we may be judged for our environmental stewardship. Appliah examines that, our prison system, and “the institutionalized and isolated elderly.”

The philosopher raises the ethical dilemma: “When we see old people who , despite many living relatives, suffer growing isolation, we know something is wrong. We scarcely try to defend the situation; when we can, we put it out of our minds. Self-interest, if nothing else, should make us hope that our descendants have worked out a better way.

Former Surgeon General Vivek H. Murthy, M.D., wrote about the epidemic of loneliness in the Harvard Business Review recently: “During my years caring for patients, the most common pathology I saw was not heart disease or diabetes; it was loneliness.”

Drs. Sachin H. Hain and Craig Sammitt, in their article, “The growing imperative to address senior loneliness,” https://catalyst.nejm.org/growing-imperative-address-senior-loneliness/add, “The problem of loneliness and social isolation is increasingly well-recognized as a societal ill, but maddeningly difficult to address. What can we do to address a problem that has roots that are not just economic, but cultural in nature, and that has downstream implications that include an undeniable effect on health?”

Here we have a population health issue as articulated from various perspectives. We are observing it close up in the population of elderly residents in HUD-contracted senior apartments in Midtown and Downtown. What is the level of their food security? How are they accessing health and social services? How is loneliness affecting their health and well-being?

As we strive preserve low income senior housing, we need to take the next step to preserving health and well-being and addressing the “imperative” of senior loneliness.

Dennis Archambault is vice president, Public Affairs, for Authority Health.