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Health Systems Interventions to Prevent Firearm Injuries and Death Proceedings of a Workshop (2019) / Chapter Skim
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2 Why Do Health Systems Have a Role?
Pages 5-10

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From page 5...
... "Every single day in America, health professionals find themselves on the front lines of treating patients injured by firearms," Choucair said. "From our emergency departments and primary care settings to behavioral health and specialty care, there are many touch points where health care systems grapple with firearm-related injuries and death.
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From page 6...
... "Beyond our own work, we hope to inspire a great many others to step in and fill the gaps in knowledge that exist today. This workshop is one of many steps on the path to filling the gaps in our evidence base, and enhancing our ability to deliver effective care in this area." GUN VIOLENCE: A COMPLEX BIOPSYCHOSOCIAL DISEASE REQUIRING A STRENGTHENED HEALTH CARE SYSTEM RESPONSE In the workshop's first presentation, Stephen Hargarten, a professor of emergency medicine, an associate dean for global health, and the director of the Comprehensive Injury Center at the Medical College of Wisconsin, framed gun violence as a complex biopsychosocial disease and defined gun violence prevention as a role that health systems should take as civic leaders of health care.
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From page 7...
... , Hargarten said, that health care ­ systems can play a significant and more effective role in identifying patients BOX 2-1 Antecedents of Homicide and Suicide Death •  urrent depressed mood C •  urrent diagnosed mental health problem C •  ype of mental health diagnosis: identifies the Diagnostic and Statistical T Manual of Mental Disorders, 4th Edition, diagnosis made by a medical or mental health practitioner •  urrent mental health treatment C •  istory of treatment for mental health problem H •  lcohol/other substance problem A • Other addictions •  amily relationship problem F •  ther relationship problem O •  istory of child abuse/neglect H •  aretaker abuse/neglect led to death C •  ictim of interpersonal violence in previous month V •  risis during previous or upcoming 2 weeks C • Other crises SOURCES: Adapted from a presentation by Stephen Hargarten at the workshop on Health Systems Inter­ entions to Prevent Firearm Injuries and Death on October 17, 2018; Jack et v al., 2015.
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From page 8...
... Preventive Services Task Force has issued guidelines on how to screen for intimate partner violence and what steps to take.1 The horrific biologic effects of a gunshot wound on the human body r ­esult from the transfer of a bullet's kinetic energy to human tissue, H ­ argarten explained. In many instances, he said, the damage is so severe that victims will experience lifelong disability, but in some instances the resulting injury can be subtle and only appear later.
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From page 9...
... He then quoted Kaiser executive Bechara Choucair, who said, "Going forward, we will study interventions to prevent gun injuries the same way we study cancer, heart disease, and other leading causes of preventable death in America. The bestin-class preventive and specialized care Kaiser Permanente provides is accomplished, in part, by using rigorous research, without bias, to determine which strategies are effective." Advancing injury science in health care systems for improved outcomes has led to a greater involvement of health care systems in the prevention of falls, suicide, domestic violence, tetanus, and at-risk alcohol use and abuse, Hargarten said.
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From page 10...
... "We must move away from political and social debates to constructive discussions to advance complex biopsychosocial disease management and prevention, supporting research all along the way, just like we do for other diseases," he said.
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  • heart disease

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  • social determinants
  • partner violence
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  • domestic violence

  • leading causes
  • bechara choucair
  • preventable death
  • critical health
  • ing health

  • psychosocial health
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  • global health
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