Buckeye broadband supports cspan is a public servicelong with these other Television Providers giving you a frontrow seat to democracy. Next, a discussion about gun violence prevention with former health and Human Services secretary Kathleen Sebelius and former senator and physician bill frist. They joined advocates to consider the importance of recognizing gun violence as a Public Health crisis and what solutions are available from a Public Health perspective. From the Aspen Institute this is one hour. [inaudible conversations] [inaudible conversations] well, good afternoon, everybody. Come on, you can be tired yet. And welcome to Public Health at the Aspen Institute would lead to have you here for this most important at advantage woulde most timely discussion about the ongoing epidemic of gun violence in this country. I am ruth katz, executive director of Health Medicine and Society Program at the Aspen Institute, and you tell everybody else. Health medicine and society, the sponsor Public Health at the Aspen Institute. Now, as many of you may know, grand rounds is a time honored feature of medicine decide to keep clinicians uptodate about scientific and medical advancement and to promote excellence in research and practice. Public health now in its eighth year at the Aspen Institute borrowers from that tradition to advance knowledge about the cutting edge Public Health or Population Health issues of the day. And sadly but certainly most urgently we do have such topic for our discussion today. The statistics on firearm injury in the United States are so bleak that they threatened to become numbing. Firearms killed more than 40,000 americans in 2021, and injured twice that many. Among adults, most firearm deaths are caused by suicide, homicide should most common cause among youth under the e of 18. A global outlier the United States has aged adjusted homicide rates that are 22 times higher than those of the european union. And that terrible toll does not stop at the victims, given the widespread impact of trauma, grief and fear associate with the proximity to violence that affects millions and millions of people. O but becoming numb is not something the nation can afford. Beyond the devastation of human beings and communities is the economic burden. In 2020 alone the cost of fatal and nonfatal firearm injuries in the United States topped a staggering 493 elgin dollars. According to a recent article in the american journal of preventive medicine. Now, no one considers any of this acceptable. These are gunowners, nongunowners, not not the Public Health or Health Care Community and not patients, parents or politicians. And yet efforts to confront this Health Crisis has stalled for years. That the increased availability of research funding, better data collection, and especially a greater recognition that a Public Health approach is the best way to reduce firearm violence, offer hope that progress can bece made. Todays program is all about how that Public Health approach can work. Joining us for the discussion is a stellar panel of experts and policymakers, and in the interest of time i will be presummit introduction but you can learn more about each of our speakers in theor invitation tht wee sent out to this event. Former senator bill frist,il nationally recognized heart and Lung Transplant surgeon represented the state of tennessee from 19942007. In which he served as Senate Majority leader for four years and was instrumental in passing the historic president s emergency plan for aids relief known as pepfar. Currently, senator frist is chair of the global board of Nature Conservancy and also chairs the aspen Health Strategy group. Kathleen sebelius served as secretary of department of health and Human Services during the Obama Administration leading the the president charged to pass, and government the Affordable Care act. Prior to her federal service, secretary sebelius was governor of the state of kansas. Today she serves as president and ceo of Sebelius Resources as well as cochair of the aspen Health Strategy group. Greg Jackson Special assistant to the present and Deputy Director on gun violence prevention. A survivor of kai billets himself, mr. Jackson has been a gun violence prevention leader for over ten years, including his work as director of the Community Justice action fund, a National Survivor led gun Violence Prevention Organization focus exclusively on the impact on black and brown communities. Megan ranney an emergency physician is dean nto whence will profess a public Mcgill School of Public Health, a professor of emergency medicine at the yale school of medicine. Shes also an aspen health fellow, class number five i believe, very good. A national advocate for innovative approaches to Public Health. Dr. Ranney focuses her research on developing, testing and disseminate Digital Health interventions to prevent violence and related behavioral problems. Moderating the conversation is a good friend of the Aspen Institute ofng the health medice Society Program, alan weil. Alan is editorinchief of health affairs, the nations leading Health Policy journal. Y and more about our hes one im really cutting short. Thank you all really thank you for being here today. Thank our panel for being here. Before entering things over 2000, just a few housekeeping notes to share. First as you can see, i think you can see, cspan2 today covering todays event but were also videotaping the program and it would uponn the Health MedicineSociety Website within 2448 hours. Our interview, our discussion interview, our discussion will run about 40 minutes or so after which will open the conversation to take your questions and comments. But please wait for a mic before speaking and then to introduce yourself and state in italy you may have. Finally, time is tight for the q a portion of the program and want to get as many questioned as they can, so please, i literally beg you, please be brief and get directly to your question. So we can get ass many as we ca. With that, by thanks again to all of you, our speaker for taking time from your drill the daily schedules to join our program. Thanks to todd again in the back who helped organize this today and, of course, thanks again to all of you for joining us. Its going to have your. With that, alan, the aspen stage is all yours. Thank you, ruth, i think all for joining us today. Im going to start off with a question building on the introduction that ruth gave around the statistics which can be numbing but we really cant become numb to them. Ikea of Public Health approach, a topic will be discussing more detail in a moment, is understanding where you are. And and i wonder if any of yot to build on the introduction ruth gave with either expanding on some of the data or maybe reflecting audit, where other misunderstandings or where does the discussion goes this way when people look at the data they might think its that way. Madam secretary, governor . I cant help it. Just a couple of things i think that struck me when we were talking about this with our wonderful experts. The sheer numbers o are just incredibly horrible. 50,000 deaths, thats a big number. But then multiply that by the people who are injured but dont die. Millions of americans are traumatized and victims of gun violence. And how much of an outlier we are, that was the second piece of the puzzle. I knew we had more, but the numbers, canadas number three, we have eight times the gun violence per capita that canada has. So it is way off the charts. Secondly, the number one cause for children, that is a number the came up and so 54, 55 or site. Stop for of a covenant i guess get a piece of the puzzle what are a suspect progress has been made. More research desperately, but spreading best practices, bill felt the same way, living in states where weve seen difficulty at the national level, so what we are talking about just not take legislation, just intent and community support. Community support. The Public Health component, people say oh youre pessimistic and thats not really a fair question. The real optimism and hope is the fact that we take what used to be a Second Amendment issue with the partisanship and reframe it because statistics number one the fact that under the age of 18 and 19, it is the number one killer. It is not Heart Disease or lung disease, accidents, anything else. It is firearm injury. That becomes a Public Health issue. When you frame this in Public Health, people come to the table, put their hats aside. It is a Public Health issue. That is a great segue to describe how to think about it as a Public Health issue. Megan, that would have to be for you. It is a join a privilege to be here with you. I testified before the judiciary about this. One thing that strikes me is folks do not understand that it is a Public Health problem. I think we can coalesce around the fact that this is a Health Problem. The Public Health approach is really reproducible standards. The first is you measure how common the problem is. Injuries, deaths, consequences. Second, identify risk factors. What puts someone at a higher likelihood of getting shot or killed . What protects them . This is important because that gives us a lens to protect people from injury or consequences. The third step is to do something with information, develop intervention and this is where it is not just about policy. Legislation is never sufficient and can be harmful in Public Health. So we evaluate interventions across a spectrum ranging from education to engineering, economic incentives or legislation. The final step is when you figure out what works, it is important to follow those steps. Without them youre liable to make mistakes and make things worse. Youre liable to act on the wrong cause or underlying risk and we do not have enough funds to address all the problems. We do not want to spend time or money on things that will not make a difference. So the four step approach allows a coalition. Strange bedfellows. I do a lot of work in states across the u. S. Universities, predominantly firearm owning communities and have found tremendous partnerships when we start from the starting point that none of us want communities hurt and we are preventing people from getting hurt and taking a four step approach. Unfortunately, people think Public Health is about laws. It is a wider set of intervention. The last thing i will say is we think about Public Health approaches and harm reduction. Many of you have heard it applied to substance use. Reducing the chance that someone will have an overdose or death or infection. Trying to reduce harm. The same approach applies to firearms. We can take a partnership that is not fall or nothing and is inherent to our Public Health to try, anything is better than nothing and we see a big effect. Jumping in, the steps are key. They are fundamental to Public Health approach. The question is why now . Theres been more firearm injuries now then there were 10 or 20 years ago. The second is for 20 years we had new research. One and to regard getting data, seeing what works, determining the risk. Because of a policy, a wrong policy, until 2018, we had no research. Nothing supported by the government. Therefore, you had people talking and feeling good, but where is the data . What works, what does not work . We had a gap. Over the last four hues the door has been open. The policy has been reversed. Thats why am hopeful. Steps one and two can empower people like megan and academics. They determine the risk. What is the data . For the first time data is coming forward. Before we hear from our expert who is working day today on this, i think the other reason i feel optimistic is there is support, gun owners, nongun owners, taking steps to find Common Ground and address Public Health. This is not you think about gun debates and it is polarizing as the senator alluded to. Public Health Approach has community support. Republicans, democrats. If we can do what megan suggested, we can make progress. In a uniform way. So if i think of myself as an observer, political debate spikes around Mass Shootings and in the absence of data, you say that is where we should focus solutions. It is a problem, but there are t wo other places i would want to look that drive a lot more harm. The first is communitybased violence. Senator, your comment on the increase in research, we know more about incidents, and also how to stop it will reduce the burden. Greg, take us through a tour of what we know. Greg research has pulled back the veil about why homicides rise and we look beyond suicide. The narrative dominated by Mass Shootings, it is interpersonal violence fueling the numbers. One huge thing we learned is what is happening in communities. There is a stereotype that innercity violence is driven by gangs and criminal activity. But that is not the case. 70 of Community Violence in shootings are not connected to a felony. 89 are not connected to gangs, but the narrative dominated how we thought about innercity homicides and violence amongst youth. So as you pull that back you say what is going on in whether it is a veteran on the edge of suicide or a 12yearold with a firearm, these are two individuals at a point of crisis with easy access to a firearm. Our approaches. About why people are in crisis, address those factors. And then how do we put time and distance between them having a firearm and reacting in crisis. Strategies for suicide and homicide work well, shifting the messenger, shifting their resources. That is what Community Violence intervention was born from. Those who are most at risk, someone who is a survivor, survivors of gun violence have a 40 chance of being shot again, harming someone else or being killed. How can we get better at engaging survivors . So they have different approaches. Some use behavioral therapy, others use healing approaches. Others take a job approach. Lets pull you out of this moment to cool down and get you into job so we can solve the acre problem. Not just conflict over resources. So the strategy has been implemented for the last there is around 12 billion in which ca a big change. Talk to senator murphy and one of their most dangerous communities went nine months with no shootings and the only change was Community Violence program was launched, they funded it in baltimore. Safe streets, 12 communities. There has been a 26 point reduction by engaging with resources, support, but trying to help them get out of the moment of crisis. We are looking at how to do that around prevention with veterans and youth not in inner cities, knowing suicide has skyrocketed. We are excited about focusing on those in crisis. The other piece you can never forget his access to firearms. The difference is we have 400 million tons. Back then we had 100 million. Guns are available and we have to think what this means for our families when egg gun can be found easier than therapist. Weve seen a 13 reduction. Last year, it was the sharpest decline and when you look at black and brown communities, that is where we saw the heaviest decline. So ruth mentioned in the introduction, everyone is affiliated with the Strategy Group which had firearms injury as a topic. The first big idea was the notion that the Health Sector needs to leave. Im thinking we have active representatives of the house affected. And i am listening to your approach is and thinking health is not the first place i think of, but it keeps coming up, so maybe you can start with what is happening within the community . Megan we are linking them to resources and taking that o