‘A huge public health concern’: How NC health officials are tackling rising gun violence
More than 1,700 North Carolinians, nearly five per day, died from gun violence in 2020, the highest number of firearm-related deaths in the state in at least 16 years.
Across the country and in North Carolina, rates of domestic violence, mental illness, substance abuse, suicide, and violent deaths have all gone up, and as a new report from state health officials states, many of these problems are “compounded because of access to and misuse of firearms.”
The report, released Thursday by the N.C. Department of Health and Human Services, details how officials at the state and local levels are taking a public health approach to the problem. Their strategy relies on data and a variety of evidence-based solutions — similar to the approach adopted in the 1970s to gradually lower the rate of vehicle-related injuries and deaths, and make roads safer to drive on — to try to reduce the number of deaths from gun violence.
In an interview with The News & Observer, DHHS Secretary Kody Kinsley said he wanted to raise awareness of the strategies that can be implemented by everyone from state, city and county leaders to individual gun owners, in order to make guns safe and prevent gun misuse.
“As we are emerging from some of the darkest times of COVID, we have seen increasing levels of violence play out in a number of spaces, and that’s a huge public health concern for us,” Kinsley said. “One of my top priorities has been building behavioral health and resiliency in our communities, and helping support people. We see a lot of the strategies outlined in this document, and leveraging a public health approach, as key to helping our communities be safer.”
Those proposed strategies include increasing awareness of safe firearm storage; expanding community-based violence-intervention programs, implementing a red flag law in the state; and passing Medicaid expansion to provide insurance and vital mental health treatment to people who can’t otherwise afford it.
Medicaid expansion and red flag laws have been priorities for Democratic Gov. Roy Cooper, who oversees DHHS.
Following a public health approach
The report cites the Centers for Disease Control and Prevention’s public health approach to violence prevention as a model for how state officials are trying to study and address the problem of gun violence in North Carolina.
The model includes four steps: defining and monitoring the problem; identifying factors that protect people from gun violence or put them at risk for experiencing or committing it; developing and testing strategies to see which ones are effective; and ensuring widespread adoption of the strategies that are proven to make a difference.
Through analysis of the data collected on firearm injuries and deaths, as well as emergency room visits, the report points to a number of risk factors that make it more likely for someone to be impacted by gun violence.
Those factors include being a member of specific populations, including men, who account for 86% of all firearm deaths and injuries; Black North Carolinians, who are nearly twice as likely to die from gun violence than white North Carolinians; as well as 18- to 24-year-olds, who are more than three times likelier to go to the emergency room for a firearm injury than other age groups.
The report also warns that firearm-related deaths are increasing among children, with 116 children dying from a firearm-related injury in 2021, and hospitalizations for children who were injured by a gun increasing by 120% between 2016 and 2020.
Other people at a higher risk include veterans; people who live in rural areas or come from socially vulnerable communities where poverty and unemployment are higher and education levels are lower; and health care workers.
Expanding safe storage initiatives
One of the strategies promoted in the report is raising awareness of safe firearm storage — through public awareness campaigns, but also at smaller levels, such as primary care physicians, emergency room doctors and other medical professionals talking to families about ways they can safely store their guns and providing them with gun locks or other safety devices.
Different safe storage options might be better-suited to different gun owners, depending on their specific situations and how they use their firearms, Kinsley said.
Some people might prefer using a gun lock, which is typically safer for environments with younger children, the report states. Other people might be willing to store their ammunition separately. Those who want quicker access to their firearms can try using a biometric or four-digit code safe that only a gun owner would have access to.
“Being able to offer different options based off different needs ... is what we want to do,” Kinsley said.
Other people who don’t have their own safe-storage options can use an interactive map of gun stores and gun vaults to find locations near them where they can keep their firearms for a short amount of time, the report states.
Implementing a red flag law in NC
The report also recommends that state lawmakers pass a red flag law, which would allow family members, current or former spouses, law enforcement officers and health care providers to petition a judge to temporarily confiscate the firearms belonging to a person who has been deemed a threat to others or themselves.
The report specifically endorses a bill introduced during last year’s legislative session by Democratic Rep. Marcia Morey of Durham, who introduced a similar bill during the previous session as well. Neither bill has been considered in the state House, despite growing calls for North Carolina to implement its own red flag law after the mass shootings in Uvalde, Texas earlier this year, and in Raleigh last month.
The report also notes that the bipartisan federal gun safety bill that was signed into law this summer provides states with funds as an incentive to pass their own red flag laws.
“There is broad support for this concept, including from many in North Carolina’s law enforcement community,” the report states. “As in other areas, North Carolina can reach consensus around specific language and enact this law.”
Kinsley reiterated that the idea behind a red flag law is confiscation for short periods of time, not permanent loss of access. He also said there needs to be due process during these proceedings, and that state lawmakers can find ways to tightly regulate the program as other states have done. One solution, he suggested, was to enact penalties for people who file inappropriate petitions.
“We’re not talking about limiting of access for long periods of time,” Kinsley said. “We’re talking about, while someone is very sick and a harm to themselves or others, we’re talking about when they’ve already had a path of violence towards someone else, we need to get them to a better place.”
Expanding Medicaid health coverage
A focus of the report is filling the mental health treatment gap.
Around one in five North Carolinians, or about 2 million people, are estimated to experience a mental illness each year. But in 2020, more than 55% of these needs for treatment didn’t get it, the report states.
“We know that an ounce of prevention is worth a pound of cure, when it comes to mental health,” Kinsley said. “When you’re devolving over time, and your anxiety turns to paranoia, and turns to psychosis, it gets worse and worse and worse, and you don’t have interventions that help you manage. The further along that path you get, the harder it is to get you back to baseline.”
After a yearslong impasse between the political parties, Republicans who control the state House and Senate began talks and negotiations with each other, and with Cooper, over a deal on Medicaid expansion. The deal failed to materialize in time for lawmakers to go on a six-month recess, however. Now, supporters hope the deal will be resurrected when lawmakers return to Raleigh in January.
Kinsley said Medicaid expansion was “incredibly overdue” and lamented that every month without a deal, the state is missing out on $521 million in federal funding.
“I respect that there’s a political process, but my gosh, we just need to get to a deal,” Kinsley said. “And I sincerely hope we see leadership from the General Assembly, and from folks in health care, to be able to serve their patients better, by making the tradeoff, the choices they need to make.”
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This story was originally published November 17, 2022 at 1:08 PM.
