I am happy and thankful to be an American citizen, where I have the freedom to speak my mind, practice whatever religion I chose and I can even pursue the career of my choosing with hard work and perseverance. I have had the good fortune to travel in many parts of the world and it is increasingly clear to me that these simple rights and privileges are not always available to others across the globe, and in fact I believe that this is in large part why people from all over the world actively chose to immigrate to the USA and other parts of the world where greater opportunities and freedoms exist for all.

As you probably already know the foundation of the laws that govern our lives here in America are rooted in the Constitution and Bill of Rights, which in quite simple terms outlined the basic elements deemed necessary for people to live freely and to protect us the abuses of power by leadership. The history of America is a brief one, compared to many other nations in the world, but even so - having been written almost 240 years ago, many components of these Bill of Rights are no longer written in a manner that I believe is as clearly applicable and interpretable today, as some appear to believe and embrace. Case in point, the Second Amendment to our Constitution speaks to the need for there to be a well-regulated militia and for the right of people to keep and bear arms. Of course in the 1700’s there were no automatic weapons even conceptualized nor magazines that could turn a gun into a weapon of war. Militaries and citizens used single loading muskets and other rudimentary and crude firearms to hunt and participate in military exercises.

It is this Second Amendment to our Constitution that is the pivot point for the pros and cons of gun access, availability of ammunition and this so called “right to bear arms” is what many have used and continue to justify the immense problem we face in the USA today with almost daily mass shootings of innocents, not in war zones and dangerous boarder areas on our periphery, but in classrooms, Universities, communities and neighborhoods across our nation. The people who fiercely embrace the second amendment argue that the framers of this document had insights into the future and somehow knew that someday anyone could walk into a gun shop or attend a local “gun show” and buy an almost unlimited amount of ammunition, as well as a high powered automatic weapon, originally created for use in settings such as military engagements and police actions, but now readily available for purchase and use in the private sector. The prevailing opinion of many Constitutional scholars has been that the Second Amendment does not address private gun ownership rights, but only guarantees the collective right of states to maintain militias, clearly separating those rights from the individual. Those opposed to a simplistic and literal interpretation of the second amendment point to the increasingly worrisome and sad reality we now face in the USA - where more than 40 to 50,000 men, woman and children per year endure gun violence, with many dying unnecessarily - making the USA the country with the overwhelmingly highest homicide rate in the world.

In 2014 it is estimated that well over 2,600 children were killed or injured due to gun violence in the streets, neighborhoods and schools of our communities. This included almost 300 episodes of mass shootings last year - which is close to one incidence per day in America! The United States accounts for nearly 75 percent of all children murdered in the developed world. Children between the ages of 5 and 14 in the United States are 17 times more likely to be murdered by firearms than children in other industrialized nations. Not unexpectedly, children from states where firearms are prevalent suffer from significantly higher rates of homicide, even after accounting for poverty, education, and urbanization. For example, a study examining youth in North Carolina found that most of these deaths were caused by legally purchased handguns. Additionally, a recent meta-analysis revealed that easy access to firearms doubled the risk of homicide and tripled the risk for suicide among all household members. Family violence is also much more likely to be lethal in homes where a firearm is present, placing children especially in danger. Murder-suicides are another major risk to children and are most likely to be committed with a gun.

The recent mass killings of innocents at elementary schools as well as those at a number of Universities in America have re-escalated the debate about “gun control” and more restrictive regulations for access to a variety of weapons and ammunition, but despite the fact that even the American Academy of Pediatrics, which I am a fellow in, strongly advocates that guns not be kept in homes, especially those where children reside or visit, American children younger than 15 year of ageremain nine times more likely to die by a gun accident than those in the rest of the developed world. Children living in parts of the USA with availability to firearms also suffer from significantly higher rates of unintentional gun deaths. Sadly, studies indicate that the vast majority of these shootings involve family or friends of the childhood victims. These statistics clearly indicate that parents’ ownership of a weapon is a significant risk not only to their own children but also to their children’s friends.

In contrast, the National Rifle Association (NRA) claims that its safety programs work and are sufficient, despite overwhelming evidence to the contrary. The NRA may continue to ignore and explain away these disturbingstatistics regarding gun access and the deaths of innocents nationwide, but it is clear that firearms make children less safe.Organizations such as the NRA continue to promote bills that forbid pediatricians from talking to parents about guns and safety measures and they spend an enormous amount of time, energy and money influencing our government officials to keep the manufacturers of guns and ammunition busy making profits as blood continues to be spilled on the streets of our communities and in the classrooms we send our children to learn, and not cower with fear of injury or death. In the developed world, over 85% of children younger than 14 years old killed by firearms live in the United States. More American children and teenagers died from gunfire in 2010-a single year-than U.S. troops in Afghanistan from 2001 to 2014. Is this the world we want for our children?

Statistics from the Centers of Disease Control reported in 2012 are additionally sobering. In 2010, there were 2,711 infant, child, and teen firearm deaths. On average there were seven such fatalities daily and 52 weekly. Between 1981 and 2010, 112,375 infants, children, and teens were killed by firearms. This is 25,000 more deaths than the number of soldiers killed in Korea, Vietnam, Iraq, and Afghanistan, combined. Of the 1,982 youth (age 10-19) murdered in 2010, 84% were killed by a firearm. Enough is enough,

According to the Children’s Defense Fund in 2013, loopholes in firearm safety laws have reduced their effectiveness. For example, the Brady Law, which requires federal background checks for guns purchased from licensed dealers, did not require such checks for guns bought through private sales (and it is currently estimated that 40% of guns are bought from private sellers, such as at gun shows). However, worth noting, those states that conducted background checks for restraining orders and fugitive status had fewer homicide and suicide deaths. Firearm suicide deaths were also lower for states with background checks for mental illness, fugitive status, and misdemeanors. Worth noting, most people with serious mental illness do not commit violent crimes, and the very few who do are unlikely to use a gun. Among the general public, there is unfortunately fear and stigma associated with people who have documented mental illness when, in fact, they are far more likely to be the victims than perpetrators of violent crime. This misperception is being promulgated by many, including membership in pro-gun lobbying organizations - such as the NRA and the politicians who need an excuse for the absurd pro-gun lobby they are wrongly influenced by. It is simply not true.

So what is the solution to all of these needless acts of violence and death due to firearms? I believe, as do countless others that we need much more restricted access to weapons and ammunition in the United States and we need to act now. The Pew Research Center recently published data (8/13/15) from over 2,000 Americans interviewed regarding gun policies and they report that although little has changed in the two years since the US Senate failed to pass legislation to expand background checks on gun purchases, the American public continues to overwhelmingly support making private gun sales and sales at gun shows subject to background checks and greater regulation. Currently, 85% of Americans - including large majorities across both predominant political parties (Democrats (88%) and Republicans (79%)) - favor expanded background checks confirming that little has changed from May 2013 (81%), when they last generated similar data, shortly after the December 2012 school shootings of innocent elementary school children in the suburban community of Newtown, Conn. Today, almost a full 80% of American people surveyed favor laws to prevent people with mental illness from purchasing guns, 70% back the creation of a federal database to track all gun sales, while sadly and surprisingly only 57% support a ban on assault-style weapons. We clearly have a lot of work to do to be sure that people are aware of the actual data available and the implications of flooding our cities with more guns and ammunition.

Almost identical shares of Republicans (81%) and Democrats (79%) support laws to prevent the mentally ill from buying guns, but as noted earlier the data available suggest that this group is of less concern overall then public opinion suggests. 85% of Democrats favor creation of a database for the federal government to track gun sales, compared with 55% of Republicans. And while 70% of Democrats back an assault-weapons ban, only about half of Republicans (48%) favor this proposal.Currently, 50% of Americans say it is more important to control gun ownership, while 47% say it is more important to protect the right of Americans to own guns. This represents a minor shift since December 2014, when more people surveyed prioritized protecting gun rights (52%) than controlling gun ownership (46%).The issue of what to do about guns and gun violence shockingly and sadly remains a highly partisan one, which is where I believe the stagnation to act and potentiate change is to blame here in the USA. Republicans choose gun rights over gun control by a 71% to 26% margin, while Democrats prioritize gun control over gun rights by a 73% to 25% margin.Guns also continue to divide the public along racial and gender lines. The PEW foundation reports that whites say it is more import to protect gun rights, by 57% to 40%, while the majority of Hispanics (75%) and blacks (72%) say it is more important to control gun ownership.

Irrespective of politics and party alignments, we clearly need to move beyond this to finally make some meaningful change in all of this needless violence against our children and communities. First, I think we need to make our gun laws reflect the world we live in today and not hide our heads and hearts in the simplicity of those words written in the Bill of Rights so long ago. We need to finally and completely ban the sale and access to military style weapons immediately, making all assault weapons illegal to own in the USA. If you can’t suitably hunt with it, you shouldn’t own it. Assault weapons have no place beyond battlefields. Along these same lines we need to immediately ban high capacity magazines that turn any gun into a killing machine at the simple grip of a trigger by the handler. We need to expand 24 hour gun background checks, making them universal and perhaps include a “cooling off” period that exceeds that. If I need to register and take a test and follow many rules and regulations to have a driver’s license, own a scooter, care for a dog, or practice the profession of medicine, why should gun ownership be any different? Since we are sadly the leading nation for gun ownership in the world, we need to make sure that people are protected and safer than they are now. We need to implement mandatory training and licensing along with more requirements for safer and more secure gun storage. Just like I have to reapply to practice medicine and confirm ongoing reeducation and skill retesting on a regular basis, so should gun owners with regular training requirements, as well as permit renewals with regular background updates. The Attorney General’s Task Force on Children Exposed to Violence noted, not unexpectedly, that in the USA children are witnessing and experiencing violence at an alarming and increasing degree and as such we need to work on implementing better and more readily available programs to help reduce the trauma of violence for our young people. Mental health is not any more of an issue in the USA than in the rest of the world, but we are doing increasingly less and less to ensure access to high quality and accessible mental health services to our people. We need to do a better job with education about mental health issues and work harder to implement more programs for all people in a less judgmental and stigma-enriched context. Once these changes are implemented, then we can start to work more at a community level to help deal with all of the currently available weapons, by supporting comprehensive violence prevention programs with real enforcement, funding and rehabilitation - as opposed to more jail cells and longer sentences for those involved. Prevention is more likely to be helpful than failed attempts at rehabilitation and that is where we need to focus more attention and resources, ideally offset in part with the funds collected from gun ownership. Lastly, for any of this to actually manifest, the American people - especially those majorities across political lines - need to wake up and vote for real change. We need to insist on changes in the laws that are badly needed immediately to implement the changes myself and many others have recommended. We also need to be sure that those we put into public office actually fully represent our best interests and not just those of heavily funded special interest groups, such as those at the NRA. Representatives that no longer represent their constituents need to be voted out of office and replaced with people responsive to our real wants and needs,…and those of our children.

Sadly, by the time this editorial is published many more children will have been shot and killed while playing in their neighborhood park or walking home from school. I believe we can no longer hide behind the second amendment and allow the money, power and resources that supports the gun lobby, which sadly has such a strong stranglehold on our current government officials that they somehow manage to ignore the obvious and allow their better judgement to be clouded by lobbyists, money and power. Our children’s lives and that of our own is too precious to continue to allow this insanity to fester any longer. As pediatricians, family practice doctors and allied healthcare professionals we prioritize the health and well-being of children and clearly guns remain a significant health hazard to our future generations. We need to also speak up more loudly and be heard for anything to change. Time is clearly running out and the time is now. Do something.

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