Ordinarily, the CEO of a health care network pledging $1 million to combat a national public health crisis would not seem that unusual.
But the pledge by Northwell Health President and CEO Michael Dowling in December was noteworthy for two reasons.
In making the pledge, Dowling challenged other large health systems nationwide to match Northwell’s investment.
And the national health care crisis Dowling was seeking to address was gun violence.
Gun violence claimed the lives of 14,623 people in the United States in 2018 – not including suicides, which would bring the number to more than 39,000, more than motor vehicle traffic deaths. And just 11,000 behind kidney disease.
More people have died from guns since 1970 (1.4 million) than in all the wars in American history (1.3 million).
The numbers do not include the number of people injured – 28,159 in 2018. The cost of these injuries to the health system is great, as is the pain and often life-altering suffering for victims. As is the fear and, in some cases, terror that results from gun violence.
This can be seen in children participating in active shooter drills and the expense in turning schools into hard targets.
But for years, a Congress in the thrall of the NRA blocked even the study of what was causing these deaths and how to prevent them.
Thanks to gun-safety groups such as Moms Demand Action, New Yorkers Against Gun Violence, Everytown and Giffords, support for legislation in Congress and among the public has grown.
This year, the House of Representatives approved legislation supported by more than 90 percent of the American public to eliminate a loophole in federal gun laws that exempts unlicensed sellers from having to perform any background check whatsoever before selling a firearm.
But Senate Majority Leader Mitch McConnell has refused to bring the legislation to a vote.
So Dowling’s challenge to his fellow health care CEOs is understandable. As is his disappointment with them.
“I have been frustrated by the inability of many health system CEOs to stand up and talk about the issue of gun violence,” Dowling told more than 170 attendees at Northwell’s Gun Violence Prevention Forum, held Dec. 12 in Manhattan. “CEOs can’t be silent anymore, not on an issue this big. If you have the courage and strength to run a big health system, you should have the courage to stand up and talk about this. My goal is to get all major health systems in the United States to pledge their support.”
A Northwell news release noted that the health system is a $3.5 trillion industry with a workforce of more than 18 million. This has the potential of being used as a great force for good – one that we hope would be picked up by the rest of corporate America.
Dr. Mark Rosenberg, a public health researcher and former head of the U.S. Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control, told conference attendees most gun deaths could be prevented by government and the medical community the same way they had worked to eradicate smallpox, reduce smoking, and decrease highway deaths through seat-belt use, stricter drunken driving enforcement and greater car safety.
But sadly we still live in a world in which it is more difficult for children to use their parents’ iPhones than their guns.
Dr. Sheldon Teperman, director of trauma and critical care services at New York City Health + Hospitals’ Jacobi Medical Center, a long-time advocate for assault weapon bans and other gun reform legislation, put our inaction in human terms.
“The sound of screaming babies (wounded or killed by gunshots) in my trauma center continues to haunt me,” he said.
Dowling served seven years as the state’s director of health, education and human services under Gov. Mario Cuomo and commissioner of the state Department of Social Services, so he has a strong appreciation for the benefits of public health efforts.
We hope other health system CEOs join Dowling’s challenge for action on gun safety. That would serve to address both the human cost and the financial cost of gun violence.
We would like that to begin with universal background checks, a ban on assault weapons and red flag laws. Then follow a model set for car safety.
We don’t ban cars but work hard to minimize the danger with seat belts and airbags and padded dashboards, speed limits and highway barriers, driver’s licenses and insurance requirements and crackdowns on drunken driving and texting while driving.
We also hope that the health system leaders do not stop with gun violence.
The life expectancy of Americans has now gone down for three straight years.
In a book Dowling recently co-authored, he cited a study that medical care is one of the less important determinants of life expectancy. The decline in life expectancy the past three years has been attributed to the opioid epidemic, alcoholism and suicide – the so-called deaths of despair.
Other factors cited as hurting life expectancy in the United States are heavy caloric intake, firearm ownership, weaker social welfare supports and lack of universal health care.
What better industry to champion people living longer and healthier than the health system.
We thank Northwell and Dowling for taking a leadership role in gun violence. We hope other health CEOs and nonhealth CEOs follow their lead.