Experts, government outline healthcare strategies for gun violence prevention at Northwell's annual forum

Providers, researchers and government officials gathered Tuesday to discuss the "urgent public health crisis" of gun violence and throw their weight behind a new multimillion-dollar awareness campaign.

The event, held in New York City and hosted by Northwell Health, drew big crowds in person and online, and even former President Bill Clinton, who delivered a keynote address. Clinton’s administration passed the Brady Bill, requiring background checks on gun sales, 30 years ago.

“We can’t live with these gun disparities. This is crazy,” Clinton said during his address. He shared a story about his own brush with death when, as a school-aged child, he was nearly shot by his stepfather accidentally. The bullet went into the wall instead, missing Clinton by three feet. 

“You can make a difference," Clinton told the audience. “You have to save the lives you can and make the progress you can and keep hoping that one day, there will be a significant breakthrough on this issue."

The Ad Council, a nonprofit focused on public service advertising, announced at the forum it would be spearheading a new national awareness campaign, funded by hospitals and health systems, to address gun violence and its impact on youth. 

The effort is being funded by members of the National Health Care CEO Council on Gun Violence Prevention and Safety. That group, formed in 2022, now includes more than 50 executives of some of the largest hospitals and health systems in the U.S. They have pledged $10 million to the Ad Council campaign, which hopes to raise $40 million over the next two years. Among the funders so far are Northwell, Intermountain Health, Johns Hopkins Medicine, the Children’s Hospital Association, Yale New Haven Health and others.

“Positive change, no matter how small, is important,” Michael Dowling, Northwell president and CEO, said in introductory remarks emphasizing that gun violence is a public health issue.

Together, the partners and the Ad Council are bringing together experts in the advertising, healthcare, marketing, media and tech industries for the campaign.

Firearm injuries have been the leading cause of death among kids and young adults for three straight years, according to a recent KFF analysis. Last August, Northwell researchers also found a nearly 42% increase in pediatric firearm deaths from 2018 to 2021. Most U.S. adults (79%) report gun violence as one of their top concerns, yet only a quarter selected gun injuries as the leading cause of death among children, a recent poll found.

“Children’s hospitals are on the frontlines of pediatric emergency care, treating children and teens as they heal from the acute physical and enduring emotional wounds of gun violence, and supporting their families as they recover,” Matt Cook, CEO of the Children’s Hospital Association, said in a press release. “It is our duty as an association of children's hospitals to bring awareness to the youth gun violence crisis."

How healthcare, community and government stakeholders are working together 

The unique role of healthcare professionals was front and center during the event. Specifically, community violence intervention, which involve trusted partnerships between community stakeholders, survivors and the government, where a go-to topic for the presenters.

Speakers also stressed the need for better data on where gun violence is happening to best direct the right resources to the right places. One way to do so is by leveraging electronic health records, Steve Sumner, M.D., senior adviser at the Centers for Disease Control and Prevention's (CDC's) Division of Violence Prevention, said.

“Understanding firearm injury really requires looking at things comprehensively,” Sumner said during a panel. Data from law enforcement and publicly available sources are not complete—for instance, they could be missing information on suicides, which account for more gun deaths in the U.S. than homicides.

The CDC currently operates the largest known near-real-time system tracking these data, Sumner said, with 75% of emergency departments participating nationally. It is interested in funding more states and local municipalities to help them produce similar dashboards for their local communities. One publicly available resource is the Gun Violence Archive, a long-standing independent research project.

Tech companies can play a major role in efforts. Amazon Web Services is supporting nonprofit hospital association the Center for Health Affairs in its Social Determinants of Health Innovation Hub. The goal of the center, launched a year ago, is to identify disparities and reshape Cleveland’s policies and outcomes. AWS’ capabilities, including those related to computing, storage and machine learning, help enable the analysis of complex data from hundreds of local partner organizations. 

“That’s where it really gets exciting, because we want to be able to understand individuals, families and communities within their context when it comes to gun violence,” Abdul Shaikh, Ph.D., global leader for population health at AWS, said on a panel.

Amy Solomon, assistant attorney general at the Department of Justice's Office of Justice Programs, highlighted hospital-based violence intervention programs. These programs exist in about 40 hospitals around the country, she said, offering community advocates to help connect survivors to resources. Solomon urged healthcare organizations to scale such programs by “partnering with the community-based organizations who have this expertise, who have the credibility within these communities.” 

It is also important to measure upstream risk factors that might influence the likelihood someone is involved in gun violence, experts said. To that end, the CDC is working to expand state-level information on secure firearm storage practices. The agency anticipates an increase from six to 18 states this year that will participate in its firearm module, per Sumner. 

David Muhammad, executive director of the National Institute for Criminal Justice Reform, advocated for “contact tracing,” as with COVID-19, for those who have survived gun violence. That’s because when someone is exposed to it, their circle of friends and family are also at greater risk, he explained. Risk factors are predictable. To be effective, prevention programs need to be informing people about their risk.

“We want to change neighborhoods? That is what we need to do," Muhammad said. "That is a long-term process.”

Other strategies include scaling access to cognitive behavioral therapy, thus far proven to be an effective intervention (PDF), and understanding the reach of prevention programs at the local level.

As with most healthcare events today, generative AI was an inevitable topic of some discussion. While “promising,” the advent of this technology is forcing stakeholders to confront how they think about the privacy of data across the board, Shaikh said. As stakeholders work together and share gun violence data, it is important for each of them to consider what its value might be to them.

“We need to have the community at the table, we need to have their voice at the table, especially those that are underrepresented,” Shaikh said.