Public Health Leadership Forum

AG Healey: Curbing Gun Violence Requires “Partnership” with Physicians

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by Erica Noonan – Comments Off on AG Healey: Curbing Gun Violence Requires “Partnership” with Physicians

Curbing the epidemic numbers of deaths and injuries from firearms in the United States  will require a “spirit of partnership” among law enforcement officials, health care providers and community leaders, said Massachusetts Attorney General Maura Healey.

“This is a public health issue, and we are not going to be able to prosecute our way out of this,” she said.  “We need to reframe the conversation and retake the issue for the good of our country.”

Healey was a featured speaker at 12th Annual MMS Public Health Leadership Forum – Firearm Violence: Policy, Prevention & Public Health on April 5 at MMS Headquarters in Waltham.

The forum was convened to discuss the latest information on firearms violence, including how physicians can reframe the debate about firearms in order to encourage strategies that support gun violence prevention policies, research and programs.

Expert faculty includes Georges Benjamin, MD, executive director of the American Public Health Association, David Rosmarin, MD, director of the Forensic Psychiatry Service at McLean Hospital, the Rev. Jeffrey Brown, longtime anti-violence activist and founder of RECAP, and many more distinguished speakers.

Healthy defended the right of physicians to speak to their patients about guns, noting that physicians in Florida were recently prohibited by an appeals court from doing so.

She also urged support for policies that would require gun manufacturers and dealers to be held more accountable for the estimated 33,000 deaths per year across the country.  “Guns are the only consumer products that enjoy full immunity (from lawsuits)” she said.

Healey drew parallels between the guns and the issue of opioid abuse, an issue on which the MMS and state officials have collaborated extensively.  “This crisis requires renewed focus and persistence,” she said. “I hope collectively we can work together and make an impact.”

–Erica Noonan

Public Health Keynote: 91 deaths a day, 33,000 a year

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by MMS Communications – Comments Off on Public Health Keynote: 91 deaths a day, 33,000 a year

The numbers represent a “true epidemic,” said Georges Benjamin, M.D., as he tallied the number of deaths per day and the number of deaths per year from gun violence in the United States in delivering the keynote address April 5 at the 12th Annual Public Health Leadership Forum, Firearm Violence: Policy, Prevention and Public Health.  The forum was attended by approximately 120 physicians, health care leaders and public health and government officials.

The numbers represent a public health crisis, and the grim statistics prove the point: on an average day, 91 Americans are killed by guns, with more than 33,000 dying every year.  In an average month, 51 women are shot to death by their intimate partners, and seven children and teens each day are killed by guns.

Dr. Benjamin, Executive Director of the American Public Health Association, had three objectives in his keynote: (1) to define the societal toll of firearm injury; (2) to articulate a public health approach to reducing injury and death from firearm violence; and (3) to offer a broad approach to reducing firearm-related injuries and deaths.

“Guns are part of our culture,” said Dr. Benjamin, noting that the U.S. has more guns than people, “and we have the fundamental belief that firearms protect us.” Yet, he said, far too often the result is death and injury. Mass shootings, like the one at Sandy Hook, Connecticut, remain a persistent issue, with the U.S. experiencing more days with mass shootings than without.

“The protective safety of guns is overestimated,” said Dr. Benjamin. “In homes with firearms, homicide is three times more likely and suicide is five times more likely.”

Dr. Benjamin argued that through technology and education we can make guns safer and make people safer with their guns.  And it is an issue, he says, that physicians should embrace.  “Why should physicians care about this?  If it hurts people, if it kills people,” he said, “physicians should care.”

— Richard P. Gulla

Dr. Benjamin’s slide presentation, A Public Health Approach to Reducing Firearm Injury, may be viewed here.

Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Posted in gun control, Public Health, Public Health Leadership Forum on March 31st, 2016 by Erica Noonan – Comments Off on Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Massachusetts Attorney General Maura Healey will speak to leaders in public health and medicine at MMS’s Public Health Leadership Forum on Firearm Violence on April 5.  MMS Public Health Manager Robyn Alie spoke with Attorney General Healey recently about firearm violence and how it affects physicians and the public.

MMS:  You have called the epidemic of gun violence a public health problem. Why?

AG HEALEY: I think what’s really important is we talk about this as a public health crisis and as a moral issue for our country.   In far too many places, across this country, people are fearful of sitting outside on their porch, fearful of letting their kids walk to school. We have too many victims of domestic violence, subject to incredible mental anguish given that their abusers have guns and are able to wield all sorts of power.

Guns have a significant impact on the health and wellbeing of families and of the community at large. The fact of the matter is that having a gun in your home does not make it a safer place to be, and actually makes it more dangerous. It’s not that people aren’t entitled to exercise their second amendment rights and to keep a gun at their house, but the risk of suicide is five times as high. Death of a household member is three times more likely. With a gun in the home, a woman’s risk of intimate partner homicide is seven times as great.

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MMS: Last year, a physician at Brigham and Women’s Hospital was fatally shot by a patient’s family member. What are your thoughts about how to protect health professionals?

AG HEALEY: It was so tragic. He was shot to death in the hospital doing his job. In the wake of that event, we reached out to the hospitals to find out how we can be helpful, and we learned that hospitals need to find the right balance, between providing secure spaces for their workers and patients, and at the same time providing a place that’s welcoming and inviting for family members and for visitors, and it’s tough. It’s a delicate balance, and one that requires the use of best protocols and policies to ensure that no one’s in harm’s way.

But I still see instances where the availability of guns has made it far too easy for someone who’s set on doing harm to obtain guns and be able to go out and cause harm.

MMS:  We have seen that mental health is often implicated in gun violence events, but research has shown that the proportion of gun violence perpetrated by people with mental illness is actually quite small, and those with mental illness are actually more likely to be victims. What are your thoughts about policies related to mental health and gun violence?

AG HEALEY: I would never want our gun violence blamed on mental health problems. We shouldn’t use this issue to create greater stigma around mental health and behavioral health. But, I think it is an opportunity to recognize that those services need to be more robust. That’s why we need true mental health parity when it comes to coverage and access. We need to focus on the reality that 62% of gun deaths are suicides. Also, we do need to provide care and treatment to those folks. How are we looking to intersect with them so that we have an opportunity to intercede? Again, here’s where I think health care and medical professionals have that opportunity. And why their involvement and engagement are so important. Because we should be doing everything we can to make sure that people who are a danger to themselves or a danger to others, who might harm themselves are not able to access guns in a way that’s going to enable them to harm themselves or someone else.

MMS: What about issues of patient privacy?

AG HEALEY: It’s an issue where I know there has been some differences across the states. There’s a law in Florida that actually prohibits physicians from asking their patients about gun ownership. That law is now being challenged in the courts. And I think it should be challenged for all the reasons we just talked about. Gun violence is a public health issue and I don’t think that doctors should be restricted from asking their patients about an issue that could affect their health. The NRA has long pushed for these kinds of laws in part because they know how influential physicians can be. I think that’s where we need to have doctors more involved in addressing this question. I don’t think doctors should be in any way prohibited from asking patients about an issue that in any way could affect their health. This is one. Obviously there are appropriate ethics that apply when it comes to physicians becoming aware that someone may do immediate harm to themselves or others, and they should act appropriately there, according to their ethical obligations.

Learn more about the 12thAnnual MMS Public Health Leadership Forum, Firearm Violence: Policy, Prevention & Public Health, on April 5 from 1:00 to 5:00 p.m.

 

Mass. Attorney General’s Office: Medical Community Is Part of the Solution

Posted in opioids, Public Health, Public Health Leadership Forum on April 8th, 2015 by MMS – Comments Off on Mass. Attorney General’s Office: Medical Community Is Part of the Solution

Massachusetts Attorney General Maura Healey has made prescription drug abuse a top priority for her office, and First Assistant Attorney General Christopher K. Barry-Smith’s message to Forum attendees was that Ms. Healey views the medical community as a “large part of the solution” to the problem of opioid abuse.

Barry-Smith said Ms. Healey decided on making opioid abuse a priority for her office as a result of her campaign for the office last year. In talking to citizens across the state, Healey discovered a recurring theme of concern from individuals and families: that drug and opioid abuse was a serious problem and something must be done about it.

Establishing opioid abuse as a priority, Barry-Smith said, takes three avenues of approach:  heroin trafficking, prescription drug trafficking, and unlawful prescribing, the last of which he said was a “small part” of the problem. He also noted that the Attorney General’s office would act to ensure that pharmaceutical marketers and dispensers take reasonable steps to reduce the risks of diversion and abuse.

Christopher K. Barry-SmithThe pricing of the anti-overdose drug naloxone and insurance coverage for behavioral health parity are other major concerns of the Attorney General, Barry-Smith said, as is the prescription monitoring program, “to make it as useful as possible.”

Finally, Barry-Smith, reprising the theme that the medical community is seen by the Attorney General as part of the solution, said that prescribing practices must take into account the possibility of overdose and he urged prescribers to “follow best practices.”

— Richard Gulla

Public Health Forum Keynote: Opioid Abuse Is a Public Health Issue

Posted in opioids, Public Health, Public Health Leadership Forum on April 8th, 2015 by MMS – Comments Off on Public Health Forum Keynote: Opioid Abuse Is a Public Health Issue

Combining raw statistics with the faces of real people who have died from drug overdoses, and at the same time reflecting on his personal experience with substance abuse, Michael Botticelli took a decidedly human approach in his address at the 2015 MMS Public Health Forum, The Opioid Epidemic: Policy and Public Health. 

Botticelli, Director of the Office of National Drug Control Policy and former Director of Substance Abuse Services for the Massachusetts Department of Public Health, provided the keynote speech at the forum, which featured a range of experts discussing the medical, clinical, and legal aspects of opioid abuse.

Botticelli was clear and direct with two main messages for the 300 in attendance: “Opioid abuse should be regarded as a public health issue” and “we cannot afford to wait as a society to act” in responding to it.

He said five areas must be the focus of efforts by physicians, policymakers, legislators, and law enforcement officials to curb the abuse of drugs: education, prescription monitoring programs, storage and disposal, enforcement, and treatment.

Education: Botticelli noted that physicians receive little training in medical schools on opiates and prescribing and recommended that medical schools begin to establish courses in these subjects and urge, if not require, students to take them.

Michael BotticelliPrescription monitoring: Regarding them as valuable tools for research and to prevent “doctor shopping” by patients, Botticelli said prescription monitoring programs in the states must continue to be modernized and given more funding.  Noting that 49 states now have prescription monitoring programs, with Missouri on the way to becoming the 50th, he urged a nationwide infrastructure for such programs, with interstate data sharing and interoperability among hospitals, clinics, and health centers.

Disposal: Acknowledging data from the Centers for Disease Control that most of those who abuse prescription drugs use drugs that are prescribed to someone else, Botticelli recognized the importance of proper storage and disposal, saying we need to get the drugs “out of the home when no longer needed.”

Enforcement: While prescription drugs constitute a major part of the abuse problem, Botticelli said priority must also be given to the illegal trafficking in heroin.

Treatment: “People can succeed with the right treatment,” he said, and we must make “every effort to reduce the stigma to help people get the care they need.  If we want better outcomes, we need to pay attention to substance abuse disorders.”

Botticelli concluded his remarks with a message for health care providers.  “The medical community must remain engaged,” he said.  “The problem can be cared for by those who can provide the highest levels of care.  We don’t have time to waste.”

The slides for Mr. Botticelli’s presentation are available at www.massmed.org/PHLF2015

— Richard Gulla