Normalizing the Public Health Conversation on Gun Violence

The Big Story: The gun violence research that’s about to change hospitals

“This is not an issue that’s right or left,” said Sathya. “It’s really not political. It’s not about taking people’s guns away. It’s about safe storage, violence prevention. It’s just the way you frame it. You can’t vilify anybody in this epidemic. It’s about coming together for the common goal.”

Creating momentum, not a moment

By Tim Stewart
3-minute read

Over the last few years, Northwell Health CEO Michael Dowling has not been shy about addressing gun violence as a public health crisis, using his platform of prominence in the industry to write op-eds calling attention to this crisis and convening and leading likeminded peers on the National Health Care CEO Council on Gun Violence Prevention & Safety.

These are important ways to draw focus to what can feel like an enormous, intractable issue, but also are (controversial maybe, but) relatively easy approaches that don’t require much elbow grease. It is not as though our current national discourse lacks for people on soapboxes or navel-gazing taskforces.

But Northwell – a nonprofit integrated health network that happens to be the state of New York’s largest health system and private employer, with more than 85,000 employees – is also demonstrating a more action-oriented approach to making headway on the problem of gun violence. The approach is expressed in small, everyday interactions with patients. But it hinges on talking clearly with their clinicians and employees about guns – specifically on how the gun violence epidemic relates to their health and that of patients, not their politics.

Northwell has integrated firearm safety questions into their standard patient screening protocol, alongside questions about sexual activity and tobacco use. It turns out that treating a public health issue like a public health issue rather than a culture war battlefield can yield results.

But of course, the culture war battlefield still looms large when it comes to guns, so the key to implementing these protocols and driving adoption is – you guessed it – clear communications and sustained change management.

Last year, we tackled the communications challenges for health systems in talking about gun violence within the charged political context. Northwell’s approach to developing their safety protocols does not ignore that context – it is the basis for their sustained internal communications and employee engagement – but their efforts are focused on practicality in an attempt to defuse some of the emotion around this issue.

Many organizations roll out big strategic initiatives with an extremely thoughtful, meticulously prepared launch event that is followed by…not a lot. The branded water bottles and badge carabiners float around for a while, signifiers of an event rather than an imperative.

Committing to meaningful change means committing to meaningful change management. The organization is holding sustained monthly conversations with employees about gun violence and its horrific cost to society’s (especially kids’) health and wellbeing, as well as the program itself. Those conversations, along with simple reminders like question cards and posters and, of course, some branded swag, Northwell employees have been brought along on the journey and bought into the work.

Flooding the zone with information has removed most of the political intensity and replaced it with something more mundane, even boring. By making gun talk normal, in a “judgment-free” context, clinicians and employees who have a range of personal opinions about the politics of gun violence can feel comfortable using the protocols.

There is also a lesson here in how large organizations and leaders choose to interact with the issues of the day. It can be easy to seize upon the headlines and grab a sliver of spotlight by making emotional appeals for support or thundering platitudes of condemnation. It is much harder to back up those appeals with the months and years of sustained, less flashy effort that actually advances public health.

The full impact of these initiatives is still unknown because public health data doesn’t move as quickly as our social media feeds. But any step that cuts through our noisy politics toward pragmatic solutions is a step forward, and worth emulating.