5 Questions With Health System CEOs on Addressing Gun Violence

The CEOs of CentraState Healthcare System and LifeBridge Health detail the importance of addressing gun violence as a public health issue.

Editor's note: This is part three of a three-part series on gun violence prevention in healthcare. Part one can be found here and part two can be found here.

Recently, a group of more than 550 CEOs and leaders of organizations from different sectors around the country signed a letter sent to the Senate demanding action on gun violence.

"Gun violence can be prevented," the letter concludes. "Transcend partisanship and work together to pass bold legislation to address gun violence in our country."  

Among the signees were several healthcare executives, including Michael Dowling, president and CEO of Northwell Health in New Hyde Park, New York, who recently spoke with HealthLeaders about gun violence prevention; Thomas W. Scott, president and CEO of CentraState Healthcare System in Freehold, New Jersey; and Neil M Meltzer, president and CEO of LifeBridge Health in Baltimore.

Scott and Meltzer recently connected with HealthLeaders via email about the letter, and also addressed the impact that gun violence has on the health of communities and how their organizations are addressing gun violence and prevention measures.

This transcript has been edited for brevity.

HealthLeaders: Why is gun violence in this country considered an epidemic?

Tom Scott: Gun violence, which includes not only mass shootings but homicide and suicide, is an epidemic because of its exponential increase in our society over the last two decades. It’s also a public health problem because it impacts the well-being of individuals, families, and communities, and is largely preventable.

Neil Meltzer: According to the American Public Health Association, gun violence is a leading cause of premature death, killing more than 38,000 people each year. Often overlooked are the victims' families whose lives are also dramatically changed by an incidence of gun violence. Those who witness the violence, including community members, are also affected, leaving lingering trauma. This violence is not isolated; it reaches every corner of the country—from big cities to small towns and everywhere in between.

HL: How will addressing gun violence help move healthcare forward?

Scott: As health professionals, we have the duty to minimize the factors that lead to illness and injury, especially if they can be prevented. There are so many challenges in preventing and treating diseases like cancer, diabetes, and heart conditions, and that’s where our focus needs to be.

Meltzer: Every day our doctors, nurses, and caregivers treat those affected by gun violence and see first-hand how it can shatter lives. This goes beyond the immediate impact of caring for the victims of gun violence themselves; there is also the impact on mental health for anyone connected to those who have been shot or witnessed the violence. This senseless loss takes a toll on everyone.

We all recognize the devastating impact of violence in our communities, as well as its impact on individuals—creating ripples of trauma that can last for generations. These individuals may need healthcare services and support services now and in the future.

As a health system, our mission is to care for people and our communities, and gun violence is affecting our communities and affecting public health.

As we see the benefits of prevention in managing illnesses such as heart attack, stroke, and diabetes, we should also look at gun violence as a public health issue. By approaching gun violence as a public health issue (if not a crisis), we can seek to reduce gun violence and prevent the needless physical and emotional effects on individuals and communities.

HL: What made you join CEOs for Gun Safety in signing a letter to the U.S. Senate to demand gun violence prevention?

Scott: Gun violence in America has become too commonplace, devastating families and communities, and no one should be afraid to go to school or out in public. Our emergency department staff, like all others, are on the front line of treating those who are victims of domestic or gang violence, accidents, homicide, or suicide, which is all difficult and upsetting to deal with.

We need to look at the issue from all angles to prevent gun violence of any kind, including the provision of mental health and other support services and common-sense gun laws. Leaders from all sectors need to support this effort because it impacts everyone. Death and injury caused by guns can't be tolerated in a civil society.

Meltzer: Every day we see the devastation gun violence is having on our patients, our communities, and our caregivers.

If we do not speak up, then our leaders will think we are OK with what is happening. We are not. After the violence in Buffalo and then the loss of the children and teachers in Uvalde, Texas, I felt it was my obligation to lend my voice to the chorus saying that it is time to do something.

It should frighten us that we can all so easily recall the names of these mass shootings: Columbine, Sandy Hook, Marjory Stoneman Douglas, Pulse nightclub, Tree of Life synagogue, Tops grocery store, Robb Elementary, and many others.

We cannot grow numb or compartmentalize these events. These are real human beings whose lives are forever changed. What does it say about our humanity if we do not speak up?

HL: What is your organization doing to address gun safety and gun violence in the communities it serves?

Scott: Preventing violence is an essential component in building a healthier community, which is our mission. We believe that strong families and communities reduce violence of all kinds, so we partner with local organizations to support them in providing food and healthcare services to those who need assistance. In addition, we always look for ways that we can make a positive impact on the lives of those we serve, such as providing healthcare services in the community and education on chronic diseases for those at risk.

Meltzer: At LifeBridge Health, community is at the heart of everything we do. A few years ago, we created a position for an executive director of violence intervention and prevention, who coordinates and implements an integrated response to violence across our health system, ranging from in-hospital services to community programs for both adults and children.

We recently cut the ribbon on our LifeBridge Health Center for Hope, a comprehensive center that serves as the hub for all of LifeBridge Health's violence prevention and response programming, addressing violence throughout the life span from child abuse, human trafficking, domestic violence, elder abuse, and community violence.

The Center for Hope runs a multidisciplinary violence response program at our two city hospitals. By reaching out to individuals when they are receiving medical care, we see a window of opportunity to introduce programs and resources to help them break away from the cycle of violence. These hospital-based violence responders work in close coordination with the medical teams at each facility.

We seek to address not only their physical needs, but their emotional, mental, and social needs as well.  As we look to preempt violence, we recognize that these patients need more than medical care: they may need a counselor, a referral for help, securing housing, education, food, or job training. These support mechanisms reduce the likelihood that someone may become a future victim or perpetrator of violence.

As a community health system, we believe we are in a unique position to work and coordinate with a variety of partners, in government, other local health systems, community organizations and others, to create an ecosystem of community violence intervention.

We championed legislation that passed to provide sustainable state funding through Medicaid for violence prevention and intervention services as guided by the Biden administration; advocated for a bill to enhance child safety through appropriate gun storage (Jaelynn’s Law); enacted the application of "Crime Prevention Through Environmental Design" principles to state parks to make them safer for communities; and addressed healthcare workplace violence through a public information campaign that supports our "healthcare heroes." We also helped to pass a bill that allows domestic violence victims to apply for temporary protective orders while still in a healthcare facility rather than having to do so in person.

HL: What best practices or solutions are you using to keep your organization's workforce and patients safe from gun violence and threats?

Scott: CentraState employs a myriad of protocols to protect our patients and team members, including security staff who are trained to identify threats of any kind and other tools for surveillance. We work closely with our local police and emergency management experts to understand how to prevent and respond to violence and continue to train staff on how to handle any potential situation.

Meltzer: As we've seen, no place is immune from gun violence, including medical facilities. While, as a health system, we want to create an environment that is open and welcoming for patients and visitors, we must balance that with the need to keep everyone safe.

Our LifeBridge Health security team has a comprehensive plan with multi-faceted security efforts and countermeasures in place. Our security team works in close coordination with local and state police as well as other agencies.

Security specifics can vary by facility and can include armed sworn officers on site (including K-9 officers), electronic access control via badging technology, facial recognition, threat assessments, enhanced lighting, emergency call boxes, and surveillance cameras.

LifeBridge Health has a workplace violence committee whose members are actively engaged and work directly with our leadership and security teams to provide input into plans. We also remind our teams that security is everyone’s responsibility, [and that they should not allow] unknown persons to follow them into secure areas and report suspicious activity, individuals, vehicles, or situations ("see something, say something").

Our security team offers monthly town hall meetings, active shooter education, and training where security will come to units or offices upon request.

We also work to raise awareness about the need to protect healthcare workers against violence.  We advocate for our employees around enforcement, criminal prosecution, and legislation to protect our healthcare workers.