Surgeon general declares gun violence a public-health crisis; new AMA president, a Louisville physician, calls it 'evidence-based'

Surgeon General Vivek Murthy (AP file photo, 2023)

This story has been updated.

By Amanda Seitz

Associated Press

The U.S. surgeon general on Tuesday declared gun violence a public-health crisis, driven by the fast-growing number of injuries and deaths involving firearms in the country.

The advisory issued by Dr. Vivek Murthy, the nation’s top doctor, came as the U.S. grappled with another summer weekend marked by mass shootings that left dozens of people dead or wounded.

“People want to be able to walk through their neighborhoods and be safe,” Murthy told The Associated Press in a phone interview. “America should be a place where all of us can go to school, go to work, go to the supermarket, go to our house of worship, without having to worry that that’s going to put our life at risk.”

To drive down gun deaths, Murthy calls on the U.S. to ban automatic rifles, introduce universal background checks for purchasing guns, regulate the industry, pass laws that would restrict their use in public spaces and penalize people who fail to safely store their weapons.

Murthy said there is “broad agreement” that gun violence is a problem, citing a poll last year that found most Americans worry at least sometimes that a loved one might be injured by a firearm. More than 48,000 Americans died from gun injuries in 2022.

His advisory promises to be controversial and will certainly incense Republican lawmakers, most of whom opposed Murthy’s confirmation — twice — to the job over his statements on gun violence.

Dr. Bruce Scott

Dr. Bruce Scott of Louisville, new president of the American Medical Association, called Murthy’s advisory an “evidence-based public-health approach to addressing firearm violence” in a statement. “Firearm violence is indeed a public health crisis,” he said, adding, “The data now show it touches the majority of U.S. adults.”

 

Murthy has published warnings about troubling health trends in American life, including social media use and loneliness. He’s stayed away from issuing a similar advisory about gun violence since his 2014 confirmation as surgeon general was stalled and nearly derailed by the firearm lobby and Republicans who opposed his past statements about firearms.

Murthy ended up promising the Senate that he did “not intend to use my office as surgeon general as a bully pulpit on gun control.”

Then-President Donald Trump dismissed Murthy in 2017, but President Joe Biden nominated Murthy again to the position in 2021. At his second confirmation hearing, he told senators that declaring guns a public-health crisis would not be his focus during a new term.

But he has faced mounting pressure from some doctors and Democratic advocacy groups to speak out more. A group of four former surgeon generals asked the Biden administration to produce a report on the problem in 2022.

“It is now time for us to take this issue out of the realm of politics and put it in the realm of public health, the way we did with smoking more than a half century ago,” Murthy told the AP.

A 1964 report from the surgeon general that raised awareness about the dangers of smoking is largely credited with snubbing out tobacco use and precipitating regulations on the industry.

Children and younger Americans, in particular, are suffering from gun violence, Murthy notes in his advisory, called “Firearm Violence: A Public Health Crisis in America.” Suicide by gun rates have increased significantly in recent years for Americans under the age of 35. Children in the U.S. are far more likely to die from gun wounds than children in other countries, the research he gathered shows.

In addition to new regulations, Murthy calls for an increase on gun violence research and for the health system — which is likely to be more amenable to his advisory — to promote gun-safety education during doctor visits.

UPDATE, June 26: New research highlights the need for a public-health approach in news reporting of gun violence, reports Journalist's Resource at Harvard University.

Headed to the water? Wear a swimsuit with colors that are easy to see, and remember, drowning rarely happens as you see it on TV

This girl is wearing a swimsuit with contrasting colors, easily
seen in the water. (Photo by Alex Bard, iStock/Getty Images Plus)

By Sherri Hannan
University of Kentucky

The temperature is rising, and everyone is heading to the pool, lake or beach to cool off. But did you know the color of your swimsuit plays a big part in water safety? And that drowning rarely looks like how it is represented on television and in motion pictures?

Drowning is the leading cause of death for children ages 1 to 4, and the second leading cause of death for children ages 5 to 14, according to the Centers for Disease Control and Prevention. Black children's chances of drowning are more than seven times greater than white children's.

Even if drowning doesn't cause death, drowning injuries can cause brain damage and other serious outcomes, including long-term disability.

Experts are urging parents and caregivers to avoid putting children in blue and green swimsuits. Even in shallow water, blue and green are very difficult to see. Drowning can happen very quickly and quietly, and visibility is important when supervising kids around water. Stick with bright, neon colors for swimsuits, pool toys and floatation devices.

Remember, drowning doesn’t look like drowning. In TV and movies, a drowning person waves their hands and calls for help. In reality, drowning is silent. A drowning person may appear to be relaxed and quietly treading water. If you see someone with their head tilted back and they look like they are climbing an invisible ladder, call for help immediately.

Here are some other tips to keep kids safe in and around water this summer:

• Use designated swimming areas and recreational areas whenever possible. Look for posted signs about open water hazards. Also look for signs that say when lifeguards will be present.
• Avoid distractions when your child is in or around water. Drowning is often silent and can occur in minutes. Put away phones, books and magazines.
• Choose a water watcher. When there are several adults present, alternate who is responsible for watching children in or near the water.
• Keep your ears open as well as your eyes. If your child gets quiet, find out why.
• Wear a U.S. Coast Guard-approved life jacket when boating or participating in other water activities. Choose a life jacket that is right for your child’s weight and water activity. Weak swimmers and children who cannot swim should wear life jackets when they are in or near water.
• Learn CPR and basic water rescue skills. It is important to know how to respond in an emergency without putting yourself at risk of drowning. Local chapters of organizations such as the Red Cross offer CPR and water safety courses.

Children are at risk of death from being left in hot cars; health officials say don't do it in any circumstances, offer prevention tips

Image from Huffington Post

Every summer, children die from heat stroke because they are unintentionally left in a hot car, with the majority of these deaths occurring in children age 3 and under The latest reported victim was a 1-year-old girl in Nashville who was accidentally left inside a hot car May 23.

According to the safety organization Kids and Cars, 37 children a year die in hot cars. These include instances of children being forgotten, accidentally locking themselves in a car or trunk, or in a small number of cases, intentionally left in a car.

“Infants and small children are not able to regulate their body temperature in the same way that adults do,” Dr. Heather Felton, medical director of the University of Louisville Pediatrics - Sam Swope Kosair Charities Centre, said in a U of L news release. “Sweating won’t cool down an infant or young child in the same way that it does an adult, and children may not be able to extract themselves from a car seat or remove clothing to help their bodies adjust.”

A new study out of Arizona State University and the University of California San Diego School of Medicine, published in the science journal Temperature, found that it takes about an hour for a child left in a hot car to suffer heatstroke, an average of 80 minutes in a sunny car to kill a child, and a little under two hours for a 2-year-old's body to reach a core temperature of greater than 104 degrees Fahrenheit, a degree from which a body cannot cool down," Dr. Sima Patel reports for ABC News. Patel notes that in reality, different children reach hyperthermia at different times, based on the climate, child's size, clothing, ethnicity and age.

"I don’t think our study can address the overall ‘risk’ of heatstroke because that depends on human behavior and actions more than anything," Jennifer Vanos, lead study author told ABC.  "All cars heat up to lethal temperatures across every state, and although it’s the level of heat that in the end causes the death, it’s the act of forgetfulness that is the trigger. Deaths have occurred in not-so-hot states as well. And even though parking in the shade decrease the heart rate of the child’s core temperature, the risk of death is likely the same as if parking in the sun."

Felton offers these American Academy of Pediatrics-endorsed tips for parents when traveling in a car with infants or young children:

• The inside of a car can reach dangerous temperatures quickly, even when the outside temperature is not hot. Never leave a child alone in a car, even if you expect to come back soon.
• Always check the back seat to make sure all children are out of the car when you arrive at your destination. 
• Avoid distractions while driving, especially cell phone use.
• Be especially aware of kids in the car when there is a change from the routine such as someone else is driving them in the morning, or you take a different route to work or child care. 
• Have your childcare provider call if your child has not arrived within 10 minutes of the expected arrival time.
• Place your cell phone, bag or purse, or shoes in the back seat, so you are reminded to check the back seat when you arrive at your destination.
•  Lock your car when it is parked so children cannot get in without supervision.
• Drink plenty of water and have your children drink plenty of water when temperatures soar.
• Plan for extra rest time – heat and a change from the normal routine leaves kids and parents feeling tired.

Seat-belt use in Kentucky is about the national average but is lower in rural counties, and our traffic-death rate is high

Only two Kentucky counties, Boone and Kenton, used seat belts at the national average or above in 2012, according to the latest local data available from the Behavioral Risk Factor Surveillance System, an ongoing poll by the Centers for Disease Control and Prevention.

A county-level map from The Washington Post using data from 2012 shows Boone and Kenton counties in yellow, meaning their seat-belt use rate is above the 85.9 percent national average (as reported by people in the survey). A few other counties are in light orange, meaning their rate is between 80 and 85 percent: McCracken, Graves, Calloway, Marshall, Christian, Hopkins, Henderson, Daviess, Warren, Hardin, Jefferson, Oldham, Spencer, Anderson, Franklin, Scott, Fayette, Jessamine, Madison, Campbell, Pendleton and Boyd.

Because seat-belt use is more common in more heavily populated counties, outweighing lesser use in rural counties, Kentucky's statewide seat-belt use rate in 2014 was approximately the national average. However, the CDC says the state's traffic-death rate is much higher than the national average. According to the Kentucky State Police, about two-thirds of people killed in traffic accidents in the state were not using a seat belt.

Kentucky's seat-belt law requires the driver and all passengers to use seat belts, unless the passenger is a child less than 40 inches tall, in which case a child restraint system must be used. Children younger than 7 and between 40 and 50 inches must be in a booster seat, which uses a seat belt.

Three doctors, nine others in western half of Kentucky are indicted in the largest-ever federal 'takedown' of Medicaid fraud

Former Dr. Fred Gott of Bowling Green was arrested.
(Photo: Miranda Pederson, Bowling Green Daily News)

Twelve people in the western half of Kentucky, including three doctors, have been charged with Medicaid fraud in what the federal government calls its biggest-ever "takedown" of the problem, Andrew Wolfson of The Courier-Journal reports.

The indictments allege "a half-dozen schemes involving nearly $8 million in alleged fraudulent billings," Wolfson writes. "The offenses include $5 million in false billings for muscle-relaxant injections that were never delivered to patients, as well as a staged car wreck in which three people allegedly conspired to get controlled substances and fraudulent reimbursements."

In another case, Wolfson reports, "a medical practice that treated car wreck patients is accused of using the DEA numbers of nurse practitioners to order hydrocodone for herself and falsely billing it to an insurance company. Nationally, the sweep resulted in charges against 243 people, including 46 doctors, nurses and other licensed medical professionals."

John Kuhn, acting U.S. attorney for the Western District of Kentucky, told Wolfson that about $1 billion of annual Medicare and Medicaid expenses are fraudulent. Medicare is the federal health-insurance program for people over 65; Medicaid is the federal-state program for the poor and disabled.

Former Dr. Fred Gott of Bowling Green, a 63-year-old cardiologist, was charged with "conspiracy to dispense controlled substances, health care fraud and money laundering," Deborah Highland reports for the Bowling Green Daily News. "The Bowling Green-Warren County Drug Task Force opened an investigation into Gott’s practices after Warren County Coroner Kevin Kirby alerted the task force about drug overdose deaths involving Gott’s patients, task force director Tommy Loving said."

Heart attacks are leading cause of death while on the job in Kentucky; being struck by objects is No. 2, and falling is No. 3

Heart attacks are the number one killer of Kentuckians who die on the job, according to a study conducted by the state Labor Cabinet.

The study found that in the last three years, 87 Kentuckians had fatal heart attacks while on the job. Their average age was 52. Ten of them were truck drivers, seven were machine operators and six were maintenance workers.

The study found that 28 of the victims were struck by an object, 19 fell, 17 had transportation crashes, 13 were being caught in or between objects, seven were electrocuted, and one each suffered hyperthermia or suffocation. Eight deaths in the workplace were from natural causes, such as stroke, brain aneurysm and failure of the pancreas.

Kentucky ranks 48th in the nation in cardiovascular deaths, with more than 12,000 per year, a state press release said. “Employers should do everything they can to raise awareness about cardiovascular health, and everyone needs to keep an eye on their blood pressure and cholesterol levels while paying close attention to diet and exercise,” Labor Secretary Larry Roberts said.

The study includes workplaces under the jurisdiction of the Kentucky Occupational Safety and Health Program, and do not include those monitored under federal agencies, such as the Mine Safety and Health Administration or the Federal Railroad Administration.