“The Tipping Point: Activating a Public Health Movement to Address Gun Violence” Chicago, IL November 3, 2015 David Satcher, M.D., PhD. Founding Director & Senior Advisor Satcher Health Leadership Institute at Morehouse School of Medicine 16th U.S. Surgeon General 143 rd Annual APHA Conference

C ONFLICT OF I NTEREST D ISCLOSURES FOR D AVID S ATCHER, M.D, P H D Grant/Research SupportNIH-TCC ConsultantNothing to disclose Speakers BureauAmerican Program Bureau; Satcher Group Stock ShareholderJohnson & Johnson/ MetLife Insurance Company Other (identify)Nothing to disclose

Satcher Health Leadership Institute Mission The mission of the Satcher Health Leadership Institute (SHLI) is to develop a diverse group of exceptional health leaders, advance and support comprehensive health system strategies, and actively promote policies and practices that will reduce and ultimately eliminate disparities in health.

W HAT I S P UBLIC H EALTH ? “What we, as a society, do collectively to assure the conditions for people to be healthy.” " Public health carries out its mission through organized, interdisciplinary efforts that address the physical, mental and environmental health concerns of communities and populations at risk for disease and injury." Source: IOM, Association of Schools of Public Health

T HE P UBLIC H EALTH A PPROACH Define the health problem or opportunity Determine the cause or risk factors involved Determine what works to prevent or ameliorate the problem Determine how to replicate the strategy more broadly and evaluate the impact.  Public health begins and ends with surveillance. Source: CDC Define the health problem or opportunity Determine the cause or risk factors involved Determine what works to prevent or ameliorate the problem Determine how to replicate the strategy more broadly and evaluate the impact.  Public health begins and ends with surveillance. Source: CDC

HIGHLIGHTS OF THE EVOLUTION OF VIOLENCE AS A PUBLIC HEALTH PROBLEM (1) Healthy People was first released as a Surgeon General Report on health promotion and disease prevention, and violence was declared a major health problem Healthy People was first released as a Surgeon General Report on health promotion and disease prevention, and violence was declared a major health problem 1985 – The Surgeon General’s workshop on violence and public health 1985 – The Surgeon General’s workshop on violence and public health 1992 – CDC receives its first congressional appropriation for youth violence prevention, and establishes the National Center for Injury Prevention and Control (NCIPC) 1992 – CDC receives its first congressional appropriation for youth violence prevention, and establishes the National Center for Injury Prevention and Control (NCIPC) 1993 – Dr. Kellerman published his article in the New England Journal of Medicine, showing guns as not protected but putting the owners at risk; and later, Congress takes money from the CDC and forbid them from funding research dealing with gun violence 1993 – Dr. Kellerman published his article in the New England Journal of Medicine, showing guns as not protected but putting the owners at risk; and later, Congress takes money from the CDC and forbid them from funding research dealing with gun violence

HIGHLIGHTS OF THE EVOLUTION OF VIOLENCE AS A PUBLIC HEALTH PROBLEM (2) 1999 – Surgeon General’s Call to Action to Prevent Suicide 1999 – Surgeon General’s Call to Action to Prevent Suicide 2001 – Following the Columbine shooting, Surgeon General’s report on Youth Violence Prevention 2001 – Following the Columbine shooting, Surgeon General’s report on Youth Violence Prevention 2012 – Mark Rosenberg and Former Representative Dickey from Arkansas combined in their call for funding research in the prevention of firearms 2012 – Mark Rosenberg and Former Representative Dickey from Arkansas combined in their call for funding research in the prevention of firearms 2013 – President Obama releases his National Plan for addressing gun violence with the call for an initiative to “End the freeze on gun violence research” 2013 – President Obama releases his National Plan for addressing gun violence with the call for an initiative to “End the freeze on gun violence research”

The 50 th Anniversary of the First Ever Surgeon General’s Report on Smoking & Health JANURARY, 2014

effective parenting positive connections academic success

Gun Violence Tobacco Taxation Social and cultural norms, education Poisoning: Safety packaging and toxicity reduction Motor vehicle injury: Enhanced safety standards Motor vehicle injury: Active protections, driver education Patient education and counseling Research and surveillance Public Health Successes

Strengthening the mental health system Ending stigma against mental illness Revising criteria for firearm ownership Strengthening background checks

M C K INLAY ’ S P OPULATION M ODEL OF H EALTH P ROMOTION : H EALTHY D IET FOR C HILDREN (upstream) (midstream) (downstream) Source: Based on McKinlay (1995), Glanz (1999) Agriculture policy Food subsidies And expanded funding/ Eligibility for NSLP/NSBP Federal /State Lobbying/discharge regulation State/Federal Food and menu Label regulations Zoning/business Inventive for grocery stores Farmers markets Community-wide Education campaigns School soda bans/ Competitive food restrictions Restaurant/grocery store/school point of purchase prompts Parent training re; feeding Practices/healthy diets BMI screening And treatment Nutrition training Requirements for professional certification (childcare Healthcare)

“In order to eliminate disparities in health, we need leaders who care enough, know enough, will do enough and are persistent enough.” “In order to eliminate disparities in health, we need leaders who care enough, know enough, will do enough and are persistent enough.”

“The Tipping Point: Activating a Public Health Movement to Address Gun Violence” Chicago, IL November 3, 2015 David Satcher, M.D., PhD. Founding Director & Senior Advisor Satcher Health Leadership Institute at Morehouse School of Medicine 16th U.S. Surgeon General 143 rd Annual APHA Conference