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1. The Gun as the Weapon of Violence
Much has been written on why gun use increases
the deadliness of attacks; for example, because guns inflict more damage
than other instruments, they can be fired multiple times with little effort,
firearms have a greater range, and assailants intending to kill choose the
most efficient instrument.16
Whatever the impact of these different factors, it is clear that the fatality
rate from gun assaults is much higher than that from other weapons. This
is true regardless of the relationship between the victim and shooter, as
the presence of a gun can turn a robbery, an argument, or an abusive relationship
into a homicide.17
According to a 1996 BJS report, 29 percent of firearm homicide victims
were killed because of an argument; 21 percent were killed during the
commission of another crime, such as a robbery or drug crime; and 6 percent
died as a result of a gang-related shooting.18 Offenders report firing
a gun within 15 seconds of brandishing it, even when they had not intended
to shoot the victim.19 Gun victims include those shot during traffic altercations,
gambling disputes, and verbal disagreements.
The lethality effect is not lost on the victims.
Participants repeatedly spoke of the nature of the weapon used. "An important
difference is the gun itself. Guns are the only instrument developed to
kill; victims facing a gun suffer the trauma of death or the fear of death,"
said family bereavement counselor Kevin O'Brien. Meanwhile, participant
DeLano Foster, an OVC Program Specialist and survivor of multiple homicides,
offered that "the difference between an armed robbery and a homicide could
be the time it takes the victim to hand over his wallet." Eyewitness accounts
frequently report victims putting their hands in front of them and "holding
up articles of all kinds in their last moments in the magical belief that
even a sheet of paper might save them."20 Bystander Victims Durham, North Carolina:
April 7, 1998. While walking with his mother, a 5-year-old
boy was hit by a stray bullet from a gunfight. The bullet
severed his spine, and Taquan Mikell may never walk again.
The bullet struck him more than half a block away from the
gunfight. Nashville, Tennessee: July
2, 1999. Nashville teenager Eric Harvey Hazelitt was fatally
shot in the chest when gunfire erupted at the John Henry Hale
public housing complex in Nashville. Just 14 years old, he
was caught in the cross-fire of two groups shooting at each
other. Referenced from In the Crossfire:
The Impact of Gun Violence on Public Housing Communities,
published by the U.S. Department of Housing and Urban Development,
February 2000. Washington, D.C.: June
21, 1999. Helen Foster-El, a 55-year-old grandmother, was
outside her home in the 100 block of 56th Place SE. watching
neighborhood children play when gunfire erupted between two
groups. On hearing the gunfire, Ms. Foster-El began to shepherd
the children into one of the neighborhood homes for their
safety. As she was doing so, she was struck in the back by
a stray bullet and died instantly. Harrisburg, Pennsylvania:
June 10, 1999. Raphael Rivera, 14, was in the immediate
area of an altercation involving several individuals. When
the altercation escalated into gunfire, Raphael, who was
not involved in the argument, sustained a fatal wound to the
chest. Referenced from The Death
Toll Since Columbine, a report of the U.S. Conference of Mayors,
Washington, D.C., January 2000. Gun violence also is frequently more random
than other types of criminal victimization. One participant noted that
"bullets don't always have a name on them. You can be shot from a great
distance even with a bullet meant for someone else." Young men can be
"casualties of a war they did not partake in" when gang members intent
on retaliating shoot at random victims when they can't find the rivals
they intended to kill.21 Other participants talked about small children
sleeping in bathtubs to hide from stray bullets penetrating bedroom walls
at night.
The bystander victim represents the most impersonal
type of crime. But participants commented that, even when the shooter targets
a particular victim, the gun crime is somewhat impersonal. The gun, as an
instrument of both power and detachment, allows the shooter to remain physically
and emotionally distanced from his or her victims. When the victims are
shot in the back, as many are, they never even see the shooter's face. This
may increase the "Why me?" response of so many gun victims, similar to the
feelings of victims of drunk driving.
The ability of mentally disturbed individuals to kill at a distance,
together with the enormous firepower of semiautomatic weapons, may have
facilitated the gun rampages that have taken so many lives in recent years.
Participant Michelle Scully Hobus was shot and her husband killed when
a crazed gunman armed with two semiautomatic TEC-9 pistols roamed a San
Francisco, California, law firm, shooting 15 people, killing 9 before
taking his own life. It was a long time before she could shake the feeling
of danger. "Even though I knew that the gun massacre at the law firm was
an extremely rare event, I kept having the feeling that it would happen
again. I couldn't sit with my back to the door; I thought someone would
come in and blow everyone away."
Moreover, gun victims face constant reminders
of their trauma from the everpresent gun seen on television programs and
commercials and in films and videos. Even American slang, for example, "one
shot," "take aim," and "set your sights," takes its toll on some victims.
Some participants reported that any loud noise, like balloons popping and
cars backfiring, could "trigger" a response. The exorbitant media attention
paid to each new multiple-victim shooting also is retraumatizing for gun
victims of similar tragedies. Security changes, such as metal detectors
in schools, hidden cameras, dress codes, and guards in the halls, are constant
visual reminders of school shootings.
Like other crime victims, gun victims seek redress against their shooters
through the criminal justice and civil justice systems. Many victims,
like participants Scully Hobus and Jaquie Algee, have become activists.
RECOMMENDATION:
Clinical evidence supports the therapeutic value of victims working as
change agents, in grassroots or church activities, informal support groups,
and anticrime organizations.23 2. The Young Age of the Victims As previously noted, gun crime disproportionately
affects young people. Their injuries and grief must be understood in this
context. The participants who work with adolescents spoke of the pessimism
and despair, particularly in the inner cities, where communities are losing
children to gun violence daily. Youngsters whose relatives and friends
have been shot automatically think that sooner or later it will happen
to them. They plan their funerals, write their obituaries, and specify
the clothing in which they want to be buried. A psychological counselor
for teenagers in Baltimore, Maryland, Dr. Rosetta Graham, spoke of the
need to do much more for this age group: “Around age 14 or 15 they
become more private and hold in their grief. They are caught between adults
who know how to make their needs known and young children whose caregivers
speak for them.” Studies of urban youth show a high correlation between
exposure to violence and depression and PTSD.24 The hopelessness of this population was a
recurring theme. The participants agreed that one major shooting, or the
daily loss of friends and classmates, can have a profound effect on young
people just beginning to explore their independence and develop plans
for their future. While some hold in their grief, others become suicidal
or act out their feelings on the street. Even in suburban settings where
violence is rare, a highly publicized school gun massacre can have a significant
impact. Counselors working with students at Columbine High School in Littleton,
Colorado, worried about kids who were somewhat depressed and doing drugs
before the shooting. In the months since the shooting, they have seen
an increase in drunk driving, suicide attempts, and fighting. Disaffected
students—or those who feel alienated or rejected—don’t
trust anyone, don’t feel safe, and don’t do well in school.
Similarly, after the 1998 shooting of 22 students at Thurston High School
in Springfield, Oregon, there was a 600-percent increase in referrals
to the school nurse and a 400-percent increase in arguments and fights
reported to the principal. Many students, even some who were not present
at the school but who watched the news coverage, experienced a loss of
control, a feeling of being violated, and a sense of guilt that they survived. For many students, the fear of gun violence
is strong enough to interfere with the quality of their lives and their
performance in school; they also may suffer from increased absentee, truancy,
and dropout rates. Participants who work with children explained the importance
of getting them to talk about their fears. They are hungry for information
and may distort facts and think they could have prevented the shooting.
They need to understand that the school shootings on the evening news
are rare events and that schools are safe places. Although exposure to violence will affect
all adolescents to some extent, different services are needed when the
shooting is an isolated tragedy versus when there is a daily threat of
violence in the community.25 In the high-profile school and
workplace shootings, crisis response teams “debrief” the victims
and witnesses, often in a group setting. The interventions for schools
and communities that witness violence are based on the assumption that
the incidents they witnessed are one-time horrific events. Participants
who had the benefit of this type of crisis response service felt a sense
of security while the teams were there and a great void when they left.
In the absence of organized training, teachers, school administrators,
and guidance counselors are scrambling to get up to speed on crisis response.
Many professionals who helped care for the students who were shot or witnessed
a massacre of their classmates also became depressed and suicidal. According
to School Superintendent Jamon Kent, the shooting at Thurston High took
place May 21, 1998, and the aftershocks still occupy one-third of his
time in the office. RECOMMENDATION: Participants recommended that
communities victimized by gun massacres be offered long-term assistance
and training so they can more effectively be involved in the healing process.
Different problems arise and different types
of interventions are needed to address chronic gun violence. For the past
10 years at least, young African-American males have experienced violent
crime at a rate significantly higher than the rate for other age groups.26 Sandra DeLeon, Director of the Rise Above It violence
prevention program in West Orange, New Jersey, reported that 60 percent
of the students they serve know someone who has been shot. In their neighborhoods,
gun violence is more predictable than random. They come to school worrying
about the gunshots they heard the night before. The students need to hear,
preferably from peer counselors, that there is a future to look forward
to and they are not destined to be either buried or behind bars in jail.
But the participants also agreed that this is an uphill battle. The strong
correlation between poverty and violent crime means that those with the
fewest resources are the most vulnerable. In some cases, the parents of
homicide victims are very young. An enormous amount of preventive counseling
is needed to keep them from exacting retribution while they struggle to
get daycare, buy food, and arrange for the burial of a loved one. The literature on children and adolescent
victims reinforces the group’s findings about the vulnerabilities
of young gun victims. A Task Force on Adolescent Assault Victim Needs,
convened by the American Academy of Pediatrics, recommends addressing
the psychosocial needs of young victims along with their physical injuries.27 To do this effectively, the task force noted that health
care providers must acknowledge and address three myths: 1) that all adolescent
victims are “bad” kids who probably deserve what they got, 2)
that it is dangerous to care for adolescent victims who may be members
of a gang, and 3) that it is hopeless to help them because of the high
risk of reinjury and subsequent acts of violence by the victim. The myth that all adolescent victims are
“bad” kids is particularly harmful for young African-American
men growing up in neighborhoods rife with drugs and gun violence. Generalizations
about “predator youth” cause added grief for gun victims and
stigmatize them and their families unfairly. Future employers may refuse
to hire a young man with a bullet in his arm, assuming that he was a gang
member or a bad person because he’d been shot.28 On the
other hand, the tendency to use violence is considered a serious potential
consequence of being a young victim of gun violence. In fact, “a
new study by the National Center on Crime and Delinquency finds that one
of the best predictors of whether a teenager will commit a crime is whether
he or she has been a victim.”29 Siblings of gunshot victims
are frequently preoccupied with revenge fantasies and may be encouraged
and assisted by their peers in exacting vigilante justice. Once having
resorted to violence, young men engage in more risk-taking behavior. Thus,
a cycle of violence continues, and being shot once becomes the greatest
predictor for being targeted again.30 However, the risk factors
for this group are often overcome by the resourcefulness and determination
of families surviving in the inner city. RECOMMENDATION: Participants agreed that assistance
for gun victims, particularly young African-American men, must include
programs designed to teach victims to regain their self-respect and status
in the community without resorting to more violence. Quick outreach and
support to newly bereaved families can help redirect their grief toward
positive efforts to honor the memory of their loved ones. Although much of the roundtable discussion centered on teenage youth,
elementary school-age children also are frequent witnesses to gun violence
and often display symptoms of PTSD and other trauma-related disorders.31 Some children are afraid of school, and many become fatalistic.
Some engage in aggressive play and perform poorly in school,32 while
others become desensitized to violence and lose the ability to recognize
and avoid dangerous situations. The few research studies that were available
to participants suggested that witnessing gun violence affects children
in many different ways, depending on the type of wound, the proximity
to the shooter, the relationship of the shooter and victim, and whether
the shooting took place in a context generally considered safe, among
other things. Different reactions can be expected from boys and girls.
Child witnesses who have been raised in a subculture of violence in the
home may have additional risk factors for long-term psychosocial consequences.33 Effects also can be seen in somatic disturbances. According to participant
Marianne Z. Wamboldt, M.D., a child psychiatrist in Denver, Colorado,
clinicians have noted a relationship between the general stress in the
community after the shooting at Columbine High and an increase in asthma
cases and deaths among preschoolers. “After
my 19-year-old son was shot in Chicago, I went to many support groups,
community organizations, and church-affiliated meetings, but I really
wasn’t getting what I needed. I needed to be more active in
the movement to reduce gun trauma. I found comfort in joining The
Bell Campaign, a grassroots victim-based organization, modeled after
Mothers Against Drunk Driving.”
—Jaquie Algee, RECOMMENDATION: The roundtable consensus was
that much more research is needed to develop services that take into account
the full range of effects that gun violence has on children. OVC should
work with other offices in the Office of Justice Programs (OJP), such
as the National Institute of Justice, the Office of Juvenile Justice and
Delinquency Prevention (OJJDP), the Violence Against Women Office (VAWO),
and BJS, to develop a research agenda concerning the needs of gun violence
victims. The evaluation of promising direct service programs for child
victims of gun violence should be encouraged and funded by OJP.
3. The High Cost of Gun
Violence Gunshot injury and death place a burden on the health care system in
the United States that far exceeds the toll of other types of criminal
victimization. Because of the traumatic nature and extent of their injuries,
gunshot victims are more likely than other crime victims to require overnight
hospitalization and followup care. BJS reports that gunshot victims represented
only 5 percent of the estimated 1.4 million hospital emergency department
patients treated in 1994 for violence-related nonfatal injuries. But while
the majority of crime victims are treated and released, gunshot victims
represent a third of those requiring hospitalization.34 The
average cost of acute care treatment ranges from $14,85035 to $32,00036 per hospital admission.
Because of the young average age of the victims and the frequent need
for rehospitalization, the lifetime medical costs are very high, around
$35,500 per victim. For all victims of firearm injuries (assaults) and
deaths (homicides) in 1994, the lifetime medical costs totaled $1.7 billion.
Government programs, primarily Medicaid, are the primary payers for 50
percent of hospitalized gunshot injury cases due to violence.37 The growing cost of gun violence can affect the trauma care available
for all community members. At King/Drew Medical Center in Los Angeles,
California, hospital expenses, not including professional fees, were more
than $270.7 million for the 34,893 patients hospitalized for gunshot injuries
from 1978 to 1992.38 Some 96 percent of these
costs were paid with public funds.39 Between
1983 and 1990, the financial strain of treating uninsured patients contributed
to the closure of 10 out of 23 trauma centers in Los Angeles County.40 In addition to direct health care and related expenditures, gun violence
exacts a substantial economic toll on its victims and society in general
in terms of lost productivity, use of the criminal justice system, pain
and suffering, and diminished quality of life. Economists and public health
statisticians estimate an annual bill of more than $100 billion for all
of these gun violence costs. An examination of more than 1,000 jury awards
in cases involving shooting victims yields an average loss of more than
$3 million for a single family of a homicide victim.41 The economic loss is even more staggering for victims who sustain spinal
cord injuries (SCIs) from gunshot wounds. These relatively rare catastrophic
cases account for the lion’s share of the medical costs for gun injuries.
Each year, approximately 10,000 persons suffer an SCI and require hospitalization.
Nearly a quarter of these injuries are caused by acts of violence, primarily
gunshot wounds. Violence-related SCIs have increased dramatically since
the early 1970s, over-taking falls as the second leading cause of SCIs
(after motor vehicle accidents) in the past 4 years.42 The
average first-year expenses have been estimated at $217,868 (in 1995 dollars)
for violence-related SCIs, although the amount varies considerably depending
on the extent of neurological damage. With recurring annual charges for
violence-related SCIs calculated at $17,275, the lifetime charges are
estimated to be more than $600,000 for each victim. This includes charges
incurred as a direct result of the injury, such as emergency medical services,
hospitalizations, attendant care, equipment, supplies, medications, environmental
modifications, physician and outpatient services, nursing homes, household
assistance, vocational rehabilitation, and similar miscellaneous items.
It does not include indirect costs, such as lost wages, fringe benefits,
productivity, pain and suffering, and diminished quality of life, which
could be twice as much as the direct costs.43 A handful of gunshot SCI victims have fared better than most. For example,
the SCI students from the Columbine shootings have had the benefit of
a community-wide effort to raise funds for remodeling living areas, paying
for medical and living expenses, specially equipped vans, and even college
scholarships. But these are atypical cases. The majority of people with
violence-related SCIs are young African-Americans with low socioeconomic
status. Many in this group have been targets of gun violence and have
sustained most of their injuries because of drug- or gang-related activity.
Those who return to their communities after surviving months with tubes
in their bodies face a daunting challenge in school. Paralyzed for life,
they never will be the same active teenagers again. The practical and
social problems like calling ahead and waiting hours for transportation,
wheelchair access to classrooms, and dealing with colostomy bags are difficult
enough without the added fears of testifying in court and being targeted
again by the shooter. Those with violence-related SCIs are more likely
than other SCI patients to have intractable pain and commit suicide. For
others, the cost of acute care and rehabilitation, among other things,
can lead to the dim prospect of constant dependence on the Government
or family.44 4. The Extraordinary Media
Attention to a Small Subset of Gun Crimes On April 20, 1999, the world watched as two high school students, armed
with automatic weapons and shotguns, killed 12 students and a teacher
and wounded 23 others before turning the guns on themselves. The tragedy
at Columbine High School is considered a defining moment in the public’s
consciousness about gun violence. The nonstop real-time media coverage
of this horrendous massacre, both on the air and in print, was traumatizing
to the victims’ families and friends, the community, the state
of Colorado, the United States, and the world. The roundtable participants
discussed this media coverage, focusing on its impact on children and
its message for those haunted by the unpublicized loss of a loved one
to gun violence. RECOMMENDATION: Participants agreed that the
media should be more sensitive to how their coverage of gun violence affects
victims and children. OVC should develop training materials and guidelines
for media coverage of gun massacres. School shootings in particular are traumatizing for children because
they all go to school.45 After Columbine, preschoolers
in Colorado began talking about where they would be going to school as
the place where they would die. School systems around the country saw
the phenomenon of school-phobic kids, as both the news media and talk
shows exaggerated a child’s risk of being shot at school. Although
participants thought that such news coverage should carry a warning caption
for parents about the possible adverse effects on young children, they
also felt that older children are hungry to know what has happened and
have a great need for information. In all cases, parents and teachers
need to help children process the information they see on television,
so they can realistically assess their own safety in school. Unfortunately, the misconceptions about the risk of school shootings
are pervasive in all age groups. A recent analysis of opinion polls taken
after the shootings in Jonesboro, Arkansas, and Littleton found a 49-percent
increase in parents’ anxiety about children’s safety in the
classroom, even though statistical studies by the U.S. Department of Justice
(DOJ) and the National School Safety Center showed a 40-percent decrease
in school-associated violent deaths in 1998–1999, the school year
including the Columbine shooting. These tragic events are truly rare—with
52 million students enrolled in public school, the chance that a school-aged
child would die in school in 1998–1999 was 1 in 2 million.46 The gap between public fear and reality is not surprising, as media coverage
is focused on less than 1 percent of homicides—those with multiple
victims. Even within a group of multiple-victim gun homicides, the rarest
events get the most media attention. For example, The family homicide, an all-too-common occurrence, was reported only
by the California press. The Baltimore shooting was prime-time news for
a day and then was eclipsed by the middle school shooting in a rural community
in Oklahoma. Even among victims of the same shooting, the media may focus on one or
two to represent the face on the story. Perhaps because of their pronounced
activism on the gun issue or because of some other special attribute,
these chosen victims become the story of the massacre. In Homicide:
The Hidden Victims, A Guide for Professionals, Deborah Spungen describes
how individual victims of multiple-victim shootings “tend to get
lost in the scale of the horror,” while “covictims who have
had a loved one selected for the [poster victim] may experience feelings
of reluctance, exploitation, loss of control, and anger.”47 |
The information on this page is archived and provided for reference purposes only.
he roundtable participants were asked to consider how gun victims may be
different from other crime victims and how the differences might affect
the services they need or receive. The main themes that emerged were 1)
the gun as the weapon of violence, 2) the young age of the victims, 3) the
high cost of gun violence, and 4) the extraordinary media attention given
to a small subset of gun crimes.