Missouri’s Public-Health Enemy No. 1: a Gun in Every Pocket

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Gun-rights activists marched last year in Ferguson, Mo., the site of unrest following the police shooting death of an unarmed black teenager in 2014. Last week Missouri lawmakers gave citizens the right to carry concealed weapons without having to take a gun-safety class, obtain a permit, or pass a criminal-background check.
September 23, 2016

My husband and I work at the University of Missouri at Columbia where, last fall, following widespread demonstrations against racism, a student from another campus in the state threatened on the anonymous social network Yik Yak to "shoot any black people" he saw.

The day after the Yik Yak threat, a black undergraduate stopped by my husband’s office to say that she was interrupting her education and going home. Her parents thought she’d be safer there. She had spent the night, she said, hiding in her bathtub.

This year, I find my well of optimism has run dry.

One of my public-health students, who came to Missouri from Mongolia, where a third to a half of the population is nomadic and gun ownership is far from the norm, had ended up in the emergency room the next day with a panic attack. She, like her classmates from Botswana and India and Indonesia and Niger, had come to mid-Missouri to learn how to prevent disease and injury, in many cases to take those skills back to their homelands. Now they were struggling to make sense of life in a country in which firearm-related deaths are 10 times more likely than in any other industrialized nation, in which a student’s social-media post could empty out their classrooms and the student union and make students sleep in their bathtubs.

The Missouri legislature voted last week to override the governor’s veto and allow an extreme loosening of the gun laws in the state. The law eliminates requirements that individuals obtain training, education, a background check, and a permit to carry a concealed firearm. Research suggests that more people will be shot as a result, and I suspect that more people will be sleeping in their bathtubs trying not to be.

If it’s hard to do public-health work in Missouri — the state ranks above only Nevada in per capita public-health funding — it sometimes seems even harder to teach it, particularly with developments such as these.

This year’s discouraging news on guns precedes the annual meeting of the Missouri Public Health Association in Columbia by only a few weeks. As the director of a master of public health program, I urge students to attend the meeting every year and mingle with working public-health professionals from around the state. As a result, one of my annual tasks is to reassure them after the workshops and the plenaries are over, when the posters are taken down.

I would often find them standing in worried knots, anxiously asking themselves and one another what they were thinking to pursue a career in public health — in this state; in these times. They would have just spent three days listening to tired administrators of rural health departments talk about the lack of funding for vital services, growing disparities between the poor and the middle class and a worsening political environment. The students have invested money in their degrees because they want to improve children’s nutrition, women’s health, prevent HIV. Their eyes are haunted.

I have a spiel by now, but it’s one I believe. I tell them that working in tough circumstances is not inconsistent with a rewarding career. I suggest that if they stay in Missouri and fight for sane public policy they will be able to move mountains if they someday end up in, say, Hawaii, which is ranked at the top of U.S. states for a variety of positive health outcomes, including preventable hospitalizations, smoking and obesity and also happens to rank at the other end of the scale with regard to per capita public-health funding. I tell them that change is incremental and that there is no work that is more important.

This year, I find my well of optimism has run dry. In an environment of increasing hostility and violence, lawmakers in my state have empowered people to shoot if they feel threatened and claim self-defense. I’m dreading the inevitable moment with the students both because I anticipate that their despair will be deeper than usual and because, in my own mind, I’m not sure what I’m going to tell them.

I’m going to have to find something to say, though, because of that student who cut short her education to go home and because these other students are showing up from as far away as Indonesia and India and from nearby Missouri counties to learn how to prevent disease and injury, if they can. They are showing up, these people just beginning their careers, to learn this in a state where the legislature voted to allow domestic abusers to carry concealed weapons.

I’ve been doing this work for most of my adult life, and I have never lacked for reasons to keep going, keep teaching, keep reminding students that it’s hard work but it’s exciting work, too, and you can make a difference. I’m coming up blank at the moment, however. The meeting is just days away, and I’m going to have to think of something to say.

Lise J. Saffran is director of the master of public health program at the University of Missouri at Columbia.