Earlier that month, I took care of a 2-year-old boy who had pulmonary tuberculosis. He was tested because of several factors that put him at high risk for TB, which in the last century killed tens of thousands of Americans, especially children. Today, only a few hundred Americans will die of this disease, due to intense public health efforts.
TB and guns? I'll get back to this.
In 2010 there were 6,570 gun-related deaths of children, 18 a day, a small classroom of innocents. This is 15 times the death rate from infections and twice the death rate from cancer. Children of color constitute 63 percent of these gun death victims. As a nation, we have invested billions in research and developed weapons to target specific cells based on a child's individual genes to prevent and treat infections and cancer. Not so for guns and kids.
Over the last half-century, through regulations and hard science, we have successfully reduced our children's exposure to toxic air pollutants and water and food contamination. With tighter regulation of the cigarette industry, we have reduced their inhalation of secondhand smoke. Yet, inexplicably, we continue to poison our children's cultural environment through various "entertainment" media that, in a child's first 18 years of life, expose a developing brain to 16,000 murders and 200,000 violent acts on television alone.
We allow 40 percent of Philadelphia's children to live in poverty, in areas where exposure to violence is common, making them more likely to fight first as they get older.
In a 2001 study of 7-year-olds, done in the area around St. Christopher's Hospital for Children, 75 percent had heard gunshots, 61 percent worried they might get killed, 10 percent had seen a shooting or stabbing inside the home, and an unbelievable 18 percent had seen a dead body outside. Toxic.
There are 300 million guns in the United States, in a third of all households. In homes with a child, 32 percent of guns are stored unlocked and 22 percent of stored guns are loaded. The estimated cost of firearms-related death, disability, and loss of wages is estimated at $47 billion. The spending represents a fiscal cliff of human suffering.
In my practice, I prescribe more care and equipment for children injured by firearms than for those in car accidents or swimming pool mishaps.
In a 2009 study looking at 395 gun-related fatalities inside a home, 333 were by suicide, 41 were domestic violence homicides, and 12 were unintentional. This is a 98 percent death rate. Nine intruders were killed in this study, a 2 percent protection rate. Feel safe?
The American Academy of Pediatrics has stated simply that "the absence of guns from children's homes and communities is the most reliable and effective measure to prevent firearm-related injuries (and death) in children and adolescents."
Back to TB.
To be infected, you must have a susceptible host, someone whose immune system is weakened, such as children and the elderly. You must also be in a place where TB is endemic, mostly crowded, impoverished areas. The public health system in the United States successfully screens high-risk individuals, treats TB early on, and is working on a vaccine. No controversy here.
The Sandy Hook tragedy once again takes our collective consciousness back to the debate about mental health and angry young men (susceptible hosts). Back to debates about how we glorify violence and defend outdated notions of First and Second Amendment rights over the health and safety of children.
After this tragedy, leaders in pediatrics across the country collectively wrote to Vice President Biden to improve firearm safety and mental health care and quell the culture of violence. And last week, President Obama proposed legislation to enhance background checks and reinstate the assault weapons ban.
It's a good start, but a long fight in Congress looms. We need action now. With inaction, 18 families a day are burying their children.
Harlem Children Zone's Geoffrey Canada had it right when he posed these questions about gun violence and children of color. "If we were fighting an outside enemy that was killing our children at a rate of more than five thousand a year, we would spare no expense in mounting the effort to subdue that enemy," he said. "What happens when the enemy is us? What happens when those American children are mostly black and brown? Do we still have the will to invest the time and resources in saving their lives?"
On Dec. 17, after work, I rushed home to meet my daughter's school bus. As the door swung open, and her tan suede shoes hit the pavement, I felt a pang of relief.
I thought of the parents of the 20 children in Newtown and the parents of 18 elsewhere on any given day who would never see their youngsters coming home from school.
Then I kissed my daughter on the same spot on her forehead as that morning, holding my lips there a little longer than before.
Daniel Taylor is an associate professor at Drexel University College of Medicine and a pediatrician with St. Christopher's Hospital for Children. His e-mail address is Daniel.Taylor@DrexelMed.edu.