The sun is shining and mild breezes usher in the anticipation of a summer full of fun and excitement. However, as an anesthesiologist at one of the nation’s top trauma centers, I am getting ready to put my boots on the ground and my mask up, anticipating increased traumas. This time of year brings the heat! Both from the Chicago sun and people who like to pack it. Life in Chicago is depicted in our childhood sitcoms like Good Times, drama series like The Chi, and the movie CHI-raq, by Spike Lee. What do they all have in common? They illustrate the intrinsic fibers of the Black struggle and violence.

Lee folded the tragedy of Chicago’s gun violence into a Greek comedy in CHI-raq, where women withhold sex from their husbands to put an end to war. Can ending gun violence be this simple? I think we all agree the answer is no. Only Spike could take a serious subject like gun violence and string together major issues like “Where do guns come from, how do they get into the community and what do we as Black men and women want to do about it?”

In 2020, reports show that Black people in Chicago were 22x more likely to experience gun violence than white people. Even during the Democratic National Convention held there in August 2024, the media took a swipe at the city to remind us that it was the murder capital of the nation. Is Chicago the only city with a history of gun violence? No. The series The Wire, set in Baltimore, turned 20 years old, and the city still struggles with gun violence in real life! The reality is per capita, Chicago does not have higher occurrences of gun violence than cities like New Orleans, Memphis and Atlanta. The politicizing and racializing of gun violence at the expense of a city, communities, and families who are also victims of this epidemic leads us back to square one. So what are we getting wrong about gun violence?

There was a shift in the 90s to start looking at gun violence as a public health disease. This allowed for funding for epidemiological studies to characterize this illness in the community. For example, John Hopkins School of Public Health now has the Center for Gun Violence Solutions, which, for thirty years, has been dedicated to identifying causes and finding evidence-based solutions for communities most affected. The Center for Disease Control and the Emory School of Public Health in Atlanta work together to analyze gun violence data and the policies that keep guns readily available. Tulane School of Public Health launched a bold initiative in 2022 in its Center for Youth Equity to motivate youth to change their behavior by helping them and their families obtain immediate support while in the trauma center.

After comparing three top public health programs that study gun violence, this community illness is described as one that thrives in environments that have:

•  Communities with poor housing, underfunded schools, and limited employment opportunities

• Limited community conflict resolution training

• High rates of drug and alcohol use

• Easy accessibility to guns

The pathology of gun violence affects Black male teenagers and men aged 16-24 years more than any other group. Just being Black increases a person’s risk of being shot more than 20x than that of a white person.

There are also political determinants of gun violence to take into account that keep this disease undertreated with remedies that are not effective. The Nation has a Gun Problem!

As I search my own mind about what we are getting wrong about gun violence in the Black community, I see exhausted faces with no answers. Visit any trauma ICU after a busy shooting weekend, and you’ll see what I see — the surgeons, the anesthesiologists, the nurses, and, yes, the families. I see the fatigue in the eyes of Black mothers and sisters as they stand, watch, and wait. When I speak to them about their son’s progress, I see the detachment and the shock. Then, after repeat surgeries and ongoing care, many of them stop coming, not because they stop caring but because they don’t have the luxury of time. They have to work, go to school, and show up for their other children despite the tragedy of one. Gun violence has a cost that many don’t think about. Even the daily parking at the hospital is a cost!

According to the research group Everytown, for the over 70,000 individuals shot and wounded, we all share 1.56 billion dollars annually in measurable medical costs. These costs account for emergency response, ambulance, immediate medical care, long-term care, rehabilitation, and mental care services. Instead of these tax dollars being invested in communities for housing, education, hospitals, and social services for our seniors, our money goes toward the aftermath of gun violence. To put it in more relatable terms, the care for a single gunshot victim can cost the entire salary of a person earning the median household income, which is about $74,500 in 2023, according to the US Census Bureau. Now imagine if your family had the hospital bills associated with a loved one being shot and wounded.

“For those individuals who are shot, there is a ripple effect among their families, friends, and communities. Who foots the bill for their medical care and their recovery? The empty chair at the dinner table or the missing desk at the kid’s school. Who bears the economic costs? In reality, we all pay with higher taxes for public safety. We pay the most for the loss of human potential. We must consider a different approach that is focused on upfront investments as an ounce of prevention is worth a pound of cure. Together, we can change the narrative and reimagine the future by paying today to prevent paying so much later.” 

— Dr. Selwyn Rogers, Director of Trauma for the
University of Chicago

A Heavy Price Indeed!

It might seem insensitive to bring up money when a life hangs in the balance, but real families will be affected as our nation inches towards Medicaid reform while forcing people to find work just to receive benefits. Some of these families are led by single women who can’t go back to work because they’ve taken on a caregiver role for a child who has been shot. Unlike the scenes in the movies when mothers cry on the shoulders of their sons, the moms I see every day come home to help turn a quadriplegic, buy supplies for wounds, or find another home that has wheelchair accessibility. If the care is too much for the family, the only other option is a nursing home. Who pays that bill? Medicaid. Young people in these situations need long-term care.

The loss of research dollars will undoubtedly affect the work that public health programs do to intervene in gun violence prevention. A lot of community grants for grassroots organizations that are heavily involved in the community are now at risk, like:

• Ceasefire 365 (Baltimore)
• Chicago CRED (Chicago)
• Jumpstart Program (New Orleans)