June 17, 2026 • 39 mins
“We should treat gun violence like a public health problem” is a phrase that is often used but rarely defined.
My guest today is Dr. Megan Ranney, an emergency physician, injury prevention researcher, and the Dean of the Yale School of Public Health .
She sees firearm injury as part of a much broader health issue, one that affects not just the person who was shot, but families, communities, health care providers, and the systems that are supposed to respond afterward.
In this episode, we talk about what a public health approach to firearm injury actually means, why that framework is often misunderstood, and how public health researchers think about prevention differently from the way these conversations usually happen in politics or media.
Dr. Megan Ranney is Dean of the Yale School of Public Health, a practicing emergency physician, and leading voice for innovative approaches to public health. For more than two decades, she has worked on the frontlines of emergency medicine, caring for patients impacted by firearm injuries, overdoses, and other preventable crises while advocating for solutions that bridge science, policy, and public trust. Her work focuses on rebuilding the connection between science and society and advancing evidence-based solutions that help people live longer, healthier lives.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
I'm Jeff Asher, and this is the Jeffalytics Podcast.
(00:03):
We should treat gun violencelike a public health problem, is
a phrase that is often used butrarely defined.
My guest today is Dr.
Megan Ranny, an emergencyphysician, injury prevention
researcher, and the dean of theYale School of Public Health.
She sees firearm injury as partof a much broader public health
issue, one that affects not justthe person who was shot, but
families, communities,healthcare providers, and the
(00:25):
systems that are supposed torespond afterwards.
In this episode, we talk aboutwhat a public health approach to
firearm injury actually means,why that framework is often
misunderstood, and how publichealth researchers think about
prevention differently from theway these conversations usually
happen in politics or the media.
We also get into firearmsuicide, the challenge of
building better data systems,and what public health learned
(00:47):
from both COVID and the recentdecline in violent crime
nationally.
This conversation is about whatchanges when you stop treating
violence as a moment of crisisand start treating it as a
long-term problem that can bestudied, understood, and
systemically eliminated.
Let's dive in.
My guest today is Dr.
Megan Ranny.
Dr.
Ranny, thank you so much forjoining the program.
SPEAKER_01 (01:07):
Thanks.
It's an honor to be here.
I've been listening toDeathalytics for a bit.
So it's a real privilege to getto be a guest on this show.
Well, great.
SPEAKER_00 (01:15):
That's great to hear.
It's a good show.
We all like our listeners.
So first question, same to everyguest.
If you've listened before,you've heard it.
But what is your background?
What brings you here today?
SPEAKER_01 (01:25):
So I am by background an emergency
physician, have practicedclinically for over 20 years, as
well as an injury preventionresearcher.
I've spent my career working onviolence and particularly gun
violence as a health problem.
SPEAKER_00 (01:41):
And what brought you to this work?
What motivates you to do all ofthis?
SPEAKER_01 (01:45):
Oh, I've worked on violence as a problem that can
be fixed since long before Iwent into emergency medicine.
I actually was a Peace Corpsvolunteer after college, working
in West Africa, wheregender-based violence was a
major issue and was a majorfactor in transmission of HIV.
Continued that interest and thatwork when I returned to the US
(02:06):
and went to med school and theninto emergency medicine, but
really started working on gunviolence as a health problem
based off of my experiencesworking in an urban emergency
department for my entire career.
Back in the early to late 2000s,that was when we were starting
to see firearm homicide ratesincrease in the United States.
(02:27):
I was taking care of folks whowere coming in, uh, having been
shot through community violenceon an almost daily basis,
started questioning why weweren't doing anything for them.
And then the event that reallychanged my trajectory, Jeff, was
actually taking care of afirearm suicide.
As I'm sure we'll talk about,firearms suicides make up, on
average, two-thirds of gundeaths in the United States.
(02:49):
But it wasn't until the late2000s that I took care of a
firearm suicide in the emergencydepartment.
That case changed my conceptionof what firearm injury looks
like in the United States.
It led me to asking why we don'ttalk about firearm suicide and
firearm homicide as preventablein the same way that we talk
about suicide in general, or inthe same way that we talk about
(03:11):
any other health problem thatcomes through my doors in the
emergency department.
And then it led me down thispath of pushing to make sure
that folks across the UnitedStates thought of firearm injury
as something that is bothpreventable and that can be
addressed by using a health orpublic health approach in the
same way that we have addresseddozens, if not hundreds, of
(03:32):
other problems over the courseof our country's history quite
successfully.
And so that has really thenbecome the career journey for me
is making sure that we haveawareness, but also trying to
develop rigorous science andscalable tools that can be used
in every community across thiscountry to reduce this truly
daily scourge of firearm injuryand death in the United States.
SPEAKER_00 (03:54):
And so, sort of big picture right now, what is your
role with Yale?
What are you guys hoping toaccomplish?
And what do you do specificallywithin that sort of ecosystem?
SPEAKER_01 (04:02):
Yeah, so so a little more about myself.
So, yes, I'm an emergencyphysician and injury prevention
researcher.
I am also now privileged to beuh the dean of the Yale School
of Public Health.
I came here to Yale just aboutthree years ago now to launch
our school into independence andto chart um the future of public
health for our country andthinking now on a global scale
(04:24):
as well.
Within the Yale School of PublicHealth, um, we have a firearm
injury prevention initiativethat we've been building over
the last few years.
It includes folks from a varietyof different disciplines, not
just my own, of injuryprevention, but we have
epidemiologists, economists,psychologists, and community
members.
(04:44):
Quite importantly, we have acommunity scholar who is herself
a survivor of firearm injury andbrings that voice, that lived
experience into the work that wedo.
Our aim is to drive high-qualityresearch using the public health
approach, which I'm happy totalk about, things that can help
both illuminate the problem, butalso again, drive us towards
solutions, to grow educationaround firearm injury as a
(05:08):
health problem, something thatagain had been abandoned for a
long time.
Um, I know from listening toyour podcast around all the
different disciplines out thereuh that are working on this
topic.
But in general, the Americanpublic and even many of the
people who have responsibilityfor policies or for social
interventions, right?
They don't understand how toconceptualize and think about
(05:29):
firearm injury.
So education on a policymakerlevel, but also on a community
level.
And then finally, thinking abouthow we do scale what works,
because I am a deep believerthat research only matters if it
is used.
Uh, I don't want the work thatwe do to sit in the pages of our
journals or within the walls ofan academic institution.
That's part of the reason wehave a community scholar, but
(05:52):
it's also part of my coremission across the school.
So within our firearm injuryprevention program, we're really
pursuing all three of thosegoals along the full spectrum of
firearm injury.
So homicide, including domesticviolence, suicide, as well as
unintentional injury and massshootings.
SPEAKER_00 (06:08):
So you you stole my next question, but what when we
talk about gun violence as apublic health issue, it's a
talking point.
We hear it all the time fromobviously from researchers like
like yourself, down to councilmembers and mayors and police
chiefs, but we don't reallydefine it, I feel like, very
well.
So, what is it with in your mindwhen we say gun violence, we
should treat it as a publichealth issue, what does that
(06:29):
mean?
SPEAKER_01 (06:30):
So that means two things.
And I'm gonna talk through eachof them in turn.
The first is thinking about thehealth problems associated with
gun violence.
And the second part is themethods that we used to define
and fix it.
So let me talk about the firstpart first.
Why is gun violence a health orpublic health issue?
Well, obviously, when a bullethits a body, when you end up in
my emergency department becauseyou've been shot, right?
(06:52):
That is an obvious physicalhealth problem and something
that I am well trained to helpreduce the bleeding, save your
life, reduce the after effectsof that bullet hitting your
body.
But there are other healthproblems associated with firearm
injury as well.
When a trigger is pulled, evenif you are not hit by the
bullet, there are emotionaleffects, right?
(07:14):
We know that there'spost-traumatic stress, anxiety,
substance use disorder amongstpeople who are present at a
shooting, also amongst familymembers or friends of someone
who is shot or present at ashooting.
So there are those psychologicalhealth effects.
There are also community-widehealth effects.
We know that after a shooting,people, whether it's a suicide,
(07:35):
a homicide, a mass shooting, weknow that people in a community
are more likely to have lots ofdifferent both physical and
emotional after effects, rangingfrom increased rates of
headaches to increased substanceuse disorder.
Um, and of course a decreasedsense of safety, which then
leads to all kinds of otherhealth problems like obesity and
(07:56):
loneliness and things like that.
So the first part of talkingabout firearm injury as a health
problem is thinking about thefull spectrum of health effects
that firearm injury causes.
And we want to measure anddocument those.
Those also give us things towork on, to try to intervene on
that go beyond just trying tostop a crime.
(08:16):
Okay.
So then the second part ofcalling firearm injury a health
or public health problem is thatit gives us some very
structured, well-defined,evidence-based methods to figure
out what the heck we do aboutthis problem.
I feel like here in the US, weare too often caught in either
numbness or hopelessness, right?
We hear that kind of the oneside is like ban all guns, the
(08:38):
other side is give everyone agun.
And the public health approachprovides us some nuance, some
direction, and honestly somehope within that.
So public health approach isfour steps.
First, you measure how common aproblem is.
This, of course, is shared withcriminal justice or econ as
well, right?
Saying what is the incidence andthe prevalence.
Second, we look at risk andprotective factors.
(08:58):
So all other things being equal,what increases the chance of
someone shooting someone else orthemselves, what increases the
chance of them experiencinginjury, either physical or
mental, right?
What helps to protect them, allother things being equal?
Once you've done those first twosteps, then you can go into the
third one of designing andevaluating interventions.
(09:19):
And within the public healthapproach, one of the things that
I think is gorgeous about it isthat that step of interventions
is informed by trying to reducerisks or improve protective
factors, but it can occur acrossa huge suite of different
potential strategies.
Everything from policy orpartnership with law enforcement
to educational interventions oreconomic incentives or changing
(09:43):
of the built environment.
Those are strategies that we'veused successfully to, for
example, reduce car crashdeaths, to reduce
tobacco-related deaths, tochange nutritional outcomes.
And we use that full suite ofstrategies in that third step of
the public health approach aswell.
So measure it, determine whatthe risk and protective factors
(10:04):
are, develop and evaluateinterventions.
And then the fourth step, ofcourse, is scaling or
disseminating what works.
And then it goes right backaround to measurement again.
The other part about the publichealth four-step approach that I
think is rather unique to publichealth is that we always do it
with community at the center.
Each of those steps, in a bestpossible practice, should be
(10:24):
informed by the lived experienceof folks who are living in a
community.
And so you can imagine that theway that we apply this public
health approach in a ruralcommunity that is primarily
affected by firearm suicide andwhere 60 to 80% of folks have a
firearm in the house may bedifferent from how we apply the
approach in, say, an urbancommunity where the vast
(10:48):
majority of firearm injuries arecommunity violence and where a
much smaller proportion ofhouseholds have firearms in the
house.
And so that kind ofcommunity-lived experience,
awareness of what resources arepresent is core to each of those
four steps across public health.
SPEAKER_00 (11:05):
And how important is trust from the community and
trust in the research tosuccessfully implementing this?
SPEAKER_01 (11:13):
Well, if I put on my dean hat rather than talking to
you about firearm injury, Iwould say that I actually think
trust is our number one publichealth issue right now, not just
in the United States, but acrossthe globe.
If you do not trust the peoplethat are doing the research or
the folks from whominterventions are being
proposed, none of the workthat's being done matters.
(11:33):
We're seeing that right now withvaccines.
Gosh, look at the debate abouthontavirus right now.
We're seeing it in uhinterventions for nutrition and
fluoride, and certainly it'spresent in firearm injury work
as well.
It's why I and my own work havemade a really concerted effort
over the entire course of mycareer to work deeply with
(11:55):
communities to make sure thatthe questions that I am asking
are informed by their prioritiesand that we are co-creating the
answers to help build that trustfrom the get-go.
And that trust has to be presentregardless of which community
I'm working in, regardless ofwhether folks are firearm owners
or not, regardless of whethersomeone themselves has been
(12:17):
affected by firearm injury,which of course we know most
American adults have been, orwhether they're someone who is
just trying to avoid firearminjury for their family members
and loved ones.
But that trust in how we do thework and in believing in the
importance of scaling andintervention, without that, the
rest of it is kind of pointless.
SPEAKER_00 (12:37):
And sort of how do we measure that work?
I know you've been involvedwith, or at least have spoken
about, the Edelman trustbarometer.
I wanted to bring that up andthings like that.
How do we measure this as aquantifiable concept of it needs
to be improved?
Here's how we can measure it andknow whether or not we're
succeeding in rebuilding andbuilding better trust.
SPEAKER_01 (12:56):
Yeah, so you can you can measure trust as a
mechanism, right?
So you can say, is it presentand is that a mediator or
moderator of outcomes?
You can also measure trust as anoutcome.
It's usually measured throughsurveys right now, although some
folks are working on alternativemetrics.
The other thing that I'llsuggest though is that you can
measure trust through uptake ofinformation.
(13:17):
So for example, if we're talkingabout vaccines, we can measure a
vaccine delivery as a proxy forwhether or not folks trust
recommendations around vaccines.
Ditto for firearm injury work.
I can measure trust.
And we've actually worked onthis in one of my projects where
we've been working with 4-H inuh 20 plus states, both red and
(13:40):
blue, rural and suburbancommunities across the United
States.
We're measuring trust byqualitative data, but also by
rates of interest in theintervention, by completion of
the intervention.
If people don't trust us,they're not even going to be
willing to have the conversationabout whether or not to
participate in research, andthey're certainly not going to
(14:00):
finish the study.
SPEAKER_00 (14:02):
So you raised this question and then we didn't
answer it.
Why do we treat firearminjuries, especially like
firearm suicide, so differentlyfrom everything else in this
country?
SPEAKER_01 (14:10):
I think it's a few different reasons.
And I'm, of course, Jeff,curious in your perspective as
well, having led this podcastfor a bit.
I think, you know, one ishonestly that we've had 24 years
of not funding firearm injury asa health problem in any
sustained way.
From the Dickey Amendment upthrough 2020, when I and others
succeeded in getting firearminjury funding reappropriated
(14:34):
under the first Trumpadministration, 25 million to
CDC, 25 million to NIH.
Between 1996 and 2020, there hadbeen no formal appropriations
for this issue.
So there was no body ofresearchers who were trained in
how to think about applying thisfour-step approach, nor were
there people out there talkingabout why it was a health
(14:56):
problem.
So I think that's the first andbiggest thing.
The second one is I think it'skind of our American identity.
We like to think of things askind of black and white.
And this is a much more nuancedapproach to how we fix firearm
injury than the kind ofpolitical extremes to which we
we like to hue.
And then the third part isbecause no one was talking about
(15:18):
it and because it's not extreme,I think many people, when they
think about firearm injury, theythink exclusively about either
community violence or they thinkabout mass shootings.
And they don't talk about kindof that full spectrum of firearm
injury, which of course is allinterrelated, right?
You can't talk about homicidewith without including domestic
violence.
You can't talk about massshootings if you don't also talk
(15:40):
about firearm suicide.
You can't talk about a sense ofsafety in a community if you
don't talk about whether or notfirearms are moving around
illicitly, or whether or notkids are able to get them from
their parents without otherparents knowing, right?
These are, they're eachintertwined.
And be but as a because wedidn't have those first two
steps, people weren't talkingabout that full spectrum of
(16:01):
firearm injury.
And so I think that's part ofthe problem too.
SPEAKER_00 (16:04):
Yeah.
I see it often as we've createdthis system, especially at the
local level, but also at thestatewide and the the national
level, where the solutions thatwe think of are always law
enforcement.
And if the things are going up,we need more law enforcement or
more jails or whatever.
And if things are going down,it's because we did all the law
enforcement and all the jails,and we don't consider the
(16:24):
complexity of the issue and thepossibility that there is
enormous role for lawenforcement, but not the sole
role inherently in the systemand the way that we can bring
things down.
That's how I sort ofcontextualize it.
SPEAKER_01 (16:35):
I totally agree with that.
And I think even within workingwith law enforcement, and I've
done a fair amount of that,right?
There is these public healthkits.
So, first of all, thinking aboutthe likelihood of law
enforcement themselves beingshot, thinking about whether or
not law enforcement believes inand is willing to enforce a
given policy, and then thinkingabout those larger cultural
norms that determine whether ornot a law that is passed is ever
(16:59):
used or paid attention to.
And I think one of the worstthings that we can do from a
criminal justice and legalperspective is pass laws that
we're not following.
I also find that people thinkabout policy or or laws or law
enforcement as these magicalthings that somehow are gonna
fix every problem.
And the reality is uh in the US,that's not how it works.
(17:21):
I don't think it works that wayanywhere, but I know our US
setting better than most.
SPEAKER_00 (17:25):
Yeah, absolutely.
So when you think about thisissue, and we've seen an
enormous drop in gun violence,especially from a sort of a
criminal homicide, yeah.
Homicides and sort of nonfatalshootings, not necessarily as
much in the uh firearmssuicides, but looking just at
the homicide and the nonfatalshootings, what do you think is
(17:46):
driving that down?
And do you think that thesechanges are sustainable, or are
we inevitably gonna bottom outand possibly start to see an
increase?
SPEAKER_01 (17:53):
So I'm gonna answer that question with the caveat
that there are lots of smartpeople looking at that right
now, and we don't havedefinitive answers yet, right?
So these are my best ideas thatthat could be disproven.
I think it's two things.
One is is kind of the regressionto the mean.
We had that huge spike inhomicide during COVID, largely
due to loss of those socialstructures that help to keep
(18:14):
people safe and kind of generaldisorder and fear in society.
And so I think part of it isjust what kind of going up and
then coming back down as societymore or less writes itself.
I also think that there much ofthat decrease is thanks to a
number of interventions thatwere put in place over the past
few years that helped drive thatkind of regression back to our
(18:36):
mean.
Things like the incredibleinvestment in community violence
intervention programming, ofwhich there's a few different
types, but which have been shownto be quite successful in some
communities, Chicago being oneof the ones that's best studied,
but Baltimore, Sacramento aswell.
So, so community violenceintervention programs, increased
investment in mental healthservices, rollout of extreme
(19:00):
risk protection orders, andincreased willingness to use
them.
I think those all have played apart as well.
The question to me as to whetherwe sustain it is are we willing
to keep doing the work?
Um, and I'll say it's the samequestion for me for firearm
homicide as I'm having right nowaround opioid overdose deaths,
which we also saw spike duringthe pandemic, probably for many
(19:21):
of the same reasons as we sawfirearm homicide increase.
We've seen a dramatic drop inopioid overdose deaths over the
past couple of years.
Preliminary data has just beenreleased showing that it's
decreased again.
Uh, but but that's both, youknow, we've again put some
social structures back in placeto help support people who are
at highest risk of shootingsomeone else or of over using
(19:45):
opioids.
We've also put structures inplace with opioids with like
naloxone and suboxone.
Are we going to keep investingin those?
For firearm homicide, are wegonna keep investing in those
community violence interventionprograms, in those adult
mentorship programs, in themental health programs, and in
the policies that havesurrounded some of that work?
That to me is an open questionand where I am so enthusiastic
(20:08):
about this podcast, hopefullydriving us to keep implementing
the programming that is showingpromise in good trials, you
know, against CBT interventions,community violence uh programs,
um, hotspotting, et cetera.
SPEAKER_00 (20:21):
I can't claim that the podcast can move, you know,
tens of millions of dollars ofresearch.
I would love to have that, butcertainly I agree that the more
that we talk about it and justsort of communicate it clearly
that these are the steps that wethink are driving it, and these
are the things that we need tobe thinking about and investing
in, absolutely is critical.
Why haven't we seen the samething with firearm suicides?
SPEAKER_01 (20:42):
Great question.
There's a few part things there.
One is is that unfortunately oneof the strongest correlates of
rates of firearm suicide ispresence of a firearm.
And we know that there are morefirearms in private hands now
than there were two years ago orfive years ago and ten years
ago.
So from a sheer numbersperspective, the number of folks
(21:03):
that have intent to hurtthemselves and have access to a
firearm is higher than it was.
We have good data from othercountries, for example, from
Israel, showing that when youseparate people from a firearm,
so like they did studies withthe Israeli Defense Force,
showing that when you forcedsoldiers to keep their um
weapons on base over theweekends, they saw firearms
(21:24):
suicide rates drop.
Um, and and so there's just thatsheer access to a firearm and a
moment of hopelessness is such ahuge driver.
And we've not addressed that inany substantive way.
The other side is that we'rehaving a growing number of
people who are suffering mentalhealth problems in the US.
I think this is deeply tied toboth if we go back to that trust
(21:44):
conversation, right?
Loneliness, isolation, lack offolks to check in, increased
economic hopelessness anddespair.
Um, those all play into driversof suicide as well.
I know there are a lot of folkswho are doing a lot of great
work on this problem,particularly.
With some communities that havevery high rates of firearm
ownership, such as military orveterans, and are showing some
(22:07):
promise in those discretecommunities, but there's a lot
more to be done.
SPEAKER_00 (22:12):
So moving to a similarly depressing but
differently depressing topic, Ijust want to talk about sort of
the COVID experience.
Obviously, COVID was traumaticfor a lot of people for a lot of
reasons, and especially so inyour field.
To what degree have you sort ofinternalized the lessons from
that?
And I was just curious, what arethe biggest takeaways that you
sort of apply to your work todayfrom what you experienced then?
SPEAKER_01 (22:34):
How long of a podcast is this?
SPEAKER_00 (22:37):
We got what, 15, 20 minutes?
SPEAKER_01 (22:39):
Fair enough.
Uh oh my God.
I mean, yes, I think COVID wastraumatic in a thousand ways for
all of us.
And I don't think that oursociety has processed that at
all.
Whether it was the trauma forthose of us working as frontline
healthcare workers who didn'thave adequate personal
protective equipment, whether itwas the trauma for those of us
who had little kids who werestuck at home, and whether it
(23:01):
was having loved ones who wereisolated or who died, who we
couldn't say goodbye to.
And of course, the politicaltrauma, the can the continued
and perhaps even worseningdivision that was hastened by
the COVID pandemic.
I think that's its own kind oftrauma.
I think for me, some of mylessons from the COVID pandemic
(23:23):
are first being really clear, asI just was with you, about what
is my best guess at the momentbased off of the data that I
have and the fact that thatmight be disproven in the
future.
Um as well as thinking a lotabout how the work that we do,
right?
When I talked about thatfour-step public health approach
and community being at thecenter, I think when I go back
(23:47):
to uh kind of not necessarilythe very earliest days of the
COVID pandemic, but getting kindof into months like three
through 12, um, thinking abouthow we needed to help our local
public health officials andlocal public health officials
make decisions that wereappropriate for their
communities, knowing that, forexample, rural Nebraska is going
(24:08):
to be really different fromdowntown Brooklyn, right?
In terms of population density,in terms of prevalence of COVID,
et cetera.
So how you localize umrecommendations and help support
public health, but also otherofficials and making decisions
appropriately.
And then finally, thinking a lotabout communication and whether
or not we in schools of publichealth are helping our students
(24:31):
and faculty to be trainedappropriately in contextualizing
their data in both the abilityto distinguish values versus
what overlay values have on topof our interpretation of data,
but also teaching and trainingus in how to communicate in ways
that are appropriate for thecommunities in which we are
(24:52):
communicating, if that makessense, right?
So, like that cold cut idea didmessengers.
What I have taken from COVIDinforms everything that I am
doing as dean, all of the waysthat I am working with my
faculty, staff, and students tothink about what the future of
our field looks like.
We've put in courses oncommunication.
We're developing more uhleadership coursework and more
(25:13):
um intensive partnerships withfolks who are in positions of
decision-making power indifferent sectors, whether
religion or education orcriminal justice, and thinking
about how we give people spaceto think about kind of those
rapid sequence decision-making,right?
When when you do have incompleteinformation, like we've seen
with hontavirus or Ebolarecently.
(25:33):
And then it, of course, itinforms my work on firearm
injury too, because it's in someways the same problem.
But I'll also, one final thing,Jeff, I'll say the opposite,
which is everything I learnedover the last 20 years by
working on firearm injury as ahealth problem, informs how I
personally try to respond toCOVID, but also how I am trying
to work as dean.
(25:54):
Because in the spaces and placeswhere I've succeeded in creating
partnership on this issue and inchanging awareness of what the
public health approach can do tofix the issue.
To me, those are examples,again, of hope that can then be
brought to other problems.
So I'm doing the opposite aswell, which is extrapolating
forward from this work.
SPEAKER_00 (26:15):
So, what would your advice be to someone like me
that's I take data, I want tocommunicate it effectively,
dispassionately, remove thebias, but also remove sort of
that political taint that comeswhenever you're looking at any
issue.
What's the best way tocommunicate this to a public
that generally doesn't believecrime data or crime statistics?
For they want to believe theirpriors and they never want to
(26:36):
believe anything is different.
SPEAKER_01 (26:38):
Right?
It's the, oh my God, crime ishorrible, it's getting worse.
And you're like, no, our datashows it's getting better.
So a couple of things.
One is I think you're alreadydoing a great service by having
the podcast, right?
You are slowly within yoursphere of influence, changing
the way that people think andtalk about the data, which is
step one, right?
You have your sphere ofinfluence.
And the second step, though,would be thinking about who you
(27:00):
can connect with who has adifferent sphere of influence
from you.
Who on the ground might you beable to partner with who may
have a different way of thinkingabout data or talking about it,
uh, who may have a differentexperience than you do and a
different way of making sense ofthe world.
So that becomes the second step.
And then the third one, and thisis the toughest part, but I
(27:23):
think people believe things whenthey feel them.
And so it's about maybe thiswon't be you, but again, it's
that partnership part isthinking about how do we help
people really kind of touch andfeel and appreciate what these
changes are.
And sometimes that's aroundvolunteer work, sometimes that's
around kind of storytelling andtheir community.
(27:43):
That to me is is the third andbiggest part, as I know we're
both parents, right?
If I tell my children something,the likelihood of them believing
me is like this, right?
It's it's through the actions.
SPEAKER_00 (27:55):
Immediately believe the opposite.
SPEAKER_01 (27:57):
Exactly.
So it's it's kind of likeparenting.
You've got to prove it right bywhat you do.
SPEAKER_00 (28:01):
I'll note that my COVID experience started with
potty training triplets,two-year-old triplets on the
first week of COVID, thinkingthat we only had two weeks until
they'd be back in school, andnow would be a good opportunity.
So different kind of trauma, butdid it work?
I just had to throw that inthere.
I'm not gonna say which, but itworked for two of them.
They're all potty trained now.
It's been six years, so I guesseventually it worked.
It added stress that I did notneed.
Sorry, I wasn't that swapping.
SPEAKER_01 (28:23):
I mean, my guy, you just answered that that's your
lesson for life.
Also, you're not gonna geteverybody, right?
SPEAKER_00 (28:28):
Right.
Two out of three is not bad.
Two out of three is good.
I'd be the Hall of Fame if I hit670 as a baseball.
You're right.
So uh getting back to my veryserious questions, if you were
advising sort of at the I wantto take all three of these, the
local level, the state level,and the federal level, of
concrete steps thatpolicymakers, a mayor, a
(28:49):
governor, the people in theWhite House should be taking.
What do you think are thosepolicies?
And I found that in just indoing the podcast that the
feedback that I get is usually,oh, that was really interesting
when somebody had these ideasfor how we can solve gun
violence or things like that.
So I'm really interested in theconcrete steps.
Do you have those things thatyou've worked through that you
might recommend?
SPEAKER_01 (29:09):
Yeah, it's a great question.
Okay, let me start with federaland then I'll do state and
local.
Um, so federal, I think it's thewhole of government approach.
And I actually will look at theWhite House Office for Gun
Violence Prevention.
Under the last administration,they did a great job of bringing
people together in a trulybipartisan way across the United
States, bringing together ATF,uh community, SAMHSA, right,
(29:33):
community mental health,department of education, in
addition to health services inways that, to me, deeply
informed those drops in firearmhomicide.
And so, were I to have thechance on a federal level, I
would encourage that whole ofgovernment approach.
I would of course, of course,also urge for continued strong
(29:53):
funding of NIH and CDC, inaddition to NIJ, to take a
nonpartisan, scientificallydriven approach to firearm
injury as a health problembecause we don't yet fully know
what works and it needs to bestudied well so that we can move
past emotion, which we all have,and into the realm of
reproducible data.
(30:15):
And we just have not had thetime as a field to do that.
So that'd be on a federal level.
On a state level, fundingoffices of gun violence
prevention that havewell-trained people leading it,
who understand both evidence andpolicy and who are committed to
working on both homicide,including again domestic
violence, homicide, massshootings, and suicide
(30:35):
prevention are core.
On a state level, those red flaglaws make a big difference.
Supporting law enforcementofficers to understand what red
flag laws are, as well as withindomestic violence, what domestic
violence restraining ordersconsist of.
And then funding, again, thoselocal programs becomes a key.
And then there are a number ofvery specific policies that we
(30:56):
know make a difference on astate-by-state level.
On a local level, this is thetoughest one, right?
Because an individual city orcounty is not going to be able
to control sale of firearms verywell.
They're not going to be able to,they're going to be able to do
some work around enforcement.
This is where on a local level,investment in some of those
structural things, things likeadult mentorship programs,
(31:18):
things like mental healthservices, things like making
sure that firearm owners knowhow to safely get a firearm out
of the house in a moment ofcrisis, things like bystander
intervention training so thatyou can recognize risk and then
know what to do about it,particularly important in
communities with high numbers offirearms.
Things like urban greening,right?
(31:40):
Those are all steps that we haveevidence behind that local
leaders can invest in.
And of course, communityviolence intervention programs
too.
They can those can all beinvested in with that caveat
that implementation iseverything.
So people will go, well, youknow, X program worked here, but
not there.
Understand those local leadersare the ones that are going to
understand their local context.
(32:00):
Which of that suite of policiesis most likely to be effective
and get political buy-in?
And which one is also most costeffective for their community?
I will say that feel free toreach out to us at Yale.
There are a number of other uhcenters across the United States
as well that are doing greatwork on local levels, happy to
think with people about whatmakes sense for them.
And again, especially on thatvery hyper-local level, thinking
(32:24):
beyond legislation aroundfirearms into all the other
things that we know drives thelikelihood of someone acquiring
a firearm or using it againstthemselves or against someone
else.
And those are modifiable riskfactors.
SPEAKER_00 (32:38):
Is there a data set when you think about these
policies at all these levels?
Is there a single data set thatshaking your head wildly no?
I'm gonna make you think aboutthis though.
If you could wave a magic wandand have one data set that was
fully available, it wascollected, it was, it was
something that you could doresearch on, what would that be?
You know, certainly if if youwant to say there's nothing and
that that's not answerable, I'llI'll take that as well.
SPEAKER_01 (32:59):
I mean, we can talk about kind of FBI data and all
the trouble with that, right?
I can talk about a vitalstatistics data and how delayed
it is and how problematic thatis.
I will say our our nationalviolent death reporting system
is a great step forward, butit's only deaths.
And our injury data on firearmsis totally unreliable, you know,
in an ideal world.
And I will say, okay, I'm gonnaput in a little plug for my
(33:21):
school.
We are working on trying tocreate some of this.
We have uh a website called PopHive Population, and then POP
like population, hive like abeehive, pophive.org, bringing
together multiple different datasources for different diseases
or health problems, bothchronic, infectious, and injury
related.
(33:41):
And we have firearm injury onthere.
We're pulling in CDC data, butwe're also pulling in Google
search data, working on bringingin local community surveys about
safety, bringing in emergencydepartment data, using data from
National Electronic MedicalRecords.
Um, it's still in a the firearminjury part is still in a beta
(34:02):
form, but that would be my dreamis that you have a place that
brings together injury, death,crime, but also some of those
psychological and safetymeasures and some of those
markers of, you know, iseveryone, are people searching
for firearm safe storage orfirearm suicide, right?
Those things as well.
That would be my ideal data set.
And in a great world, we wouldhave it able to be updated on a
(34:25):
monthly or quarterly basis sothat you can implement and then
do real-time evaluation ofinterventions.
One of the things that makes mesad as a researcher is when I
see a spending time and money,like really precious taxpayer
dollars or philanthropicdollars, on things that don't
work.
And so that rapid cycle ofevaluation matters a lot.
(34:46):
So that would be my idealscenario.
I know we are very, very farfrom it right now with lots and
lots of incomplete data sets.
To me, though, that's whereputting a bunch of data sets
together helps to fill in thegaps that, you know, one data,
you know, FBI data has one crimedata has one whole, emergency
department data has a differentwhole.
And when you triangulate, youcan see where they're similar
(35:07):
and where they're different.
SPEAKER_00 (35:08):
Yeah, absolutely.
Uh just pulled up pophive.org.
Very interesting.
I'll I'm excited to play withit.
And give me suggestions too, asyou as you I will for sure.
Well, you've got me thinking.
So we did a shooting dashboardtracker that goes out and it
scrapes daily shooting data from30 cities, some of which publish
data uh daily data like Phillyand Chicago that have their sort
(35:30):
of victim-level data.
Only a handful do that.
Others that get weekly data ordo aggregated daily data, and
then some do monthly data.
But that it's like an enormousundertaking to just get 30
agencies of data.
It's ridiculous how hard it is.
SPEAKER_01 (35:43):
Well, we'd be happy to bring that in and put it on
Pophive too, and kind of giveyou credit.
Like we're working with CarnegieMellon, with Delphi.
Like we're we've got a bunch ofpartners across the country.
SPEAKER_00 (35:52):
Absolutely.
We'd we would we would lovethat.
That would be awesome.
This this conversation will betaken offline at this point.
Uh so my last question, I I knowthat you're busy and I don't
want to take up too much time,but this is a very serious
question, which is what is thebest hospital/slash emergency
room television show?
I just finished watching themost recent season of St.
Dennis.
Um, I don't know if you've seenthat.
(36:13):
I love Scrubs.
I obviously like comedies.
Which of these is the best one?
And you can grade based onrealism or you can grade based
on entertainment value.
I'll leave that completely up toyou.
SPEAKER_01 (36:21):
So, based on realism, the pit, hands down.
It is, I mean, I know some ofthe folks that are writers and
consultants and they are reallive emergency physicians.
It is so real to the point thatI almost sometimes can't watch
it because it gives me some PTSDmyself.
That's why I love the feelthough.
For humor, gosh, I think nothingbeats Scrubs.
(36:41):
I love Scrubs.
Me too.
Read the reboot was was prettydecent.
It's entertaining.
What's your best crime show?
SPEAKER_00 (36:49):
I don't watch any of them.
Um, I I guess I re I reallyenjoyed we we run this city, the
Baltimore Gun Gun Trace TaskForce miniseries on HBO.
I really enjoyed that.
I thought that was entertainingand well done and was telling
the the true story truthfully.
If you've read the book.
If not, I'm gonna add it now tomy list.
It's it's a very it's a goodshow and it's a good read, and
(37:11):
they're very similar and it'sit's cool.
My my actual last question, I'mreally interested to see your
response to this is is there arole?
I'm sure there is, for AI inimproving your work and how you
approach it?
SPEAKER_01 (37:21):
Uh, I mean, yes.
We are already with Pop Hive,we're already using AI to help
us ingest and normalize ourdata.
Um, it's been a huge help, savesso much time.
I think uh there's someinteresting work to do around
kind of the data analysis thatfeels the most straightforwards.
There may be work to do, andwe're doing some thinking about
this with some of the AIchatbots, thinking about how you
(37:44):
create definitions of risk andlinkages to help.
And knowing that a lot of folks,I've done work with social media
in the past, um, and a lot offolks are turning to social
media or now increasinglychatbots, both as sources of
help, but also potentially asinstigators of harm.
And so I think there's a reallyimportant body of work to do
(38:04):
around that.
And then the rest is still kindof right, I feel like there's a
lot of AI propaganda and hypeand trying to sort through
what's real versus what isn't.
I'll tell you, we've been tryingto use chatbots to make sense of
some data in real, like toprovide real-time
interpretations, and we've notfound that to be particularly
useful yet.
But there's a lot more to come.
And I think it's gonna beknowing how to use AI well and
(38:26):
ethically and responsibly isgonna be a core skill set for
all of our students goingforwards.
Um, hopefully not in a way thatremoves the human side of what
we do.
SPEAKER_00 (38:37):
Absolutely.
Great.
Dr.
Any, this was wonderful.
It loved this conversation,really appreciate it.
And uh thank you for coming onthe show.
SPEAKER_01 (38:44):
Thank you.
Thank you again for doing theshow.
Fills a much needed hole uh inour civil discourse.
SPEAKER_00 (38:50):
Thanks for listening to the Jeffalytics Podcast.
Be sure to subscribe and tolearn more, head on over to
ahdatalytics.com for moreinformation and previous
episodes.
If you like what you heard,please leave a glowing review,
which will help others todiscover the show.
Until next time, I'm Jeff Asher.
I'm Jeff Asher, and this is the Jeffalytics Podcast.
(00:03):
We should treat gun violencelike a public health problem, is
a phrase that is often used butrarely defined.
My guest today is Dr.
Megan Ranny, an emergencyphysician, injury prevention
researcher, and the dean of theYale School of Public Health.
She sees firearm injury as partof a much broader public health
issue, one that affects not justthe person who was shot, but
families, communities,healthcare providers, and the
(00:25):
systems that are supposed torespond afterwards.
In this episode, we talk aboutwhat a public health approach to
firearm injury actually means,why that framework is often
misunderstood, and how publichealth researchers think about
prevention differently from theway these conversations usually
happen in politics or the media.
We also get into firearmsuicide, the challenge of
building better data systems,and what public health learned
(00:47):
from both COVID and the recentdecline in violent crime
nationally.
This conversation is about whatchanges when you stop treating
violence as a moment of crisisand start treating it as a
long-term problem that can bestudied, understood, and
systemically eliminated.
Let's dive in.
My guest today is Dr.
Megan Ranny.
Dr.
Ranny, thank you so much forjoining the program.
SPEAKER_01 (01:07):
Thanks.
It's an honor to be here.
I've been listening toDeathalytics for a bit.
So it's a real privilege to getto be a guest on this show.
Well, great.
SPEAKER_00 (01:15):
That's great to hear.
It's a good show.
We all like our listeners.
So first question, same to everyguest.
If you've listened before,you've heard it.
But what is your background?
What brings you here today?
SPEAKER_01 (01:25):
So I am by background an emergency
physician, have practicedclinically for over 20 years, as
well as an injury preventionresearcher.
I've spent my career working onviolence and particularly gun
violence as a health problem.
SPEAKER_00 (01:41):
And what brought you to this work?
What motivates you to do all ofthis?
SPEAKER_01 (01:45):
Oh, I've worked on violence as a problem that can
be fixed since long before Iwent into emergency medicine.
I actually was a Peace Corpsvolunteer after college, working
in West Africa, wheregender-based violence was a
major issue and was a majorfactor in transmission of HIV.
Continued that interest and thatwork when I returned to the US
(02:06):
and went to med school and theninto emergency medicine, but
really started working on gunviolence as a health problem
based off of my experiencesworking in an urban emergency
department for my entire career.
Back in the early to late 2000s,that was when we were starting
to see firearm homicide ratesincrease in the United States.
(02:27):
I was taking care of folks whowere coming in, uh, having been
shot through community violenceon an almost daily basis,
started questioning why weweren't doing anything for them.
And then the event that reallychanged my trajectory, Jeff, was
actually taking care of afirearm suicide.
As I'm sure we'll talk about,firearms suicides make up, on
average, two-thirds of gundeaths in the United States.
(02:49):
But it wasn't until the late2000s that I took care of a
firearm suicide in the emergencydepartment.
That case changed my conceptionof what firearm injury looks
like in the United States.
It led me to asking why we don'ttalk about firearm suicide and
firearm homicide as preventablein the same way that we talk
about suicide in general, or inthe same way that we talk about
(03:11):
any other health problem thatcomes through my doors in the
emergency department.
And then it led me down thispath of pushing to make sure
that folks across the UnitedStates thought of firearm injury
as something that is bothpreventable and that can be
addressed by using a health orpublic health approach in the
same way that we have addresseddozens, if not hundreds, of
(03:32):
other problems over the courseof our country's history quite
successfully.
And so that has really thenbecome the career journey for me
is making sure that we haveawareness, but also trying to
develop rigorous science andscalable tools that can be used
in every community across thiscountry to reduce this truly
daily scourge of firearm injuryand death in the United States.
SPEAKER_00 (03:54):
And so, sort of big picture right now, what is your
role with Yale?
What are you guys hoping toaccomplish?
And what do you do specificallywithin that sort of ecosystem?
SPEAKER_01 (04:02):
Yeah, so so a little more about myself.
So, yes, I'm an emergencyphysician and injury prevention
researcher.
I am also now privileged to beuh the dean of the Yale School
of Public Health.
I came here to Yale just aboutthree years ago now to launch
our school into independence andto chart um the future of public
health for our country andthinking now on a global scale
(04:24):
as well.
Within the Yale School of PublicHealth, um, we have a firearm
injury prevention initiativethat we've been building over
the last few years.
It includes folks from a varietyof different disciplines, not
just my own, of injuryprevention, but we have
epidemiologists, economists,psychologists, and community
members.
(04:44):
Quite importantly, we have acommunity scholar who is herself
a survivor of firearm injury andbrings that voice, that lived
experience into the work that wedo.
Our aim is to drive high-qualityresearch using the public health
approach, which I'm happy totalk about, things that can help
both illuminate the problem, butalso again, drive us towards
solutions, to grow educationaround firearm injury as a
(05:08):
health problem, something thatagain had been abandoned for a
long time.
Um, I know from listening toyour podcast around all the
different disciplines out thereuh that are working on this
topic.
But in general, the Americanpublic and even many of the
people who have responsibilityfor policies or for social
interventions, right?
They don't understand how toconceptualize and think about
(05:29):
firearm injury.
So education on a policymakerlevel, but also on a community
level.
And then finally, thinking abouthow we do scale what works,
because I am a deep believerthat research only matters if it
is used.
Uh, I don't want the work thatwe do to sit in the pages of our
journals or within the walls ofan academic institution.
That's part of the reason wehave a community scholar, but
(05:52):
it's also part of my coremission across the school.
So within our firearm injuryprevention program, we're really
pursuing all three of thosegoals along the full spectrum of
firearm injury.
So homicide, including domesticviolence, suicide, as well as
unintentional injury and massshootings.
SPEAKER_00 (06:08):
So you you stole my next question, but what when we
talk about gun violence as apublic health issue, it's a
talking point.
We hear it all the time fromobviously from researchers like
like yourself, down to councilmembers and mayors and police
chiefs, but we don't reallydefine it, I feel like, very
well.
So, what is it with in your mindwhen we say gun violence, we
should treat it as a publichealth issue, what does that
(06:29):
mean?
SPEAKER_01 (06:30):
So that means two things.
And I'm gonna talk through eachof them in turn.
The first is thinking about thehealth problems associated with
gun violence.
And the second part is themethods that we used to define
and fix it.
So let me talk about the firstpart first.
Why is gun violence a health orpublic health issue?
Well, obviously, when a bullethits a body, when you end up in
my emergency department becauseyou've been shot, right?
(06:52):
That is an obvious physicalhealth problem and something
that I am well trained to helpreduce the bleeding, save your
life, reduce the after effectsof that bullet hitting your
body.
But there are other healthproblems associated with firearm
injury as well.
When a trigger is pulled, evenif you are not hit by the
bullet, there are emotionaleffects, right?
(07:14):
We know that there'spost-traumatic stress, anxiety,
substance use disorder amongstpeople who are present at a
shooting, also amongst familymembers or friends of someone
who is shot or present at ashooting.
So there are those psychologicalhealth effects.
There are also community-widehealth effects.
We know that after a shooting,people, whether it's a suicide,
(07:35):
a homicide, a mass shooting, weknow that people in a community
are more likely to have lots ofdifferent both physical and
emotional after effects, rangingfrom increased rates of
headaches to increased substanceuse disorder.
Um, and of course a decreasedsense of safety, which then
leads to all kinds of otherhealth problems like obesity and
(07:56):
loneliness and things like that.
So the first part of talkingabout firearm injury as a health
problem is thinking about thefull spectrum of health effects
that firearm injury causes.
And we want to measure anddocument those.
Those also give us things towork on, to try to intervene on
that go beyond just trying tostop a crime.
(08:16):
Okay.
So then the second part ofcalling firearm injury a health
or public health problem is thatit gives us some very
structured, well-defined,evidence-based methods to figure
out what the heck we do aboutthis problem.
I feel like here in the US, weare too often caught in either
numbness or hopelessness, right?
We hear that kind of the oneside is like ban all guns, the
(08:38):
other side is give everyone agun.
And the public health approachprovides us some nuance, some
direction, and honestly somehope within that.
So public health approach isfour steps.
First, you measure how common aproblem is.
This, of course, is shared withcriminal justice or econ as
well, right?
Saying what is the incidence andthe prevalence.
Second, we look at risk andprotective factors.
(08:58):
So all other things being equal,what increases the chance of
someone shooting someone else orthemselves, what increases the
chance of them experiencinginjury, either physical or
mental, right?
What helps to protect them, allother things being equal?
Once you've done those first twosteps, then you can go into the
third one of designing andevaluating interventions.
(09:19):
And within the public healthapproach, one of the things that
I think is gorgeous about it isthat that step of interventions
is informed by trying to reducerisks or improve protective
factors, but it can occur acrossa huge suite of different
potential strategies.
Everything from policy orpartnership with law enforcement
to educational interventions oreconomic incentives or changing
(09:43):
of the built environment.
Those are strategies that we'veused successfully to, for
example, reduce car crashdeaths, to reduce
tobacco-related deaths, tochange nutritional outcomes.
And we use that full suite ofstrategies in that third step of
the public health approach aswell.
So measure it, determine whatthe risk and protective factors
(10:04):
are, develop and evaluateinterventions.
And then the fourth step, ofcourse, is scaling or
disseminating what works.
And then it goes right backaround to measurement again.
The other part about the publichealth four-step approach that I
think is rather unique to publichealth is that we always do it
with community at the center.
Each of those steps, in a bestpossible practice, should be
(10:24):
informed by the lived experienceof folks who are living in a
community.
And so you can imagine that theway that we apply this public
health approach in a ruralcommunity that is primarily
affected by firearm suicide andwhere 60 to 80% of folks have a
firearm in the house may bedifferent from how we apply the
approach in, say, an urbancommunity where the vast
(10:48):
majority of firearm injuries arecommunity violence and where a
much smaller proportion ofhouseholds have firearms in the
house.
And so that kind ofcommunity-lived experience,
awareness of what resources arepresent is core to each of those
four steps across public health.
SPEAKER_00 (11:05):
And how important is trust from the community and
trust in the research tosuccessfully implementing this?
SPEAKER_01 (11:13):
Well, if I put on my dean hat rather than talking to
you about firearm injury, Iwould say that I actually think
trust is our number one publichealth issue right now, not just
in the United States, but acrossthe globe.
If you do not trust the peoplethat are doing the research or
the folks from whominterventions are being
proposed, none of the workthat's being done matters.
(11:33):
We're seeing that right now withvaccines.
Gosh, look at the debate abouthontavirus right now.
We're seeing it in uhinterventions for nutrition and
fluoride, and certainly it'spresent in firearm injury work
as well.
It's why I and my own work havemade a really concerted effort
over the entire course of mycareer to work deeply with
(11:55):
communities to make sure thatthe questions that I am asking
are informed by their prioritiesand that we are co-creating the
answers to help build that trustfrom the get-go.
And that trust has to be presentregardless of which community
I'm working in, regardless ofwhether folks are firearm owners
or not, regardless of whethersomeone themselves has been
(12:17):
affected by firearm injury,which of course we know most
American adults have been, orwhether they're someone who is
just trying to avoid firearminjury for their family members
and loved ones.
But that trust in how we do thework and in believing in the
importance of scaling andintervention, without that, the
rest of it is kind of pointless.
SPEAKER_00 (12:37):
And sort of how do we measure that work?
I know you've been involvedwith, or at least have spoken
about, the Edelman trustbarometer.
I wanted to bring that up andthings like that.
How do we measure this as aquantifiable concept of it needs
to be improved?
Here's how we can measure it andknow whether or not we're
succeeding in rebuilding andbuilding better trust.
SPEAKER_01 (12:56):
Yeah, so you can you can measure trust as a
mechanism, right?
So you can say, is it presentand is that a mediator or
moderator of outcomes?
You can also measure trust as anoutcome.
It's usually measured throughsurveys right now, although some
folks are working on alternativemetrics.
The other thing that I'llsuggest though is that you can
measure trust through uptake ofinformation.
(13:17):
So for example, if we're talkingabout vaccines, we can measure a
vaccine delivery as a proxy forwhether or not folks trust
recommendations around vaccines.
Ditto for firearm injury work.
I can measure trust.
And we've actually worked onthis in one of my projects where
we've been working with 4-H inuh 20 plus states, both red and
(13:40):
blue, rural and suburbancommunities across the United
States.
We're measuring trust byqualitative data, but also by
rates of interest in theintervention, by completion of
the intervention.
If people don't trust us,they're not even going to be
willing to have the conversationabout whether or not to
participate in research, andthey're certainly not going to
(14:00):
finish the study.
SPEAKER_00 (14:02):
So you raised this question and then we didn't
answer it.
Why do we treat firearminjuries, especially like
firearm suicide, so differentlyfrom everything else in this
country?
SPEAKER_01 (14:10):
I think it's a few different reasons.
And I'm, of course, Jeff,curious in your perspective as
well, having led this podcastfor a bit.
I think, you know, one ishonestly that we've had 24 years
of not funding firearm injury asa health problem in any
sustained way.
From the Dickey Amendment upthrough 2020, when I and others
succeeded in getting firearminjury funding reappropriated
(14:34):
under the first Trumpadministration, 25 million to
CDC, 25 million to NIH.
Between 1996 and 2020, there hadbeen no formal appropriations
for this issue.
So there was no body ofresearchers who were trained in
how to think about applying thisfour-step approach, nor were
there people out there talkingabout why it was a health
(14:56):
problem.
So I think that's the first andbiggest thing.
The second one is I think it'skind of our American identity.
We like to think of things askind of black and white.
And this is a much more nuancedapproach to how we fix firearm
injury than the kind ofpolitical extremes to which we
we like to hue.
And then the third part isbecause no one was talking about
(15:18):
it and because it's not extreme,I think many people, when they
think about firearm injury, theythink exclusively about either
community violence or they thinkabout mass shootings.
And they don't talk about kindof that full spectrum of firearm
injury, which of course is allinterrelated, right?
You can't talk about homicidewith without including domestic
violence.
You can't talk about massshootings if you don't also talk
(15:40):
about firearm suicide.
You can't talk about a sense ofsafety in a community if you
don't talk about whether or notfirearms are moving around
illicitly, or whether or notkids are able to get them from
their parents without otherparents knowing, right?
These are, they're eachintertwined.
And be but as a because wedidn't have those first two
steps, people weren't talkingabout that full spectrum of
(16:01):
firearm injury.
And so I think that's part ofthe problem too.
SPEAKER_00 (16:04):
Yeah.
I see it often as we've createdthis system, especially at the
local level, but also at thestatewide and the the national
level, where the solutions thatwe think of are always law
enforcement.
And if the things are going up,we need more law enforcement or
more jails or whatever.
And if things are going down,it's because we did all the law
enforcement and all the jails,and we don't consider the
(16:24):
complexity of the issue and thepossibility that there is
enormous role for lawenforcement, but not the sole
role inherently in the systemand the way that we can bring
things down.
That's how I sort ofcontextualize it.
SPEAKER_01 (16:35):
I totally agree with that.
And I think even within workingwith law enforcement, and I've
done a fair amount of that,right?
There is these public healthkits.
So, first of all, thinking aboutthe likelihood of law
enforcement themselves beingshot, thinking about whether or
not law enforcement believes inand is willing to enforce a
given policy, and then thinkingabout those larger cultural
norms that determine whether ornot a law that is passed is ever
(16:59):
used or paid attention to.
And I think one of the worstthings that we can do from a
criminal justice and legalperspective is pass laws that
we're not following.
I also find that people thinkabout policy or or laws or law
enforcement as these magicalthings that somehow are gonna
fix every problem.
And the reality is uh in the US,that's not how it works.
(17:21):
I don't think it works that wayanywhere, but I know our US
setting better than most.
SPEAKER_00 (17:25):
Yeah, absolutely.
So when you think about thisissue, and we've seen an
enormous drop in gun violence,especially from a sort of a
criminal homicide, yeah.
Homicides and sort of nonfatalshootings, not necessarily as
much in the uh firearmssuicides, but looking just at
the homicide and the nonfatalshootings, what do you think is
(17:46):
driving that down?
And do you think that thesechanges are sustainable, or are
we inevitably gonna bottom outand possibly start to see an
increase?
SPEAKER_01 (17:53):
So I'm gonna answer that question with the caveat
that there are lots of smartpeople looking at that right
now, and we don't havedefinitive answers yet, right?
So these are my best ideas thatthat could be disproven.
I think it's two things.
One is is kind of the regressionto the mean.
We had that huge spike inhomicide during COVID, largely
due to loss of those socialstructures that help to keep
(18:14):
people safe and kind of generaldisorder and fear in society.
And so I think part of it isjust what kind of going up and
then coming back down as societymore or less writes itself.
I also think that there much ofthat decrease is thanks to a
number of interventions thatwere put in place over the past
few years that helped drive thatkind of regression back to our
(18:36):
mean.
Things like the incredibleinvestment in community violence
intervention programming, ofwhich there's a few different
types, but which have been shownto be quite successful in some
communities, Chicago being oneof the ones that's best studied,
but Baltimore, Sacramento aswell.
So, so community violenceintervention programs, increased
investment in mental healthservices, rollout of extreme
(19:00):
risk protection orders, andincreased willingness to use
them.
I think those all have played apart as well.
The question to me as to whetherwe sustain it is are we willing
to keep doing the work?
Um, and I'll say it's the samequestion for me for firearm
homicide as I'm having right nowaround opioid overdose deaths,
which we also saw spike duringthe pandemic, probably for many
(19:21):
of the same reasons as we sawfirearm homicide increase.
We've seen a dramatic drop inopioid overdose deaths over the
past couple of years.
Preliminary data has just beenreleased showing that it's
decreased again.
Uh, but but that's both, youknow, we've again put some
social structures back in placeto help support people who are
at highest risk of shootingsomeone else or of over using
(19:45):
opioids.
We've also put structures inplace with opioids with like
naloxone and suboxone.
Are we going to keep investingin those?
For firearm homicide, are wegonna keep investing in those
community violence interventionprograms, in those adult
mentorship programs, in themental health programs, and in
the policies that havesurrounded some of that work?
That to me is an open questionand where I am so enthusiastic
(20:08):
about this podcast, hopefullydriving us to keep implementing
the programming that is showingpromise in good trials, you
know, against CBT interventions,community violence uh programs,
um, hotspotting, et cetera.
SPEAKER_00 (20:21):
I can't claim that the podcast can move, you know,
tens of millions of dollars ofresearch.
I would love to have that, butcertainly I agree that the more
that we talk about it and justsort of communicate it clearly
that these are the steps that wethink are driving it, and these
are the things that we need tobe thinking about and investing
in, absolutely is critical.
Why haven't we seen the samething with firearm suicides?
SPEAKER_01 (20:42):
Great question.
There's a few part things there.
One is is that unfortunately oneof the strongest correlates of
rates of firearm suicide ispresence of a firearm.
And we know that there are morefirearms in private hands now
than there were two years ago orfive years ago and ten years
ago.
So from a sheer numbersperspective, the number of folks
(21:03):
that have intent to hurtthemselves and have access to a
firearm is higher than it was.
We have good data from othercountries, for example, from
Israel, showing that when youseparate people from a firearm,
so like they did studies withthe Israeli Defense Force,
showing that when you forcedsoldiers to keep their um
weapons on base over theweekends, they saw firearms
(21:24):
suicide rates drop.
Um, and and so there's just thatsheer access to a firearm and a
moment of hopelessness is such ahuge driver.
And we've not addressed that inany substantive way.
The other side is that we'rehaving a growing number of
people who are suffering mentalhealth problems in the US.
I think this is deeply tied toboth if we go back to that trust
(21:44):
conversation, right?
Loneliness, isolation, lack offolks to check in, increased
economic hopelessness anddespair.
Um, those all play into driversof suicide as well.
I know there are a lot of folkswho are doing a lot of great
work on this problem,particularly.
With some communities that havevery high rates of firearm
ownership, such as military orveterans, and are showing some
(22:07):
promise in those discretecommunities, but there's a lot
more to be done.
SPEAKER_00 (22:12):
So moving to a similarly depressing but
differently depressing topic, Ijust want to talk about sort of
the COVID experience.
Obviously, COVID was traumaticfor a lot of people for a lot of
reasons, and especially so inyour field.
To what degree have you sort ofinternalized the lessons from
that?
And I was just curious, what arethe biggest takeaways that you
sort of apply to your work todayfrom what you experienced then?
SPEAKER_01 (22:34):
How long of a podcast is this?
SPEAKER_00 (22:37):
We got what, 15, 20 minutes?
SPEAKER_01 (22:39):
Fair enough.
Uh oh my God.
I mean, yes, I think COVID wastraumatic in a thousand ways for
all of us.
And I don't think that oursociety has processed that at
all.
Whether it was the trauma forthose of us working as frontline
healthcare workers who didn'thave adequate personal
protective equipment, whether itwas the trauma for those of us
who had little kids who werestuck at home, and whether it
(23:01):
was having loved ones who wereisolated or who died, who we
couldn't say goodbye to.
And of course, the politicaltrauma, the can the continued
and perhaps even worseningdivision that was hastened by
the COVID pandemic.
I think that's its own kind oftrauma.
I think for me, some of mylessons from the COVID pandemic
(23:23):
are first being really clear, asI just was with you, about what
is my best guess at the momentbased off of the data that I
have and the fact that thatmight be disproven in the
future.
Um as well as thinking a lotabout how the work that we do,
right?
When I talked about thatfour-step public health approach
and community being at thecenter, I think when I go back
(23:47):
to uh kind of not necessarilythe very earliest days of the
COVID pandemic, but getting kindof into months like three
through 12, um, thinking abouthow we needed to help our local
public health officials andlocal public health officials
make decisions that wereappropriate for their
communities, knowing that, forexample, rural Nebraska is going
(24:08):
to be really different fromdowntown Brooklyn, right?
In terms of population density,in terms of prevalence of COVID,
et cetera.
So how you localize umrecommendations and help support
public health, but also otherofficials and making decisions
appropriately.
And then finally, thinking a lotabout communication and whether
or not we in schools of publichealth are helping our students
(24:31):
and faculty to be trainedappropriately in contextualizing
their data in both the abilityto distinguish values versus
what overlay values have on topof our interpretation of data,
but also teaching and trainingus in how to communicate in ways
that are appropriate for thecommunities in which we are
(24:52):
communicating, if that makessense, right?
So, like that cold cut idea didmessengers.
What I have taken from COVIDinforms everything that I am
doing as dean, all of the waysthat I am working with my
faculty, staff, and students tothink about what the future of
our field looks like.
We've put in courses oncommunication.
We're developing more uhleadership coursework and more
(25:13):
um intensive partnerships withfolks who are in positions of
decision-making power indifferent sectors, whether
religion or education orcriminal justice, and thinking
about how we give people spaceto think about kind of those
rapid sequence decision-making,right?
When when you do have incompleteinformation, like we've seen
with hontavirus or Ebolarecently.
(25:33):
And then it, of course, itinforms my work on firearm
injury too, because it's in someways the same problem.
But I'll also, one final thing,Jeff, I'll say the opposite,
which is everything I learnedover the last 20 years by
working on firearm injury as ahealth problem, informs how I
personally try to respond toCOVID, but also how I am trying
to work as dean.
(25:54):
Because in the spaces and placeswhere I've succeeded in creating
partnership on this issue and inchanging awareness of what the
public health approach can do tofix the issue.
To me, those are examples,again, of hope that can then be
brought to other problems.
So I'm doing the opposite aswell, which is extrapolating
forward from this work.
SPEAKER_00 (26:15):
So, what would your advice be to someone like me
that's I take data, I want tocommunicate it effectively,
dispassionately, remove thebias, but also remove sort of
that political taint that comeswhenever you're looking at any
issue.
What's the best way tocommunicate this to a public
that generally doesn't believecrime data or crime statistics?
For they want to believe theirpriors and they never want to
(26:36):
believe anything is different.
SPEAKER_01 (26:38):
Right?
It's the, oh my God, crime ishorrible, it's getting worse.
And you're like, no, our datashows it's getting better.
So a couple of things.
One is I think you're alreadydoing a great service by having
the podcast, right?
You are slowly within yoursphere of influence, changing
the way that people think andtalk about the data, which is
step one, right?
You have your sphere ofinfluence.
And the second step, though,would be thinking about who you
(27:00):
can connect with who has adifferent sphere of influence
from you.
Who on the ground might you beable to partner with who may
have a different way of thinkingabout data or talking about it,
uh, who may have a differentexperience than you do and a
different way of making sense ofthe world.
So that becomes the second step.
And then the third one, and thisis the toughest part, but I
(27:23):
think people believe things whenthey feel them.
And so it's about maybe thiswon't be you, but again, it's
that partnership part isthinking about how do we help
people really kind of touch andfeel and appreciate what these
changes are.
And sometimes that's aroundvolunteer work, sometimes that's
around kind of storytelling andtheir community.
(27:43):
That to me is is the third andbiggest part, as I know we're
both parents, right?
If I tell my children something,the likelihood of them believing
me is like this, right?
It's it's through the actions.
SPEAKER_00 (27:55):
Immediately believe the opposite.
SPEAKER_01 (27:57):
Exactly.
So it's it's kind of likeparenting.
You've got to prove it right bywhat you do.
SPEAKER_00 (28:01):
I'll note that my COVID experience started with
potty training triplets,two-year-old triplets on the
first week of COVID, thinkingthat we only had two weeks until
they'd be back in school, andnow would be a good opportunity.
So different kind of trauma, butdid it work?
I just had to throw that inthere.
I'm not gonna say which, but itworked for two of them.
They're all potty trained now.
It's been six years, so I guesseventually it worked.
It added stress that I did notneed.
Sorry, I wasn't that swapping.
SPEAKER_01 (28:23):
I mean, my guy, you just answered that that's your
lesson for life.
Also, you're not gonna geteverybody, right?
SPEAKER_00 (28:28):
Right.
Two out of three is not bad.
Two out of three is good.
I'd be the Hall of Fame if I hit670 as a baseball.
You're right.
So uh getting back to my veryserious questions, if you were
advising sort of at the I wantto take all three of these, the
local level, the state level,and the federal level, of
concrete steps thatpolicymakers, a mayor, a
(28:49):
governor, the people in theWhite House should be taking.
What do you think are thosepolicies?
And I found that in just indoing the podcast that the
feedback that I get is usually,oh, that was really interesting
when somebody had these ideasfor how we can solve gun
violence or things like that.
So I'm really interested in theconcrete steps.
Do you have those things thatyou've worked through that you
might recommend?
SPEAKER_01 (29:09):
Yeah, it's a great question.
Okay, let me start with federaland then I'll do state and
local.
Um, so federal, I think it's thewhole of government approach.
And I actually will look at theWhite House Office for Gun
Violence Prevention.
Under the last administration,they did a great job of bringing
people together in a trulybipartisan way across the United
States, bringing together ATF,uh community, SAMHSA, right,
(29:33):
community mental health,department of education, in
addition to health services inways that, to me, deeply
informed those drops in firearmhomicide.
And so, were I to have thechance on a federal level, I
would encourage that whole ofgovernment approach.
I would of course, of course,also urge for continued strong
(29:53):
funding of NIH and CDC, inaddition to NIJ, to take a
nonpartisan, scientificallydriven approach to firearm
injury as a health problembecause we don't yet fully know
what works and it needs to bestudied well so that we can move
past emotion, which we all have,and into the realm of
reproducible data.
(30:15):
And we just have not had thetime as a field to do that.
So that'd be on a federal level.
On a state level, fundingoffices of gun violence
prevention that havewell-trained people leading it,
who understand both evidence andpolicy and who are committed to
working on both homicide,including again domestic
violence, homicide, massshootings, and suicide
(30:35):
prevention are core.
On a state level, those red flaglaws make a big difference.
Supporting law enforcementofficers to understand what red
flag laws are, as well as withindomestic violence, what domestic
violence restraining ordersconsist of.
And then funding, again, thoselocal programs becomes a key.
And then there are a number ofvery specific policies that we
(30:56):
know make a difference on astate-by-state level.
On a local level, this is thetoughest one, right?
Because an individual city orcounty is not going to be able
to control sale of firearms verywell.
They're not going to be able to,they're going to be able to do
some work around enforcement.
This is where on a local level,investment in some of those
structural things, things likeadult mentorship programs,
(31:18):
things like mental healthservices, things like making
sure that firearm owners knowhow to safely get a firearm out
of the house in a moment ofcrisis, things like bystander
intervention training so thatyou can recognize risk and then
know what to do about it,particularly important in
communities with high numbers offirearms.
Things like urban greening,right?
(31:40):
Those are all steps that we haveevidence behind that local
leaders can invest in.
And of course, communityviolence intervention programs
too.
They can those can all beinvested in with that caveat
that implementation iseverything.
So people will go, well, youknow, X program worked here, but
not there.
Understand those local leadersare the ones that are going to
understand their local context.
(32:00):
Which of that suite of policiesis most likely to be effective
and get political buy-in?
And which one is also most costeffective for their community?
I will say that feel free toreach out to us at Yale.
There are a number of other uhcenters across the United States
as well that are doing greatwork on local levels, happy to
think with people about whatmakes sense for them.
And again, especially on thatvery hyper-local level, thinking
(32:24):
beyond legislation aroundfirearms into all the other
things that we know drives thelikelihood of someone acquiring
a firearm or using it againstthemselves or against someone
else.
And those are modifiable riskfactors.
SPEAKER_00 (32:38):
Is there a data set when you think about these
policies at all these levels?
Is there a single data set thatshaking your head wildly no?
I'm gonna make you think aboutthis though.
If you could wave a magic wandand have one data set that was
fully available, it wascollected, it was, it was
something that you could doresearch on, what would that be?
You know, certainly if if youwant to say there's nothing and
that that's not answerable, I'llI'll take that as well.
SPEAKER_01 (32:59):
I mean, we can talk about kind of FBI data and all
the trouble with that, right?
I can talk about a vitalstatistics data and how delayed
it is and how problematic thatis.
I will say our our nationalviolent death reporting system
is a great step forward, butit's only deaths.
And our injury data on firearmsis totally unreliable, you know,
in an ideal world.
And I will say, okay, I'm gonnaput in a little plug for my
(33:21):
school.
We are working on trying tocreate some of this.
We have uh a website called PopHive Population, and then POP
like population, hive like abeehive, pophive.org, bringing
together multiple different datasources for different diseases
or health problems, bothchronic, infectious, and injury
related.
(33:41):
And we have firearm injury onthere.
We're pulling in CDC data, butwe're also pulling in Google
search data, working on bringingin local community surveys about
safety, bringing in emergencydepartment data, using data from
National Electronic MedicalRecords.
Um, it's still in a the firearminjury part is still in a beta
(34:02):
form, but that would be my dreamis that you have a place that
brings together injury, death,crime, but also some of those
psychological and safetymeasures and some of those
markers of, you know, iseveryone, are people searching
for firearm safe storage orfirearm suicide, right?
Those things as well.
That would be my ideal data set.
And in a great world, we wouldhave it able to be updated on a
(34:25):
monthly or quarterly basis sothat you can implement and then
do real-time evaluation ofinterventions.
One of the things that makes mesad as a researcher is when I
see a spending time and money,like really precious taxpayer
dollars or philanthropicdollars, on things that don't
work.
And so that rapid cycle ofevaluation matters a lot.
(34:46):
So that would be my idealscenario.
I know we are very, very farfrom it right now with lots and
lots of incomplete data sets.
To me, though, that's whereputting a bunch of data sets
together helps to fill in thegaps that, you know, one data,
you know, FBI data has one crimedata has one whole, emergency
department data has a differentwhole.
And when you triangulate, youcan see where they're similar
(35:07):
and where they're different.
SPEAKER_00 (35:08):
Yeah, absolutely.
Uh just pulled up pophive.org.
Very interesting.
I'll I'm excited to play withit.
And give me suggestions too, asyou as you I will for sure.
Well, you've got me thinking.
So we did a shooting dashboardtracker that goes out and it
scrapes daily shooting data from30 cities, some of which publish
data uh daily data like Phillyand Chicago that have their sort
(35:30):
of victim-level data.
Only a handful do that.
Others that get weekly data ordo aggregated daily data, and
then some do monthly data.
But that it's like an enormousundertaking to just get 30
agencies of data.
It's ridiculous how hard it is.
SPEAKER_01 (35:43):
Well, we'd be happy to bring that in and put it on
Pophive too, and kind of giveyou credit.
Like we're working with CarnegieMellon, with Delphi.
Like we're we've got a bunch ofpartners across the country.
SPEAKER_00 (35:52):
Absolutely.
We'd we would we would lovethat.
That would be awesome.
This this conversation will betaken offline at this point.
Uh so my last question, I I knowthat you're busy and I don't
want to take up too much time,but this is a very serious
question, which is what is thebest hospital/slash emergency
room television show?
I just finished watching themost recent season of St.
Dennis.
Um, I don't know if you've seenthat.
(36:13):
I love Scrubs.
I obviously like comedies.
Which of these is the best one?
And you can grade based onrealism or you can grade based
on entertainment value.
I'll leave that completely up toyou.
SPEAKER_01 (36:21):
So, based on realism, the pit, hands down.
It is, I mean, I know some ofthe folks that are writers and
consultants and they are reallive emergency physicians.
It is so real to the point thatI almost sometimes can't watch
it because it gives me some PTSDmyself.
That's why I love the feelthough.
For humor, gosh, I think nothingbeats Scrubs.
(36:41):
I love Scrubs.
Me too.
Read the reboot was was prettydecent.
It's entertaining.
What's your best crime show?
SPEAKER_00 (36:49):
I don't watch any of them.
Um, I I guess I re I reallyenjoyed we we run this city, the
Baltimore Gun Gun Trace TaskForce miniseries on HBO.
I really enjoyed that.
I thought that was entertainingand well done and was telling
the the true story truthfully.
If you've read the book.
If not, I'm gonna add it now tomy list.
It's it's a very it's a goodshow and it's a good read, and
(37:11):
they're very similar and it'sit's cool.
My my actual last question, I'mreally interested to see your
response to this is is there arole?
I'm sure there is, for AI inimproving your work and how you
approach it?
SPEAKER_01 (37:21):
Uh, I mean, yes.
We are already with Pop Hive,we're already using AI to help
us ingest and normalize ourdata.
Um, it's been a huge help, savesso much time.
I think uh there's someinteresting work to do around
kind of the data analysis thatfeels the most straightforwards.
There may be work to do, andwe're doing some thinking about
this with some of the AIchatbots, thinking about how you
(37:44):
create definitions of risk andlinkages to help.
And knowing that a lot of folks,I've done work with social media
in the past, um, and a lot offolks are turning to social
media or now increasinglychatbots, both as sources of
help, but also potentially asinstigators of harm.
And so I think there's a reallyimportant body of work to do
(38:04):
around that.
And then the rest is still kindof right, I feel like there's a
lot of AI propaganda and hypeand trying to sort through
what's real versus what isn't.
I'll tell you, we've been tryingto use chatbots to make sense of
some data in real, like toprovide real-time
interpretations, and we've notfound that to be particularly
useful yet.
But there's a lot more to come.
And I think it's gonna beknowing how to use AI well and
(38:26):
ethically and responsibly isgonna be a core skill set for
all of our students goingforwards.
Um, hopefully not in a way thatremoves the human side of what
we do.
SPEAKER_00 (38:37):
Absolutely.
Great.
Dr.
Any, this was wonderful.
It loved this conversation,really appreciate it.
And uh thank you for coming onthe show.
SPEAKER_01 (38:44):
Thank you.
Thank you again for doing theshow.
Fills a much needed hole uh inour civil discourse.
SPEAKER_00 (38:50):
Thanks for listening to the Jeffalytics Podcast.
Be sure to subscribe and tolearn more, head on over to
ahdatalytics.com for moreinformation and previous
episodes.
If you like what you heard,please leave a glowing review,
which will help others todiscover the show.
Until next time, I'm Jeff Asher.
Popular Podcasts
Betrayal Weekly
Betrayal Weekly is back for a new season. Every Thursday, Betrayal Weekly shares first-hand accounts of broken trust, shocking deceptions, and the trail of destruction they leave behind. Hosted by Andrea Gunning, this weekly ongoing series digs into real-life stories of betrayal and the aftermath. From stories of double lives to dark discoveries, these are cautionary tales and accounts of resilience against all odds. From the producers of the critically acclaimed Betrayal series, Betrayal Weekly drops new episodes every Thursday. If you would like to share your story, you can reach out to the Betrayal Team by emailing them at betrayalpod@gmail.com and follow us on Instagram at @betrayalpod and @glasspodcasts. Please join our Substack for additional exclusive content, curated book recommendations, and community discussions. Sign up FREE by clicking this link Beyond Betrayal Substack. Join our community dedicated to truth, resilience, and healing. Your voice matters! Be a part of our Betrayal journey on Substack.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by Audiochuck Media Company.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.