Pipeline how we process and get information, its largely solely demonstrated as an act of violence or a very abrasive vice. Rarely is it narrated in a way where people are constantly having to live in many of our communities in this country in war zones. That are actually assaulting the psychology, the emotion, and the spirit of young people and families far beyond just a physical toll. I think the daily impact, at least how we understand it, particularly here in the way area, is very much around trauma. We just really quickly, 600 shootings have happened in the bay area averaged over the last 20 years. City of oakland, im talking about specifically the city of oakland, 120 killings or so average. You can just imagine the concentric circles of trauma, of families that have had to deal with gunrelated hop sides, not even speaking about suicides. I think trauma is something we have to continue to imagine. Its not just literally the victims themselves or even their immediate families, that the impact of this goes far beyond that. Im sure that you see that in the hospitals too, doctor. Yeah, i know, its a really sad thing in the bay area when we know when its going to be a hot summer well be seeing more gun victims in our wards. Theres an anecdotal relationship. Warm summers, more gunshot victims. We did a survey. It was an informal survey of our members, 20,000 physicians in our organization, asking them, what is your number . When you reflect on medical school, residency, in your practice, in your personal lives, how many gun violence victims have you had interaction with . And the average number was 40. Thats an incredible number. And i think that again reminds us that we are in health care in medicine, at this really important intersection where were trying to care for the victims of violence but also have the opportunity to take move one step ahead and take steps toward prevention as well. Margo hirsch, someone who is working in the realm of solutions, were talking about the bay area and the problems here which in some ways are reflected in every major cosmopolitan area in the country. The bay area is the epicenter of technological innovation. We often in america have were producing worldchanging technology and specifically here. What technologies of available to us now to address this problem . The primary technologies that were seeing today through the challenge that the Smart Foundation started in january 2014 are primarily biotech nick technology. Ridf technology. Those are the standouts right now. They are effective in different use cases. A biometric fingerprint reading reader would be extremely effective in a personal protection home environment or a gun range where theres no dirt, no water, no blood. Whereas for hunters who might have dirty hands or wear gloves, an rfid solution might be more effective. Also for Law Enforcement, rfid could be potentially a preferred solution because it requires you to wear a ring or a bracelet in order to fire the trigger of a firearm. Alternatively, you could put a small chip into your hand, because for Law Enforcement you actually have to be able to fire out of both hands. And a concern is that if the gun was taken away or if you injureds ainjured yourself youd have to use someone elses gun or fire out of your other hand. So that technology could be very effective. Were seeing things like smart ammunition, which is unusual. Another approach. Were also seeing a variety of technologies that can be retrofitted to existing firearms because there are 300 million firearms in this country today. So not only do you have to think about the new firearms which are 10 million that come into the market every year, but youve got all those existing firearms out there that youd want to make safer as well. So were seeing retrofit technologies, external locking technologies which i very interesting, as well as a few that are actually integrated into the gun itself. They sound like some promising technologies, yet i think few people have heard of them even. Why have they not taken better hold . Very good point. I think one of the big issues is that theres no market demand for these technologies because people arent aware of them. Theres been no incentive in the past to get involved in this type of project because the nra has not been extremely supportive of bringing these types of technologies to market. Back in 1990, colt received some funding to develop smart guns and they were boycotted. And then in 2000, smith and wesson through the Clinton Administration received funding to develop a smart gun and they too were boycotted, almost went out of business. So the gun manufacturers have no desire to jump into this space. And then for people, new innovators, theres a lack of capital available for them because when you go to raise money, a venture capitalist is going to say, whats the Market Opportunity . How big is the market demand . And there really isnt a market demand because the technologies dont exist. So its a real catch22. But at the foundation were trying to deal with and hopefully overcome. Technology certainly seems like one promising avenue. But of course whats done at the Community Level is a much more complicated picture. And varies widely depending on where you are in the country. Pastor mcbride, what do you think are the most crucial things that local Community Leaders are doing on this issue or perhaps should be doing . Well, you know, i think the first thing we all have to do is change our assumption that this problem is unsolvable. And i think theres a certain attract ability as relates to what people believe is inevitable, particularly as it relates to gun violence in urban communities. For the last ten years or so we have been engaging in a number of strategies that have popularly been known as ceasefire to help reduce the number of firearm offenders and offenses in our communities across the country and weve had amazing results. Particularly in the bay area since 2007, 2008, weve seen a 60 to 70 decline in 1related whom many homicides in the city of richmond. The reason is many of the fire arm offenders or people who are engaged in gun violence, its a very small number of individuals. If you have 100 gunrelated shootings or gunrelated homicides in the city its not because you have 100 individual armed offenders or shooters, its because you have a small number of individuals who are engaging in volume activity. So our work has been actually to interact and engage with those individuals and interrupt their engagement. The analogy i use is many of these young people are caught on a dryer cycle. How many of you have seen a dryer, you all know what dryers are, you dry your clothes. Its twirling, twirling, twirling. If you open the dryer clothes start flying out, right . Because its been on a cycle for so long. Well, many of us have never opened the door of the cycles. And i have found that when you open doors and pathways for individuals to actually choose different kinds of choices, many of them, the overwhelming majority of them, stop shooting with no incentive because many of them want to live. They just have not had those kind of cycles interrupted with love, with structure, with a pathway out. So those strategies are strategies were trying to bring to scale across the country, even more so in the bay area. We do find that that allows us to engage in Public Safety measures that do not criminalize whole communities, send more of our black and brown young people to jail and prison, and keep our communities intact. Were finding great promise, we just need a lot more political support, a lot more constitutional policing to help us have legitimacy in the community. Hopefully all those things will continue to come together. You mentioned policing. Policing in the United States and officerinvolved shootings in particular have become a Major National issue in the last year or so. How do you think that might be affecting perceptions of the gun violence problem in our country . Its a big perception problem. Because since the war on drugs well, let me say this. In 1939, a prominent clergymen for of mine was born in the south and his mom registered him as a lifelong in the event naacp. The number one issue in 1939 was police brutality. Long before the war on drugs, long before the black panther party, long before the civil rights movement, long before integration. Police brutality. There has not been one day that black folk have been in the United States and not a had their lives subject to arbitrary violence by the state or by its Law Enforcement apparatus. Its important to historicize this conversation. What weve seen around Law EnforcementTipping Point is a longtime strategy. Our strategies which depend on outside working with Law Enforcement to do constitutional policing in communities require us to have policing services that are constitutional, that are not dominated by rogue, lethal force policing, and even here in the city, earlier today i was at a rally for almacar lopez, another young brother named alex nieto, many of us know the story of is on gar grant. Many case whefrs Law Enforcement are actively gaining in violent, even lethal acts. That erodes Community Trust that is necessary to create the Public Safety partnership. These things are inextricably linked. People say, what about black on black crime . I say, what about constitutional policing . We cant have one without the other. We work on both sides of the issues. I hope people will begin to see the connections soar else we wont have the Public Safety results, particularly around gun violence that we all say we want and need. Another aspect thats come up with the policing issue and people ive spoken with in the world of Law Enforcement, robin thomas, maybe you can comment on this. A lot of police go out into their daily work with the expectation that everybodys armed and dangerous. And theres a lot of discussion about the kind of warrior mentality that police are trained to have. Pastor mcbride saying that thats causing Serious Problems in terms of the local community fabric. When you think about that in terms of gun violence as a Public Health issue, gun violence as a highly charged political issue in and the legal landscape, what are your thoughts about that, how thats come to the forefront with policing . I think when you think about and talk about gun violence you need to look at it as a holistic problem. Its not a problem you can solve purely through Community Approaches even though i think thats absolutely crucial in some communities. Its certainly not a problem even though we really work on the policy side thats going to be solved through policy solutions. It has to be approached holistically. Pastor mcbride and i talk about the supply side problem and the demand side problem in a lot of communities. Theres a demand satisfied problem that needs to be met through innovative, thoughtful, Integrative Community mechanisms. We have to deal with the flow of firearms into these communities which is so prolific and so unchecked. And thats creating another piece of the puzzle. I think looking at those two things hand in hand in the way that they fit together is really important. One of the policies that weve always cared about is assault weapons and largecapacity ammunition. Partly thats because you see a mass shooting, thats the kind of weaponry thats being utilized. But its also because theres this sort of arms war that happens in inner cities. Not as badly in california because the laws are stronger. Certainly cities where Law Enforcement demands stronger and stronger weapons to contend with the types of weapons that theyre encountering. Whether thats even true or not is irrelevant because if thats the perception look at what happened in ferguson. That kind of military force being brought into a community is crazy. And part of the argument behind that was, we have to be able to take on these assault weapons that are now proliferating everywhere. Theres millions of them, legally and illegally. So i think that that sort of arms war problem that we have in this country with so many guns, i think that the ready availability of the ar15s and other assault weapons that have become the choice weapons in a lot of illegal enterprises, as well as for horrific tragedies. You know, should spur action. Unfortunately what hasnt been mentioned that much yet on this panel is the nra and the force that lobbying brings to the equation and how that inhibits us from being able to approach things holistically and with a real clear eye for solutions. We have research. Dr. Choi and i have talked at length about the types of research that exists as to what policies are out there that work. What evidence do we have of what works . And the problem is even when we know what works, we cant get it in place. Because we have this really interesting special Interest Group that inhibits us from really tackling this problem with intelligence, with solutions that we know are available. What do you see as at the top of the list of those policies that we know work yet cant be in place . Universal background checks. Not even a pause. We need to have absolutely background checks on every single sale and transfer of weapons in this country by law. It doesnt mean were going to completely stop the flow. But guns, unlike drugs, are actually manufactured legitimately and have to be imported and tracked, if you just put in place universal background checks for every sale you can begin to assess where theyre coming from, whos getting them, how are they getting them, in a way thats simply impossible now because you dont need a background check in a private sale. Theres no system in place that epps us even understand the flow of the 300 million guns in this country. Thats just step one but i think its absolutely crucial. What youre describing is from the perception of the American Public, not a radical idea . Right, 92 of the American People after newtown, when polled, supported universal background checks on all sales. Thats in wyoming, alabama, everywhere. Yet our senate only managed to muster 54 votes to put that in place. So unfortunately even though americans want it, our leaders dont represent the will of what the American People want and need to address this problem. I think we have to ask the question why. I think what the nra has done a wonderful job, along with gun manufacturers, is peddling fear. Many of us were in the senate during Dianne Feinsteins hearing several weeks after the newtown tragedy. And we heard Lindsay Graham from South Carolina just go on this long diatribe about how the police would not be able to come and protect us in our homes when the looters come and when the hordes at the gate. The natural disasters and youre going to need your guns Lindsey Graham should know better. Hes not someone who i think believes that in his heart. But its politics of fear. And the fear of the other. The ways in which people feel like they need to have a gun in order to protect themselves. When all the Research Says that if you own a gun, youre more likely to be harmed by that gun or a member in your family be harmed by that gun. Its a cruel joke. Cruel irony being played on the American People. Until were able to overcome our fears with more hope and love for one another, i think nra and these weapon manufacturers will actually continue to provide cover for elected officials to keep doing things that they know arent creating Public Safety. I think one of the things were getting at here too is that the politics of guns has a way of obscuring some important things about the issue. We tend to focus a lot on Mass Shootings, on homicides. But according to cdc data, over 20,000 gunrelated deaths each year, which is approximately twothirds of the annual toll, are suicides. More than 80 of suicide attempts using a gun are successful. Yet as a country we tend to think of homicides as the biggest part of the problem. Why is that, dr. Choi . If you look at adolescents, for example, two of the top three causes of death in what we would typically think of is a healthy population are homicides and the suicides, both which of have close associations with guns. We were talking about evidence. Evidence shows that having a gun in the home increases the risk of suicide and unintentional injury. We know that providing advice, telling families that if you lock up your gun, keep it unloaded, keep the ammunition separate from the gun, that not only do patients listen, but it actually does reduce the risk of injury and harm. This is of particular concern when it comes to children. There have been studies that show that while parents think that their kids dont know where their guns are, the kids do. And anyone who has any recent experience with an inquisitive child knows that they find those things. So i think that recognizing this data requires us to then take that next step in doing and follow up with an intervention. While we have some of this data, i think one of the frustrations the medical community is at, we dont have enough data. In the mid90s the gun lobby blocked funding for gun research on gun violence, explicitly stated cdc could not pursue research around gun violence. What we dont know is still h t hurting us. Theres this big problem that we know is there. And we think we know some things. We dont know enough. To continue to build a strong case of kind of thins that we already know is true is challenging in this context. And so theyve tied us up when we talk about Public Health and research in a couple of different ways. Another issue that comes up a lot in the context of Mass Shootings