Tag: Guns

Retratos convierten a muertes por armas de fuego en historias imborrables

Philadelphia. — Zarinah Lomax es una documentalista poco común. Ha diseñado vestidos con las cintas amarillas de escenas de crimen y abrigos con leyendas pintadas a mano que dicen: “No Disparen”, en dorado, negro y púrpura. Cada pocos meses, transporta docenas de retratos de habitantes de Philadelphia —caras vibrantes, audaces y más grandes que la vida misma— a galerías temporales para alertar sobre la violencia armada en su ciudad natal, y en América.

En un depósito, Lomax estima que tiene unos mil lienzos, en su mayoría de jóvenes que murieron por disparos, y otros de madres, hermanas, amigos y dolientes que se preguntan por qué.

“El propósito no es hacer llorar a la gente”, dijo Lomax, una nativa de Philadelphia que ha viajado a Nueva York, Atlanta y Miami para colaborar en exhibiciones similares sobre este trauma. “Es para que las familias y las personas que han pasado por esto sepan que no son olvidadas”.

Cada persona “no es un número. Este es el hijo de alguien. La hija de alguien que estaba trabajando en algo”, dijo. “Los retratos no son solo retratos. Nos están diciendo cuáles son las consecuencias de lo que está sucediendo en nuestras ciudades”.

Las armas de fuego en 2020 se convirtieron en la causa número uno de muerte en niños y adolescentes menores de 18 años —tanto por suicidios como por agresiones— y una nueva investigación sobre la crisis de salud pública del Instituto Blavatnik de la Escuela de Medicina de Harvard muestra cómo esas pérdidas se extienden a través de familias y vecindarios, con costos económicos y psicológicos significativos.

El 25 de junio, Vivek Murthy, cirujano general de Estados Unidos, declaró a la violencia armada como una crisis de salud pública, remarcando: “Cada día que pasa perdemos más niños por la violencia armada. Cuantos más niños presencian episodios de violencia armada, más niños que son heridos por disparos y sobreviven están lidiando con impactos físicos y mentales de por vida”.

Philadelphia ha registrado más de 9,000 tiroteos fatales y no fatales desde 2020, con aproximadamente el 80% de las víctimas identificadas como negras no hispanas, según el controlador de la ciudad. Entre los heridos o muertos, aproximadamente el 60% tenía 30 años o menos.

Lomax ha sido una fuerza singular para que las estadísticas no se olviden. Desde 2018, cuando un joven amigo que estaba a punto de graduarse de la Universidad Estatal de Pennsylvania fue asesinada a tiros un domingo por la tarde en Philadelphia, Lomax se propuso apoyar la sanación entre aquellos que experimentan violencia.

Lanzó un programa en PhillyCAM, un canal de medios de acceso comunitario, para alentar a las personas a hablar sobre armas, opioides y el duelo. Organizó desfiles de moda con artistas locales y familias que se centraron en dar testimonio del sufrimiento. Se centró en el retrato, contactando a artistas locales para conmemorar las vidas, no las muertes, de los jóvenes de Philadelphia.

Comenzó a rastrear tiroteos en las redes sociales, en las noticias y a veces de boca en boca. En 2022, el Ayuntamiento abrió tres pisos para una notable exhibición de vidas perdidas, organizada por Lomax y creada por docenas de artistas.

Recientemente compartió los retratos en una cumbre patrocinada por la organización sin fines de lucro Brady: United Against Gun Violence y CeaseFirePA. La reunión ofreció orientación sobre la aplicación de regulaciones para prevenir compras de armas que impulsan el crimen y proporcionó datos sobre el tráfico de armas a través de las fronteras estatales.

Lomax sabía que el arte, exhibido a lo largo del escenario, ponía en evidencia la importancia del tema.

Miren estas caras, dijo ella. Estas personas eran prometedoras. ¿Qué pasó? ¿Qué se puede hacer?

Lomax, ahora de 40 años, dijo que las conversaciones que inicia tienen un propósito. Algunos cuadros los regala a las familias. Otros los guarda para futuras exhibiciones.

“Esto no es lo que me propuse hacer en la vida”, dijo ella. “Cuando estaba creciendo, pensé que sería enfermera. Pero supongo que de esta forma estoy cuidando a las personas”.

En lo que va del año, Philadelphia ha visto una disminución en el número de asesinatos, según una base de datos en línea de AH Datalytics, pero se encuentra entre las cinco ciudades principales en conteo de asesinatos. El año pasado, los investigadores de Harvard establecieron que las comunidades y familias quedan vulnerables por las lesiones con armas de fuego.

There are two rows of colorfully painted portraits. The top row has four paintings and the bottom row has five.
Retratos de Zarinah Lomax pintados por encargo. Cada persona “no es un número. Este es el hijo de alguien. La hija de alguien que estaba trabajando por algo”, dijo Lomax. “Los retratos no son sólo retratos. Nos están diciendo cuáles son las consecuencias de lo que está sucediendo en nuestras ciudades”.(Christine Spolar for KFF Health News)

El estudio de 2023 dirigido por Zirui Song, profesor asociado de política de atención médica en Harvard, examinó datos relacionados con recién nacidos hasta los 19 años. La investigación documentó un costo económico “masivo”, con un aumento promedio de $35,000 en el gasto en atención médica para los sobrevivientes en el año posterior a un tiroteo, y desafíos de salud mental que alteran la vida.

Los sobrevivientes de tiroteos y sus cuidadores, ya sea lidiando con lesiones físicas o miedo generalizado, a menudo luchan con “lesiones invisibles y duraderas, incluidos trastornos psicológicos y de uso de sustancias”, según Song, quien también es internista general en el Hospital General de Massachusetts.

Su estudio encontró que los padres de niños heridos experimentaron un aumento del 30% en trastornos psiquiátricos en comparación con los padres cuyos hijos no sufrieron heridas de bala.

Desiree Norwood, quien pinta con acrílicos, ha estado ayudando a Lomax desde 2021. Como a todos los artistas, Lomax le paga. Ha completado unos 30 retratos, siempre después de sentarse con la familia de la víctima. “Obtengo una historia de fondo para poder incorporarla en el retrato”, dijo. “A veces lloramos. A veces rezamos. A veces tratamos de animarnos mutuamente. Es difícil de hacer”.

“Espero que un día no tenga que pintar otro retrato”, dijo Norwood, madre de cinco hijos. “La idea de que Zarinah haya tenido tantas exhibiciones, con numerosas personas que han muerto, es aterradora y desgarradora”.

Mike Doughty, un artista digital autodidacta, fue uno de los que querían ayudar a “honrar y ofrecer una mejor mirada de quiénes eran estas personas”. Doughty, un empleado de la ciudad que trabaja en un juzgado, puede ser mejor conocido Philadelphia por una serie de murales en los que ha agrupado a famosos nacidos en la ciudad como Will Smith, Grace Kelly y Kevin Hart.

Ha producido unos 150 retratos en su iPad y laptop, trabajando con el grupo sin fines de lucro de Lomax, The Apologues, para ponerle rostro a una frase, incrustada en una escena, que transmite el potencial perdido de la juventud.

“Al principio fue difícil de hacer,” dijo Doughty, quien trabaja a partir de fotografías familiares. “Miro y pienso: Son niños. Solo niños”.

Una vez, recibió un mensaje de texto de Lomax buscando un retrato de un rapero que reconoció de espectáculos de arte y música. Otro día, abrió un correo electrónico y encontró una foto de un hombre que conocía de la escuela secundaria. En mayo, Doughty compartió en Instagram su proceso de trabajo para un retrato de Derrick Gant, un rapero con el nombre artístico Phat Geez, que fue asesinado a tiros en marzo.

El asesinato ocurrió unas semanas después que el rapero lanzara “No Gunzone”, un video musical que hace referencia a una cuenta de Instagram que promueve esfuerzos contra la violencia en la ciudad.

Doughty, de 33 años, que creció en la sección Nicetown del norte de Philadelphia, señaló irónicamente: “No era tan agradable”. Las exhibiciones de Lomax, dijo, permiten a las familias, incluso a los vecindarios, procesar el dolor y el sufrimiento.

“Fui a la última y una madre se acercó y dijo, ‘¿Dibujaste el retrato de mi hijo?’ Simplemente cayó en mis brazos, llorando. Fue un momento tan emotivo”, contó. “Y un recordatorio de por qué hacemos lo que hacemos”.

These Vibrant, Bigger-Than-Life Portraits Turn Gun Death Statistics Into Indelible Stories

PHILADELPHIA — Zarinah Lomax is an uncommon documentarian of our times. She has designed dresses from yellow crime-scene tape and styled jackets with hand-painted demands like “Don’t Shoot” in purple, black, and gold script. Every few months, she hauls dozens of portraits of Philadelphians — vibrant, bold, bigger-than-life faces — to pop-up galleries to raise an alarm about gun violence in her hometown and America.

In a storage unit, Lomax has a thousand canvasses, she estimates, mostly of young people who died from gunfire, and others of the mothers, sisters, friends, and mourners left to ask why.

“The purpose is not to make people cry,” said Lomax, a Philadelphia native who has traveled to New York, Atlanta, and Miami to collaborate on similar exhibitions on trauma. “It is for families and for people who have gone through this to know that they are not forgotten.”

Each person “is not a number. This is somebody’s child. Somebody’s son, somebody’s daughter who was working toward something,” she said. “The portraits are not just portraits. They are telling us what the consequences are for what’s happening in our cities.”

Firearms in 2020 became the No. 1 cause of death for children and teens under 18 — from both suicides and assaults — and fresh research on the public health crisis from Harvard Medical School’s Blavatnik Institute show how those losses ripple through families and neighborhoods with significant economic and psychological costs.

On June 25, U.S. Surgeon General Vivek Murthy declared gun violence a public health crisis, noting: “Every day that passes we lose more kids to gun violence. The more children who are witnessing episodes of gun violence, the more children who are shot and survive that are dealing with a lifetime of physical and mental health impacts.”

Philadelphia has recorded more than 9,000 fatal and nonfatal shootings since 2020, with about 80% of the victims identified as Black, according to the city controller. Among those injured or dead, about 60% were age 30 or younger.

Lomax has been a singular, and perhaps unlikely, force in making the statistics unforgettable. Since 2018, when a young friend poised to graduate from Penn State University was shot to death on a Sunday afternoon in Philadelphia, Lomax has set out to support healing among those who experience violence.

She launched a show on PhillyCAM, a community access media channel, to encourage people to talk about guns and opioids and grief. She organized fashion shows with local artists and families that focused on bearing witness to distress. She seized on portraiture, reaching out to local artists to memorialize the lives, not the deaths, of Philadelphia’s young. She began tracking shootings on social media, in news accounts, and sometimes by word of mouth. In 2022, City Hall opened three floors to a remarkable exhibition of lost lives, organized by Lomax and created by dozens of artists.

She recently shared the portraits at a summit sponsored by the nonprofit Brady: United Against Gun Violence and CeaseFirePA. The meeting offered guidance on enforcing regulations to prevent straw gun purchases that propel crime and provided data on weapon trafficking across state lines. Lomax knew the art, displayed along the stage, brought home the stakes.

Look at these faces, she said. These people had promise. What happened? What can be done?

There are two rows of colorfully painted portraits. The top row has four paintings and the bottom row has five.
Painted portraits commissioned by Zarinah Lomax. Each person “is not a number. This is somebody’s child. Somebody’s son, somebody’s daughter who was working toward something,” Lomax says. “The portraits are not just portraits. They are telling us what the consequences are for what’s happening in our cities.” (Christine Spolar for KFF Health News)

Lomax, now 40, said the conversations she starts have purpose. Some paintings she gives to families. Others she stores for future exhibits.

“This is not what I set out to do in life,” she said. “When I was growing up, I thought I’d be a nurse. But I guess I am kind of nursing people this way.”

So far this year, Philadelphia has seen a drop in the number of murders, according to an online database by AH Datalytics, but ranks among the top five cities in murder count. Last year, the Harvard researchers established that communities and families are left vulnerable by gun injuries.

The 2023 study led by Zirui Song, an associate professor of health care policy at Harvard Medical School, examined data related to newborns through age 19. The research documented a “massive” economic toll, with health care spending increasing by an average of $35,000 for survivors in the year after a shooting, and life-altering mental health challenges.

Survivors of shootings and their caregivers, whether dealing with physical injuries or generalized fear, often struggle with “long-lasting, invisible injuries, including psychological and substance-use disorders,” according to Song, who is also a general internist at Massachusetts General Hospital. His study found that parents of injured children experienced a 30% increase in psychiatric disorders compared with parents whose children did not sustain gunshot injuries.

Desiree Norwood, who paints with acrylics, has been helping Lomax since 2021. Like all the artists, she’s paid by Lomax. She has completed about 30 portraits, always after sitting down with the subject’s family. “I get a backstory so I can incorporate that in the portrait,” she said. “Sometimes we cry. Sometimes we pray. Sometimes we try to uplift each other. It is hard to do.”

“I hope one day I would not have to paint another portrait,” said Norwood, a mother of five children. “The idea that Zarinah has had so many exhibits, with numerous people who have died, is scary and heartbreaking.”

Mike Doughty, a self-taught digital artist, was among those who wanted to help to “honor and to offer a better look at who these people were.” Doughty, a city employee who works at a courthouse, may be best known within Philadelphia for a series of fanciful murals in which he has grouped famous natives such as Will Smith, Grace Kelly, and Kevin Hart.

He has produced about 150 portraits on his iPad and laptop, working with Lomax’s nonprofit group, The Apologues, to best match a face with a phrase, embedded in the scene, that telegraphs the lost potential of youth.

“At the beginning it was hard to do,” said Doughty, who works from family photographs. “I look and I think: They are kids. Just kids.”

One time, he received a text from Lomax seeking a portrait of a rapper he recognized from art and music shows. Another day, he opened an email to find a photo of a man he knew from high school. In May, Doughty shared on Instagram his work process for a portrait of Derrick Gant, a rapper with the stage name Phat Geez, who was gunned down in March. The killing happened a few weeks after the rapper released “No Gunzone,” a music video referring to an Instagram account that promotes anti-violence efforts in the city.

Doughty, 33, who grew up in the Nicetown section of north Philadelphia, wryly noted: “It wasn’t so nice.” Lomax’s exhibitions, he said, allow families, even neighborhoods, to sort through sorrow and pain.

“I went to the last one and a mother came up and said, ‘Did you draw my child’s portrait?’ She just fell into my arms, crying. It was such a moment,” he said. “And a reminder on why we do what we do.”

Pandemic Stress, Gangs, and Utter Fear Fueled a Rise in Teen Shootings

Diego never imagined he’d carry a gun.

Not as a child, when shots were fired outside his Chicago-area home. Not at age 12, when one of his friends was gunned down.

Diego’s mind changed at 14, when he and his friends were getting ready to walk to midnight Mass for the feast of Our Lady of Guadalupe. But instead of hymns, Diego heard gunfire, and then screaming. A gang member shot two people, including one of Diego’s friends, who was hit nine times.

“My friend was bleeding out,” said Diego, who asked KHN not to use his last name to protect his safety and privacy. As his friend lay on the ground, “he was choking on his own blood.”

The attack left Diego’s friend paralyzed from the waist down. And it left Diego, one of a growing number of teens who witness gun violence, traumatized and afraid to go outside without a gun.

Research shows that adolescents exposed to gun violence are twice as likely as others to perpetrate a serious violent crime within two years, perpetuating a cycle that can be hard to interrupt.

Diego asked his friends for help finding a handgun and — in a country supersaturated with firearms — they had no trouble procuring one, which they gave him free.

“I felt safer with the gun,” said Diego, now 21. “I hoped I wouldn’t use it.”

For two years, Diego kept the gun only as a deterrent. When he finally pulled the trigger, it changed his life forever.

Disturbing Trends

The news media focuses heavily on mass shootings and the mental state of the people who commit them. But there is a far larger epidemic of gun violence — particularly among Black, Hispanic, and Native American youth — ensnaring some kids not even old enough to get a driver’s license.

Research shows that chronic exposure to trauma can change the way a child’s brain develops. Trauma also can play a central role in explaining why some young people look to guns for protection and wind up using them against their peers.

The number of children under 18 who killed someone with a firearm jumped from 836 in 2019 to 1,150 in 2020.

In New York City, the number of young people who killed someone with a gun more than doubled, rising from 48 juvenile offenders in 2019 to 124 in 2022, according to data from the city’s police department.

Youth gun violence increased more modestly in other cities; in many places, the number of teen gun homicides rose in 2020 but has since fallen closer to pre-pandemic levels.

Researchers who analyze crime statistics stress that teens are not driving the overall rise in gun violence, which has increased across all ages. In 2020, 7.5% of homicide arrests involved children under 18, a slightly smaller share than in previous years.

Local leaders have struggled with the best way to respond to teen shootings.

A handful of communities — including Pittsburgh; Fulton County, Georgia; and Prince George’s County, Maryland — have debated or implemented youth curfews to curb teen violence. What’s not in dispute: More people ages 1 to 19 die by gun violence than by any other cause.

A Lifetime of Limits

The devastating toll of gun violence shows up in emergency rooms every day.

At the UChicago Medicine trauma center, the number of gunshot wounds in children under 16 has doubled in the past six years, said Dr. Selwyn Rogers, the center’s founding director. The youngest victim was 2. “You hear the mother wail, or the brother say, ‘It’s not true,’” said Rogers, who works with local youth as the hospital’s executive vice president for community health engagement. “You have to be present in that moment, but then walk out the door and deal with it all over again.”

Dr. Selwyn Rogers sits on a chair in a hospital lobby. He wears a white doctor's coat and looks directly at the camera. The room is sunny and spacious.
Dr. Selwyn Rogers is the founding director of UChicago Medicine’s trauma center. In the past six years, the trauma center has seen the number of gunshot wounds in children under 16 double.(UChicago Medicine)

In recent years, the justice system has struggled to balance the need for public safety with compassion for kids, based on research that shows a young person’s brain doesn’t fully mature until age 25. Most young offenders “age out” of criminal or violent behavior around the same time, as they develop more self-control and long-range thinking skills.

Yet teens accused of shootings are often charged as adults, which means they face harsher punishments than kids charged as juveniles, said Josh Rovner, director of youth justice at the Sentencing Project, which advocates for justice system reform.

About 53,000 juveniles in 2019 were charged as adults, which can have serious health repercussions. These teens are more likely to be victimized while incarcerated, Rovner said, and to be arrested again after release.

Young people can spend much of their lives in a poverty-imposed lockdown, never venturing far beyond their neighborhoods, learning little about opportunities that exist in the wider world, Rogers said. Millions of American children — particularly Black, Hispanic, and Native American kids — live in environments plagued by poverty, violence, and drug use.

The covid-19 pandemic amplified all those problems, from unemployment to food and housing insecurity.

Although no one can say with certainty what spurred the surge in shootings in 2020, research has long linked hopelessness and lack of trust in police — which increased after the murder of George Floyd that year — to an increased risk of community violence. Gun sales soared 64% from 2019 to 2020, while many violence prevention programs shut down.

One of the most serious losses children faced during the pandemic was the closure of schools — institutions that might provide the only stabilizing force in their young lives — for a year or more in many places.

“The pandemic just turned up the fire under the pot,” said Elise White, deputy director of research at the nonprofit Center for Justice Innovation, which works with communities and justice systems. “Looking back, it’s easy to underplay now just how uncertain that time [during the pandemic] felt. The more that people feel uncertain, the more they feel there’s no safety around them, the more likely they are to carry weapons.”

Of course, most children who experience hardship never break the law. Multiple studies have found that most gun violence is perpetrated by a relatively small number of people.

The presence of even one supportive adult can protect children from becoming involved with crime, said Dr. Abdullah Pratt, a UChicago Medicine emergency physician who lost his brother to gun violence.

Pratt also lost four friends to gun violence during the pandemic. All four died in his emergency room; one was the son of a hospital nurse.

Although Pratt grew up in a part of Chicago where street gangs were common, he benefited from the support of loving parents and strong role models, such as teachers and football coaches. Pratt was also protected by his older brother, who looked out for him and made sure gangs left the future doctor alone.

“Everything I’ve been able to accomplish,” Pratt said, “is because someone helped me.”

Growing Up in a ‘War Zone’

Diego had no adults at home to help him feel safe.

His parents were often violent. Once, in a drunken rage, Diego’s father grabbed him by the leg and swung him around the room, Diego said, and his mother once threw a toaster at his father.

At age 12, Diego’s efforts to help the family pay overdue bills — by selling marijuana and stealing from unlocked cars and apartments — led his father to throw him out of the house.

At 13, Diego joined a gang made up of neighborhood kids. Gang members — who recounted similar stories about leaving the house to escape abuse — gave him food and a place to stay. “We were like a family,” Diego said. When the kids were hungry, and there was no food at home, “we’d go to a gas station together to steal some breakfast.”

Dr. Abdullah Pratt stands at a reception desk in a medical building. He wears a white doctor's coat and gently smiles at the camera.
Dr. Abdullah Pratt is a UChicago Medicine emergency physician who lost his brother to gun violence. Pratt says the presence of even one supportive adult can protect children from becoming involved with crime.(UChicago Medicine)

But Diego, who was smaller than most of the others, lived in fear. At 16, Diego weighed only 100 pounds. Bigger boys bullied and beat him up. And his successful hustle — selling stolen merchandise on the street for cash — got the attention of rival gang members, who threatened to rob him.

Children who experience chronic violence can develop a “war zone mentality,” becoming hypervigilant to threats, sometimes sensing danger where it doesn’t exist, said James Garbarino, an emeritus professor of psychology at Cornell University and Loyola University-Chicago. Kids who live with constant fear are more likely to look to firearms or gangs for protection. They can be triggered to take preemptive action — such as firing a gun without thinking — against a perceived threat.

“Their bodies are constantly ready for a fight,” said Gianna Tran, deputy executive director of the East Bay Asian Youth Center in Oakland, California, which works with young people living in poverty, trauma, and neglect.

Unlike mass shooters, who buy guns and ammunition because they’re intent on murder, most teen violence is not premeditated, Garbarino said.

In surveys, most young people who carry guns — including gang members — say they do so out of fear or to deter attacks, rather than perpetrate them. But fear of community violence, both from rivals and the police, can stoke an urban arms race, in which kids feel that only the foolish walk around without a weapon.

“Fundamentally, violence is a contagious disease,” said Dr. Gary Slutkin, founder of Cure Violence Global, which works to prevent community violence.

Although a small number of teens become hardened and remorseless, Pratt said, he sees far more shootings caused by “poor conflict resolution” and teenage impulsivity rather than a desire to kill.

Indeed, firearms and an immature teenage brain are a dangerous mix, Garbarino said. Alcohol and drugs can magnify the risk. When confronted with a potentially life-or-death situation, kids may act without thinking.

When Diego was 16, he was walking a girl to school and they were approached by three boys, including a gang member who, using obscene and threatening language, asked if Diego was also in a gang. Diego said he tried to walk past the boys, one of whom appeared to have a gun.

“I didn’t know how to fire a gun,” Diego said. “I just wanted them to get away.”

In news accounts of the shooting, witnesses said they heard five gunshots. “The only thing I remember is the sound of the shots,” Diego said. “Everything else was going in slow motion.”

Diego had shot two of the boys in the legs. The girl ran one way, and he ran another. Police arrested Diego at home a few hours later. He was tried as an adult, convicted of two counts of attempted homicide, and sentenced to 12 years.

A Second Chance

In the past two decades, the justice system has made major changes in the way it treats children.

Youth arrests for violent crime plummeted 67% from 2006 to 2020, and 40 states have made it harder to charge minors as adults. States also are adopting alternatives to incarceration, such as group homes that allow teens to remain in their communities, while providing treatment to help them change their behavior.

Because Diego was 17 when he was sentenced, he was sent to a juvenile facility, where he received therapy for the first time.

Diego finished high school while behind bars and went on to earn an associate’s degree from a community college. He and other young inmates went on field trips to theaters and the aquarium — places he had never been. The detention center director asked Diego to accompany her to events about juvenile justice reform, where he was invited to tell his story.

Those were eye-opening experiences for Diego, who realized he had seen very little of Chicago, even though he had spent his life there.

“Growing up, the only thing you see is your community,” said Diego, who was released after four years in detention, when the governor commuted his sentence. “You assume that is what the whole world is like.”

KHN data editor Holly K. Hacker and researcher Megan Kalata contributed to this report.

Journalists Discuss Insulin Prices, Gun Violence, Distracted Driving, and More

Midwest KHN correspondent Bram Sable-Smith discussed the Eli Lilly news on insulin prices on “PBS NewsHour” and insulin prices on Slate’s “What Next” on March 1.


KHN contributor Andy Miller discussed Georgia’s legislative wrap-up including Medicaid work requirements on Georgia Public Broadcasting’s “Lawmakers” on Feb. 28. He also discussed health care for foster children on WUGA’s “The Georgia Health Report” on Feb. 3.


Senior KHN correspondent Julie Appleby discussed how the end of the public health emergency will affect costs for covid-19 vaccines, treatments, and masks on KMOX’s “Health Matters” on Feb. 25.


KHN correspondent Cara Anthony discussed the youngest victims of gun violence and those who dig their graves on America’s Heroes Group on Feb. 25.


KHN contributor Eric Berger discussed distracted driving laws and why Missouri still doesn’t have one on St. Louis Public Radio’s “St. Louis on the Air” on Feb 24.


El tema del aborto ayuda a los demócratas a minimizar pérdidas en estas elecciones

Es probable que los republicanos tomen el control de una o ambas cámaras del Congreso cuando todos los votos estén contados. Pero los demócratas están celebrando el hecho de que su partido desafió las pérdidas pronosticadas para estas elecciones de medio término.

La reacción a la decisión de la Corte Suprema en junio pasado de anular 49 años de derecho al aborto aparentemente fue una de las principales razones.

Como mostraron consistentemente las encuestas pre electorales, la inflación y la economía fueron los temas de votación más importantes, citados por el 51% de los votantes en las encuestas a boca de urna realizadas por Associated Press y analizadas por encuestadores de KFF.

Pero el aborto fue el tema más importante para una cuarta parte de todos los votantes y para una tercera parte de las mujeres menores de 50 años. Las encuestas a boca de urna de NBC News indicaron que la inflación fue el principal tema para votar para un 32%, y en segundo lugar el aborto, 27%.

La pronosticada “ola roja” de republicanos derrocando a los demócratas en la Cámara y el Senado no sucedió, aunque a partir del miércoles por la mañana parecía probable que los republicanos obtuvieran el puñado de escaños que necesitaban para lograr la mayoría de la Cámara.

En el Senado, donde los republicanos solo necesitaban un asiento para tomar el control, ningún titular había perdido oficialmente, aunque los demócratas capturaron el escaño de Pennsylvania que dejó vacante el senador republicano Pat Toomey.

Aún no se habían convocado varias otras contiendas reñidas, y el control de la cámara bien podría descansar en una posible segunda vuelta en diciembre en Georgia entre el actual senador demócrata Raphael Warnock y el republicano Herschel Walker.

Entre otros problemas que enfrentaron los votantes el martes, los residentes de Dakota del Sur aprobaron una expansión de Medicaid bajo la Ley de Cuidado de Salud a Bajo Precio (ACA). Se convirtió así en el séptimo estado en expandir el programa a pesar de las objeciones de su gobernador republicano y/o la legislatura estatal.

Antes, medidas similares fueron aprobadas en Idaho, Maine, Missouri, Nebraska, Oklahoma y Utah. La aprobación de Dakota del Sur reducirá a 11 el número de estados que no han ampliado el programa a personas con ingresos de hasta el 138 % de la línea de pobreza, entre ellos Texas, Florida y Georgia.

Sobre el tema del derecho al aborto, los votantes de media docena de estados de todo el espectro político mostraron su apoyo directo a través de iniciativas electorales. En la más observada de esas medidas, los votantes de Michigan aprobaron una enmienda constitucional que garantiza la libertad reproductiva, evitando así que entre en vigencia una prohibición de 1931.

Los votantes de Kentucky rechazaron por poco margen una enmienda que habría declarado en su constitución que no había derecho al aborto. Eso lo convirtió en el primer estado del sur en expresar su apoyo directo al derecho al aborto.

Se aprobaron otras preguntas sobre el derecho al aborto en Vermont y California. La medida de California, que fue aprobada con el 65% de los votos, consolidó el derecho al aborto y a la  anticoncepción.

En Montana, una medida electoral para exigir que los bebés nacidos vivos después de un intento de aborto reciban atención médica estaba perdiendo con el 80% de los votos. Este requisito ya existe en la ley federal.

Además, en varios estados clave donde la legalidad del aborto está en juego, los gobernadores y candidatos a favor del derecho al aborto derrotaron a los opositores al aborto, incluidos Pennsylvania, Wisconsin y Michigan.

El aborto también fue un tema en las elecciones de la Corte Suprema en al menos seis estados, donde los desafíos a las leyes del aborto o las interpretaciones constitucionales podrían decidir si sigue o no siendo legal.

En Kentucky, la jueza Michelle Keller estaba liderando sobre Joe Fischer, un legislador estatal republicano que patrocinó la ley de activación del aborto de Kentucky. La jueza titular de Montana, Ingrid Gustafson, derrotó a su rival, James Brown, un republicano respaldado por el gobernador republicano del estado y los líderes del partido que buscaban revertir un fallo judicial de 1999 de que la constitución estatal protege el derecho al aborto.

Pero el aborto no fue el único problema de salud en las papeletas estatales del martes.

En Arizona, una pregunta electoral para limitar el interés de la deuda médica estaba ganando fácilmente con el 60% de los votos contados. En Oregon, sin embargo, una cuestión en su mayoría inaplicable que declaraba un “derecho a la atención médica” en la constitución estatal estaba perdiendo por poco con el 64% de los votos escrutados.

En medidas más específicas, los votantes de California aprobaron la prohibición de los productos de tabaco con sabor, mientras que los votantes de Massachusetts apoyaron a los dentistas sobre las compañías de seguros al aprobar el requisito de que al menos el 83% de las primas del seguro dental se gasten en atención dental directa. Massachusetts no es el primer estado en imponer tal requisito.

En Iowa, los defensores del derecho a portar armas lograron una victoria con la fácil aprobación de una enmienda constitucional que declara que los habitantes del estado tienen “un derecho individual fundamental” a poseer y portar armas, y que cualquier restricción sobre las armas debe pasar por un “escrutinio estricto” en los tribunales. Para el miércoles por la mañana, con 97 de 99 condados reportando boletas, la enmienda tenía el respaldo del 65% de los votantes de Iowa.

Abortion Issue Helps Limit Democrats’ Losses in Midterms

Republicans are likely to take control of one or both houses of Congress when all the votes are counted, but Democrats on Wednesday were celebrating after their party defied expectations of substantial losses in the midterm election. The backlash over the Supreme Court’s decision in June to overturn 49 years of abortion rights was apparently a big reason.

Inflation and the economy proved the most important voting issue, cited as the motivation of 51% of voters in exit polls conducted by the Associated Press and analyzed by KFF pollsters. But abortion was the single-most important issue for a quarter of all voters, and for a third of women under age 50. Exit polls by NBC News placed the importance of abortion even higher, with 32% of voters saying inflation was their top voting issue and abortion ranking second at 27%.

The predicted “red wave” of Republicans toppling Democrats in the House and Senate did not happen, although as of Wednesday afternoon, it seemed likely that Republicans would gain the handful of seats they needed to take over the House majority.

In the Senate, where Republicans needed just one pickup to take control, no incumbent had officially lost, and Democrats captured the Pennsylvania seat being vacated by Republican Sen. Pat Toomey. Several other close races had yet to be called, and control of the chamber may well rest on a December runoff in Georgia between Democratic incumbent Sen. Raphael Warnock and Republican Herschel Walker. In recent decades, the party that controls the White House has generally suffered serious setbacks in congressional power in the midterms.

Among other issues facing voters Tuesday, residents of South Dakota approved an expansion of Medicaid under the Affordable Care Act. That made it the seventh state to expand the program over the objections of a Republican governor and/or state legislature. Previous successful initiatives passed in Idaho, Maine, Missouri, Nebraska, Oklahoma, and Utah. South Dakota’s approval will reduce to 11 the number of states that have not expanded the program to people with incomes up to 138% of the federal poverty level, although included in that list are the heavily populated states of Texas, Florida, and Georgia.

On the issue of abortion rights, voters in five states across the political spectrum showed direct support through ballot initiatives. In the most closely watched of those measures, Michigan voters approved a constitutional amendment guaranteeing reproductive freedom, thus preventing a ban from 1931 from taking effect.

Kentucky voters narrowly rejected an amendment that would have declared in its constitution that there was no right to abortion. That made it the first Southern state to express direct support for abortion rights.

Other abortion rights ballot questions were approved in Vermont and California. The California measure, which passed with 65% of the vote, enshrined the rights to both abortion and contraception.

In Montana, a ballot measure to require that infants born alive after attempted abortions be given medical care was losing with 80% of the votes in. Such a requirement already exists in federal law.

In addition, in several key states where the legality of abortion hangs in the balance, governors and candidates who favor abortion rights defeated anti-abortion challengers, including Pennsylvania, Wisconsin, and Michigan.

Abortion was also an issue in contested Supreme Court elections in at least six states, where challenges to abortion laws or constitutional interpretations could decide whether the procedure remains legal. One state saw party control of its high court flip: North Carolina, where a Republican challenger defeated a Democratic incumbent to give the GOP a 4-3 majority. Democratic judicial majorities appeared to be holding in Illinois and in Michigan, which holds nonpartisan judicial elections after the candidates are nominated by political parties. In Ohio, Republicans kept their majority on the high court.

In Kentucky, Justice Michelle Keller defeated challenger Joe Fischer, a Republican state legislator who sponsored Kentucky’s abortion trigger law. Montana incumbent Justice Ingrid Gustafson defeated her challenger, James Brown, a Republican endorsed by the state’s GOP governor and party leaders seeking to reverse a 1999 court ruling that the state constitution protects the right to an abortion.

Abortion was not the only health issue on state ballots Tuesday.

In Arizona, a ballot question to limit interest on medical debt won easily with 66% of the vote counted. In Oregon, however, a mostly unenforceable question declaring a “right to health care” in the state constitution was losing narrowly with 64% of the votes in.

California voters approved a ban on the sale of most flavored tobacco products while voters in Massachusetts supported dentists over insurance companies in approving a requirement that at least 83% of dental insurance premiums be spent on direct dental care. Massachusetts is the first state to impose such a requirement.

In Iowa, gun rights advocates scored a victory with easy passage of a constitutional amendment declaring that Iowans have “a fundamental individual right” to keep and bear arms, and that any restrictions on guns must stand up to “strict scrutiny” in court.

Texas Revamps ‘Active-Shooter’ Drills at K-12 Schools to Minimize Trauma

AUSTIN, Texas — After Britt Kelly’s son participated in a lockdown drill two years ago in his Lamar, Texas, kindergarten class, he had nightmares and wet his bed. Now 8, he can sleep only with a light on.

In August, Mary Jackson’s daughter, a kindergartner in Leander, asked her mom to put a “special lock” on her bedroom door to “keep bad adults out” in the wake of a separate lockdown drill.

Clay Giampaolo, a high school senior with special needs, said that after drills at his school in Plano, he goes to the special education room to “calm down.”

As the nation reevaluates its gun laws, training for violent threats has become a grisly yet commonplace reality in K-12 schools. More than 40 states require schools to prepare students to react when a campus comes under attack. Nearly every student in America experiences at least one or more of these drills a year, even though their effectiveness has been hotly debated by state legislators, school staffers, safety experts, and parents.

About 98% of public schools taught students lockdown procedures before the pandemic, according to the National Center for Education Statistics. The reasons for them are clear: The 2020-21 school year saw 93 school shootings with casualties, the highest number in two decades, according to the NCES. While school shootings are rare, they have devastating consequences.

But the preparations for these events also can come with a price. “The literal trauma caused just by them is horrifying,” Giampaolo said.

Anxiety, stress, and depression increased 39%-42% in K-12 students following lockdown drills, according to a study published in December in the journal Nature that examined social media posts. The drills, especially those that involve simulations, heightened students’ fear around the possibility of a shooting and made them feel unsafe in school. The more realistic the drill, the more fear they provoked. Students like Giampaolo who have special needs, and those who have experienced previous trauma, are among the most affected, according to safety experts.

At least one state is taking a step toward balancing school safety and student health. To minimize trauma to participants, new Texas regulations require schools to ensure that drills don’t simulate shootings — a change that comes just one semester after a gunman killed 19 students and two teachers in Uvalde.

“If some kids are coming away traumatized or we’re magnifying existing trauma, we’re not moving in the right direction,” said Nicole Golden, executive director of Texas Gun Sense, an advocacy group that supported the bill.

Texas mandates that schools complete two lockdown drills a year. But there was confusion and wide-ranging interpretations about how they should be conducted, said state Rep. Claudia Ordaz Perez, a Democrat who sponsored the bill that passed during the 2021 legislative session.

Despite a growing body of research about how to prepare for worst-case scenarios, not all schools are following best practices and there’s no way to tell which ones are, said Jaclyn Schildkraut, an associate professor of criminal justice at the State University of New York-Oswego, who has argued in favor of drills.

“We have no national standard, no national guidance, and no tracking system,” Schildkraut said.

In extreme cases, schools simulate shootings, with officers brandishing weapons or mimicking gunshot sounds, which she said is unnecessarily traumatizing for both students and staff members. “We don’t set schools on fire to practice a fire drill,” said Schildkraut.

The Texas rules now more clearly distinguish between lockdown drills, which are required, and active-threat exercises, which are voluntary and can involve re-creating aspects of a shooting.

A drill doesn’t involve fake injuries or gunshot sounds. Instead, students either talk through what to do, or practice activities like turning off the lights, locking doors, and staying quiet and away from windows.

Active-threat exercises, which are intended to train first responders, might involve realistic depictions of injured students or loud sounds. They give officials in different jurisdictions a chance to plan a coordinated response, said Kathy Martinez-Prather, director of the Texas School Safety Center. But schools need to plan those simulations carefully without requiring student participation, she said.

The new regulations require schools to tailor drills and exercises to students’ ages and development, but they focus on creating guardrails for active threat exercises. Students aren’t banned from participating in exercises, a move some gun safety and parents’ groups wanted. But the rules advise schools to carry them out during a time when students are not on campus. They also require that everyone involved be given adequate notice before an exercise and a public announcement be made immediately before, so that no participants confuse a simulation with an actual shooter.

The measure, which also orders school districts to find ways to minimize potential trauma to students and staffers, such as consulting mental health professionals while planning the drills, was in effect during the previous school year. But the Texas Education Agency didn’t finalize rules until this year.

The clarifications come as schools renew their focus on safety. “Especially everything that came out of Uvalde, this legislation is more important than ever,” Ordaz Perez said.

The measure is a sign of incremental progress, but it is not comprehensive, said Blair Taylor, an advocate at Moms Demand Action in Texas, a nonprofit that focuses on ending gun violence. She wants the Texas legislature to do more to prevent school shootings from taking place at all.

These are “band-aids for bullet holes,” Taylor said. “We are not addressing the actual problem of easy access to guns and toxic gun culture.”

The Texas American Federation of Teachers is creating posters to make sure teachers know about the new rules, so they can file any complaints to school districts. But the Texas regulations don’t specify punitive measures if districts fail to comply.

The San Marcos Consolidated Independent School District has no plans to change how it conducts drills this year, said Doug Wozniak, the district’s director of safety and health services.

Once a semester, students are instructed to hide in a corner silently while first responders go through the hallways and “lightly jiggle” classroom doorknobs, he said. Officers then yell, “Police, open up.” Students with special needs aren’t exempt from these lockdown drills, he said, but officers try to check on classrooms with those students first so that they can quickly resume class.

After the drill, students, teachers, and first responders gather in the cafeteria to debrief.

But even jiggling doorknobs might be too much like a simulation for many students, particularly those who are younger or have experienced a previous shooting, some experts say.

When schools simulate any aspect of a shooting, they can potentially make students feel unsafe on school grounds, said M. Aurora Vasquez, vice president of state policy and engagement for Sandy Hook Promise.

“The anxiety starts to sit with them on a regular basis when they go to school,” she said.

Texas limits the number of all types of drills that school districts should perform to 16 per school year, but many argue that lockdown drills don’t need to be conducted frequently.

“When you start doing these drills every month, which some school districts require, then it starts to suggest they are relatively likely,” said David Schonfeld, director of the National Center for School Crisis and Bereavement at Children’s Hospital Los Angeles. “That is a bad perception for kids.”

Many students say that the way Texas schools are currently conducting drills has a lasting impact. Jackson’s daughter is on the autism spectrum. Before August, she was never worried about a bedroom intruder. “She’s never been afraid of monsters; she’s never been afraid of the dark,” said Jackson. Afterward, that changed.

Between the Uvalde shooting and the regularity of drills, Giampaolo said, he and many of his peers feel uneasy in school this year. “We literally just want to go to school and not worry about being shot,” he said.

Kelly said she understands the necessity of school shooter preparedness, but it’s been difficult for her son.

“I don’t even know what the answer is, and I think that’s where I feel so powerless in this fight,” she said. “The kids are taking the brunt of bad decisions.”

Watch: Navigating Social Media After Mass Shootings

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(Hannah Norman / KHN)

Click here for a transcript of the interview.

A University of Pennsylvania professor shares advice on navigating the intersection of gun violence and social media as part of KHN’s new “Spotlight” interview series.

Buffalo, New York. Uvalde, Texas. Highland Park, Illinois. Graphic imagery and news about the recent string of mass shootings has ricocheted across social media, and professor Desmond Patton shares advice on how to navigate it. Earlier this year, Patton, the Brian and Randi Schwartz university professor at the University of Pennsylvania, spoke with Midwest correspondent Cara Anthony about the wrapping of caskets in colorful images to pay tribute to young lives lost to trauma and violence. 

This video is part of KHN’s new “Spotlight” interview series, which aims to amplify the voices of health experts, patients, and really anyone interacting with the U.S. health care system.