[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]


               A PUBLIC HEALTH CRISIS: THE GUN VIOLENCE 
                          EPIDEMIC IN AMERICA

=======================================================================

                                HEARING

                               BEFORE THE

                         SUBCOMMITTEE ON HEALTH

                                 OF THE

                    COMMITTEE ON ENERGY AND COMMERCE
                        HOUSE OF REPRESENTATIVES

                     ONE HUNDRED SIXTEENTH CONGRESS

                             FIRST SESSION

                               __________

                            OCTOBER 3, 2019

                               __________

                           Serial No. 116-68
                           
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]                           


      Printed for the use of the Committee on Energy and Commerce

                   govinfo.gov/committee/house-energy
                        energycommerce.house.gov

                              __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
43-411 PDF                 WASHINGTON : 2022                     
          
-----------------------------------------------------------------------------------                           
                       
                    COMMITTEE ON ENERGY AND COMMERCE

                     FRANK PALLONE, Jr., New Jersey
                                 Chairman
BOBBY L. RUSH, Illinois              GREG WALDEN, Oregon
ANNA G. ESHOO, California              Ranking Member
ELIOT L. ENGEL, New York             FRED UPTON, Michigan
DIANA DeGETTE, Colorado              JOHN SHIMKUS, Illinois
MIKE DOYLE, Pennsylvania             MICHAEL C. BURGESS, Texas
JAN SCHAKOWSKY, Illinois             STEVE SCALISE, Louisiana
G. K. BUTTERFIELD, North Carolina    ROBERT E. LATTA, Ohio
DORIS O. MATSUI, California          CATHY McMORRIS RODGERS, Washington
KATHY CASTOR, Florida                BRETT GUTHRIE, Kentucky
JOHN P. SARBANES, Maryland           PETE OLSON, Texas
JERRY McNERNEY, California           DAVID B. McKINLEY, West Virginia
PETER WELCH, Vermont                 ADAM KINZINGER, Illinois
BEN RAY LUJAN, New Mexico            H. MORGAN GRIFFITH, Virginia
PAUL TONKO, New York                 GUS M. BILIRAKIS, Florida
YVETTE D. CLARKE, New York, Vice     BILL JOHNSON, Ohio
    Chair                            BILLY LONG, Missouri
DAVID LOEBSACK, Iowa                 LARRY BUCSHON, Indiana
KURT SCHRADER, Oregon                BILL FLORES, Texas
JOSEPH P. KENNEDY III,               SUSAN W. BROOKS, Indiana
    Massachusetts                    MARKWAYNE MULLIN, Oklahoma
TONY CARDENAS, California            RICHARD HUDSON, North Carolina
RAUL RUIZ, California                TIM WALBERG, Michigan
SCOTT H. PETERS, California          EARL L. ``BUDDY'' CARTER, Georgia
DEBBIE DINGELL, Michigan             JEFF DUNCAN, South Carolina
MARC A. VEASEY, Texas                GREG GIANFORTE, Montana
ANN M. KUSTER, New Hampshire
ROBIN L. KELLY, Illinois
NANETTE DIAZ BARRAGAN, California
A. DONALD McEACHIN, Virginia
LISA BLUNT ROCHESTER, Delaware
DARREN SOTO, Florida
TOM O'HALLERAN, Arizona
                                 ------                                

                           Professional Staff

                   JEFFREY C. CARROLL, Staff Director
                TIFFANY GUARASCIO, Deputy Staff Director
                MIKE BLOOMQUIST, Minority Staff Director
                         Subcommittee on Health

                       ANNA G. ESHOO, California
                                Chairwoman
ELIOT L. ENGEL, New York             MICHAEL C. BURGESS, Texas
G. K. BUTTERFIELD, North Carolina,     Ranking Member
    Vice Chair                       FRED UPTON, Michigan
DORIS O. MATSUI, California          JOHN SHIMKUS, Illinois
KATHY CASTOR, Florida                BRETT GUTHRIE, Kentucky
JOHN P. SARBANES, Maryland           H. MORGAN GRIFFITH, Virginia
BEN RAY LUJAN, New Mexico            GUS M. BILIRAKIS, Florida
KURT SCHRADER, Oregon                BILLY LONG, Missouri
JOSEPH P. KENNEDY III,               LARRY BUCSHON, Indiana
    Massachusetts                    SUSAN W. BROOKS, Indiana
TONY CARDENAS, California            MARKWAYNE MULLIN, Oklahoma
PETER WELCH, Vermont                 RICHARD HUDSON, North Carolina
RAUL RUIZ, California                EARL L. ``BUDDY'' CARTER, Georgia
DEBBIE DINGELL, Michigan             GREG GIANFORTE, Montana
ANN M. KUSTER, New Hampshire         GREG WALDEN, Oregon (ex officio)
ROBIN L. KELLY, Illinois
NANETTE DIAZ BARRAGAN, California
LISA BLUNT ROCHESTER, Delaware
BOBBY L. RUSH, Illinois
FRANK PALLONE, Jr., New Jersey (ex 
    officio)
                             
                             C O N T E N T S

                              ----------                              
                                                                   Page
Hon. Anna G. Eshoo, a Representative in Congress from the State 
  of California, opening statement...............................     1
    Prepared statement...........................................     4
Hon. Bobby L. Rush, a Representative in Congress from the State 
  of Illinois, opening statement.................................     5
Hon. Adam Kinzinger, a Representative in Congress from the State 
  of Illinois, opening statement.................................     6
    Prepared statement...........................................     8
Hon. G. K. Butterfield, a Representative in Congress from the 
  State of North Carolina, opening statement.....................     9
Hon. Robin L. Kelly, a Representative in Congress from the State 
  of Illinois, opening statement.................................    11

                               Witnesses

Brenda K. Mitchell, pastor and mother of Kenneth D. Mitchell, Jr.    13
    Prepared statement...........................................    15
Selwyn Rogers, Jr., M.D., Chief of Trauma and Acute Care Surgery, 
  Univesity of Chicago Medicine..................................    18
    Prepared statement...........................................    20
Ronald M. Stewart, M.D., Medical Director, Committee on Trauma, 
  American College of Surgeons...................................    23
    Prepared statement...........................................    26
    Additional material submitted for the record \1\
Norman Livingston Kerr, Director of Violence Prevention, City of 
  Chicago........................................................    36
    Prepared statement...........................................    38
Spencer Leak, Sr., President and Chief Executive Officer, Leak 
  and Sons Funeral Home..........................................    40
    Prepared statement...........................................    42
Niva Lubin-Johnson, M.D., Immediate Past President, National 
  Medical Association............................................    46
    Prepared statement...........................................    49
    Additional material submitted for the record.................    55

                           Submitted Material

Testimony of Megan L. Ranney, Chief Research Officer, AFFIRM 
  Research, submitted by Mr.Rush.................................    87
Report, ``2014 Kelly Report: Gun Violence in America,'' by Office 
  of Congresswoman Robin L. Kelly, submitted by Ms. Kelly \2\
Letter of October 1, 2019, from David J. Skorton, President and 
  Chief Executive Officer, Association of American Medical 
  Colleges, to Ms. Eshoo and Mr. Burgess, submitted by Ms. Eshoo.    91

----------

\1\ Two articles submitted by Dr. Stewart have been retained in 
committee files and also are available at https://docs.house.gov/
meetings/IF/IF14/20191003/110968/HHRG-116-IF14-Wstate-StewartR-
20191003-SD004.pdf.
\2\ The report has been retained in committee files and also is 
available at https://docs.house.gov/meetings/IF/IF14/20191003/110968/
HHRG-116-IF14-20191003-SD008.pdf.

 
      A PUBLIC HEALTH CRISIS: THE GUN VIOLENCE EPIDEMIC IN AMERICA

                              ----------                              


                       THURSDAY, OCTOBER 3, 2019

                  House of Representatives,
                  Committee on Energy and Commerce,
                                    Subcommittee on Health,
                                                    Washington, DC.
    The subcommittee met, pursuant to call, at 9:35 a.m., in 
the Great Hall at Kennedy-King College, 6301 South Halsted 
Street, Chicago, IL, Hon. Anna G. Eshoo (chairwoman of the 
subcommittee), presiding.
    Members present: Representatives Eshoo, Rush, Schakowsky, 
Butterfield, Clarke, Kelly, and Kinzinger.
    Also present: Representatives Danny K. Davis and Jesus G. 
``Chuy'' Garcia.
    Staff present: Stephen Holland, Health Counsel; John 
Marshall, Policy Coordinator; Aisling McDonough, Policy 
Coordinator; Rebecca Tomilchik, Staff Assistant; CJ Young, 
Press Secretary; Lauren Citron, Legislative Assistant, Rep. 
Rush; Jeremy Edwards, Communications Director, Rep. Rush; 
Nishith Pandya, Legislative Director, Rep. Rush; Yardly Pollas, 
Chief of Staff, Rep. Rush; Robyn Wheeler-Grange, District 
Director, Rep. Rush; Michael Brady, Press Assistant, Rep. 
Eshoo; Osaremen Okolo, Health Policy Advisor, Rep. Schakowsky; 
Kristen Shatynski, Minority Professional Staff Member; Paul 
Laurie, Minority Legislative Assistant, Rep. Kinzinger; Austin 
Weatherford, Minority Chief of Staff, Rep. Kinzinger; and 
Lanette Garcia, Legislative Assistant, Rep. Garcia.
    Ms. Eshoo. Good morning, everyone.
    The Subcommittee on Health will now come to order. Before 
we begin, per an agreement between the majority and the 
minority, I would like to ask for unanimous consent for the 
House Members who are with us today who are not members of the 
committee, that they be recognized for 3 minutes to ask 
questions after committee members have asked theirs.
    And note, only committee members will be allowed to make 
opening statements. Hearing no objections, so ordered.
    The Chair now recognizes herself for 5 minutes for an 
opening statement.

 OPENING STATEMENT OF HON. ANNA G. ESHOO, A REPRESENTATIVE IN 
             CONGRESS FROM THE STATE OF CALIFORNIA

    First of all, thank you, everyone, for being here this 
morning. It is an honor for those of us that are not from 
Chicago to be here.
    I am Anna Eshoo. I have the honor of chairing this 
subcommittee, and I have many relatives in Chicago. So this is 
the Midwestern part of my family, and it is an honor to be here 
with my colleagues on a very serious issue.
    This is the very first Energy and Commerce Committee 
hearing on the gun violence epidemic in our country as a public 
health issue, and this subcommittee has jurisdiction over 
public health issues in our country.
    I want to recognize first the members of the committee who 
represent parts of Chicago and the region, starting with 
Congressman Bobby Rush, whose district we are in.
    Thank you, Bobby, very much for inviting us--asking the 
subcommittee to come here.
    Congresswoman Robin Kelly, who is here to my left; 
Congresswoman Jan Schakowsky from the Chicago region; and to 
Representative Adam Kinzinger, who is also a representative 
here from the State of Illinois, a little farther away--I think 
next door to Robin.
    Mr. Kinzinger. Yes. Yes.
    Ms. Eshoo. And Mr. Kinzinger makes this hearing a 
bipartisan hearing, and we are grateful to him for being here 
today for his leadership and the leadership of each Member that 
is here today.
    We are also grateful to have with us, and we welcome our 
congressional colleagues who are guests of the committee today, 
Representative Danny Davis, whom I always say is the voice of 
God when you----
    [Laughter.]
    Mr. Rush. Yes.
    Ms. Eshoo [continuing]. Hear that magnificent voice of his, 
and Chuy Garcia, who is here; the vice chair of the Energy and 
Commerce Committee, Congresswoman Yvette Clarke; and I already 
mentioned Congresswoman Jan Schakowsky.
    Now, on this--on the subject matter that is before us 
today, it is important to note that 100 Americans are killed by 
a gun and hundreds more are shot and injured every day in our 
country. Millions of Americans have watched in horror to see 
the shootings and the massacres that have taken place in our 
country.
    They have watched families bury their loved ones, and there 
are too many that live in fear of what could happen next, and 
some are here with us today.
    They are in the audience, they are at the witness table, 
and they are on the dais as Members of Congress. Congressman 
Rush buried his son as a result of gun violence.
    I think this collective heartbreak will move us to work 
with real purpose. We are here to treat American gun violence 
for what it is: an epidemic.
    And to treat an epidemic, we have to study it, we have to 
understand what works to prevent it, and we need to learn how 
to treat the trauma that is caused by it.
    We know that a public health approach can work. Consider 
antismoking efforts, or preventing injuries from car crashes. 
We have achieved lifesaving results through funding data 
analysis, encouraging research, and adopting commonsense 
product improvements with these epidemics.
    Another simple yet profound and proven method is listening 
to people from the communities most affected by an epidemic and 
the public health it represents.
    We are here in Chicago's South Side, where so many have 
lived with the epidemic of gun violence and for decades. Thank 
you, again, Congressman Rush, for inviting our committee to 
hold this hearing in your district and for your years of work 
to address gun violence.
    Gun homicide is the leading cause of death for African-
American boys and men ages 15 to 34, and it is the second-
leading cause of death for Hispanic boys and men ages 15 to 34 
as well.
    African-American men make up 52 percent of all gun homicide 
victims despite only being 7 percent of the population of our 
country.
    Compared to the rate of gun homicides for white boys and 
men of the same ages, the rate for African Americans is 21 
times greater, and the rate for Hispanic men is nearly four 
times greater.
    Notably, the communities most impacted by gun violence are 
the most knowledgeable about how to treat it and prevent it.
    It is why our witnesses include Mr. Spencer Leak, Sr., 
owner of a family-run funeral home in the Chatham neighborhood, 
who has comforted hundreds if not thousands of families whose 
loved ones have been killed by a gun.
    It is why we are listening to Pastor Brenda Mitchell and 
Mr. Norman Kerr, who have taken their experiences with gun 
violence and used them to promote commonsense, evidence-based 
policies.
    And it is why we are hearing from the physicians who work 
every day to heal the physical, mental, and generational trauma 
from shootings and who see the bodies that are ravaged by gun 
violence.
    Today's hearing will not be enough to stop the daily 
violence. But we can broaden our understanding of how best to 
treat this epidemic and provide resources for public health 
research.
    I am proud that the House voted to provide $50 million for 
gun violence research at the CDC and the NIH, and the Senate 
needs to do the same.
    I want to thank Congresswoman Robin Kelly, a leader on the 
issue of gun violence and for introducing----
    [Applause.]
    Ms. Eshoo. Sure, you can applaud. Every Member welcomes 
that. It is a validation of our work.
    I want to thank her for introducing H.R. 1114, and this is 
legislation that requires the U.S. Surgeon General to provide 
an annual report to Congress on the public health impacts and 
the--you can applaud--and the costs of gun violence in America.
    And I hope that our hearing today helps that bill come 
closer to become law. So thank you, Congresswoman Robin Kelly.
    Again, I thank each of my congressional colleagues. It is a 
special honor to join with you here today in Chicago. I want to 
thank each one of our witnesses for your professionalism and 
your willingness to be here with us today, and everyone else 
that has joined us. Those that are in the audience, thank you 
for being here today.
    Collectively, I think your presence and your testimony is 
going to fuel our action.
    [The prepared statement of Ms. Eshoo follows:]

                Prepared Statement of Hon. Anna G. Eshoo

    Welcome to the very first Energy and Commerce hearing on 
gun violence as a public health issue.
    First, I'd like to recognize the members of the committee 
who represent the Chicago region: Representative Bobby Rush 
whose district we are in, Congresswomen Robin Kelly and Jan 
Schakowsky, and our Republican colleague, Representative Adam 
Kinzinger, thank you for your leadership and for participating 
in this hearing today.
    We're grateful to and welcome our Congressional colleagues 
who represent the Chicago region and are guests of the 
Committee today: Representatives Danny Davis, Sean Casten, and 
Chuy Garcia.
    One hundred Americans are killed with a gun and hundreds 
more are shot and injured every day. Millions of Americans have 
seen a shooting, buried a loved one, or live in fear of what 
could happen next, and some are here with us today.
    They are in the audience, they are at our witness table, 
and they are on the dais as Members of Congress.
    Your heartbreak moves us to work with purpose.
    We're here to treat American gun violence for what it is--
an epidemic, and to treat an epidemic, we must study it, 
understand what works to prevent it, and learn how to treat the 
trauma caused by it.
    We know that a public health approach can work. Consider 
antismoking efforts or preventing injuries from car crashes. 
We've achieved life-saving results through funding data 
analysis, encouraging research, and adopting commonsense 
product improvements with these epidemics.
    Another simple yet profound and proven method is listening 
to people from the communities most affected by the public 
health threat.
    We're here in Chicago's South Side where so many have lived 
with the epidemic of gun violence for decades. I thank 
Congressman Bobby Rush for inviting our committee to hold this 
hearing in Chicago and for his years of work to address gun 
violence.
    Gun homicide is the leading cause of death for Africa-
American boys and men ages 15 to 34, and the second-leading 
cause of death for Hispanic boys and men ages 15 to 34.
    African-American men make up 52% of all gun homicide 
victims, despite only being seven percent of the U.S. 
population.
    Compared to the rate of gun homicides for white boys and 
men of the same ages, the rate for African Americans is 21 
times greater, and the rate for Hispanic men is nearly four 
times greater.
    Notably, the communities most impacted by gun violence are 
the most knowledgeable about how to treat and prevent it.
    It's why our witnesses include Mr. Spencer Leak, Sr., owner 
of a family-run funeral home in the Chatham neighborhood who 
has comforted hundreds of families whose loved ones have been 
killed by a gun.
    It's why we're listening to Pastor Brenda Mitchell and Mr. 
Norman Kerr, who've taken their experiences with gun violence 
and used it to promote commonsense, evidence-based policies.
    And it's why we're hearing from the physicians who work 
every day to heal the physical, mental, and generational trauma 
from shootings and see the human beings whose bodies are 
ravaged by gun violence.
    Today's hearing will not be enough to stop the daily 
violence. We need to provide money for public health research.
    I'm proud the House voted to provide $50 million for gun 
violence research at the CDC and NIH. The Senate needs to do 
the same.
    I want to thank Congresswoman Robin Kelly for introducing 
H.R. 1114, legislation that requires the U.S. Surgeon General 
to provide an annual report to Congress on the public health 
impacts and the costs of gun violence in America. I hope our 
hearing today helps that bill come closer to being law.
    Again, I thank each Member of Congress, our witnesses, and 
our audience for joining us today. Your presence and testimony 
will fuel our action.

    Ms. Eshoo. I now have the privilege of recognizing the 
gentleman from Illinois, Mr. Rush, for his opening statement.

 OPENING STATEMENT OF HON. BOBBY L. RUSH, A REPRESENTATIVE IN 
              CONGRESS FROM THE STATE OF ILLINOIS

    Mr. Rush. I want to thank you, Madam Chairman, and my 
friend from the great state of California. You and I were sworn 
in together in Congress back in January of 1993, and we have 
enjoyed each other and had our--our friendship has flowed all 
the way to this day and including this day.
    I want to thank you for convening this important hearing 
and discussion right here in my district in the Kennedy-King 
College.
    Kennedy-King College is, in some sense, apropos for a 
discussion on nonviolence in that both John F. Kennedy and 
Robert F. Kennedy and Dr. Martin Luther King, Jr., were killed 
by gun violence.
    Gun violence, Madam Chairman, is indeed a national 
epidemic. Gun violence undermines the public health and the 
public safety of all of our communities.
    This epidemic has had painful consequences for far too many 
families here in Chicago, including my own family. Far too many 
families in my district and similarly situated districts all 
across the country have felt these painful consequences.
    Madam Chairman, you mentioned my son, whose name was Huey. 
Huey's murder was 10 years ago this very month. The anniversary 
of his murder was October 31st.
    So we are--10 years later, we are still fighting, still 
wanting to try to resolve this matter of--this epidemic of gun 
violence in our Nation.
    Madam Chair, way back in 2017 I started calling more 
hearings such as this to take place here in my district. 
Important conversations are going on in Washington, DC.
    But just as important if not more so is that we are having 
these conversations right here in a community that for too long 
has felt the pain of this epidemic.
    It is for this very reason that I am pleased that we are 
finally convening today this hearing to discuss this public 
health crisis, this epidemic of gun violence.
    And I want to thank all of my colleagues on both sides of 
the aisle for being here today, and I want to thank the 
witnesses who have come out at their own expense, sacrificing 
their own time and resources, to bear testimony at this 
hearing.
    And, Madam Chairman, I am confident that during today's 
hearing we will be able to shine a light on the public health 
impacts of gun violence, and I am optimistic that we will walk 
away and conclude this hearing with tangible ideas and 
solutions that will protect our communities in the future from 
this widespread and totally unrecognized epidemic.
    This epidemic gun violence is not just a law enforcement 
issue, Madam Chairman. It is a healthcare crisis in our Nation, 
and as you stated earlier, it is an epidemic that we must 
address as an epidemic in our Federal Government.
    Madam Chairman, I look forward--Madame Chairwoman, I look 
forward to hearing from today's witnesses, and with that said, 
I ask for unanimous consent to insert in the record the 
testimony of an individual who appeared at a hearing that I had 
in Washington.
    That was an unofficial hearing, but I had a hearing at the 
Library of Congress almost 2 years ago where Dr. Megan Ranney, 
an emergency physician, a violence prevention leader, and the 
chief research officer of affirmed research in the country's 
only nonprofit institution dedicated to solving gun violence 
through the public health approach.
    Madam Chairman, I want to submit with unanimous consent her 
testimony for the record.
    Ms. Eshoo. So ordered.
    [The information appears at the conclusion of the hearing.]
    Mr. Rush. And, Madam Chairman, with that I yield back the 
balance of my time, and again, thank you for your participation 
and your leadership on this and on the issue in our Congress.
    Ms. Eshoo. The gentleman yields back.
    Let me just say on behalf of my colleagues we are all very, 
very grateful to the faculty, to the entire team here at 
Kennedy-King, for your hospitality, for your warm welcome, for 
the coffee when we came through the door and had this morning.
    Let me just say that the two words, Kennedy and King, will 
always be a source of inspiration to each one of us, and how 
fitting it is that we are having this hearing in an institution 
of learning.
    It is now my pleasure to recognize the gentleman from 
Illinois, Adam Kinzinger, for his 5 minutes and his opening 
statement.

 OPENING STATEMENT OF HON. ADAM KINZINGER, A REPRESENTATIVE IN 
              CONGRESS FROM THE STATE OF ILLINOIS

    Mr. Kinzinger. Well, good morning, everybody, and for our 
witnesses, thank you very much for being here. Chairwoman 
Eshoo, thank you for making the trip, and to all my colleagues, 
I really appreciate you all being here.
    I may be outnumbered today, but I assure you there is a 100 
percent turnout of Republicans from northern Illinois.
    [Laughter.]
    Mr. Kinzinger. So yes. Let me----
    [Applause.]
    Mr. Kinzinger. One of the other things I want to make very 
clear, because you don't get to see this a lot when you watch 
TV and stuff, most of us here--I think all of us get along 
really well. We actually respect each other.
    Unfortunately, you just see the times we argue and debate, 
and you assume that it is like that all the time. We actually 
like each other, and if I don't like somebody it is not because 
of their politics. It is maybe because they are a jerk. But 
nobody here fits that bill.
    But I think that is important for me because I want to say 
this. You know, I think when we get into these debates, whether 
it is guns or gun violence, a lot of the times both sides just 
retreat to their corner and mistrust each other in a 
conversation and they assume the worst of what folks are 
saying, and in some cases people may mean the worst when they 
make a position.
    But I think this is--while we are never going to agree at 
whatever the end result is in the near future, I think there 
are a lot of areas we can agree, and I think if we can begin to 
talk to each other again and respect each other again and 
listen to each other again, I think we will be able to make 
some progress, and that is why I am here.
    I am actually here not to debate my points and not to 
argue. I am here to listen. I am here to listen to the people 
of this community, to learn more about what is working and what 
more we can do at the Federal level to help remedy some of 
these issues.
    You know, whether it is a small town or a big city across 
the Nation, Americans are terrified by the mass shootings they 
have seen that have, sadly, become a regular occurrence.
    Too often, though, our attention to gun-related violence 
focuses more on the mass shootings, and hardly any goes to the 
steady, devastating strings of violence and daily killings that 
happen here in Chicago and elsewhere, and frankly, I am 
horrified each week when I see the number of people shot or 
killed over the weekend in Chicago or when I get a notification 
on my phone about an active shooter. This is our community, and 
we need to work together to stop this violence.
    As a Congressman, I feel the heat on all ends of this 
debate, as all my colleagues do here, and I see the validity of 
both sides of the conversation.
    We, clearly, have a gun violence epidemic here in America, 
and I want to work with my colleagues on both sides of the 
aisle to find solutions that will reduce suicides, drug-related 
violence, gang violence, and mass shootings.
    While the larger gun debate continues, I believe there are 
many areas we can find agreement, and it is our duty to do so. 
And today I look forward to hearing from our distinguished 
panel of witnesses about what more we can do to address this 
problem.
    During this hearing, I am interested in discussing the 
community aspect of the gun violence crisis. I believe this 
component is at the heart of a lot of issues we face.
    I know there have been community initiatives in Chicago, 
including job training, youth-based programs and support 
groups, which have made a significant impact.
    These programs that are often formed by the community and 
for the community have shown how critical of a role communities 
can play in addressing this crisis.
    We really need to make sure we are paying attention to 
these programs and replicate them when they are successful. I 
am also interested in the mental health aspect of gun violence 
and what we can do in Congress to ensure we provide the tools 
necessary to address this component of the problem, such as 
improving access to community health centers and those needing 
medical help.
    But we can't legislate a heart, and that is where community 
and religious organizations come into play. They can help guide 
and give people hope for a better future.
    If you don't have hope and you don't have any reason to 
follow a moral code or fear the results of your action, 
tragedy, in many cases, follows.
    Desperation can be a dangerous trigger, and to the extent 
we can work on helping and healing those who are struggling and 
end the stigma of discussing and facing mental illness in this 
country, I fear things may only get worse.
    In discussing the desperation and hopelessness, we come to 
the issue of suicide. In 2017, 60 percent of gun-related deaths 
were suicides, and here in Illinois 1 person dies by suicide 
every 6 hours.
    In the age of technology and instant gratification, more 
and more people are feeling less connected. They feel isolated 
and hopeless, and it is an issue we need to resolve as a 
society.
    Kids today feel that their self-worth depends on the number 
of likes or comments or snaps they get in a given day, and that 
is a concern to me.
    So, as we get into these different issues surrounding gun 
violence, I want to reiterate it is a complex problem that 
requires a comprehensive, holistic approach.
    I am grateful to our subcommittee for holding this hearing 
today and especially to our panelists for being here to share 
their experience, their expertise, and insight as we look at 
the root cause of this violence and work together to find real 
solutions to address the gun violence epidemic.
    With that, I yield back.
    [The prepared statement of Mr. Kinzinger follows:]

               Prepared Statement of Hon. Adam Kinzinger

    Good morning, everyone. I'd like to thank the chairman and 
staff for organizing today's hearing in Chicago, and the 
witnesses for taking the time to discuss some of the outside 
factors at play in the public health aspect of the gun violence 
crisis we face as nation.
    I'm here to listen to our witnesses and the people of this 
community to learn more about what's working and what more we 
can do at the Federal level to help remedy some of these 
issues.
    Across the country, from small towns to big cities, 
Americans have been terrified by the mass shootings that have 
sadly become a regular occurrence.
    Too often, our attention to gun-related violence focuses 
more on the mass shootings and hardly any goes to the steady, 
devastating strings of violence and daily killings that happen 
here in Chicago, just north of my hometown.
    Frankly, I am horrified each week when I see the number of 
people shot and/or killed over the weekend in Chicago or when I 
get a notification on my phone about an active shooter in our 
area. This is our community and we need to work together to 
stop this violence.
    As a Congressman, I feel the heat on all ends of this 
debate, and I see the validity of both sides of the 
conversation.
    We clearly have a gun violence epidemic here in America, 
and I want to work with my colleagues on both sides of the 
aisle to find solutions that will reduce suicides, drug-related 
violence, gang violence, and mass shootings.
    While the larger gun debate continues, I believe there are 
many areas where we can find agreement and it is our duty to do 
so.
    Today, I look forward to hearing from our distinguished 
witnesses about what more we can do to address this problem.
    During this hearing, I'm interested in discussing the 
community aspect of our gun violence crisis. I believe this 
component is at the heart of the issues we face.
    I know there have been community initiatives in Chicago, 
including job training, youth-based programs, and support 
groups, which have made a significant impact.
    These programs that are often formed by the community and 
for the community, and have shown how critical of a role 
communities play in addressing the crisis.
    We really need to make sure we're paying attention to these 
programs and replicate them when they are successful.
    I'm also interested in the mental health aspect of gun 
violence, and what we can do in Congress to ensure we are 
providing the tools necessary to address this component of the 
problem, such as improving access to Community Health Centers 
for those needing medical help.
    But we cannot legislate the heart. And that's where the 
community and religious organizations come into play. They can 
help guide and give people hope for a better tomorrow.
    If you don't have hope, you don't have any reason to follow 
a moral code or fear the results of your actions.
    Desperation can be a dangerous trigger, and to the extent 
we can work on helping and healing those who are struggling, 
and end the stigma of discussing and facing mental illness in 
this country, I fear things may only get worse.
    In discussing this desperation and hopelessness, we come to 
the issue of suicide.
     In 2017, 60% of gun-related deaths in the U.S. 
were suicides.
     And here in Illinois, one person dies by suicide 
every six hours.
    In the age of technology and instant gratification, more 
and more people are feeling less connected--they feel isolated 
and hopeless, and it's an issue we need to resolve as a 
society. Kids today feel their self-worth depends on the number 
of likes or comments or snaps they get in a given day, and 
that's a real concern to me.
    As we get into the different issues surrounding gun 
violence today, I want to reiterate that this is a complex 
problem that requires a comprehensive, holistic approach.
    I'm grateful to our subcommittee for holding this hearing 
today and especially to our panelists for being here to share 
their expertise, experience, and insight as we try to look at 
the root causes of this violence and work together to find real 
solutions to address the gun violence epidemic.

    Ms. Eshoo. The gentleman yields back.
    It is now--the Chair would like to recognize Mr. 
Butterfield, the vice chairman of the full committee, for his 5 
minutes for an opening statement. A pleasure to recognize you.

 OPENING STATEMENT OF HON. G. K. BUTTERFIELD, A REPRESENTATIVE 
          IN CONGRESS FROM THE STATE OF NORTH CAROLINA

    Mr. Butterfield. Thank you very much, Madam Chair. I know 
Ms. Clarke may not take too kindly to that. She is the vice 
chair of the full committee. I am vice chair of the 
subcommittee. Thank you.
    Ms. Eshoo. You just got a raise.
    Mr. Butterfield. I know. Thank you.
    [Laughter.]
    Mr. Butterfield. But let me join Congressman Rush and 
Congressman Kinzinger for--join with them in thanking you for 
your incredible work on this subcommittee.
    You promised us months ago that you would have this field 
hearing, and you have fulfilled that commitment, and so we 
thank you very much.
    It is good to be with my colleagues, particularly those 
from Illinois, and my good friend, Bobby Rush, who sits to my 
right, and I understand that we are physically in your 
congressional district. So thank you for your work.
    Madam Chair, the gun violence epidemic in America can no 
longer be ignored. We must treat this epidemic for what it is. 
It is a public health crisis, and that is why we are here 
today.
    Democrats in the House recognize this crisis, and we are 
determined--yes, we are--we are determined to take some action.
    With that said, Madam Chair, I would like to yield 2 
minutes to my friend from Illinois, Congresswoman Kelly.
    Ms. Eshoo. Are you yielding?
    Mr. Butterfield. I was going to yield Congresswoman Kelly 
some time if she is not on the schedule to do an opening 
statement.
    She is on the schedule? Reclaiming my time.
    [Laughter.]
    Ms. Eshoo. Now, don't lose the time.
    Mr. Butterfield. I just didn't want to--I just didn't want 
to leave my friend out--Ms. Kelly--because she works so hard.
    But for too long, Madam Chair, we have handcuffed the 
Federal Government from researching the affliction of gun 
violence in America and its impacts on public health.
    We need to marshal the resources of the Department of 
Health and Human Services and the CDC to know the impact--the 
huge impact--that gun violence is having on kids right here in 
Chicago and our neighbors all across the country.
    We need to know how they will be impacted throughout their 
lives after they witness their loved ones get gunned down in 
the streets or committing suicide with the assistance of a 
firearm.
    We need to know why the homicide rate in America is more 
than 25 times the average of other developed nations. We are 
going to face the gun violence epidemic head on, and today's 
hearing will help us in that fight.
    I now want to yield time to Ms. Schakowsky, since she is on 
the second tier. But she is nonetheless a very strong and 
forceful leader in this area.
    Ms. Schakowsky?
    Ms. Schakowsky. I thank the gentleman for yielding.
    So we heard that number--an average of a hundred people a 
day. That adds up. If you multiply it by 365, 36,500 people a 
year dying from guns. In Chicago, as of Sunday 2,101 people 
shot and 382 killed.
    This is a crisis. It demands a sense of urgency right now. 
We are raising the profile right now today, but we need action.
    So, you know, in Chicago and in Illinois we have good laws 
on guns. But 60 percent of the guns that come into our State 
come from other States across the border.
    You can go to Indiana on a weekend and go to a gun show, 
open up your trunk, and load up that car with any kind of gun 
that you want, and drive across the border. We don't stop 
people.
    I want to thank not only our panel, but I see people in the 
audience with red shirts, moms against gun violence. Moms--
thank you so much.
    [Applause.]
    Ms. Schakowsky. I see people that are here that want to 
help us. They deserve our help. And on the panel, let me just 
thank Pastor Mitchell, especially because of the feeling of a 
mom, not only as an expert now, on this to bring that.
    And I want to--Mr. Leak, a friend of mine--when we are 
talking about the number of people killed, I said, ``Think 
about if it were a virus, what would we be doing? We would be 
searching for that.'' And he said, ``Well, what about if it 
were terrorism?'' He said, ``We would be at war.''
    This is a war that we have to win. Children are hiding in 
bathtubs in their homes to seek refuge from bullets that may 
come through.
    So this is an opportunity and an obligation today to 
actually move ahead.
    Thank you. I yield back. I thank the gentleman for yielding 
to me.
    Mr. Butterfield. Thank you. Madam Chair, I yield back.
    [Applause.]
    Ms. Eshoo. The gentleman yields back.
    I now would like to recognize the gentlewoman from 
Illinois, Congresswoman Robin Kelly, for her statement, and 
with thanks for your work as well.

 OPENING STATEMENT OF HON. ROBIN L. KELLY, A REPRESENTATIVE IN 
              CONGRESS FROM THE STATE OF ILLINOIS

    Ms. Kelly. Thank you, Chairwoman Eshoo, and thank you for 
your leadership in this area, and I want to welcome all of my 
colleagues to Chicago and thank all of the witnesses for taking 
their time to be here.
    But thank you for holding this important hearing on gun 
violence as a public health crisis. Thank you to all of my 
colleagues. As I said, really appreciate you being here. By 
being here you are showing your commitment to solutions that 
will end our Nation's gun violence epidemic.
    Congresswoman Schakowsky talked about the statistics--over 
35,000 people, and the number of people in the Chicagoland 
area. Like nationwide statistics, a disproportionate number of 
these victims are young African-American men. Specific to the 
public health threat posed by gun violence, I have introduced, 
as you have heard, H.R. 1114, legislation to require the 
Surgeon General, our Nation's doctor, to submit an annual 
report on the impacts of gun violence on public health.
    In 1964, the Surgeon General issued this report, ``Smoking 
and Health.'' That report sparked a revolution in thinking 
about tobacco use, smoking, and public health.
    In 2019, it is time for this Surgeon General to issue a 
report on gun violence. In addressing the public health impacts 
of gun violence, we cannot be limited to the immediate impacts 
of bullets on the human body.
    We know that gun violence takes an emotional and 
psychological toll on communities. In some parts of my 
district, young people experience levels of PTSD on par with 
returning veterans because of regular gun violence.
    Simply addressing easy access to guns will not solve all 
the challenges in these communities. Decades of systemic 
underinvestments and disinvestments in schools, transportation, 
businesses, and public spaces coupled with residential 
segregation by race has created a divided city--a divided city 
in which gun violence is largely concentrated in black and 
brown communities that are underserved, underresourced, and, 
for some, wary of law enforcement.
    As a member of this subcommittee and chair of the 
Congressional Black Caucus Health Braintrust, I am dedicated to 
finding solutions that improve the health of all communities 
across the country. This includes preventing gun violence.
    As I said, gun violence impacts our society in various 
ways, and not only does it take a toll on our healthcare 
system, it also negatively impacts our economics and reduces 
worker productivity.
    A recent study on gun violence found that loss of quality 
of life, psychological and emotional trauma, decline in 
property values, and other legal and societal consequences 
stemming from gun violence cost an estimated $174 billion.
    Of that cost, the Government directly absorbs $12 billion. 
Instead of using these funds to invest in our communities, 
workers, and their families, these dollars are bled away due to 
gun violence and its impacts.
    I always say nothing stops a bullet like an opportunity. In 
order to combat gun violence and help these communities 
rebuild, they need investment.
    In this Congress I have introduced several pieces of 
legislation to improve economic opportunities in underserved 
areas, including Creating Pathways for Youth Employment Act, 
Heroes for At-Risk Youth, and Community College to Career Fund 
Act.
    For the past several Congresses, I have also introduced the 
Urban Progress Act that would also help to fill this void in 
economic opportunities, strengthen police-community relations, 
and promote commonsense gun violence prevention policies.
    I look forward to the witnesses' testimony and, again, 
welcome.
    And I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    The Chair reminds Members that, pursuant to committee 
rules, all Members' written opening statements shall be made 
part of the record.
    I now would like to introduce the witnesses for today's 
hearing.
    To my left, Pastor Brenda Mitchell. She is the mother of 
Kenneth D. Mitchell, Jr. Welcome to you and thank you for being 
here with us today.
    Dr. Selwyn Rogers, Jr., chief, section for trauma and acute 
care surgery, and founding director, the Trauma Center, 
University of Chicago Medicine. Welcome to you, and thank you 
for joining us here today.
    Dr. Ronald Stewart, director of trauma programs, American 
College of Surgeons Committee on Trauma. Traveled from Texas to 
be with us here today.
    Mr. Norman Kerr, director of violence prevention from the 
city of Chicago. Thank you for joining us today.
    Mr. Spencer Leak, Sr., the president and CEO of Leak and 
Sons Funeral Home. He has a real story to tell.
    And last but not least, Dr. Niva Lubin-Johnson, immediate 
past president of the National Medical Association. Thank you 
to you.
    Thank you to each witness. We look forward to your 
testimony and now, at this time, the Chair recognizes each 
witness for 5 minutes.
    We will begin with Pastor Brenda Mitchell. I think that you 
are probably familiar. Do we have the lighting system there?
    Yes. Green--you know what green means. Yellow, caution. 
When the red light comes on, full stop.
    All right. You are probably wondering why that doesn't 
apply to Members of Congress.
    [Laughter.]
    Ms. Eshoo. But anyway, so thank you again, and the Chair is 
pleased to recognize Pastor Brenda Mitchell for your 5 minutes 
of testimony.

STATEMENTS OF BRENDA K. MITCHELL, PASTOR AND MOTHER OF KENNETH 
D. MITCHELL, Jr.; SELWYN ROGERS, Jr., M.D., CHIEF OF TRAUMA AND 
 ACUTE CARE SURGERY, UNIVERSITY OF CHICAGO MEDICINE; RONALD M. 
STEWART, M.D., MEDICAL DIRECTOR, COMMITTEE ON TRAUMA, AMERICAN 
   COLLEGE OF SURGEONS; NORMAN LIVINGSTON KERR, DIRECTOR OF 
   VIOLENCE PREVENTION, CITY OF CHICAGO; SPENCER LEAK, Sr., 
 PRESIDENT AND CHIEF EXECUTIVE OFFICER, LEAK AND SONS FUNERAL 
   HOME; NIVA LUBIN-JOHNSON, M.D., IMMEDIATE PAST PRESIDENT, 
                  NATIONAL MEDICAL ASSOCIATION

                STATEMENT OF BRENDA K. MITCHELL

    Ms. Mitchell. Thank you.
    Good morning to this esteemed body, to Everytown Survivor 
Network for allowing me to be here, to the moms of Mom Demand 
Action and Purpose Over Pain, who has also given me my voice. I 
also recognize Spencer Leak, Sr., who was the recipient of my 
son's burial service and given me a voice also on Black-on-
Black love.
    I am Pastor Brenda Mitchell. I live in University Park, 
Illinois. I have lived and worked in the Chicago area most of 
my life.
    Today I am here as someone who has experienced two family 
members taken by gun violence--my brother and my son. Today I 
am here as a voice for my son.
    I am here as a voice for my community. I am here on behalf 
of the hundreds of mothers who have had their children torn 
from their lives by gun violence.
    My son, Kenneth, was the center of our family. He was the 
first grandchild on both sides of the family and became a role 
model for his younger siblings and cousins.
    At the age of 31, he was a single parent of two little 
boys, 8 and 6, and another son who would be born 30 days after 
his death.
    It was Super Bowl weekend. As the manager of a golf center 
in University Park, he was hosting a Super Bowl party on 
Sunday. His boys were with their mother, so he took the rare 
opportunity that evening to spend some time with friends at a 
local sports bar, playing darts and enjoying each other's 
company.
    As Kenneth was leaving, an argument broke out between two 
individuals outside of the bar. Kenneth intervened, attempting 
to diffuse the situation and make peace, when a friend of one 
of the individuals went to his van, grabbed a gun, and started 
randomly firing into the crowd.
    Kenneth was struck by a stray bullet and killed. I received 
a call in the middle of the night that no parent wants to 
receive. I was told my son, Kenneth, had been hurt in a 
shooting and he was lying at the scene with a sheet over him.
    I could not tell my husband his son, his namesake, our 
first-born child, was dead. Earlier that day, I distinctly 
remember feeling so satisfied with my life, and I thanked God 
for meeting my needs and the needs of my family. I could not 
ask for anything.
    Little did I realize that in less than 24 hours I would 
have to ask God for strength.
    After Kenneth's death, I felt for the first time in our 
lives that my family was dysfunctional. My son was a crime 
scene. I could not touch him. The pain was so intense that I 
would not wish this experience on my own worst enemy.
    Even worse was trying to navigate through it with no 
resources. I was traumatized with nowhere to go.
    Just a week before Kenneth's death, our younger son, Kevin, 
left for his third tour of duty in Afghanistan. This is the 
kind of thing that a mother worries about.
    I prayed for Kevin, placed him on the altar, and in my mind 
he was the one who was in danger. I never would have imagined 
Kenneth would be the one to die from an act of gun violence 
right here at home in a free country.
    A week later, I brought Kevin back to bury his brother in a 
free country. My life shows that trauma. Post-traumatic stress 
syndrome and grief have lasting effects in the lives of those 
that are touched by gun violence.
    However, I learned these terms and the impact on health. 
Even if I didn't know what it was called, I knew how it felt 
and I saw the effect it had on my life and the lives of 
surviving family members.
    My mother could not handle after losing her first grandson, 
to gun violence, after the death of her own son. My mother 
willed herself out of her pain. She died from a broken heart.
    I myself had to leave a successful career because of PTSD 
and trauma. I lost cognitive memory. I did not know my phone 
number or the names of people very close to me.
    I still struggle to recall the date of my son's death. This 
is not because the date is not significant to me, but because 
it is a manifestation of that trauma.
    I almost died three times with extreme hypertension and 
narrowing of the arteries in my brain because of the level of 
stress I was under. I was grieving for my son, raising my 
grandsons left without their primary parent.
    I had to look at my youngest grandson and know that he 
would never meet his father. I had to recreate his father for 
him. There are no words that communicate the depth of that 
loss. How many young men and women have we lost who will never 
have the chance to reach their full potential?
    Every day there are communities being shattered by the 
devastation that is this crisis of gun violence. We have 
children in Chicago who aren't worried about growing up to be a 
doctor or a lawyer. They are just worried about growing up, 
period.
    That reality is unacceptable. In my own journey--and I am 
almost done--I have come full circle. I identify with the 
devastation families experience every day in our country and in 
Chicago.
    It has become my passion to help others understand how 
trauma of gun violence can affect individuals and communities. 
I have become an advocate for trauma-informed care, and I will 
do whatever I can to help others so that they don't have to 
experience what I have gone through.
    It is so important that families like mine who have been 
deeply impacted by gun violence to keep telling their stories. 
If we keep shining the light on the impact of gun violence, 
then our children's deaths are no longer in vain.
    I thank you for allowing me to humbly submit this 
testimony.
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

    Ms. Eshoo. Pastor Mitchell----
    [Applause.]
    Ms. Eshoo. Pastor Mitchell, thank you for the courage you 
have exhibited today in coming here to tell your story, which 
is just riddled with just tremendous grief. Thank you. We 
really hold you in our debt.
    I now would like to recognize Dr. Selwyn Rogers, Jr., and 
thank you for being here today to be a witness. You have 5 
minutes for your testimony.

             STATEMENT OF SELWYN ROGERS, Jr., M.D.

    Dr. Rogers. Good morning. Thank you very much, Chairwoman 
Eshoo, and the entire Subcommittee on Health. I want to thank 
all of you, including Bobby Rush, for all that you do to 
continue to keep Chicago and America safe.
    We are honored to have you here in Chicago and appreciate 
the time you are spending to understand the devastating toll 
violence has on the lives of Americans, and the steps you and 
Congress can do to help protect our children, our families, and 
our country.
    My name is Selwyn Rogers, and I serve as a professor of 
surgery and chair of trauma and acute care surgery at the 
University of Chicago Medicine.
    In my work, I lead a dedicated staff of specialists who 
care for people who have been traumatically injured. In my own 
location in the South Side of Chicago, we sit in the epicenter 
of much of our city's gun violence.
    When we think of gun violence in the United States, we 
often think of tragic events such as mass shootings in Dayton, 
Ohio, or El Paso, Texas.
    However, in Chicago, every day we see smaller examples that 
are no less devastating. We see a 22-year-old man driving with 
his girlfriend shot and killed in a carjacking. His crime--he 
owned a nice car. His name was Alexis Andrade.
    We see a 36-year-old mother of three shot and killed in 
front of her children at a cell phone store. Her name was 
Candice Dickerson.
    We see the 11-year-old girl killed by a stray bullet in her 
living room while she planned her birthday party the next day. 
Her name was Kentayvia Blackful.
    At our hospital at the University of Chicago Medicine, we 
work to the absolute limits of our abilities every day to save 
people like these.
    But far too often the bullets lead to death, despite all of 
our efforts. When that happens, we have a moment of silence to 
mourn the loss.
    However, we know that that moment will soon be pierced by 
screams of anguish and sometimes anger at a life that has been 
extinguished way too soon.
    The loved ones plea to tell us that their daughter, their 
son, their significant other is not dead. They ask me, ``How 
could this happen? Why did this happen?''
    I have no answers. But answers are exactly what we need. I 
am here to testify today that we collectively need to find 
answers to the intentional gun violence that has killed over 
14,000 Americans in 2017, the data that is most recently 
available.
    In addition, as we also noted, over 23,000 Americans were 
killed by gun suicides last year. In February of this year, I 
joined a medical summit of more than 40 professional 
organizations that agreed upon a united statement on the impact 
bullets have on the health of people.
    My colleague Dr. Ron Stewart, to my left, will elaborate on 
these in his remarks. We must understand this violence is a 
public health issue and a public health crisis, and as such we 
should address it with the same urgency that we do for Ebola or 
any other disease we know we can treat.
    Because when we do that, when we look at gun violence as a 
disease, that means it can be treated and it can be cured. If 
we make a true, meaningful investment in our communities, we 
can address some of the holistic issues that have created this 
gun violence epidemic.
    Consider, for example, that the unemployment rate in our 
South Side coverage area is more than 5 times the national 
average, or that 43 percent of children of color here live in 
poverty, more than double the State average, or that South Side 
residents suffer significantly higher rates of chronic health 
conditions such as asthma and diabetes, breast cancer and HIV.
    In this unhealthy environment, where day-to-day life is a 
constant struggle, where homelessness and hopelessness are all 
too common, is it any wonder that there is such a high rate of 
gun violence?
    To address this, we need to develop evidence-based 
solutions and invest in research to address these root issues. 
Federal, State, and city dollars need to be dedicated to the 
study of improved prevention efforts.
    Beyond that, we have to invest in remedying the social 
factors such as education disparities and lack of economic 
opportunities that are often at the root base of gun violence.
    While these measures will take years to enact and take 
effect, there are a number of programs that can be invested in 
now. Violence interruption programs such as Cure Violence or 
the Institute for Nonviolence Chicago use community outreach 
workers to help prevent retaliatory violence. Hospital-based 
violence intervention programs such as at the University of 
Chicago Medicine and other medical centers throughout Chicago 
have been shown to reduce recidivism.
    These efforts are all aimed at secondary prevention. But we 
must also focus on primary prevention initiatives so that 
people are not injured in the first place. I know that gun 
violence feels like an overwhelming problem. I have seen the 
pain with my own eyes. I have wiped the blood from my own 
hands.
    Yet, I am still hopeful because I know that, if we take 
concrete actions and we do the small things that make big 
changes, we can change the tide of violence that has become way 
too common and such a devastating problem for so many in our 
communities and in our Nation.
    Thank you for the opportunity for this testimony.
    [The prepared statement of Dr. Rogers follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Eshoo. Thank you, Dr. Rogers.
    Now it is a pleasure to recognize Dr. Ronald Stewart for 
your 5 minutes of testimony, and thank you for being with us 
and traveling a distance to do so.

              STATEMENT OF RONALD M. STEWART, M.D.

    Dr. Stewart. Thank you, Chairwoman Eshoo, and members of 
the subcommittee. Thank you for inviting the ACS to 
participate. It is an honor to follow a hero and colleague of 
mine, Dr. Selwyn Rogers.
    I would also like to thank the leadership and staff of 
Kennedy-King College for their terrific hospitality.
    The ACS is based out of Chicago, and we are also very 
grateful for the invitation. For 96 years, the American College 
of Surgeons has worked to comprehensively improve the care of 
injured patients in areas such as EMS, trauma centers, disaster 
response systems, and this has resulted in dramatic 
improvements in care and outcomes for our patients.
    For the past 5 years, we have focused much of our efforts 
on implementing a durable public health approach to reduce 
firearm violence and to increase the resilience of our country 
and the health of our patients.
    The ACS represents those who care for the patients who 
suffer from firearm injuries. The hardest part of my work is 
trying to explain to the family of a child, a child who is the 
very embodiment of the future of that family, a child who was 
completely normal at breakfast, is now dead.
    For those in this audience who have lost loved ones--Pastor 
Mitchell, Representative Rush--I know my pain pales in 
comparison to yours. But I want you to know that we, the 
American College of Surgeons, are committed to let no one die 
or suffer in vain.
    And we know that by working together we can prevent injury 
and violence, and we are driven to make this goal a reality.
    Over the course of the 5 years, we developed our strategy 
around three guiding principles.
    One, address firearm violence as a public health and 
medical problem, not a political problem. This means focusing 
our attention on serving humanity and basing our actions on 
scientific truth as best we can determine it.
    Two, search for evidence-based violence prevention programs 
and best practices with the goal of implementing these programs 
through our network of 554 trauma centers across the U.S.
    What do we mean by implementing evidence-based violence 
prevention programs? Is it possible to prevent or cure 
violence? Well, yes, it is.
    For those who believe that this is really too difficult a 
task, to me, it is definitely not more difficult than managing 
a complex viral epidemic. With the will, it is possible to 
prevent and cure violence.
    But to get this right requires the full commitment of all 
medicine along with partnerships at the local, State, and 
Federal levels. The people who are right now here, this 
community, communities across the United States who are working 
to make this a goal, to make this goal a reality, need our full 
support and our full commitment.
    Three, foster and provide a forum for a collegial civil 
dialogue centered on reducing unnecessary death and suffering 
related to firearm injury.
    In a very interesting way, this principle has led us to 
realize that achieving the goals of the first two are not as 
difficult as we initially thought.
    I told you the hardest thing about my job. I also know your 
job is difficult. We, the voters, send you conflicting and 
mixed messages. But I have learned that the message on firearm 
violence is not as conflicting and mixed as many would guess if 
we can actually talk about the problem.
    We have been intentionally inclusive in our discussions. I 
have probably talked to more people in medicine on both sides 
of the political firearm debate than anyone. I presented and 
talked with people from Texas and from California, from Chicago 
and from Little Rock, Arkansas.
    We have extensively surveyed ourselves and are surveying 
medical organizations. We have held town halls. We have put 
together a working group of surgeons who are also serious 
firearm owners.
    This group produced a set of recommendations which they 
call the Chicago Consensus One. These recommendations are 
included in my written testimony, and I ask you to carefully 
review these recommendations to give you a real feel for what 
we can do when we work together.
    In February, as Dr. Rogers noted, we hosted a historic 
medical summit on firearm injury prevention in Chicago. This 
summit consisted of the largest medical and public health 
organizations in the United States, 47 leading medical 
organizations.
    The group identified many opportunities to collaborate in 
the areas of research, education, target injury prevention 
initiatives. These 47 all support nine consensus-based 
recommendations published this month in the Journal of American 
College of Surgeons.
    Our written testimony includes this entire document, which 
I ask you to also carefully consider because it provides a 
comprehensive overview of what we mean by a public health 
approach.
    Wrapping up, intentional violence is the most neglected 
health problem in America, and firearm violence is a public 
health crisis.
    But I am optimistic. If we commit to addressing intentional 
violence in the same way we did with motor vehicle-related 
injury and death five decades ago, we can and we will make 
dramatic progress.
    This means working together to, one, make firearm ownership 
as safe as reasonably possible for those who own firearms and 
for those who do not; two, work together to understand and 
address the root causes of violence.
    In summary, this is the core of a public health approach to 
firearm injury prevention. As I said, I am optimistic. While 
our country currently appears paralyzed by political 
polarization, we hope that our recent work of building 
consensus among a range of diverse stakeholders and then moving 
to action provides a hopeful guide.
    We do understand there is not a simple solution to complex 
problems. But we also know if we use the power of partnership, 
innovation, science, these complex problems are completely 
manageable and, yes, even curable.
    We are fully committed to working with you. Thank you very 
much for the opportunity to present today.
    [The prepared statement of Dr. Stewart follows:\1\]
---------------------------------------------------------------------------
    \1\ Additional material submitted by Dr. Stewart has been retained 
in committee files and is available at https://docs.house.gov/meetings/
IF/IF14/20191003/110968/HHRG-116-IF14-Wstate-StewartR-20191003-
SD004.pdf.
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

    Ms. Eshoo. Thank you very much, Dr. Stewart.
    I think each one of you gives us hope with your testimony.
    I now have the privilege of recognizing Mr. Kerr, who is 
here today. We welcome you. He is the director of violence 
prevention for the city of Chicago.
    You have 5 minutes for your testimony, sir, and welcome.

              STATEMENT OF NORMAN LIVINGSTON KERR

    Mr. Kerr. Thank you.
    Good morning, Chairwoman Eshoo and members of the 
committee. So great to see you, Illinois delegation here this 
morning,and to be at this great campus, Kennedy-King College.
    I would like to thank the committee for holding this 
important hearing on community responses to gun violence. Let 
me start by introducing myself.
    My name is Norman Kerr. I am the new director of violence 
prevention under Mayor Lightfoot's Office of Public Safety.
    Since day one, Mayor Lightfoot has been clear that her 
highest priority and greatest responsibility as mayor is 
ensuring peace and safety in all of Chicago's neighborhoods.
    And each and every day since May 20th, the mayor's Office 
of Public Safety has been building on our comprehensive 
reduction strategy with the goal of measurably reducing gun 
violence.
    Chicago finds itself in a unique period. In 2016, the city 
suffered a dramatic increase in shootings and homicides more 
severe than that experienced by any of the other 5 largest 
American cities over the past 25 years.
    The vast majority of these homicides were committed with 
illegal guns. Across Chicago, communities have been devastated 
by the hundreds of homicides and by the thousands of nonfatal 
shootings that occur each year.
    In addition to long-lasting trauma, estimates of the direct 
and indirect economic costs run to billions of dollars per 
year.
    Since 2016, the trends have improved. Shootings and 
homicides have seen double-digit year-over-year decreases 2 
years in a row.
    In fact, over this past summer, we saw an accelerated 
decrease in violent crimes with June, July, and August seeing 
the lowest number of shooting victims since 2014.
    And, while many organizations are tackling gun violence 
independently of city leadership through various privately 
funded frameworks, the experience of peer cities shows that 
violence reduction efforts are far more successful through 
effective coordination of resources, policy, and management 
decisions across all stakeholders.
    Mayor Lightfoot's commitment to promoting safe communities 
and reducing gun violence is evident in her appointment of 
Deputy Mayor for Public Safety Susan Lee, who leads the city's 
first-ever Office of Public Safety.
    As the mayor's point person for all antiviolence efforts, 
the deputy mayor is responsible for public safety oversight and 
operations with activities grounded in three areas:
    Leading a comprehensive violence reduction strategy by 
collaborating with street outreach and other community-based 
antiviolence organizations while also ensuring coordination 
with city agencies and the police department;
    Guiding public safety agency operations, including Chicago 
Police Department, Chicago Fire Department, Office of Emergency 
Management and Communications, Civilian Office of Police 
Accountability, and Police Board, managing consent decree 
reform priorities, leading gun policy strategy and liaising 
with State and county governments.
    And finally, building on data and research critical to 
policy decisions, including regular analysis and review of 
violence trends as well as evaluation of violence reduction 
initiatives.
    As core components of its initial efforts, the Mayor's 
office has convened biweekly regional coordination meetings on 
the West Side and South Side, facilitated broad yet targeted 
collaboration across city agencies through monthly public 
safety cabinet meetings, and launched a gun stat initiative, an 
unprecedented collaborative effort with the U.S. Department of 
Justice, the Cook County State's Attorney's Office, the Office 
of Cook County Sheriff, and other major partners that is 
designed to track gun offenders in order to identify trends and 
strengths and address any weaknesses within the criminal 
justice system.
    We have embarked on a proactive strategy that looks at gun 
violence as a public health crisis, which is what it is. While 
we continue to seek consistent reductions of violence crime 
throughout the city, Mayor Lightfoot will be the first to say 
we have much more work to do.
    Together, we have to restitch our broken safety net. We 
have to work on providing wraparound services and job training 
in the neighborhoods that have been under siege and 
economically distressed for decades.
    We recognize the fact that this will not be solved 
overnight. By investing in neighborhoods and addressing the 
root causes of gun violence, we can continue to make meaningful 
gains in public safety and communities throughout the city.
    We will continue working with Chicagoans from every 
neighborhood and background, from block clubs and faith groups 
to businesses and school communities who have joined us hand in 
hand in our multifaceted, comprehensive approach to reducing 
violence in our city.
    Continued improvement for the people of Chicago will also 
take cooperation by all levels of government. I look forward to 
working with this committee to further policies and programs 
that create and maintain safe communities for our families to 
thrive.
    Thank you, and I look forward to continued work.
    [The prepared statement of Mr. Kerr follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Eshoo. Thank you, Mr. Kerr, and please give the best of 
all of the committee members to the mayor. Thank you for being 
here this morning.
    The Chair now recognizes Mr. Leak for his 5 minutes of 
testimony. Thank you for being with us.

                 STATEMENT OF SPENCER LEAK, Sr.

    Mr. Leak. Thank you, Madam Chairman. Would it be out of 
order if I give honor to God, my maker, my creator, this 
morning, as we approach these most important hearings where --
--
    [Applause.]
    Ms. Eshoo. Amen.
    Mr. Leak [continuing]. Our congressmen, who represent us 
well who are here today, Congressman Garcia, Congresswoman 
Schakowsky, and Cook and Davis, and my brother, Congressman 
Bobby Rush, who gave us the invitation to come here.
    I thank you for this privilege, and I want to say to you 
that I am the CEO of an 85-year-old funeral service 
organization that no week goes by, Members of Congress, that I 
don't service the families of at least two gun violence 
victims.
    I have to service them and then try to counsel them and try 
to answer the question that is invariably asked by the mothers 
and fathers of the children that I service, and that question 
is one word: ``Why, Mr. Leak? Why?''
    Of all of the families that I have serviced, one comes to 
mind this morning. Let me share with you. It is on March 12th, 
2013. The mother and father of 6-month-old Jonylah Watkins came 
to our funeral home seeking our service. The city of Chicago 
had to lay this precious child to rest, and her death touched 
my heart even though I am a professional funeral director.
    When I think about her short lifespan, a verse of Scripture 
found in the Book of Revelations, the sixth chapter and the 
thirteenth verse, seems to define her in a profound manner: 
``And the stars of heaven fell onto the Earth even as a fig 
tree casts her untimely figs when she is shaken by a mighty 
wind.''
    Truly, this little baby girl was an untimely fig who was 
not allowed to reach her potential. Her life was cut off by the 
mighty winds of guns and drugs causing so much death and 
destruction to the hearts of the future of our children--death 
and destruction caused by Black-on-Black gun violence. So much 
evil is manifested in its wake.
    The challenge to all of us who live in this city as well as 
this Nation is to engage those mighty winds of adversity. We 
must reverse the tide that has seen too many figs cast out, 
untimely figs here in Chicago and across our Nation.
    Thirty years ago, Madam Chairman, I had the honor to be the 
director of the Cook County Department of Corrections. Inmates 
coming into the jail accused of homicides were predominantly 
black, their perpetrators were predominantly black as well as 
the victims. They were abusing alcohol and drugs during the 
commission of the crime.
    And finally, the perpetrators and the victims were known to 
one another. There was a relationship, and because of that 
relationship the police were able to arrest the perpetrator in 
the majority of the instances.
    Today, Madam Chairman, those circumstances are reversed. In 
the majority of homicides, the perpetrator has no relationship 
to the victim. These homicides are mostly random violence and 
so often render the police and the courts a challenge in 
seeking an arrest.
    The role, I believe, of Congress must be one that 
recognizes that, unless in an earlier period of the life of the 
would-be perpetrator, they must receive some type of special 
crime prevention.
    It is not found as it could be in the home, in the church, 
but it is found, in my examination, in the schools. The 
perpetrator and the future victims were students at one time in 
the Chicago public schools.
    If we can create an environment that in those particular 
schools that teaches morals, character, good citizenship during 
their formative years, we will be able to save hundreds, even 
thousands of lives.
    My brothers and sisters, you, who are Congressmen, we are 
depending on you today to leave Chicago knowing that you are 
going to do something about what plagues us as a city.
    God bless you.
    [Applause.]
    [The prepared statement of Mr. Leak follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Eshoo. Thank you, Mr. Leak. You have summoned us to a 
higher place, for sure.
    I now would like to recognize, last but not least, Dr. Niva 
Lubin-Johnson, the immediate past president of the National 
Medical Association, and welcome to you and thank you for being 
here.
    You have 5 minutes for your testimony.

             STATEMENT OF NIVA LUBIN-JOHNSON, M.D.

    Dr. Lubin-Johnson. Thank you, and thank you, Congressman 
Eshoo, for the invitation this morning, to all of the Health 
Subcommittee members for holding this hearing today here in my 
hometown of Chicago.
    I would especially like to thank subcommittee member 
Congressman Bobby Rush, who is my Congressman, as well as 
Congresswoman Robin Kelly, who I have had the pleasure with--
working with quite frequently on a myriad of health issues 
dating back to when she was a State representative, and the 
other Chicago Congressman here today, my colleague in 
healthcare, the Honorable Danny K. Davis, and to Jesus Garcia 
and Jan Schakowsky, also fellow natives of Chicago.
    I am here today to talk about policies and solutions to the 
public health threat posed by gun violence, not only as a 
physician who has practiced internal medicine for over 30 years 
here in Chicago but also as the immediate past president of the 
National Medical Association.
    NMA is the largest and oldest national organization 
representing African-American professionals, doing so for over 
50,000 African-American physicians and our patients in the 
United States and its Territories.
    We are the collective voice of African-American physicians 
and the collective voice and the leading voice for parity and 
justice in medicine. Gun violence has been a key issue for NMA 
and continues to be on the forefront this year as it was 
throughout my presidency.
    As you know, it is one of the leading causes of death in 
America, where more than 39,000 people die by guns every year 
and 85,000 more suffer nonfatal injuries.
    It costs our economy $229 billion annually, and the cost of 
firearm assault injury includes work loss, medical and mental 
healthcare, emergency transportation, police criminal justice 
activities, insurance claims processing, employer cost, and 
decreased quality of life.
    We know the statistics about what has gone on here in 
Chicago. Fortunately, those numbers are decreasing. But also I 
want to make note that Chicago per capita is not the highest 
city of gun violence. I believe we rank about number 15 in the 
country, definitely not in the top 10.
    So what do we do about it? One, as mentioned before, we 
have got to look at where the guns come from. Sixty percent 
come from outside of Chicago, and we have to deal with how they 
get into the city.
    In November of last year, the National Rifle Association 
had the audacity to tweet ``Someone should tell self-important 
anti-gun doctors to stay in their lane'' after the American 
College of Physicians released a report calling this a public 
health crisis.
    Physicians, including NMA, countered, ``This is our lane,'' 
and, as you heard, more than 40 medical organizations, 
including NMA, joined forces as a coalition to raise money to 
confront this related death and injury epidemic as a public 
health initiative.
    It hit close to home here in Chicago after the tragic 
shooting of award-winning NMA member Dr. Tamara O'Neal outside 
of Mercy Hospital.
    I, too, am on staff at Mercy Hospital and have been so for 
over 30 years. I didn't know Dr. O'Neal, but I wish I had.
    As you know, she was a graduate of University of Illinois 
and worked at Mercy Hospital. Two physicians I know closely 
were involved that day.
    One is a urologist who saved my husband's life--he is a 
prostate cancer survivor--who actually was going across the 
hall when he heard the shots, and another who--I will tell a 
little bit of my age. I am over 50, yes, and I need a 
colonoscopy. The first man to do that was in a room getting 
ready to do a procedure on a patient, had to lock himself in 
the room when that perpetrator knocked on the door where he 
was.
    NMA has long been an advocate of stemming gun violence in 
our communities and the country at large. We are in full 
agreement with the American College of Physicians that gun 
violence and violence prevention is a public health crisis, and 
we believe it demands a multifaceted approach because, as we 
all know, as the late Carl Bell said, this is a multifaceted 
problem. There are different types of violence.
    In 2017, we published a position paper on gun violence. In 
2018, we developed a fact sheet on gun violence and advocated 
for it while on our Capitol Hill day during March of this year.
    In July, with 10 other African-American professional 
organizations, we crafted a letter to all of the presidential 
candidates outlining gun violence as one of our top issues of 
concern.
    On August 4th of this year, myself along with Dr. Stewart 
and Dr. Roger Mitchell, who is the chair of our task force, 
appeared on ``CBS Sunday Morning'' on a story about gun 
violence and the public health coalition that has formed as a 
result of that NRA tweet.
    We have endorsed the House-passed H.R. 8, and we have also 
advocated for other pieces of legislation that have been 
crafted by the House of Representatives.
    We call on the Federal Government to immediately convene a 
bipartisan commission to evaluate steps to reduce and 
eventually eliminate gun violence utilizing a public health 
approach.
    Especially I would like to include in this research the 
fact that NMA is now surveying our four historically black 
medical schools to see where they can come and help in this 
space, but also to study the effects of lead in terms of 
violence and aggressiveness, but also to continue the work of 
Dr. Carl Bell in terms of fetal alcohol syndrome. It is 
decrease of choline levels and that leading to increase of 
violence.
    I want to thank you all for the opportunity to be here this 
morning on behalf of NMA and our president, Oliver Brooks, and 
I look forward to your questions.
    Thank you.
    [The prepared statement of Dr. Lubin-Johnson follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Eshoo. Thank you very much, Dr. Lubin-Johnson, and 
thank you for the support that you just expressed for H.R. 8, 
the comprehensive background check legislation that is now at 
the doorstep of the United States Senate, and we pray that that 
will be taken up because we know the good that can come from 
that.
    Now, all of our witnesses have testified. I am going to 
call on Congresswoman Robin Kelly. I won't start with the 
questioning.
    I want to make sure that both Congresswoman Kelly and 
Congressman Kinzinger get to ask their questions. They both 
have time limitations today.
    So I will set my questions aside for now. Recognize the 
gentlewoman for her 5 minutes of questioning.
    Ms. Kelly. Thank you, Chairwoman Eshoo, and thank all of 
you for your testimony. It is very much appreciated and we are 
listening, believe me.
    I am not--you know, I am not going to call you Pastor 
Mitchell. I am going to call you Brenda, because you call me 
Robin.
    [Laughter.]
    Ms. Kelly. Thank you so much for testifying today and, as 
you have heard me say before, thank you for being so selfless, 
because you could go in your home and close your door and not 
be bothered. But as you chose to be an advocate, you chose to 
turn your pain into passion. So thank you so much.
    I am just going to cut right to the chase. What do you want 
Congress to do? What do you feel like we can do to be helpful, 
to help families and communities?
    Ms. Mitchell. I think that what we need to do is to, number 
one, pass H.R. 8, which I did--I am speaking for the Senate to 
take seriously what is happening in our communities and the 
blood that is left on the ground in our communities, to 
understand that that becomes holy ground for us.
    It is sacred. And even with the lack of resources around 
trauma-informed care, it took me to almost have to lose my life 
three times to realize what I was going through.
    And in addition to that, to be vulnerable enough to remove 
the stigma of accepting therapy and counseling to move through 
all the emotions that I was experiencing that were attacking my 
internal organs and to be able to understand what it is to try 
to come back to yourself, because that is life changing.
    I became somebody that even I didn't recognize or know 
anymore, and I had to find my way back to myself. And so I ask 
Congress to put forth more research into trauma, and when we 
talk about trauma to move it from being a mental health issue, 
because I don't identify with mental health, but I do identify 
with being traumatized and having my heart ripped out of my 
chest and a sore that I know would never be healed.
    Ms. Kelly. Thank you. And also, I don't know if anyone in 
the audience was there, but I just want to publicly thank all 
the people that got on the bus to come to Washington, DC. I 
think that was so very important.
    And I don't know if everyone knows, but after the rally was 
over we took families from Kentucky into Senator McConnell's 
office to talk to them about please passing both bills that we 
sent over in February.
    Dr. Stewart, I wanted to ask you--you stated in your 
testimony that there is a workgroup to address the social 
determinants of health and its impact on violence in vulnerable 
communities.
    Can you explain the intersectionality of structural 
violence and social determinants of health, especially as it 
relates to gun violence in underserved communities?
    Dr. Stewart. Yes, ma'am. The----
    [Disturbance in hearing room.]
    Ms. Kelly. We talked--we talked about that.
    Ms. Eshoo. If the Chair can just----
    Ms. Kelly. I talked about that in my statement.
    Ms. Eshoo. If the Chair can just intervene here. We have--
--
    [Disturbance in hearing room.]
    Ms. Eshoo. Well, we need to go on. We need to go on with 
our hearing. Congresswoman Kelly, you have the floor and keep 
your--please, sir, we are trying to have a hearing here. All 
right.
    [Disturbance in hearing room.]
    Dr. Stewart. Yes, ma'am. You want me to just answer? So, if 
you look at our--if you look at the strategy--if you look at 
the strategy for the American College of Surgeons, I was clear 
with respect to that. Make firearm ownership as safe as 
reasonably----
    [Disturbance in hearing room.]
    Ms. Eshoo. Why don't we--why don't we just pause for a few 
moments?
    [Disturbance in hearing room.]
    Ms. Eshoo. I think if we can ask--I think if we can ask the 
gentleman to move with the others out of the room so that we 
can continue with the hearing, please.
    I think that it is very important to understand that this 
is not a town hall meeting. This is a congressional committee 
having an official congressional hearing to listen to witnesses 
that will instruct us in order to address the epidemic of gun 
violence.
    Each one of us does town hall meetings in our congressional 
districts. We are thoroughly accustomed to people shouting out 
at us and being unrestrained and hearing from them.
    But that is not what today is. Today is the hearing with 
the witnesses, professionals all, being instructive to the 
Congress on how we can shape tangible legislation that is going 
to have an effect on addressing this epidemic in our country.
    So I think it is important to delineate the difference 
between the town hall meeting and a congressional hearing.
    So now I would ask my colleague, Congresswoman Kelly, to 
resume her questioning. And I thank you, everyone, for your 
patience.
    Ms. Kelly. I just wanted to add to that. We did have 
Members of Congress come to Illinois, and we did meet with a 
group of--of course, we can't meet with everybody, but we 
specifically met with young folks under 25. Most of them were 
under 20. So we have done things like that also.
    But, Dr. Stewart, do you remember the question?
    Dr. Stewart. I do.
    Ms. Kelly. OK.
    Dr. Stewart. And so working to understand and address the 
root cause of violence is one of our two-prong strategies, and 
that means we have to get to what many people have testified 
and what many of you commented on: addressing social 
determinants of health and structural violence.
    What do we mean--what does Dr. Rogers mean by structural 
violence? It is the ways we put individuals in our communities 
in harm's way, and there are things it is not easy to see.
    As a fish--we have a colleague, Wayne Meredith, who would 
say a fish can't see water. And so it may not be obvious to us, 
but there are structural issues that lead to increased violence 
and increased rates of death.
    And so we have put together a workgroup, which is a 
national workgroup of experts, in addressing social 
determinants of health and structural violence.
    We call that the I Save workgroup. We view that as 
complementary to our Firearm Strategy Team workgroup--making 
firearm ownership as safe as reasonably possible while trying 
to work to understand and address the root causes of violence.
    And violence, too, I will just say--feel free to interrupt 
me--but I would say that it is a bigger problem than what we 
realize, because it is true that there is a hundred to 109, a 
hundred to 110 people who die every day from firearm violence.
    There is actually 182 who die every day from intentional 
violence from all mechanisms. So working to understand and 
address the root causes of violence is critical, and that is 
just the death.
    That is just the deaths. It does not take into account the 
magnitude of the health burden, which is tremendous, and an 
investment by Congress in this, I believe, is critically 
needed, and I think it will return benefits far beyond that 
investment.
    Ms. Kelly. Thank you, Dr. Stewart.
    And finally, I would like to submit for the record my Kelly 
Report on Gun Violence in America, which includes commonsense 
policy recommendations to reduce the gun violence epidemic.
    Ms. Eshoo. So ordered.\1\
---------------------------------------------------------------------------
    \1\ The report has been retained in committee files and also is 
available at https://docs.house.gov/meetings/IF/IF14/20191003/110968/
HHRG-116-IF14-20191003-SD008.pdf.
---------------------------------------------------------------------------
    Ms. Kelly. I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    And now I would like to call on Congressman Adam Kinzinger 
for his 5 minutes of questioning and thank him again for being 
here and making our hearing, very importantly, a bipartisan 
one.
    Mr. Kinzinger. Well, thank you, Madam Chair. And again, 
thank you for yielding the time. I appreciate it, and to all my 
colleagues and Robin, thank you for your good questions, too.
    But especially to the witnesses. Thank you for being here. 
Your stories were both emotional and also informing. So thank 
you for that.
    Pastor Mitchell, I don't know what to say except my deepest 
condolences, and I appreciate you sharing your story because I 
think it is important for all of us to see how it affects 
family, how family can do their best to overcome, and it brings 
a human element that sometimes when we talk about statistics, 
which, you know, we have to talk about statistics, but 
sometimes that gets missing, and I appreciate you doing the 
very difficult thing, but bringing a human face to that.
    And so my deepest condolences and to you.
    Mr. Leak, I just want to say to you--I don't have any 
questions, but I wanted to make a point, which is thank you for 
your testimony as well.
    You know, evil is a very real thing, and we don't talk a 
lot about it.
    But for whatever reason, there is a generation of young 
people, and I think it transcends race and it transcends income 
and boundary lines, that are listening to the whispers in their 
ear and doing really terrible things at very young ages.
    And I attribute that partially to evil, mental health, and 
I appreciate you bringing that up.
    But to the questions, Dr. Rogers, you mentioned in your 
testimony that the University of Chicago has developed a 
program that employs people with similar life experiences who 
help connect trauma patients and families to wraparound 
services, which include vocational training, mental health 
counseling, and other social services.
    Can you elaborate further on how this kind of hospital-
based intervention and outreach to high-risk individuals 
presents a unique teachable moment, basically improves outcomes 
and prevents future violent injuries?
    Dr. Rogers. There is a network of hospital-based policy and 
prevention programs across the country. Approximately 30 
hospitals have invested in these programs, and they basically 
take people who have been injured by violent injuries, be it 
gun violence, stabbings, or assault, and use that moment to 
intervene in their lives.
    Basically, think of violence as a chronic disease instead 
of an acute event. And in the context of that, people often 
come in with preexisting social issues that they need, 
educational disparities, economic opportunities they have not 
taken advantage of, and being able to invest in people through 
these hospital-based intervention programs has found 
significant effects in decreasing recidivism rates of recurrent 
injury or retaliatory violence.
    The other aspect is preventing people from injuring someone 
else. There is a common saying that hurt people hurt people, 
and when you think about the opportunity that hospitals, health 
systems, may have to intervene in people's lives who have been 
hurt to prevent retaliatory violence, it is a very important 
possible intervention.
    Mr. Kinzinger. And I want to add to that. So a lot of 
people don't know this about me, but my father was a director 
of an organization that helped the homeless, and one of the 
things that they really took as a way to do that is to 
understand that homelessness was not just the fact that you 
don't have a shelter over your head at night.
    There was a lot of other things that lead to that, and how 
do you wrap that around.
    And I think the same thing comes--when it comes to 
violence. Somebody comes into a hospital with a gunshot wound, 
obviously, your priority is to heal that person and ensure they 
continue to live.
    But if they are just pushed out the door or they are not 
given any other opportunity, you will likely see that person 
back in the same position. So it is how do we interdict that, 
and I appreciate you bringing that up.
    Dr. Stewart, you were the lead author of a study published 
which you discussed that identifies some common ground 
solutions to reduce violent harm.
    Number five in the consensus statement raises the 
importance of engaging both firearm owners and populations at 
risk. Can you elaborate further on the need to engage the 
community of firearm owners and why, as part of that solution?
    Dr. Stewart. I can, and I do think it is a critical piece 
of the public health approach, which is to engage people who 
are at risk and a part of a knowledgeable stakeholder group.
    I will just give an example. If we were going to do a 
bicycle safety initiative in a neighborhood, we would come with 
data. We would come with expertise. We would have all that.
    But one of the things that we would do right away is we 
would engage with the bicycle riders. We would engage with them 
for their expertise, for their knowledge, and for their buy-in, 
and we have done that in the past, and we know that we learn 
from bicycle safety initiatives.
    We learn that bicycle helmets were not cool. They are not 
thermally cool and they weren't culturally cool, and so we made 
bicycle helmets thermally cooler and culturally cooler, and you 
see people wearing bicycle helmets.
    Mr. Kinzinger. Yes, that has always been a surprise to me. 
I was raised in the generation where you never wore bicycle 
helmets.
    But I will tell you, we have got a lot of questions. Thank 
you all for being here.
    My time is up and, Madam Chair, I yield back.
    Ms. Eshoo. The gentleman yields back, and I know both of 
the Members that just questioned have other commitments and 
need to leave the committee, the witnesses, and everyone that 
is here today. Thanks, both of you, both for your leadership 
and your ongoing work and your attendance today.
    And you may have noticed that we were leaning over and kind 
of whispering to each other. It is part of our team building 
because you are giving us ideas. So travel safely. Make your 
meetings, and thank you for being here today.
    I want--let us applaud them. Let us applaud them.
    [Applause.]
    Ms. Eshoo. All right. The Chair now recognizes herself for 
5 minutes to ask questions. Is there anyone on the panel that 
does not agree that this--that gun violence is an epidemic and 
that we work through the public health lens to address it? Is 
there agreement across the panel on that?
    I think I heard all of you. Yes, I see everyone nodding. 
Because that is what this hearing is addressing itself to.
    In the work of the Congress, if you were to advise us on 
shaping legislation, what would the top three or top five 
initiatives be that you would recommend to us?
    I think at the top of the list is is that we need to, 
first, secure the kind of data that can be shared when there is 
an epidemic.
    Certainly, the CDC and the NIH develop the information, so 
we can work off of facts. It is very important, especially in 
the scientific community, that we have facts. And we have 
already--as I said in my opening statement, Congress has 
appropriated $50 million.
    If you divide that by 50 States, it is not a lot of money. 
But it is a start, and we have to start somewhere, and we can 
build on that.
    But aside from that, what would you recommend to us that we 
take back to DC with us and build into legislation to address 
this epidemic in the public health lane?
    Whomever would like to go first. Mr. Kerr?
    Mr. Kerr. Sure, I will go first.
    So with an epidemic you have to go to the population that 
is most infected, and in this case you have to go to the 
population that is violent, and there is no way around it. You 
have to develop that relationship with them and change their 
trajectory.
    So if you are going to vaccinate them, if you will, and 
provide opportunities and guidance and support so that 
vaccination will take and they will be on different trajectory.
    Now, I am not opposed to prevention programs. I think it 
all has to be in concert. It is not a competition between 
intervention and prevention. But we have to look at where the 
data says.
    OK, this is the group that is most violent, and if we don't 
develop a relationship with them, that change is going to be 
minimal.
    So this is something that we have to invest in. Just even 
this thought is that this population is not a throwaway 
population, that they can change, and we have seen this.
    We have worked with individuals who have been on a certain 
path, and the intervention is with them and then they change 
what they are doing.
    Now they are actually working for the program and helping 
others to make that change as well. But it has to be something 
that is really thought out, and also we have to look at their 
ecosystems.
    So it is not just working with that individual. What does 
their home life look like? What does the people who are in 
their network--social networks, family networks--look like? 
What are they going through, because they impact that 
individual.
    Ms. Eshoo. Thank you. The doctors, I think, want to lean in 
on this.
    Dr. Rogers. I will lean in and add what Mr. Kerr said. 
There has to be a lot of investment to reverse the chronic 
disinvestment in communities, especially communities of color 
that have been disproportionately affected by violence.
    Way too often, violence can be intergenerational. I meet 
with families every day who say that not just their cousin, not 
just their father, not just their brother has been impacted by 
gun violence, but multiple people in their families over 
generations have been impacted.
    And without really thinking about what the psychological, 
emotional toll that that takes upon families and how that leads 
to secondary trauma in people, we will not be able to make a 
lasting impact.
    And in many ways, because this is so longstanding we are 
going to have to make a very deep, concentrated effort to make 
an impact, and I think, if I could make any recommendation to 
Congress, it is not going to be a simple Band-Aid solution.
    Ms. Eshoo. No, we know that.
    Dr. Rogers. This is going to take years of commitment over 
time to reverse what has been present for decades.
    Ms. Eshoo. Well, in listening to Pastor Mitchell talk about 
all that she went through physically and the depression that 
surrounded her and deepened her grief even more that we do a 
lot through the Department of Defense relative--and the 
Veterans Administration relative to PTSD.
    It seems to me that you are a witness and someone that has 
experienced that, and I think this--it needs to be a part of 
what we do.
    Did you want to add to that?
    Ms. Mitchell. Yes. I think--I was on a town hall with 
Senator Chris Murphy and Congresswoman Lucy McBath and the 
question was asked, What was the one thing that we are not 
speaking about or addressing in terms of the gun violence 
initiatives? And the laws--we know how important that is and, 
though they have not made it to the Senate floor for reality to 
be our experience, we realized that there is devastation in our 
communities, and those things have not been addressed.
    And as Dr. Rogers has stated, it is not anything that has 
happened overnight. But I believe that, with the research that 
has to happen in our community, there also has to be dollars 
that deal with the socioeconomic issues in the communities as 
well as the devastation and to have more resources out there.
    I had the luxury of having insurance. I had the luxury of 
being able to talk through my issues. Everybody doesn't have 
that luxury, and unfortunately it is not even available in most 
cases because we are not even creating the narrative around 
trauma and trauma-informed care until most recently.
    But there still needs to be more work and support driven in 
those avenues.
    Ms. Eshoo. Thank you very much.
    My time has expired. I now would like to recognize the 
gentleman, and a gentleman he is, Mr. Butterfield from North 
Carolina.
    Mr. Butterfield. North Carolina. Thank you so much, Madam 
Chair.
    Let me just begin by reiterating what Chairwoman Eshoo said 
a few minutes ago. This is not a town hall meeting. All of us 
have our own individual town hall meetings from time to time.
    This is a congressional hearing. Why do I make this point? 
I make the point to say that this is not a political exercise 
that we are conducting today. This is serious business.
    The Congress of the United States spends billions of 
dollars every year in nondefense discretionary spending, and if 
we are to invest in this issue and invest in methods of gun 
prevention and the other issues that we care about, including 
education, we have got to build a congressional record, and 
that is what this is all about today.
    We are building a congressional record. We will take this 
information, and a verbatim copy of what is being said here 
today is being placed in a congressional record.
    We will take this information back to our committee. Our 
committee will then have further hearings. We will mark up 
legislation, and at some point it will be presented to the 
entire House of Representatives for a vote.
    And so I just wanted to go on record making that known, for 
those who may not fully understand the scope of what we are 
doing today.
    The statistics show, Madam Chair, that 39,000 firearm-
related fatalities occurred in 2017--39,000. Eighty-three 
children injured or killed by guns each day. Inaction is not an 
option.
    Even more disturbing is the way in which we fail to treat 
this as a public health issue. We have not invested Federal 
dollars in public health research to better understand how to 
prevent firearm-related injuries and death.
    We have invested in criminal justice initiatives, but we 
have not invested significantly in public health research.
    We were able, a few weeks ago, to approve appropriations in 
legislation in the House to provide $50 million to support this 
research, and that is just the beginning.
    So let me ask our witnesses--and thank you to all six of 
the witnesses--but let me ask our medical experts, if I can.
    Can you share how you think this investment could help us 
better understand and address this crisis and the impacts it 
has on your patients and your friends?
    Let us start with Dr. Rogers.
    Dr. Rogers. Every day I am struck by the fact that gun 
violence has devastating effects not just on those who are 
killed but those who are left behind, and I think those people 
who are left behind we often don't provide much in the way of 
any services.
    And echoing your comments, Mr. Butterfield, we have to 
invest in research to better understand what works and what 
doesn't work. Even for our returning veterans, post-traumatic 
stress disorders are a very difficult problem to fix.
    And, as Ms. Mitchell noted--Pastor Mitchell noted--it has 
long-ranging effects for decades after the traumatic event, and 
we have to find ways and approaches to address this in a more 
lasting way.
    Only through research can we do that. We have found 
incredible ways of addressing the AIDS epidemic, for example. 
So AIDS is now a chronic illness--that people can live for 
decades with HIV.
    We have to find ways of intervening in people's lives to 
prevent violence and find solutions to problems that in the 
greater society are often ignored.
    And I think if that focus can happen through this 
congressional hearing, that may be an important start.
    Mr. Butterfield. Thank you.
    In the last minute that I have remaining, Dr. Stewart and 
then Dr. Lubin-Johnson, please.
    Dr. Stewart. I would say the impact on our patients would 
be that they would be--if we invest in these things we have 
talked about, they would be healthier. They would be more 
resilient. They would be stronger and they would be more free.
    And it is critical that we make this investment, and we do 
it across the entire spectrum of violence.
    Mr. Butterfield. Thank you.
    Dr. Lubin-Johnson?
    Dr. Lubin-Johnson. Yes. Yes, and thank you for that 
question, Congressman Butterfield.
    I believe, you know, the investment is important for our 
patients, our communities, especially their families who are 
remaining, whether they have been--their loved ones have been 
injured or killed.
    I took care of two patients that come to note. One, her 
daughter was killed going to the grocery store and left a 5-
year-old son behind, who she cared for during the week, and the 
father--they had a great relationship. He took care of the 
child during the weekends.
    She ended up obtaining care through her job through 
employee assistance programs, but I think other programs need 
to be available to those who are left behind after these 
tragedies.
    But also we need programs to help those who remain in the 
families, because we know part of structural violence is also 
there are some elements of structural racism and we have to do 
something and level the playing field in terms of the 
economics, the education, and the healthcare that these victims 
and their families have to receive and go through also.
    Thank you.
    Mr. Butterfield. Thank you. My time has expired. Thank you 
for your response.
    I yield back.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize Mr. Rush, whose district we 
are in today, for his 5 minutes of testimony--I mean, of 
questioning.
    Mr. Rush. Thank you, Madam Chair.
    Madam Chair, I certainly want to associate my remarks with 
my friend, Mr. Butterfield.
    I want to just reiterate the fact that this is not a town 
hall hearing where we are going to have a lot of rah-rah and a 
lot of--the applause meter is going to go up. It wasn't 
intended for that purpose.
    This is a sober and somber gathering of witnesses and 
Members of Congress so that we can do the work that we were 
elected to do, and that is to try to provide Federal resources 
to solve the problems that we are discussing today, and that is 
the epidemic of gun violence, and eliminate or ameliorate the 
tragedies and suffering and the pain of families and 
communities and nations that are affected by this senseless and 
ceaseless epidemic of gun violence.
    And with that, I want to ask my friend, Mr. Leak, who I 
have known for many years and he has funeralized so many 
families, including my family.
    Mr. Leak, has there been a significant and striking 
demographic change that you recognize among funeralizing 
families during this particular era of epidemic gun violence? 
Do you see a significant change in the demographics of your--of 
gun violence victims that you have to funeralize twice a week?
    Mr. Leak. What I have seen, Congressman Rush, is that the 
perpetrator and the victim, as I have said, were African 
American, and what I have seen is that there is not today the 
relationship between perpetrator and victim that resulted in a 
successful arrest and adjudication of the particular 
perpetrator.
    And the reason that we are not seeing that as we did 30, 40 
years ago, the fact that there is no relationship between the 
perpetrator and the victim.
    Random violence is what we are seeing now, violence as we 
talked about--this 6-month-old baby. That baby was not 
targeted. It was just random violence that plagues us. And I 
would say there is only one solution to that, and I----
    Mr. Rush. Mr. Leak, let me just get to the heart of this. 
You know, I remember in Chicago locally in the late '70s there 
was a young man on the near North Side by the name of Dantrell 
Davis, and he was shot down on the grounds in Cabrini-Green.
    I think he might have been on his way to school that 
morning, and he was shot down. And since that time, there have 
been more and more younger people who are killed, and when 
Dantrell Davis was killed there was a general alarm because he 
was a young man, 9 years old, who was murdered.
    But now the incidences of young people being killed has 
increased, and I am saying do you agree that unlike our--when 
we were becoming adults, most funerals were for older family 
members who had died mostly of natural causes. But today, is it 
the same today or is it--has there been a subtle and 
significant switch that most funerals now are not folks who die 
of natural causes, but young people who die of gun violence or 
some other type of violent behavior?
    Do you see that?
    Mr. Leak. Yes, I do see that.
    Congressman, I should not have to be servicing a family of 
a 6-month-old girl. I should be servicing families where the 
deceased person is my age. I should not be servicing families 
who have lost their loved ones through homicide, suicide, drug 
overdoses.
    I am seeing more of that now than I had in the past, and I 
just say to you I must reiterate and I ask that the Congress--
you have an effect upon the schools of our city.
    Federal dollars come from Washington to our city, and all 
due respect to my friend who represents the mayor, I am saying 
to you that take back to Washington this story.
    Two young kids were acting up. They were sent to the 
principal's office. The principal asked them to come in one by 
one. The first one came in. The principal asked him, he says, 
``Johnny, where is God in your life? And go ask Jimmy to come 
in here.''
    Johnny went out to Jimmy and he said, ``Jimmy, we are in 
big trouble. God is missing, and the principal thinks we have 
something to do with it.''
    God is missing from our schools, and we have a lot to do 
with it, and I am asking you, when you go back to Washington, 
DC, send some money here and most of all put God back into our 
schools.
    Mr. Rush. Thank you.
    Dr. Rogers, I want to ask you, you made a statement in 
your--you made a declaration in your statement. I want to quote 
you: ``This violence is a public health issue as a disease, and 
it means it can be treated and it can be cured.''
    Can you expound upon treatment and the cure for it? What 
can we do as Members of Congress to provide Federal resources, 
more dollars, to cure this epidemic?
    Dr. Rogers. I will start by saying there is so much about 
gun violence that we don't understand. We have made tremendous 
progress on the ability to do surgical procedures and medical 
interventions to fix physical parts of human beings--broken 
bones, or put back together damaged organs.
    But we haven't really done much to figure out how to help 
people's souls and minds, and investing more in the mental 
health impact of violence both on people who have been directly 
impacted by violence physically but also those who are in close 
contact, because there is secondary trauma to everyone who is 
in close contact with that individual who has been shot and/or 
killed.
    And to think about ways that we can actually create greater 
mental health support for individuals who have been victimized 
by violence, but also their close contacts.
    Mr. Rush. I want to ask, Madam Chair, if I could, Dr. 
Stewart--Dr. Stewart, are you saying that----
    Oh. I yield back the balance of my time that has already 
run out.
    [Laughter.]
    Ms. Eshoo. I thank the gentleman.
    And I understand you are being driven to ask more questions 
because you care so much about this issue. But now I would like 
to start recognizing our colleagues that are here as guests of 
the committee today, all Members of Congress, all from the 
great State of Illinois.
    And I want to recognize first my friend and colleague, 
Congresswoman Jan Schakowsky. She has--for many years she has 
served on our Health Subcommittee. In this Congress she is 
chairing another one.
    But she turns up religiously to our subcommittee hearings 
and has to wait for everyone else to ask their questions, and 
then it is her turn, and it is the same today.
    But she is here. She cares enormously, and it is a pleasure 
to recognize her and welcome her once again to the committee 
and its work.
    Ms. Schakowsky. Thank you. I want to thank you, Chairman 
Eshoo. It is really a privilege to be able to waive onto the 
Health Subcommittee, and so I don't mind waiving. I thank you 
for the opportunity.
    I want to ask a question of everyone here today. How many 
of you have lost a loved one due to gun violence that are here 
in this room? Raise your hand so I can see that.
    So it has affected a good chunk of this room for the panel 
to know--on the panel and people behind you and including--we 
have talked about Bobby Rush, but also I was at the funeral for 
Danny Davis's grandson.
    So two issues I want to talk to. I want to talk more about 
the issue of trauma-informed care, which you raised, Pastor 
Mitchell, but also the intersection with race, which is really 
in many ways, I think, an elephant in this room and on this 
issue.
    We know that black children and teens are 14 times more 
likely than white children and teens to die because of gun 
violence, and that black men make up 52 percent of all gun 
homicide victims.
    So when you were talking about how it is people around 
those that have been killed, I think we are talking about whole 
communities--whole communities--where black children in 
particular, but children of color--let me put it that way, 
black and brown children--are traumatized just from the time 
they are aware in this world of the dangers of their 
communities.
    So racial disparities--we know, for example, that women of 
color in Illinois are six times more likely to die related to 
childbirth than white women.
    So these disparities in healthcare are a real challenge. So 
I wanted to ask Dr. Lubin-Johnson, Dr. Rogers, anyone who 
really wants to answer this, to share what has been successful 
in dealing with trauma-informed and culturally competent care 
as we look at solutions to these problems.
    Did you want to start, Doctor, on the end?
    Dr. Lubin-Johnson. Thank you for the question, Congressman 
Schakowsky, and I am not a trauma surgeon, so I will leave that 
to Dr. Rogers.
    But in terms of the culturally informed competent care, I 
think we really need to start with what I alluded to before, 
which is the structural racism in our country, in our--that is 
affecting our communities, the healthcare that is received 
where those residents live, the education they receive, the 
housing that they live in, and understand and recognize that 
there is a disparity there that leads further due to the 
socioeconomic differences between our communities and others, 
that really serves as a nadir, let us say, for violence to 
occur.
    And so, you know, I have become someone who is a proponent 
of implicit bias training as to start with in terms of helping 
to eliminate some of the bias and discrimination in our 
country.
    And so what is implicit bias? It is bias that we are not 
conscious of but gets exhibited in various ways. And we are 
discovering, as you mentioned, with the issue with maternal 
mortality in African Americans, that this plays a basis in it.
    I mean, if Serena Williams can't get the healthcare she 
needs, you know, post partum, who can? And because of that, we 
have developed now--most States have a maternal mortality 
review board.
    And maybe we need a violence fatality review board in our 
municipalities that take a look at the systems that interface 
with at-risk youth and who are victims of the perpetrators of 
violence and that will work.
    There are programs that do work----
    Ms. Schakowsky. I am going to cut--sorry.
    Dr. Lubin-Johnson. Mm-hmm. No problem.
    Ms. Schakowsky. I do want to ask anyone. Dr. Rogers?
    Dr. Rogers. Addressing the point about trauma-informed 
care, basically involves meeting people where they are, not 
where you want them to be.
    Oftentimes, when we face people who have been the victims 
of violence, we don't think about the lived experiences that 
those people have had and how that impacts how they relate to 
the trauma that they are experiencing.
    Oftentimes, the trauma is not just an event that happened 
today but something that happened a week ago, a year ago, a 
decade ago, a generation ago.
    And we often do not find ways to incorporate that into care 
that will provide for that individual patient.
    Ms. Schakowsky. Let me--I am sorry, let me just let Pastor 
Mitchell finish.
    Ms. Mitchell. I think the other thing, when you talk about 
the trauma-informed care, is to really identify that there is a 
need for that in our communities, because in the communities of 
color we don't identify with mental health or trauma care. 
There is always the stigma of being treated or seeking 
counseling and therapy.
    As a pastor, it is very difficult to say because in the 
congregation we believe that, if God and I can't fix it, then 
it is not meant to be done.
    But to actually, as I stated before, to allow yourself to 
be vulnerable enough to understand that God has said in that 
day knowledge would increase and to be able to accept the 
knowledge that is before us and to move ourselves toward 
wholeness.
    Ms. Schakowsky. I just want to say one more sentence. While 
I agree with all of you that it is going to take time, I also 
want to--the T-shirts are Moms Demand Action, and I think 
whether it is going to take long or short, what people want to 
see now is steps--concrete steps--that represent action that is 
going to address this problem of gun violence in our 
communities.
    Thank you. I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    And now I would like to recognize the gentlewoman from New 
York, Congresswoman Yvette Clarke, and thank you for traveling 
from New York to be with us here today.
    You have 3 minutes for--5 minutes for your questioning.
    Ms. Clarke. Very well. Thank you so much, Madam Chairwoman.
    Let me thank you for doing this field hearing. Let me thank 
my colleagues of the Illinois delegation for welcoming an East 
Coast sister from Brooklyn for this hearing.
    And let me thank our expert witnesses who have come to 
testify before us today.
    Dr. Rogers, in the colloquialism of a New Yorker, it is a 
lot of levels to this thing, and I think that is one of the 
things that you have mentioned in and repeatedly through your 
testimony here today.
    Reverend Brenda Mitchell, I want you to know that we are on 
the same wavelength. I am going to give you three names: James 
E. Davis, Gabrielle Giffords, Steven Scalise.
    Each of these are colleagues of mine. One is in the past 
tense. His name is James E. Davis. He was a colleague who was 
gunned down before me in the New York City Council.
    I walk with that trauma every day. Every single day. And as 
you spoke of your experience, my experience is sitting here 
bubbling up.
    There is a lot of walking wounded, and there are many 
levels to this. It is proximity to what happened, relation to 
the individuals involved, community, and we have not really 
wrapped our arms around the extent to which Americans are being 
subjected to the pain of violence in our communities, in our 
Nation overall.
    Because for many it may not even be someone who is 
immediate in their families. It may be a colleague. I have had 
two colleagues now in Congress gunned down. Thank God they were 
able to survive.
    But it is--and we still haven't acted. One Republican, one 
Democrat. All of us walking around knowing that our colleagues 
were gunned down before us.
    So my question is, and I am going to open this to the 
panel, a comprehensive approach from a health and well-being 
standpoint, how does gun access and availability through 
trafficking create a dynamic for those who are looking to 
commit violence?
    And then what are the socioeconomic indicators that we need 
to look at in terms of education and the opportunity gaps that 
help to fortify us against future actions?
    So it is a multipronged approach, but I would like to just 
sort of get your take on it because I think that we are only 
scratching the surface of the many levels that we have to 
address through legislation and through behavior modification.
    Ms. Mitchell. I am going to yield to the experts in just a 
second. But I think that I am also on the school board in my 
community, and so I get to see the disparity in terms of the 
education system and what children are presenting themselves 
with when coming into the classroom.
    I also get to see the socioeconomics and the institutional 
racism that kind of denies access to individuals.
    And so, unless we take care of all of the different 
layers--because it is not a one size fits all. There is trauma. 
There is gun violence. There is a lack of action from the 
Senate to move on things like the firearms and the red flag 
laws.
    And so all of those things, while they are not being taken 
care of, is still our reality, and until, as Dr. Rogers said, 
we deal with the different levels of gun violence and the 
byproducts of gun violence, then we are doing a disservice to 
the public.
    Ms. Clarke. We only got a couple minutes. Does anyone else 
want to address that issue?
    Dr. Lubin-Johnson. So I would like to add something to that 
issue in terms of the intersectionality of what occurs with 
victims of, you know, violence and the socioeconomic status.
    One thing is, you know, we talk about adverse childhood 
experiences, and this is one of those, but also others are, you 
know, housing and access to food, et cetera.
    All these things are interrelated. I mean, we know that 
even those stressful childhood experiences of violence can 
carry over into adulthood with increased rates of heart 
disease, diabetes, high blood pressure, et cetera, and I think 
we have to develop programs that take all of that into account.
    Even, you know, the increased stress level of a mother 
could lead to increased preterm births, you know, as--you know, 
as she is pregnant.
    And so I think we really have to look at how all these 
things, you know, in terms of efforts, childhood experiences, 
social determinants of health, how they all play a part in any 
program that is crafted to help ----
    Ms. Clarke. Dr. Rogers, I did invoke your name. I did want 
to get your response very quickly.
    Dr. Rogers. Thank you. I do think, as you said, Ms. Clarke, 
it is multilevel, and I think it is not going to be any one 
simple solution to this problem.
    But we have to be willing to tackle it on multi levels. I 
think--I was going to make the comment earlier that race 
matters. I think if gun violence--intentional gun violence--was 
disproportionately affecting only white people, there would be 
a different impetus for making some impact.
    But, similarly, if you look at the issue across the United 
States, we don't talk about the impact of suicide--gun 
suicide--upon people's lives, the silent burden that families 
bear, and we need to be more open about the impact that that 
has throughout the country.
    Ms. Clarke. The red flag law.
    Madam Chair, I yield back. Thank you.
    Ms. Eshoo. The gentlewoman yields back. It is now an honor 
to recognize our colleague, Congressman Danny Davis. I said 
earlier ``the voice of God,'' and the sorrow of the tragedy of 
losing a family member, that burden is being carried by the 
Congressman and his family when they buried their grandson.
    So this is--it is very important to us that he is here with 
us today and that he will work to be part of the solution, 
learning from the witnesses. You have your 5 minutes to 
question, my friend.
    Mr. Davis. Thank you very much, Chairman Eshoo, and I 
really want to thank you for bringing this hearing to Chicago. 
As far away as New York might be, California is even much 
further.
    And I want to thank Congressman Rush for requesting and the 
entire committee for acceding to that request.
    I am so pleased that so many members of the Committee on 
Energy and Commerce are here participating. We often have these 
kind of discussions throughout the country.
    But oftentimes, we don't have as many individuals who come 
from their districts to participate because there are things 
going on where they are.
    And so, Madam Chairman, this is an absolute great day for 
us. I want to thank all of the expert witnesses who have come, 
and as I have listened I thought of the fact that less than 2 
months ago, 2 young individuals were tried, convicted, and 
sentenced to prison for the murder of my grandson, 15 years 
old.
    Their families are traumatized as much as our family, and 
my son was amazed when, at one of the eulogies, I said, you 
know, ``I am hurting for the families of the individuals who 
shot Javon.''
    And he asked me--he says, ``Daddy, did you mean what you 
said?'' I said, ``Yes, I really did, because just as there are 
going to be empty spaces at our Thanksgiving dinner table, 
there are going to be empty spaces at their Thanksgiving dinner 
table.'' And he said, ``Well, the only thing I can say is, I 
think you are a better man than I am.''
    But that is one of the reasons that I am so pleased to have 
introduced with Senator Durbin a trauma-informed care bill 
that, hopefully, will move us in the direction of providing 
greater access to individuals who have experienced traumatic 
events.
    As we have heard, all of us, one way or the other, either 
collectively or individually, are having these experiences. And 
so yes, we need resources.
    But when I think of public health, my mother taught us that 
prevention was worth much more than cure. She would say an 
ounce of prevention is worth more than a pound of cure. And so 
we know that there are things that we need to do in order to 
reduce the presence of guns.
    For example, I am big on mental health, trying to recognize 
its impact. But, you know, if a person is feeling a certain 
kind of anxiety and all they have got is a toothpick, they 
cannot kill 10 or 12 people in 30 seconds or less.
    So we must find a way to reduce the presence of guns in our 
society. We must find a way.
    [Applause.]
    Mr. Davis. We must find a way to eliminate access to these 
automatic and semi-automatic weapons that shouldn't be in the 
hands of anyone except military and perhaps in some instances 
law enforcement.
    [Applause.]
    Mr. Davis. We know what to do, but we must have the will to 
do it. Had there not been a gun present in the little 
conversation that my grandson and his friends were having, he 
would be alive today and they would not be traumatized and 
facing prison. And so recognizing what to do and then doing it.
    My question is and my comment: Gun violence is a crisis, 
but so is poverty a health crisis. So is economic oppression. I 
understand the young man over here who is talking about jobs, 
and he has come to believe that of all the issues--because when 
we talk about the stats and the group that has the most 
homicides, half of those individuals are out of work, don't 
have a job, don't go to school, are not engaged in any kind of 
training program. So this also contributes to their utilization 
of other forces to do what they do.
    So, Spencer, my question--Mr. Leak--and I have attended 
many of those services that you provided, and we see each other 
pretty much on a regular basis, almost every weekend there is 
one.
    How do we comprehensively face the issue that we have and 
try and make sure that we can seriously reduce gun violence and 
provide the help that individuals need to have once they have 
experienced it?
    Mr. Leak. Well, thank you, Congressman Davis. Let me say 
that I have found that, if we can change the mindset of the 
individuals, that we--these groups that we are talking about.
    When I was director of the jail, I was telling Dr. Lubin 
that 50 percent of the inmate population were there because of 
mental health issues, and what can the jail do about mental 
health other than to contain?
    But I submit that we have not brought into play the 
correctional systems--Federal and State and county--of our 
nation.
    When I was the director of the jail, I did not, Congressman 
Davis, think that my job was to contain inmates or to confine 
them.
    My job was to correct them, and what I tried to do in that 
jail is to correct the individuals who come to us. They have no 
else--they are confined, and therefore they are individuals 
that we may change their life set.
    So that is one area there. But I cannot--I cannot reiterate 
to you and all of the Congressmen here that when I sit down 
with those mothers, Congressman, of those children killed in 
violence, I can't come up with anything comprehensive. I can't 
be really profound. I can only put my hand around that mother 
and say to her, ``Let us have prayer.''
    And the only thing that will get us through this crisis in 
gun violence and violence in general is we must--there must be 
a faith-based solution. And I know that there are those who say 
it is unconstitutional.
    We should not--we should separate church and State. But I 
say to you, we have got to change the mindset, and the only one 
who can change the mindset is the one who changes not.
    Mr. Davis. Thank you again, Chairman Eshoo. I really do, 
from a personal vantage point, thank you, Congressman Rush, and 
the entire subcommittee for bringing this tremendous hearing to 
Chicago.
    And I yield back.
    Ms. Eshoo. The gentleman yields back.
    And you should know that we all hold you in the center of 
our hearts, and we think you are very, very special.
    I would just like to say to Mr. Leak that, when you see a 
picture of the floor of the House of Representatives and the 
Speaker's chair, what is engraved over it are the following 
words: ``In God We Trust.''
    I now would like to recognize, last but not least, 
certainly, our colleague, Chuy Garcia, from the Chicago area, 
and thank you for joining us today and for your patience.
    You now have 5 minutes to question.
    Mr. Garcia. Thank you, Madam Chair, and to all the members 
of the committee and, of course, all the panelists. As all of 
you are keenly aware, gun violence is ravaging our communities.
    It is sad to think how normalized gun violence has become 
in our city and across the country, and it is time for the 
Government to quit cowering to the NRA and to do something 
about it.
    [Applause.]
    Mr. Garcia. I am sick of seeing headlines of shooting after 
shooting occurring all over our country.
    This week marked a 2-year anniversary since my wife was 
coming home from going to visit a friend and parking her car in 
the garage and heard four gunshots.
    She ran to the front of the house to check to see what had 
happened. A 26-year-old was shot while standing over his bike. 
She called me to hurry home because this had happened. This is 
just one more testimonial to others that Members have shared, 
that none of us are immune to gun violence in our country 
today.
    Mass shootings have captured the national attention but 
are, in fact, a small share of gun violence in our country, and 
Chicago is no stranger to the gun violence. It is constantly 
demonized by the President. It is a popular talking point for 
those who claim that gun control doesn't work.
    But there is a big difference between the factors that 
create the conditions for shootings and our city and mass 
shootings other places. Our Black and Latino communities have 
been harmed for generations by disinvestment, racism, poverty, 
and gang violence.
    I want to ask Dr. Rogers, why is it important that research 
properly identifies the root causes of gun violence and 
distinguishes mass shootings from the types of gun violence we 
witness in Chicago?
    Dr. Rogers. Thank you, Congressman Garcia.
    As noted, mass shootings represent less than 1 percent of 
total shootings in the United States but disproportionately 
gets all of the media attention when, in fact, daily people die 
from gun violence and suicides by guns without getting the same 
attention.
    It is only through dedicated research will we understand 
exactly what works, be it safer guns, be it hand-imprinted ways 
of protecting who actually fires a handgun, for example, or 
actually thinking more holistically what are the primary and 
secondary prevention efforts that we can do to prevent people 
from being injured by firearms in the United States.
    Mr. Garcia. And very briefly, how do we get stakeholders, 
including the media and law enforcement, to properly and 
responsibly report and highlight these differences?
    Dr. Rogers. I think one of the things that is happening 
today, the ability to try to listen in a way that actually 
respects people's different viewpoints. I think that is a 
important starting point for dialogue.
    Mr. Garcia. Very well.
    So recently our country witnessed the deadliest racially 
motivated attack targeting Latinos in modern American history, 
in El Paso. But this is not an isolated incident.
    In fact, nationally, from 2016 to 2017, there was a 24 
percent increase in hate crimes against Latinos, fueled by 
white supremacy and hateful rhetoric coming from the White 
House.
    I visited El Paso in the wake of the shooting, and as our 
community mourned we also understood that the President is not 
contributing to preventing these incidents. He is contributing 
to encouraging this type of violence.
    I want to ask Dr. Kerr as my final question--Mr. Kerr--what 
types of resources and community engagement will the city and 
the relatively new administration commit to providing 
communities most afflicted by gun violence in Chicago?
    And I ask that understanding that this is a national panel, 
but we are also looking at what cities are doing to--in 
response to the gun epidemic.
    Mr. Kerr. Sure. So, as I mentioned earlier, Mayor 
Lightfoot's investment in violence--this is something I know is 
a big issue for her, and we are poised to work with other 
organizations and entities because this is an all-hands-on-deck 
approach that is needed to address this issue.
    So we are doing inventory of our programming to making sure 
that we have ample prevention programs but also thinking in a 
comprehensive way. We need prevention and we need intervention, 
and we need that comprehensive approach to also go along 
partners.
    So who needs to be at the table? So, of course, city, 
county, State, Federal, but also including our local partners 
in the process.
    So we have been able to have different town hall meetings 
over the last few months to engage organizations, to engage 
residents to be on board to give their input, to contribute to 
the strategy, because we know it is important to have them 
available on the ground.
    Mr. Garcia. Thank you, Madam Chair. I think my time has run 
out.
    Ms. Eshoo. The gentleman yields back.
    I think that this now concludes the time of questioning on 
the part of Members. On behalf of every member of the 
subcommittee, we want to thank each one of you, the witnesses.
    Chicago is known as the Windy City. But I think here today 
you have really put some wind at our back to address this issue 
that we are grappling with that has caused so much grief not 
only here in this community but in communities across our 
country, the damage to people's lives, the loss of life, but 
what we can do about this relative to public health and the 
epidemic that it really represents.
    So each one of us are extraordinarily grateful to you. What 
you have given to us will be the--is foundational for us to 
build legislation on, and I believe that we have a lot to work 
with because you have given us examples of what is happening at 
the medical center here, what is happening at the medical 
center in Texas. That can be highly instructive to us, that we 
have wraparound services.
    Pastor Mitchell, for what you referenced and other 
witnesses, this is a rich record that you have provided for us. 
We are very grateful to you for it.
    I want to remind Members that, pursuant to committee rules, 
each Member has 10 business days to submit additional questions 
to the witnesses.
    We hope that you will respond in a timely manner, because 
that part of the record is very important to us, as well, that 
all of it be captured, and I trust that you will do that.
    I now would like to ask unanimous consent to enter into the 
record the letter of support from the Association of American 
Medical Colleges. We thank the association for that and, 
hearing no objection, so ordered.
    [The information appears at the conclusion of the hearing.]
    Ms. Eshoo. Isn't that nice that I can say that? Hearing 
no--just like that, it is like my little magic wand.
    And, again, to everyone that is here in the audience, there 
are advocates here that give so much of their time to push and 
to push, to push and to push.
    Your time is not wasted. You are really--you have formed a 
national corps of patriots to address gun violence in our 
country, and we are so deeply grateful to you.
    To those who have suffered the losses in your family, I 
said in the beginning that your grief more than fuels the 
effort that we are taking on. We carry you with us, and we want 
you to know that.
    To all the press that is here--I also want to salute and 
thank the committee staff. It is not an easy thing to do, to 
take a committee on the road and to get everything set up.
    So they not only worked in Washington, DC, but they came 
here before the Members arrived to get everything organized, 
and I think that we can show our appreciation by applauding and 
thanking them.
    Thank you.
    [Applause.]
    Ms. Eshoo. Thank you to everyone. And with that, at this 
time the subcommittee ----
    Mr. Rush. Madam Chair? Madam Chair?
    Ms. Eshoo. Yes, Mr. Rush?
    Mr. Rush. I also want to acknowledge the work of my own 
district staff who worked hand in hand with the committee staff 
to make sure that this was set up.
    Ms. Eshoo. Well, of course, and I know how closely they 
worked with the committee staff. Thank you.
    [Applause.]
    Ms. Eshoo. With that, the subcommittee is now adjourned.
    [Whereupon, at 11:58 a.m., the subcommittee was adjourned.]
    [Material submitted for inclusion in the record follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
                                 [all]