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>> buckeye broadband supports c-span is a public servicelong with these other television providers giving you a front-row seat to democracy. >> next, a discussion about gun violence prevention with former health and human services secretary kathleen sebelius and former senator and physician bill frist. they joined advocates to consider the importance of recognizing gun violence as a public health crisis and what solutions are available from a public health perspective. from the aspen institute this is one hour. [inaudible conversations] [inaudible conversations] >> well, good afternoon, everybody. come on, you can be tired yet. and welcome to public health at

the aspen institute would lead to have you here for this most important at advantage woulde most timely discussion about the ongoing epidemic of gun violence in this country. i am ruth katz, executive director of health medicine and society program at the aspen institute, and you tell everybody else. health medicine and society, the sponsor public health at the aspen institute. now, as many of you may know, grand rounds is a time honored feature of medicine decide to keep clinicians up-to-date about scientific and medical advancement and to promote excellence in research and practice. public health now in its eighth year at the aspen institute borrowers from that tradition to advance knowledge about the cutting edge public health or population health issues of the day. and sadly but certainly most urgently we do have such topic

for our discussion today. the statistics on firearm injury in the united states are so bleak that they threatened to become numbing. firearms killed more than 40,000 americans in 2021, and injured twice that many. among adults, most firearm deaths are caused by suicide, homicide should most common cause among youth under the e of 18. a global outlier the united states has aged adjusted homicide rates that are 22 times higher than those of the european union. and that terrible toll does not stop at the victims, given the widespread impact of trauma, grief and fear associate with the proximity to violence that affects millions and millions of people.o but becoming numb is not something the nation can afford. beyond the devastation of human beings and communities is the economic burden. in 2020 alone the cost of fatal

and nonfatal firearm injuries in the united states topped a staggering 493 elgin dollars. according to a recent article in the american journal of preventive medicine. now, no one considers any of this acceptable. these are gunowners, non-gunowners, not not the public health or health care community and not patients, parents or politicians. and yet efforts to confront this health crisis has stalled for years. that the increased availability of research funding, better data collection, and especially a greater recognition that a public health approach is the best way to reduce firearm violence, offer hope that progress can bece made. today's program is all about how that public health approach can work. joining us for the discussion is a stellar panel of experts and policymakers, and in the interest of time i will be

presummit introduction but you can learn more about each of our speakers in theor invitation tht wee sent out to this event. former senator bill frist,il nationally recognized heart and lung transplant surgeon represented the state of tennessee from 1994-2007. in which he served as senate majority leader for four years and was instrumental in passing the historic presidents emergency plan for aids relief known as pepfar. currently, senator frist is chair of the global board of nature conservancy and also chairs the aspen health strategy group. kathleen sebelius served as secretary of department of health and human services during the obama administration leading the the president charged to pass, and government the affordable care act. prior to her federal service, secretary sebelius was governor of the state of kansas. today she serves as president and ceo of sebelius resources as well as cochair of the aspen health strategy group.

greg jackson special assistant to the present and deputy director on gun violence prevention. a survivor of kai billets himself, mr. jackson has been a gun violence prevention leader for over ten years, including his work as director of the community justice action fund, a national survivor led gun violence prevention organization focus exclusively on the impact on black and brown communities. megan ranney an emergency physician is dean nto whence will profess a public mcgill school of public health, a professor of emergency medicine at the yale school of medicine. she's also an aspen health fellow, class number five i believe, very good. a national advocate for innovative approaches to public health. dr. ranney focuses her research on developing, , testing and disseminate digital health interventions to prevent

violence and related behavioral problems. moderating the conversation is a good friend of the aspen institute ofng the health medice society program, alan weil. alan is editor-in-chief of health affairs, the nation's leading health policy journal.y and more about our he's one i'm really cutting short. thank you all really thank you for being here today. thank our panel for being here. before entering things over 2000, just a few housekeeping notes to share. first as you can see, i think you can see, c-span2 today covering today's event but we're also videotaping the program and it would uponn the health medicine society website within 24-48 hours. our interview, our discussion interview, our discussion will run about 40 minutes or so after which will open the conversation to take your questions and comments. but please wait for a mic before speaking and then to introduce yourself and state in italy you may have. finally, time is tight for the

q&a portion of the program and want to get as many questioned as they can, so please, i literally beg you, please be brief and get directly to your question. so we can get ass many as we ca. with that, by thanks again to all of you, our speaker for taking time from your drill the daily schedules to join our program. thanks to todd again in the back who helped organize this today and, of course, thanks again to all of you for joining us. it's going to have your. with that, alan, the aspen stage is all yours. >> thank you, ruth, i think all for joining us today. i'm going to start off with a question building on the introduction that ruth gave around the statistics which can be numbing but we really can't become numb to them. ikea of public health approach, a topic will be discussing more detail in a moment, is understanding where you are. and and i wonder if any of yot to build on the introduction

ruth gave with either expanding on some of the data or maybe reflecting audit, where other misunderstandings or where does the discussion goes this way when people look at the data they might think it's that way. madam secretary, governor? i can't help it. >> just a couple of things i think that struck me when we were talking about this with our wonderful experts. the sheer numbers o are just incredibly horrible. 50,000 deaths, that's a big number. but then multiply that by the people who are injured but don't die. .. millions of americans are traumatized and victims of gun violence. and how much of an outlier we

are, that was the second piece of the puzzle. i knew we had more, but the numbers, canada's number three, we have eight times the gun violence per capita that canada has. so it is way off the charts. secondly, the number one cause for children, that is a number the came up and so 54, 55% or site. stop for of a covenant i guess get a piece of the puzzle what are a suspect progress has been made.

more research desperately, but spreading best practices, bill felt the same way, living in states where we've seen difficulty at the national level, so what we are talking about just not take legislation, just intent and community support. community support. >> the public health component, people say oh you're pessimistic and that's not really a fair question. the real optimism and hope is the fact that we take what used to be a second amendment issue with the partisanship and

reframe it because statistics -- number one the fact that under the age of 18 and 19, it is the number one killer. it is not heart disease or lung disease, accidents, anything else. it is firearm injury. that becomes a public health issue. when you frame this in public health, people come to the table, put their hats aside. it is a public health issue. >> that is a great segue to describe how to think about it as a public health issue. megan, that would have to be for you. >> it is a join a privilege to

be here with you. i testified before the judiciary about this. one thing that strikes me is folks do not understand that it is a public health problem. i think we can coalesce around the fact that this is a health problem. the public health approach is really reproducible standards. the first is you measure how common the problem is. injuries, deaths, consequences. second, identify risk factors. what puts someone at a higher likelihood of getting shot or killed? what protects them? this is important because that gives us a lens to protect people from injury or

consequences. the third step is to do something with information, develop intervention and this is where it is not just about policy. legislation is never sufficient and can be harmful in public health. so we evaluate interventions across a spectrum ranging from education to engineering, economic incentives or legislation. the final step is when you figure out what works, it is important to follow those steps. without them you're liable to make mistakes and make things worse. you're liable to act on the wrong cause or underlying risk and we do not have enough funds

to address all the problems. we do not want to spend time or money on things that will not make a difference. so the four step approach allows a coalition. strange bedfellows. i do a lot of work in states across the u.s.. universities, predominantly firearm owning communities and have found tremendous partnerships when we start from the starting point that none of us want communities hurt and we are preventing people from getting hurt and taking a four step approach. unfortunately, people think public health is about laws. it is a wider set of intervention. the last thing i will say is we

think about public health approaches and harm reduction. many of you have heard it applied to substance use. reducing the chance that someone will have an overdose or death or infection. trying to reduce harm. the same approach applies to firearms. we can take a partnership that is not fall or nothing and is inherent to our public health to try, anything is better than nothing and we see a big effect. >> jumping in, the steps are key. they are fundamental to public health approach. the question is why now? there's been more firearm injuries now then there were 10

or 20 years ago. the second is for 20 years we had new research. one and to regard getting data, seeing what works, determining the risk. because of a policy, a wrong policy, until 2018, we had no research. nothing supported by the government. therefore, you had people talking and feeling good, but where is the data? what works, what does not work? we had a gap. over the last four hues the door has been open. the policy has been reversed. that's why am hopeful.

steps one and two can empower people like megan and academics. they determine the risk. what is the data? for the first time data is coming forward. >> before we hear from our expert who is working day today on this, i think the other reason i feel optimistic is there is support, gun owners, non-gun owners, taking steps to find common ground and address public health. this is not -- you think about gun debates and it is polarizing as the senator alluded to. public health approach has community support.

republicans, democrats. if we can do what megan suggested, we can make progress. in a uniform way. >> so if i think of myself as an observer, political debate spikes around mass shootings and in the absence of data, you say that is where we should focus solutions. it is a problem, but there are t wo other places i would want to look that drive a lot more harm. the first is community-based violence.

senator, your comment on the increase in research, we know more about incidents, and also how to stop it will reduce the burden. greg, take us through a tour of what we know. greg: research has pulled back the veil about why homicides rise and we look beyond suicide. the narrative dominated by mass shootings, it is interpersonal violence fueling the numbers. one huge thing we learned is what is happening in communities. there is a stereotype that inner-city violence is driven by gangs and criminal activity. but that is not the case. 70% of community violence in

shootings are not connected to a felony. 89% are not connected to gangs, but the narrative dominated how we thought about inner-city homicides and violence amongst youth. so as you pull that back you say what is going on in whether it is a veteran on the edge of suicide or a 12-year-old with a firearm, these are two individuals at a point of crisis with easy access to a firearm. our approaches. about why people are in crisis, address those factors. and then how do we put time and distance between them having a firearm and reacting in crisis. strategies for suicide and homicide work well, shifting the messenger, shifting their resources.

that is what community violence intervention was born from. those who are most at risk, someone who is a survivor, survivors of gun violence have a 40% chance of being shot again, harming someone else or being killed. how can we get better at engaging survivors? so they have different approaches. some use behavioral therapy, others use healing approaches. others take a job approach. let's pull you out of this moment to cool down and get you into job so we can solve the acre problem. not just conflict over resources. so the strategy has been implemented for the last there

is around $12 billion in which ca a big change. talk to senator murphy and one of their most dangerous communities went nine months with no shootings and the only change was community violence program was launched, they funded it in baltimore. safe streets, 12 communities. there has been a 26 point reduction by engaging with resources, support, but trying to help them get out of the moment of crisis. we are looking at how to do that around prevention with veterans and youth not in inner cities,

knowing suicide has skyrocketed. we are excited about focusing on those in crisis. the other piece you can never forget his access to firearms. the difference is we have 400 million tons. back then we had 100 million. guns are available and we have to think what this means for our families when egg gun can be found easier than therapist. we've seen a 13% reduction. last year, it was the sharpest decline and when you look at black and brown communities, that is where we saw the heaviest decline. >> so ruth mentioned in the

introduction, everyone is affiliated with the strategy group which had firearms injury as a topic. the first big idea was the notion that the health sector needs to leave. i'm thinking we have active representatives of the house affected. and i am listening to your approach is and thinking health is not the first place i think of, but it keeps coming up, so maybe you can start with what is happening within the community? megan: we are linking them to

resources and taking that on in different ways. for community violence, i know kids who have been assaulted or shot are more likely to be seen by me than a therapist so we can use that moment to link them to community organizations like the one we are talking about or a hospital violence intervention program. we are creating coalitions between hospital systems and police, community-based organizations, parents, education to create this multifaceted intervention. we have a huge role in suicide prevention and i share what drove me to take on gun violence was the daily shootings through my emergency department and i had a man who shot him self that

held me to take on this issue. the role that we can play in identifying folks who are high risk and providing counseling to put time and space between a person and their time. we cannot do it alone and to say health care is sufficient, i love the way you came up with big ideas, but it is health care physicians and workers and everyone else helping to change this. it may be public health organizations that have a focus on health and can be more trusted in terms of providing advice around storage were getting a gun out of the house or linking a kid to afterschool programs.

health care are just as important as hospitals or clinics. >> to that point, we talked a lot this summer about the notion that it has got to be called what it is. we have an epidemic and health providers, nurses, others calling it out is a big step. so it is not behind the curtain anymore and people become more familiar, the number one killer of children, that catches people's attention and becomes a great focal point. but also, there are clearly not only direct intervention when a victim comes in and family members and others, but indirect. helping greg talk about his own situation and the notion of community violence intervention programs going back home with

people who are in a crisis. they are all in a crisis. if a family member has been killed, there is a crisis around that unit and one alternative is go home, get a gun and take retribution. the other is figuring out ways to grieve, what are the next steps? to process what has happened. that takes help and support. just thinking about those issues and then the third in the suicide area is there are lots and lots and lots of people who feel themselves to be responsible gun owners who do not stow their gun in a responsible way. it is just what it is and to have more conversations about that, gun ownership rights, there are responsibilities, there is a burden on right for gun owners to actually protect

the firearm. >> i think that is right, but i want to add something which is important. most gun owners are in favor of safe storage. most republicans are in favor by overwhelming majorities, safe storage. universal background checks. most gun owners are overwhelming majority in favor of universal background checks. temporary transfer of being able -- if someone says they're going to harm themselves, to remove firearms from -- most gun owners . you have to go deeper then sort of saying they have to take responsibility. it may be us. it starts with health care. the only thing i would add is

the disconnect for me when i think about it is who is communicating and then you say who do you want -- who are you willing to listen to? we have the facts, we have the data. who are you going to listen to? it is more likely you will listen to a trusted source and that may be an athlete, nurse, doctor, emt person coming in. to me that is the opportunity that we have. leaders or trusted sources, not really institutions. certainly not government. people do not want more government. but what they will listen to, the data, the disconnect between policies and risks which is not

representative of what the state believes or facts or evidence. you need to communicate and that public health. we've got things where we know it works. none will work unless you communicate. it opens their eyes. it gets dumped into partisanship , but that is what the health care community -- not just >> while you are talking i want you to bring in your experience. you have been very active in the discussion. early in the session both of you talked about reasons for optimism. can you give us a sense of what you are experiencing and why you are optimistic? >> it is fascinating to me. optimism, first of all, even from a washington standpoint,

just 24 months ago government passed the most significant firearm injury legislation in 30 years. republicans and democrats came together and passed the most powerful and effective legislation around firearm injury, a public health issue. first time in 30 years. so there is optimism. tennessee is as you read state as you can get. maga state legislator in the house, senate. a year ago with the shooting, people opened their eyes. you can look at statistics but

it opened eyes and with that all sorts of things happened. a gun owning republican conservative governor looked at the state legislature and said, we have to act, we have to do something, we have to figure this out. he did not know much about guns on the data but he said we have to act so he said to the general assembly, i ask you to come together and address firearm injury protection. our assembly itself, tennessee is a republican extreme, the further you can move to the extreme, that is who ends up in power. so how do you connect them? the governors said combat, they said we are not doing it.

so the governor after they left said you are coming back and called a special session and said you will address public safety and they said, how can the governor do this? this conservative governor? they came back. how much did they get done, probably not much. not what we would like to see with universal background checks and bigger things coming out but some little progress. but in the eight months since then, it has to be incremental, common sense, pulling people together, based on data and that is exactly what happened. we had a group come together called voices for a safer tennessee. 25,000 people strong all over the state organizing and coming together who said let's take a nonpartisan approach looking at data. progress has been made.

recently you probably read that the legislator passed weeks ago that teachers can be armed. but what you did not see is that tennessee after 10 years of opening up to more guns passed the first single most restriction on the restrictive enactment in guns in the history of the state and it basically says if you have been adjudicated for a mental health issue for mental illness or a violent crime, you cannot purchase a gun at all. at all. a reversal of the last 10 years coming in. universal background checks sound good, we pat ourselves on the back if we get the bend but are they enforced?

with a backlog of gun purchases, we have background checks, but there is a backlog of 781,000. so the lawmakers came together and past funding. so slow-moving incremental lead in part by people coming together can correct and move toward overtime what we would all regard as evidence-based policy that will reinforce where people are in understanding gun safety. >> there are other beautiful examples. kudos and congratulations to you and tennessee i'm making progress. there are other things that have been done bipartisan money that you might not think you are making progress on but have had

real effect, like putting a garden in vacant lots decreases the crime rate in the shooting around where the garden is. a recent study showed in baltimore when they changed the hours stores could sell alcohol there was a 23 percent year-long reduction in violent crime in the neighborhood around where those restrictions were put. some things we do to create change might not have to do with gun laws per se but has to do with circumstances and factors that put people in situations where they are more likely to reach for a gun. and you have done some pretty good stuff since you have been in your role. >> thinking about small changes, for some they say it is small but i think they are a big deal and a lot of it feels

governmental but once you start to see the numbers they have a ripple effect. you move one inch at the federal level and it ripples throughout the country and has a huge impact. we did the first analysis of gun trafficking in 20 years and we know access to illegal guns is a big challenge and how our six euros and 12-year-olds getting guns -- six-year-olds and 12-year-olds getting guns. the number one source was unlicensed private sellers. the first buyers they sell to might not have a holiday -- felony but a few days later the gun gets moved. one person traffic to 103,000 guns -- trafficked 103,000 guns. the historic bill spoken of made

gun trafficking a felony. before they were getting a warning and now it is a federal charge so we have already prosecuted over 300 people for gun trafficking so we are catching them moving guns into communities. and we rolled out an expansion of the background checks to include anyone engaged in the business of selling guns for profit to ensure they must be licensed and do a background check on that impacted over 20,000 sellers across the country, the unlicensed private sellers. it closed the loopholes and had a huge impact in achieving as close as possible to a universal background check we have seen in the last 30 years and it goes directly at the source of where the guns are being trafficked so starting to think about the

small shifts that are incremental but have a huge monumental impact. thinking about funding for intervention and victim services, why don't we include that in the guidance for public relief funds, you can use the money for victim services and violence intervention and as a result across the country big cities and local counties, you see that money investing in victim services and everywhere we did that we saw a drastic reduction so we have been working hard to make sure we look at the risk factors and also think about how to make sure guns are not getting into the hands and look at what the government can do to help. >> will talk about what needs to be done but part of the evidence

shows things that should not be done. i wonder if one of you could take that up for a minute. there are policies that research shows maybe we should not have. >> stand your ground laws have shown to increase homicide and suicide. not the world's best policy. on the other hand, demonizing gun owners is also shown to be harmful. talking about trafficking, there are wonderful partnerships around suicide prevention with national sports foundations and gun shop owners nationwide so that demonization is shown to clearly not work. another thing is scared straight programs.

talking about community violence intervention programs, there is a focus on survivorship and providing mentorship and a safe space. bringing kids into the hospital and showing them all the horrible things that will happen doesn't work. yelling at them and telling them they will get arrested and we will be sticking a breathing tube down your throat doesn't work. so three very different groups but at the bottom is working in partnership with communities rather than trying to privateer people. >> you have alluded to the fact that messages are hugely important. community intervention programs, having a member of the community dropping into the community and lecturing them doesn't work. if you are a trusted member of the community and not

surprisingly in a lot of low income communities and small groups don't have the funding so driving funds but also training and mentoring people who can then become effective communicators i think is a piece of the puzzle. >> i did not fully understand it until i watched it play out last summer. the voices for a safer tennessee. it has to be a trusted voice of someone who was respected and that varies from community to community. it cannot be who we might think is the trusted voice. a voice that is able to modify legislation coming through, we have legislators who do not represent the majority of republicans on the gun issues or

the gun owners themselves so how do you communicate this at all these facts we keep talking about and injected into the system? voices for a safer tennessee are people from tennessee, they are not funded by a lobbying group. they are a diverse reflection of where tennessee and republicans are and that diversity is represented on the board, where they raise money, it is homegrown but the difference is they are in the advocacy business, getting volunteers to understand the policy so they earn the right to be a diverse voice and it has the diversity

and i say that because typically a lot of these organizations get in and they do not solve the problem. you do not ban assault rifles, it takes diligent representative diversity but representing what the facts really are and that is why it is a good model in terms of answering the question of if that is really where people are and they really get it to the most part once they have the data, how do you get it reflected in policy in states, tennessee -- >> we promised you all time to ask questions. you have already been admonished to make them questions and brief. we will send you the microphone. please identify yourself.

>> i am heather from kfs. this has been important and fantastic. thank you. i wonder about a sustainable financing strategy for some interventions you mentioned and i was hoping you could talk about that. >> i will jump in first. we are already paying for it. the economy loses money each year and we have to think about how we want to pay for it. it is more important to invest in life and right now we are paying for death. implementing red flag laws, finding the atf and victim services, it is nowhere near the impact of the violence we are seeing and the president proposed we put replenish the victim services fund to serve the victims impacted.

we talked about what the atf needs to hold gun shops accountable and crackdown on traffickers. their budget was cut. they need an increase. so what we are asking for is maybe 10% of what we are paying for on the backend and every homicide, the cost is between 500000 and $1 million that is a huge thing we have to recognize is that it impacts through law enforcement, hospital bills, the impact on the community and the cost-of-living and families and their abilities, it all adds up. so the question is not sustainability, it's about how we want to pay for this and is it a priority. >> coming back from the policymaker standpoint, everybody wants more money all the time. somebody walks through the door, they want more money.

but what registers and this is why grassroots is important, is defining specific issues that there is some agreement on. universal background checks are hard to argue against. but only state -- only 16 states have it. but it will not solve the whole problem. it is fundamental. it takes somebody, some entity, to say what is the problem with the legislation on the books if everyone agrees with it and it takes someone to investigate and as soon as you figure out there are 781,000 people in tennessee who are required to get a background check who don't and if you don't, you get a gun, someone has to come and identify

that as a problem and as soon as that problem spreads the word, everyone says, how much does it cost? 300,000 dollars to fix the problem but it takes policy that has to be proposed by the governor and the general assembly has to pass it and then that is where the impact is. that is just an example from a red state in tennessee in the last two weeks and that is where it gets done. get the public health approach but then you have to have that action that has to start locally and it has take people to identify problems that are low hanging fruit first and have some success and then another success and then everybody starts listening. >> also just recognizing and embracing that this is a health crisis. it opens the door to look at what are we investing in other health crises.

in the top 30 causes of death in america, this is the least you researched. we can start their. it is the number one killer of our youth but that top 30 it's the least researched. how many people are lost to fires in their homes, think about how many fire departments and fire trucks and firefighters in the country and how much we invest in infrastructure to help people respond and recover. compare that to the issue of gun violence, the health approach, not crime, it is nominal what we have done. that is a huge thing we have to think about. like we did with automobile accidents when we started shift in and holding the industry accountable, there was a shift in behavior and look at all the resources that went into it, way beyond what we are now and we are just getting started but i think the first major steps we have made show the reduction in this year we are looking at 20%

reduction so even a small investment is having a huge impact so imagine if we leaned in collectively everywhere. >> to add onto that point, i think the data, the statistics we started with repeated and broken down into local levels i think are wet starts the funding. nothing gets funded unless it is a priority and it is not a priority unless it is a problem and it's not a problem unless people know what is going on. so i think at the local level, looking at the laws on the books not being enforced, the backlogs, some of it is very solvable as local as you get but it is driven by a sense of urgency and a sense that this is a crisis and i think it does not belong to the health community

or health sector, but calling this out as a public health crisis is really important. the language is not used often around this topic. it is more a political you are this side, i am that side. and i think statistics are pretty much the same in kansas. do not mess with my gun is a pretty ferocious part of the mantra. but there is a sense of common ship responsibility and what can we do and how do we deal with this and a lot of emphasis in our state around what steps can be taken and how do we do it and better educate people and what screening can go on. when i think about the kind of

health care provider questions, now there is a better emphasis in the women's health area on are you safe in your home, are you fearful about what is going on? the questions about our you a gun owner, is your gun safe, do you have children, that should not be seen as political. it is part of a health exam. helping parents think about it. so i think there are some very common sense things starting at the local level, then identifying the resources. greg can talk about billions of dollars and i think that is really important and bill wants to talk about a couple hundred thousand dollars and i think that is where it needs to be. >> also creating -- thinking about creative sources of financing. we got a code that allows us to

now bill for peer counseling around violence prevention so that is a source of funding to see specialists come into the er or hospital, kudos to that hospital that push that through but it is a nice example of a creative source of funding. there are others where traffickers could be redirected toward prevention effort. we have car manufacturers competing with each other and that sends the money to create safer cars. so thinking creatively about where we can find sustainable sources of funding. >> as we get to the point of acknowledging the public health crisis there is funding that is flexible for public health

initiatives promote one of which is medicaid. i think that is the direction we are going. medicaid dollars, there are pools of money set aside to deal with health crises but we have not quite gotten states and cities and county officials to catch up to that concept or the acknowledgment of the health crisis so there are a lot of health resources available once we get everyone on track. >> i think the media really has an opportunity. it was mentioned about

demonizing gun owners, it doesn't work. not that the media does that, it depends on who was writing the story. i mentioned the positive things that have come out of tennessee. the one that came out nationwide last week is teachers can carry guns. what was not reported, i am exaggerating to make a point a little bit [indiscernible] what was not reported is the teacher had to apply for it and have 40 hours of safety instruction. the principal and superintendent had to sign off on it to allow it. the school district had to accept it and the school

districts immediately came out and said no way will we allow that. even when the bill passed there were less than one in 1000 teachers the possibly qualified for it. that is to say even if you have something out and you have people monitoring, you can modify it in a way and i think it should be reported by the media more completely otherwise you are just sending a signal that we need to write off tennessee. >> ok. >> this was amazing. a head and heart question. you need to appeal to a motion to build support and energy yet

doesn't that conflict with the kind of common sense pragmatism? >> i will use a quick example, the campaign we organized a few years ago, this is arlene. always in which fire are -- our lane. all the ways in which firearm injury is our lane, it's a health problem that is not divisive. it was hearing stories from people who had been there. i do not think it has to be divisive. you can use a motion in ways that create coalition. >> raise your hand if you had to go in a fire drill in school? >> i hope all of you.

>> raise your hand if you had to go through an active shooter drill. this is a small sample. the vice president has been traveling the country, talking about gun violence in schools. when she asked that question, every hand raises. the emotional trauma, that front of mind fear is real for the next few generations. whether -- that fear and anxiety about the crisis of gun violence is alive and well in young people and they know it. they see the stories. they hear the videos. they have been threatened. they have lost friends. they have been in lockdown drills. it is important for us to recognize it is not something we can shy away from then we have to step in with pragmatic solutions, recognizing that debt

energy will turn into something. we do not know what it looks like, it might become a generation that wants to arm everyone. it might be a generation that really steps up and helps us get to the solutions we want. i think we have the opportunity here to start that movement in a real way, recognizing the next generation will run with it very far. >> we will take our last question and then wrap up the panel. >> thank you all for what you are doing. you talk about a sense of urgency and bonding together. why is it capitol hill passed legislation that shows unified support against tiktok when it pertains to kids, yet nothing on gun violence? >> they passed a bipartisan saver community act. they banded together.

there has been some progress. >> that bill was historic. 15 republicans and when you compare that versus the failed universal background checks vote in 2013, and i viewed that for my hospital bed because i had been shot, he only had three republicans. it's not that their hearts have changed or arguments have changed. what changed is the constituents are speaking up and now, democrat or republican, everyone is singing a similar song. we need action and urgent change and you will have to get together and figure it out. so republicans came with some of the most transformative mental health suggestions of our time. this is the largest investment in youth mental health came out of that bill. both sides say they believe that gun trafficking and background checks are a big challenge and we got to a point where now we have expanded the checks and

closed big loopholes so i think we have seen probably the biggest testament of bipartisan support. our office is the first white house office of gun violence prevention. we had eight republicans who said our constituents want to see this change so we will put politics aside to let this change. so i think on this issue we have more support than it seems. it is just the dysfunction i think of congress in general that has cost us a lot of progress on a lot of issues here >> i think that is a good place to end this. i hope we have given you a sense of a way to look at this issue with encouragement, some data,

not to be naïve about the challenges ahead but also to see that there are many bright lights at all levels, not just in public policy but in the private sector. with leadership in part from the health sector but others as well. the issue will not go away but we hope we have given you some new tools for working on it. with that, please thank our panelists. [applause] >> as we say at the aspen institute, thank you all for being here and thanks to our terrific panel. [applause]

today a hearing to examine concerned with rental custom-made to imitate the voice or there like mr. artificial intelligence. watch live for that subcommittee on intellectual property 2:30 p.m. eastern on c-span three. she's gone now, free mobile video art or online at c-span.org. ♪♪ >> nonfiction book lovers is get has a number of podcast for you. best-selling nonfiction authors on the "afterwards" podcast and q&a, here wide-ranging conversations with nonfiction authors and others making things happen. weekly hour-long conversations that feature fascinating authors of nonfiction books on a wide variety of topics. about books takes you behind the scenes of the publishing industry with insider industries, updates and

bestseller list. download the free c-span now cap or wherever you get a podcast and on c-span.org/podcast. >> c-span the wrong coverage for 45 years. the highlight. >> i stand here with my colleagues from the arizona delegation to remember a tragic event three years ago to this day. can you write it, 201110:10 a.m. and 19.6 seconds 19 people including congresswoman and myself were shot