Northwell Health CEO Addresses Gun Violence Prevention

Michael Dowling speaks about how gun violence affects the health of the community and how Northwell Health is addressing gun violence prevention, and he urges healthcare leaders to step up and treat gun violence as a health issue.

Editor's note: This is part one of a three-part series on gun violence prevention in healthcare.

Recently, a group of more than 550 CEOs and leaders of organizations from different sectors around the country signed a letter sent to the U.S. Senate, demanding action on gun violence. Among the signees were several healthcare executives, including Michael Dowling, president and CEO of Northwell Health, New York's largest healthcare provider.

The letter reads: Taken together, the gun violence epidemic represents a public health crisis that continues to devastate communities – especially Black and Brown communities – and harm our national economy. All of this points to a clear need for action: the Senate must take urgent action to pass bold gun safety legislation as soon as possible in order to avoid more death and injury. 

Not too long after, the Senate then passed, by a 65-33 vote, a bipartisan bill to address gun violence across the country. Now the bill will head to the House of Representatives.

Dowling is a strong voice on gun violence prevention and advocacy and has been for quite some time. In the past, he has spoken to HealthLeaders about how healthcare providers needed to rally and mobilize for gun control. He has also shared his thoughts on gun violence as a public health issue through media sources and Northwell Health's blog.

He recently spoke to HealthLeaders about the current gun violence climate, including how gun violence affects the health of the community and how Northwell is addressing gun violence prevention, and he is urging other healthcare leaders to step up and treat gun violence as a health issue.

Michael Dowling, president and CEO of Northwell Health. Photo courtesy of Northwell Health.

This transcript has been edited for clarity and brevity.

HealthLeaders: How will addressing gun violence as a public health crisis help move healthcare forward?

Michael Dowling: Those of us in healthcare have to take a broad view of what we mean by healthcare. Healthcare, in my view, is more than just the medical aspect of care delivery. It is more than treating illness. If we're really concerned about health, we've got to be concerned and take action with regard to those things that affect health.

Gun violence, in my view, is a public health issue. If you live in a community with lots of gun violence, it directly affects families and children. If you are the victim of gun violence, you end up in our emergency departments, you end up in our health centers. If you have a family member affected by gun violence, it affects the whole family. I [recently] held a meeting with [several families whose] kids had been killed by guns. If you sit and you listen to the families affected, their whole health is affected by this.

We have to take a broader definition of what we mean by health. If we're concerned about it, we've got to deal with those things that affect health overall, and gun violence is one. It broadens our perspective. We are much more than an organization that just treats you after you get injured, or hurt, or after you get shot with a gun and you end up in the emergency department, or in the morgue. It gets us to talk about things that cause ill health and that's a very positive thing.

HL: What have you and your organization experienced when it comes to gun violence?

Dowling: We've had more children so far this year come to our Children's Hospital with gunshot wounds and injuries than any time in history. We see the results of gun violence; we see the physical results, the family results, and the behavioral health results of it.

We live in the community. I've had employees killed recently. I've had an employee shot multiple times in the head by her former boyfriend.

We see this every day. And our employees, many of them, live in those communities that have a high incidence of gun violence. We are intimately involved. And it's just not good enough to say "I will treat you after you're shot." We also have that obligation to try to do everything we can to educate people and advocate for those things that help prevent that inevitability.

For example, I created a Center for Gun Violence Prevention. The person who is heading it for me is Chethan Sathya, MD. He is a former pediatric trauma surgeon. He has had to take bullets out of six-month-old babies. He had a 14-year-old come to him recently, who was [injured by] a drive-by shooting. He did surgery on her neck. She's 14 years old, just walking down the street; she is now paralyzed from the neck down.

This is the reason four years ago I went public and declared all healthcare leaders across the United States should be unbelievably involved in this, to be actively involved, and treat it as a public health issue.

We live in the community, we work with the community, we're in those communities that have a high incidence of gun violence, and we see the results in our hospitals.

HL: How do you address gun violence prevention as part of the Center for Gun Violence Prevention?

Dowling: We hold an annual forum on gun violence. We've held three of them now over the last three years. Of course, the one held during COVID was virtual.

We invite to those meetings a lot of the organizations that have been involved around the country on gun violence. We bring together advocates, people out there doing work on survivorship and gun violence.

It's a forum [where] we can get different perspectives, bring people together to exchange views, share information, figure out how to broaden and strengthen the coalition of people that want to work on this. They've been very successful. We get up to 1,000 people sign up at these meetings. We're going to be holding another one this year.

We plan to continue our advocacy and continue to work on educating people as much as we possibly can. It's all about trying to enhance safety and prevention. We are not tackling the issue of the right to own a gun or the Second Amendment, we're mostly focused on safety and prevention.

HL: How can healthcare executives address gun violence prevention while avoiding the political side of the issue? Can you give examples?

Dowling: Focus on prevention and educate people about the epidemic of gun violence; you educate people about the circumstance.

I don't know if people realize, for example, that guns are the leading cause of death among children and teenagers. It is ahead of car accidents, and more kids die of gun violence than cancer. [People don't realize it] so you do that education. Then you educate people about if they have a gun, how to make sure you keep it locked up at home.

I think every healthcare organization, especially large healthcare organizations, should create a center on gun violence prevention. What we do is, [when a] person comes to the emergency department, we ask questions about gun safety and about their interaction with guns; just like we ask questions about nutrition, and about substance abuse. And people do open up and talk about them, and people will indicate that they've had severe issues related to this, and some people need to be referred for service. We were one of the first in the country to get an NIH grant to do this.

We do a lot of education amongst our employees. We educate thousands of employees every week on what to do if there is an active shooter incident at our facility.

We have an educational program called Stop the Bleed. If there is a shooting and you are in that vicinity and somebody is bleeding out, how do you put on a tourniquet? What do you do in those circumstances? How can you assist?

The other thing we're doing, which I never thought that we would have to do, but it shows the environment that we're in, we are now putting weapon detection technology in each of our facilities. So, when you walk in, you walk through a screening device that will indicate whether you have a gun or a knife in your possession. You should not be able to walk into a healthcare facility carrying a gun.

The education also extends to how visitors behave and how the staff behaves, because you hear all the time, not only in hospitals now, about bad behavior in restaurants, bad behavior in the airports, and now the airlines. We're losing something here; the degree of civility, and decency, and dignity, and how we relate to one another. We've got to work together and we've got to respect one another, and so we provide a lot of education around that.

We work very closely with a lot of the local community-based organizations (CBOs) on gun violence issues; we have very close relationships with them. One of the local CBOs in an underserved community near us that has violence stats needed us to train them on things like Stop the Bleed. They also needed a vehicle to act as an ambulance, and we gave them one. We work with CBOs in a very deliberate way and I'm out in those communities a lot.

We have a community obligation. We are major influences of the community; every CEO of a healthcare organization is. We are out there doing things around food insecurity, how we handle diabetes, how we handle childhood asthma. We've also got to be out there dealing with the debilitating effects of gun violence. It is our responsibility. It is what we should be doing. We should not shy away from it. I've been criticized for why I am involved in this; I'm involved in this because my view is it is definitively a health issue.

We have to look forward and create a better future. That's what leadership is about, creating a better future. That future is one with zero gun violence. It's a future where people don't have to fear walking down the street. It's a future where we build that sense of community, where there is trust and reliance on one another without having to armor ourselves to exist.

Related: Keeping Your Communities, Employees Safe from Gun Violence