Mark S. KaplanUCLA Luskin

Social Work Journal Tackles Firearm Violence in Special Issue Professor Mark Kaplan of UCLA Luskin sees latest issue of Health & Social Work as a call to action for social workers and the profession to address a national epidemic

By Stan Paul

A new special edition of a social work journal focuses on gun violence in part because of guidance provided by Mark Kaplan, professor of social welfare at UCLA Luskin.

Kaplan was part of an editorial team of social work scholars from throughout the United States who bring together research on various aspects of firearm violence in the November edition of Health & Social Work, which is published by the National Association of Social Workers (NASW) Press and Oxford University Press.

He said that the special edition was meant to spark serious discussion and serve as “a call to action to people to begin thinking of this as a major challenge in professional circles.”

Kaplan, who uses population data to understand suicide risk factors among veterans, seniors and other vulnerable populations, joined colleagues in contributing articles to the publication. Kaplan’s contributions were co-authored with UCLA Luskin Social Welfare Ph.D. students Amelia Cromwell Mueller-Williams and Carol Leung, along with Ziming Xuan, an associate professor at Boston University’s School of Health.

According to an editor’s note about the special issue, “The field of social work has an obligation to address significant issues affecting clients and communities, including the outstanding issues of gun violence in the United States.”

Firearm violence in the United States is considered a public health crisis, and statistics cited in connection to the special issue paint a sobering picture.

Almost 40,000 people — about 60 percent from suicide — die annually. A large proportion of those dying are young people, the editors noted in their call for papers. Not all populations are affected equally — African American men make up the majority of firearm homicides.

The special issue also looks at the stress faced by people who survive shootings, pointing out that many live with chronic effects from their injuries. Gun violence affects immediate victims plus their families and communities.

Kaplan serves on the Board of Scientific Counselors for the National Center for Injury Prevention and Control, a branch of the Centers for Disease Control and Prevention. And he is a scientific advisor to the American Foundation for Suicide Prevention.

“Given the alarming rates of gun deaths in this country, the time seems right for social workers to address this issue in a more comprehensive way,” said co-editor Mickey Sperlich, an assistant professor at the University at Buffalo’s School of Social Work. The volume’s other co-editors are Patricia Logan-Greene, also an associate professor at the University of Buffalo, and Karen Slovak, who serves on the faculty of the School of Social Work at Capella University in Minneapolis.

Although recent mass shootings across the country have heightened public awareness and concern, policy action and research remain obstructed at the federal and state levels by strong opposition from national anti-gun-regulation groups, according to the editors. They note that some professional organizations have responded to this crisis by issuing comprehensive policy statements and practice guidelines for frontline workers, but little guidance exists for social work practice.

Contributors to the special edition delve into the relationship of firearm violence to race, gender and geography, as well as a less-publicized aspect — suicide.

Articles focus on the impact of firearm safety legislation on homicide rates and data that show differences in effectiveness for black and white populations. Another article looks at how fear of crime and racial bias influence gun ownership, especially for white people. A literature review of gun violence published in social work journals since the 1990s identifies the strengths and weaknesses of existing scholarship. Another literature review of community-based gun violence interventions suggests the value of systems-based approaches.

An article by Kaplan and his co-authors looks at the effects of firearm control policies on suicide rates for men, a “hidden epidemic” that accounts for the majority of deaths — not only of suicides but all gun-related deaths nationwide.

“One of the things we tried to do with the hidden epidemic paper was to even dig deeper and show that suicides involving firearms are even more hidden than other forms of gun violence, which often get most of the attention,” Kaplan said. “Most gun deaths in the country are suicides.”

At one level, the more guns in a community and the more guns in a state, the greater the age-adjusted firearm suicide rate, according to the article. “There are policy levers that we identified,” Kaplan explained. “So this is an epidemic that may be amenable to policies that would restrict people’s access, population-level access, to guns.”

In a “Viewpoint” article, Kaplan writes that “evidence suggests firearm-means restriction and firearm-suicide prevention represent gaps in social work education and practice, offering opportunities for universities and continuing education programs.” By increasing knowledge in this area, social workers can effectively engage their communities and advocate for stricter firearms laws. When enacted statewide, such laws lead to decreased numbers of firearm suicides.

A “Practice Forum” in the volume describes how social workers who were already engaged in a community-violence-prevention initiative responded to local outrage over the shooting of Alton Sterling, a 37-year-old black man and father of five who was shot and killed by Baton Rouge police in 2016.

“Social workers have an important role to play in supporting communities to heal and promoting community health in the aftermath of gun violence and trauma,” the authors conclude.

“Hopefully, it’s the start of a conversation that people will have about resorting to means that are more policy-oriented approaches,” Kaplan said. But he cautioned, “This is not a problem that will be resolved or addressed adequately on a one-by-one individual level. This is a much larger problem that needs to be addressed in a more upstream, universal way.”

For more information on the special edition of Health and Social Work and to access the articles, visit Oxford University Press (Oxford Academic) or NASW Press.

Kaplan to Advise CDC on Prevention of Violence and Injuries

The U.S. Department of Health and Human Services has named UCLA Luskin Professor of Social Welfare Mark S. Kaplan to a board of experts on the prevention of violence and injuries. Kaplan will serve a four-year term on the Board of Scientific Counselors for the National Center for Injury Prevention and Control, a branch of the Centers for Disease Control and Prevention. The CDC reports that 214,000 people die from injury every year in the United States, and millions who survive an injury face lifelong mental, physical and financial problems. The board will advise the federal agencies on a variety of research areas to help set priorities and improve public health. “This is an incredible career achievement,” Social Welfare chair Laura Abrams said of the appointment. Kaplan’s research has focused on understanding suicide risk factors among veterans, seniors and other vulnerable populations. The CDC reports that suicide is one of just three leading causes of death that are on the rise. Members of the Board of Scientific Counselors represent several disciplines and include epidemiologists, statisticians, trauma surgeons, behavioral scientists, health economists, political scientists and criminologists.

In Wake of Recent Celebrity Suicides, Kaplan Appears on Radio Panel

Professor of Social Welfare Mark S. Kaplan joined other experts in a recent KPCC broadcast following recent high-profile suicides that included celebrity chef Anthony Bourdain and designer Kate Spade. “Suicide is a remarkable public health issue because it is to some extent a hidden problem and in some cases almost a hidden epidemic. … And it is a remarkable problem because it is also associated with firearms,” said Kaplan, who studies suicide risk among vulnerable populations. Kaplan noted that of the approximately 45,000 yearly suicide deaths, half involve the use of firearms.


 

Suicides by Drugs in U.S. Are Undercounted, Study Suggests Report co-authored by UCLA Luskin professor Mark S. Kaplan finds that a substantial gap between the rates of drug suicides and 'accidental' drug deaths is likely due to misclassification

By Stan Paul

Mark S. Kaplan

The rate of suicides by drug intoxication in the United States may be vastly underreported and misclassified, according to a new study co-written by Mark S. Kaplan, professor of social welfare at the UCLA Luskin School of Public Affairs.

The study was published online Jan. 10 in the journal PLOS ONE. The researchers report that the drug suicide rate in the United States rose nearly one-quarter (24 percent) between 2000 and 2016, and the accidental opioid and other drug intoxication death rate increased by 312 percent. This rate gap suggests an increase in suicide undercounting, according to the multidisciplinary international team of researchers led by Ian Rockett of West Virginia University School of Public Health.

“Unfortunately, part of the problem is due to serious under-resourcing of state and local death investigation systems throughout most of the U.S.,” said Kaplan, whose research has focused on using population-wide data to understand suicide risk factors among veterans, seniors and other vulnerable populations. Kaplan added that the Centers for Disease Control and Prevention (CDC) recently reported more than 63,000 drug deaths in 2016, up from 52,000 in 2015.

“Many of these deaths were probably suicides, yet reported as accidental self-poisoning rather than intentional self-harm, particularly among the middle-aged,” Kaplan said.

The researchers report that suicide notes and psychiatric history, including a prior suicide attempt or diagnosed depression, are much more important in helping medical examiners and coroners identify drug suicides than suicides by more violent and obvious methods. The new research further shows this evidence is absent in a large majority of suicide and possible suicide cases.

“A suicide note, prior suicide attempt or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths,” the research team reported in the study. The researchers cited larger prevalence gaps among drug intoxication cases than gunshot or hanging cases.

“Our incorporation of undetermined deaths, as well as registered suicides, not only provided a window on the nature of suicide misclassification within the undetermined death category, but within the accident category — as a much larger reservoir for obscuring drug intoxication suicides,” the researchers wrote in the report.

The opioid epidemic in the United States is also exacerbating problems with suicide accounting, the researchers report. And that severely impedes the understanding and prevention of suicide and drug deaths nationally.

The team analyzed data from the Restricted Access Database in the National Violent Death Reporting System, which is administered by the CDC.

Mark S. Kaplan

Mark S. Kaplan, Dr.P.H., is professor of Social Welfare at the UCLA Luskin School of Public Affairs and holds adjunct appointments in psychiatry at the Oregon Health & Science University and in epidemiology and community medicine at the University of Ottawa. He received his doctorate in public health from the University of California, Berkeley and holds master’s degrees in social work and public health with postdoctoral training in preventive medicine at the University of Southern California. His research, funded by the National Institutes of Health and private foundations, has focused on using population-wide data to understand suicide risk factors among veterans, seniors and other vulnerable populations.

Dr. Kaplan is the recipient of a Distinguished Investigator Award from the American Foundation for Suicide Prevention. He has contributed to state and federal suicide prevention initiatives. Dr. Kaplan testified before the Senate Special Committee on Aging at its hearing on veterans’ health and was a member of the Expert Panel on the VA Blue Ribbon Work Group on Suicide Prevention in the Veteran Population. He serves as a scientific advisor to the American Foundation for Suicide Prevention.

Currently, he is principal investigator on two National Institute on Alcohol Abuse and Alcoholism funded projects: “Acute alcohol use and suicide” and “Economic contraction and alcohol-associated suicides: A multi-level analysis.”