From  Guns in American Society: An Encyclopedia of History, Politics, Culture, and the Law (ABC/Clio: 2d ed. 2012). 

By Paul Gallant and Joanne Eisen


The Handgun Epidemic Lowering Plan (HELP) Network is an international group of medical and allied organizations formed in 1993 for the purpose of reducing firearm-related deaths and injuries, especially from handgun use. HELP has over 100 organizational members which include the American Academy of Pediatrics, the American College of Physicians, the American Society of Internal Medicine, the American Academy of Child and Adolescent Psychiatry, the Child Welfare League of America, and the American Medical Association. Members also include a variety of local medical groups, and numerous anti-gun lobbying and educational organizations.

HELP believes that deaths and injuries from handgun use have reached epidemic proportions in the United States. It views this situation as a "man-made plague," and regards it as a major public health emergency, no less threatening than any medical disease. According to HELP, the best available evidence shows that guns endanger their owners, and those around them, far more often than they protect them. Furthermore, guns are not only a crime problem, but they cause mental and physical harm, lead to the expenditure of large amounts of medical resources, and are the most dangerous of products, yet they remain unregulated.

Among HELP's policy goals are: reducing civilian access to handguns and handgun ammunition; development of tracking systems for handgun injuries and the firearms used in crime; and mandating personalized gun technology (designed so that guns can only be fired by their owners).

HELP also works to support the research and prevention activities of the Centers for Disease Control's (CDC) National Center for Injury Prevention and Control, and CDC speakers sometimes appear at HELP events. In 1996, the CDC rescinded a grant which it had given HELP, after CDC critics in Congress pointed out that the money had been used to produce a newsletter which urged readers to lobby for gun control.

HELP believes that certain strategies are useful in reducing the public health toll from firearm injuries: mobilization of health professionals to provide clinical counseling, advocacy and public awareness/education on the "gun epidemic"; the use of litigation to target the design and distribution of firearms; and the mobilization of survivors of firearm-related incidents to keep public attention focused on the need to prevent future incidents.

HELP's medical director is Katherine Kaufer Christoffel, M.D., a pediatrician. Christoffel believes that firearm injuries can be reduced through a variety of measures, including: waiting periods for gun purchases; restrictions on purchases of "assault -weapons" (guns which look like military weapons); the mandatory use of trigger-locks and other safety devices; increased taxation on firearms and ammunition; firearm registration and licensure of gun-owners; modification of ammunition to reduce its lethality and the severity of nonfatal injury; adding safety features to handguns such as triggers requiring greater force to activate them, highly visible loaded-gun indicators, and automatic safety locks on triggers; and banning the possession of all handguns in locations where children live and visit.

In a 1994 interview with American Medical News,Christoffel stated: "Guns are a virus that must be eradicated....They are causing an epidemic of death by gunshot, which should be treated like any epidemic - you get rid of the virus....Get rid of the guns, get rid of the bullets, and you get rid of the deaths."

However, the public health parallel made between firearm-related violence and medical disease by Christoffel and others in the HELP Network has been criticized as an illogical extension of the disease model. The criticism is based on the fact that firearm-related violence does not meet the criteria of a true disease, capable of treatment using epidemiology methods.

The pathogen model of disease was first put forth by German bacteriologist Robert Koch (1843-1910). "Koch's postulates" establish the relationship between a microorganism and a disease: (1) The microorganism must be regularly isolated from cases of the specific illness, (2) The microorganism must be able to be grown in a culture medium outside the diseased host, (3) The susceptible host must be inoculated with the microorganism which has been isolated from the culture medium, and the disease must result, and (4) The microorganism must be able to be again isolated from the inoculated host. (Koch's postulates were later modified for other infections, particularly viral diseases, but the principles remain essentially the same.)

Critics of the "guns are a virus" theory argue that if a scientist "inoculates" a host with a firearm (e.g., gives someone a gun), the "host" may come down with the "disease" of "violence." But the vast majority of gun owners do not perpetrate gun violence. Most gun owners who commit violence showed signs of the "disease" of "violence" prior to being "inoculated" with a firearm. If one gives a violence-prone person a baseball bat, a knife, or a gun, the person might use any of the weapons to commit violence; although the weapon would be a tool of violence, it would not be the "cause" of violence. A germ or virus causes an otherwise healthy person to become sick; a gun (or knife or bat) does not cause an otherwise peaceful person to become violent.

To take the analogy further, as Prof. Max von Pettenkofer proved when he drank a cup of cholera germs, germs can only cause infection if there is a susceptible population and a suitable environment. HELP's critics contend that the group pays much too little attention to factors which make some people, but not the majority of the American population, susceptible to violence.

The critics argue that if guns were truly disease agents like deadly viruses, we could expect tens of millions of America's gun owners to be dead or dying because of the guns in their homes. Instead, almost all of the more than seventy million gun-owners escape injury, because they are responsible and safety-conscious stewards of a tool that can be used for good, and not only for bad.

Critics suggest that a better analogy would be to consider private firearm ownership a vaccine against violent crime, because of its protective and deterrent value.

HELP provides a variety of publications and newsletters for both its members and the public (especially health professionals, the media, and policymakers), such as newsletters, fact sheets, and brochures.

The HELP Network holds a national conference every twelve to twenty-four months for the purpose of devising strategies for reducing firearm injuries, as well as for sharing new research on public health approaches to firearm injury prevention. Since its inception, it has held six such conferences, most recently in April 2001. Among the speakers at HELP events have been various officials from the Centers for Disease Control.


For more information, contact:


Children's Memorial Hospital

The HELP Network

2300 Children's Plaza, #88

Chicago, IL 60614



Doctors for Responsible Gun Ownership

The Claremont Institute

250 W. First St., Suite 330

Claremont, CA 91711




For Further Reading:


Christoffel, Katherine K. 1991. "Toward Reducing Pediatric Injuries from Firearms: Charting a Legislative and Regulatory Course." Pediatrics: 294-305.


Kates, Don B., Schaffer, Henry E., and Waters, William C. 1997. "Sick of Guns: the Centers for Disease Control's Campaign Against Gun Ownership." Reason Magazine (April): 24-29.


Marwick, Charles. 1999. "HELP Network Says Firearms Data Gap Makes Reducing Gun Injuries More Difficult." Journal of the American Medical Association 281(9): 784-785.


Suter, Edgar A., Waters, William C., Murray, George B., et al. 1995. "Violence in America: Effective Solutions." Journal of the Medical Association of Georgia (June): 253-263.


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