ongoing -- epidemic of gun violence. i am the executive director of the health medicine and science program. health medicine and society, the sponsor of public health at the aspen institute. rounds is a time-honored feature of medicine to keep clinicians up to date about scientific and medical advancements. now in its eighth year,

borrowing from the tradition to advance knowledge about population health issues of the day. sadly but most urgently, we have a topic for discussion. statistics on firearm injury in the u.s. are bleak. they threatened to become numbing. firearms killed more than 48,000 americans and injured twice as many. most firearm deaths are caused by suicide while homicides are the most common cause under the age of 18. the united states has adjusted homicide rates 22 times higher than the european union. that toll does not stop with the victims. given the trauma and fear associated with the proximity to violence, it affects millions.

becoming numb is not something the nation can afford. in 2020, the cost of fatal and non-fatal firearm injuries in the u.s. topped $493 billion. according to a recent article. no one considers this acceptable , these are gun owners, not the public health care community and not patients, parents or politicians. efforts to confront the crisis have stalled. the availability of research funding, data collection and greater recognition that public health is the best way to reduce violence offer hope that progress can be made.

today's program is about how that can work. joining us is a panel of experts and i will be brief, but you can learn more about each speaker in the invitation we sent out. former senator bill frist, a surgeon representing tennessee from 1994 through 2007. he served as servant -- senate majority leader and passed the president's emergency plan for age relief. currently, he is chair of the board of nature conservancy and chairs the aspen health strategy group. kathleen served as secretary of health and human services, leading the charge to implement

the affordable care act. the secretary was governor of kansas. she serves as president and ceo as well as cochair of the past in -- aspen group. they are director of gun violence prevention. a survivor of gun violence, mr. jackson has been a gun violence leader for 10 years including a community justice action fund, a survivor led gun violence prevention organization august on impact on black and brown communities. megan randy is the dean and ceo at the yale school of public health and professor of medicine at the yield school of medicine and an aspen health fellow, very

good. a national advocate for innovative approaches to public health, she focuses on developing, testing and disseminating digital health and prevention to prevent behavioral problems. moderating is a good friend of the institute, alan wilde, now editor-in-chief of health affairs, the leading policy journal. thank you all for being here, think our panel. before i turn things over, housekeeping notes to share. first, c-span is here covering today's event, but we are videotaping and it will be up on the health medicine society website in 24 for 48 hours. our discussion will go on 40

minutes and we will open the conversation to take questions and comments. wait for the microphone before speaking and then introduce yourself and any affiliation you may have. time is tight for the question-and-answer portion and we want as many questions as we can, so i beg you, be brief and get to your question. with that, my thanks to our speakers for taking time to join our program. thank you katia who helped organize this and all of you for joining us. with that, alan, the stage is yours. >> thank you for joining us. i'm going to start with a question building on the introduction ruth gave about statistics which we cannot

become numb to. a key element of public health approach is understanding where you are and i wonder if any of you want to build upon the introduction by expanding on data or maybe reflecting. where are there misunderstandings or when does the discussion go this way when they might think it is that way. governor, i cannot help it. you will be governor for the rest of my life. >> a couple of things struck me when we were talking about this with our experts. sheer numbers are horrible. 50,000 deaths is a big number. multiply that by people injured who do not die and family

members and community members. 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 that is just blowing my mind. and the fact that 54 or 55% are suicides. not mass shootings, not horrific events covered, but suicides in

community violence. the other piece of the puzzle is that there are places where progress has been made, we need 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]

♪ host: it is the washington journal for the last day of april. while black not generally abandoning support for giving president biden another term in office, trends show some support going for former president trump or third-party candidate. to shore up support, vice president harris headed to atlanta yesterday. more stops are planned.