Opinión pública en los Estados Unidos respecto a la portación de armas de fuego en lugares públicos / US Public Opinion on Carrying Firearms in Public Places

[RESUMEN]. Objetivos. Calcular la opinión pública en los Estados Unidos, general y según la posesión o no de armas de fuego, acerca de los lugares públicos donde debe permitirse a los dueños legales de armas de fuego portarlas. Métodos. Aplicamos una encuesta en línea a 3 949 adultos, incluida una sobrerrepresentación de propietarios de armas de fuego y exmilitares, en abril del 2015. Usamos tabulaciones cruzadas con ponderaciones de la encuesta para generar cálculos representativos a nivel nacional. Resultados. Menos de uno de cada tres adultos estadounidenses apoyaron la portación de armas de fuego en cualquiera de los sitios especificados. El apoyo para la portación en público fue sistemáticamente mayor entre los propietarios de armas de fuego que entre quienes no poseen armas de fuego. En términos generales, el apoyo para la portación en público fue menor en el caso de las escuelas (19%; intervalo de confianza de 95% [IC] = 16,7, 21,1), los bares (18%; IC de 95% = 15,9, 20,6) y los estadios deportivos (17%; IC de 95% = 15,0, 19,5). Conclusiones. La mayoría de los estadounidenses, incluida la mayoría de los propietarios de armas de fuego, apoyan la restricción de los lugares públicos donde los propietarios autorizados de armas de fuego pueden portarlas. Esta perspectiva contrasta notablemente con la tendencia actual en las legislaturas estatales de ampliar los lugares donde pueden portarse armas de fuego en público, al igual que cómo y por quiénes. Las leyes estatales recientes y la propuesta de legislación federal que obligaría a los estados a respetar las licencias de portación oculta de otros estados no son acordes con la opinión pública estadounidense.

[ABSTRACT]. Objectives. To estimate US public opinion, overall and by gun ownership status, about the public places where legal gun owners should be allowed to carry firearms. Methods. We fielded an online survey among 3949 adults, including an oversample of gun owners and veterans, in April 2015. We used cross-tabulations with survey weights to generate nationally representative estimates. Results. Fewer than 1 in 3 US adults supported gun carrying in any of the specified venues. Support for carrying in public was consistently higher among gun owners than among non–gun owners. Overall, support for carrying in public was lowest for schools (19%; 95% confidence interval [CI] = 16.7, 21.1), bars (18%; 95% CI = 15.9, 20.6), and sports stadiums (17%; 95% CI = 15.0, 19.5). Conclusions. Most Americans, including most gun owners, support restricting public places legal gun owners can carry firearms. These views contrast sharply with the current trend in state legislatures of expanding where, how, and by whom guns can be carried in public. Recent state laws and proposed federal legislation that would force states to honor out-of-state concealed carry permits are out of step with American public opinion.

US Public Opinion on Carrying Firearms in Public Places.

OBJECTIVES: To estimate US public opinion, overall and by gun ownership status, about the public places where legal gun owners should be allowed to carry firearms. METHODS: We fielded an online survey among 3949 adults, including an oversample of gun owners and veterans, in April 2015. We used cross-tabulations with survey weights to generate nationally representative estimates. RESULTS: Fewer than 1 in 3 US adults supported gun carrying in any of the specified venues. Support for carrying in public was consistently higher among gun owners than among non-gun owners. Overall, support for carrying in public was lowest for schools (19%; 95% confidence interval [CI] = 16.7, 21.1), bars (18%; 95% CI = 15.9, 20.6), and sports stadiums (17%; 95% CI = 15.0, 19.5). CONCLUSIONS: Most Americans, including most gun owners, support restricting public places legal gun owners can carry firearms. These views contrast sharply with the current trend in state legislatures of expanding where, how, and by whom guns can be carried in public. Recent state laws and proposed federal legislation that would force states to honor out-of-state concealed carry permits are out of step with American public opinion.

Perspectives on learning to cook and public support for cooking education policies in the United States: A mixed methods study.

Declines in cooking skills in the United States may contribute to poor diet quality and high obesity rates. Little is known about how Americans learn to cook or their support for cooking education policies. The objective of this study was to examine how Americans learn to cook, attributions of responsibility for teaching children how to cook, and public support for policies to teach cooking skills. We used a concurrent, triangulation mixed-methods design that combined qualitative focus group data (from 7 focus groups in Baltimore, MD (N = 53)) with quantitative survey data from a nationally representative, web-based survey (N = 1112). We analyzed focus group data (using grounded theory) and survey data (using multivariable logistic regression). We find that relatively few Americans learn to cook from formal instruction in school or community cooking classes; rather, they primarily learn from their parents and/or by teaching themselves using cookbooks, recipe websites or by watching cooking shows on television. While almost all Americans hold parents and other family members responsible for teaching children how to cook, a broad majority of the public supports requiring cooking skills to be taught in schools either through existing health education (64%) or through dedicated home economics courses (67%). Slightly less than half of all Americans (45%) support increasing funding for cooking instruction for participants in the Supplemental Nutrition Assistance Program (SNAP). Broad public support for teaching cooking skills in schools suggests that schools are one promising avenue for policy action. However, school-based strategies should be complemented with alternatives that facilitate self-learning. More research is needed to identify effective means of teaching and disseminating the key cooking skills and knowledge that support healthy eating.

Changing the constitutional landscape for firearms: the US Supreme Court's recent Second Amendment decisions.

In 2 recent cases-with important implications for public health practitioners, courts, and researchers-the US Supreme Court changed the landscape for judging the constitutionality of firearm laws under the Constitution's Second Amendment. In District of Columbia v Heller (2008), the court determined for the first time that the Second Amendment grants individuals a personal right to possess handguns in their home. In McDonald v City of Chicago (2010), the court concluded that this right affects the powers of state and local governments. The court identified broad categories of gun laws-other than handgun bans-that remain presumptively valid but did not provide a standard to judge their constitutionality. We discuss ways that researchers can assist decision makers.

The food industry and self-regulation: standards to promote success and to avoid public health failures.

Threatened by possible government regulation and critical public opinion, industries often undertake self-regulatory actions, issue statements of concern for public welfare, and assert that self-regulation is sufficient to protect the public. The food industry has made highly visible pledges to curtail children's food marketing, sell fewer unhealthy products in schools, and label foods in responsible ways. Ceding regulation to industry carries opportunities but is highly risky. In some industries (e.g., tobacco), self-regulation has been an abject failure, but in others (e.g., forestry and marine fisheries), it has been more successful. We examined food industry self-regulation in the context of other self-regulatory successes and failures and defined 8 standards that should be met if self-regulation is to be effective.

Innovative legal approaches to address obesity.

CONTEXT: The law is a powerful public health tool with considerable potential to address the obesity issue. Scientific advances, gaps in the current regulatory environment, and new ways of conceptualizing rights and responsibilities offer a foundation for legal innovation. METHODS: This article connects developments in public health and nutrition with legal advances to define promising avenues for preventing obesity through the application of the law. FINDINGS: Two sets of approaches are defined: (1) direct application of the law to factors known to contribute to obesity and (2) original and innovative legal solutions that address the weak regulatory stance of government and the ineffectiveness of existing policies used to control obesity. Specific legal strategies are discussed for limiting children's food marketing, confronting the potential addictive properties of food, compelling industry speech, increasing government speech, regulating conduct, using tort litigation, applying nuisance law as a litigation strategy, and considering performance-based regulation as an alternative to typical regulatory actions. Finally, preemption is an overriding issue and can play both a facilitative and a hindering role in obesity policy. CONCLUSIONS: Legal solutions are immediately available to the government to address obesity and should be considered at the federal, state, and local levels. New and innovative legal solutions represent opportunities to take the law in creative directions and to link legal, nutrition, and public health communities in constructive ways.

Preemption and the obesity epidemic: state and local menu labeling laws and the nutrition labeling and education act.

Obesity is widely recognized as a preventable cause of death and disease. Reducing obesity among adults and children has become a national health goal in the United States. As one approach to the obesity epidemic, public health practitioners and others have asserted the need to provide consumers with information about the foods they eat. Some state and local governments across the United States have introduced menu labeling bills and regulations that require restaurants to post information, such as calorie content, for foods offered on their menus or menu boards. A major dilemma is whether state and local menu labeling laws are preempted by the federal Nutrition Labeling and Education Act (NLEA). While few courts have addressed this issue, ongoing litigation in New York City provides an early glimpse of judicial interpretation in this area. This article explores these preemption issues, arguing that appropriately written and implemented menu labeling laws should not be preempted by the NLEA. We offer guidance for states and localities that wish to develop and implement menu labeling laws.

Limited liability and the public's health.

Corporations, through their products and behaviors, exert a strong effect on the well-being of populations. Industries including firearms, motor vehicles, tobacco, and alcohol produce and market products negatively impact public health. All of these industries are composed of corporations, which are legal fictions designed to provide limited exposure to liability, through a variety of mechanisms, for their investors and directors. This means that when actions are taken on behalf of a corporate entity, the individuals responsible generally will not face personal liability for the negative results of those actions. To illustrate this point, this article considers corporate products or practices that have caused harm in varied settings, and analyzes the role that limited liability played in these cases. In addition, the article identifies ways to modify or eliminate some of the principles and practices that accompany limited liability.

Counseling about firearms: proposed legislation is a threat to physicians and their patients.

In early 2006, 2 separate but virtually identical bills were introduced in the Virginia and West Virginia legislatures that would have profoundly affected the relationship between a physician and his or her patients. Each bill would have prohibited a physician from asking a patient if he or she owned firearms for the purpose of counseling that patient about ways to reduce risks associated with firearms. Penalties for violation of the bills included revocation of a physician's license to practice. The Virginia bill was initially approved by its state House of Delegates by a vote of 88 to 11. It was ultimately defeated in a Virginia Senate committee. The West Virginia bill did not receive a vote during the 2006 legislative session. Although neither bill became law this year, this type of bill is likely to reappear in future legislative sessions. The Virginia and West Virginia bills were contrary to the best-practices recommendations of medical societies, including the American Academy of Pediatrics. Anticipatory guidance regarding firearms can indeed reduce risks to patients. Yet, the bills would have preferred the judgment of legislators over physicians regarding this aspect of the practice of medicine. In addition, the 2 bills raise legal issues regarding both medical malpractice and the First Amendment protection of the freedom of speech. The Virginia and West Virginia bills would have treated risks associated with firearms differently from other hazards and interfered with a physician's ability to protect his or her patients. The Virginia bill was defeated, in part, through the efforts of physicians to educate legislators. However, physicians must remain prepared to respond to similar state legislative initiatives in the future.

Understanding and informing policy implementation: a case study of the domestic violence provisions of the Maryland Gun Violence Act.

The Maryland Gun Violence Act, enacted into law in 1996, explicitly authorized courts to order batterers to surrender their firearms through civil protective orders. It also vested law enforcement with the explicit authority to remove guns when responding to a domestic violence complaint. In order to assess how these laws were implemented, we designed a case study and collected data from in-depth, key informant interviews, court observations, and relevant documents. We present findings from this study and recommend how to increase the likelihood that policies designed to separate batterers and guns are implemented in a way that will result in greater protections for victims of domestic violence.

Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future.

Compulsory vaccination has contributed to the success of immunisation programmes in the USA and Australia, yet the benefits from compulsory vaccination are not universally recognised. Some people--experts and the public alike--believe that the benefits of compulsory vaccination are outweighed by the associated ethical problems. A review of vaccination legislation in the UK, Australia, and the USA raises four main points. First, compulsory vaccination may be effective in preventing disease outbreaks, reaching and sustaining high immunisation coverage rates, and expediting the introduction of new vaccines. Second, to be effective, compulsory programmes must have a reliable supply of safe and effective vaccines and most people must be willing to be vaccinated. Third, allowance of exemptions to compulsory vaccination may limit public backlash. Finally, compulsory vaccination may increase the burden on governments to ensure the safety of vaccines. Nevertheless, although compulsory immunisation can be very effective, it might not be acceptable in some countries where high coverage has been achieved through other approaches or efforts, such as in Sweden, Norway, Denmark, the Netherlands, and the UK. These factors should be considered when compulsory vaccinations are being introduced or immunisation laws refined. Lessons learned from compulsory vaccination could be useful to other public-health programmes.

Litigating for Native American health: the liability of alcoholic beverage makers and distributors.

Native American populations have long experienced excess morbidity and mortality attributable to alcohol. Historically, alcohol was introduced to the Native American population by European settlers, and was used to help those settlers get land and goods from the Indian population. In modern times, alcohol beverage makers and distributors continue to supply and market their products to Native American populations in amounts and manners that contribute to continuing health and safety problems. When some other products have been over-supplied or over-promoted to the detriment of the public's health, litigation has been brought against the makers or dealers of those products, sometimes using the legal theory of public nuisance. This article explores the potential for litigation brought by Native Americans against alcoholic beverage makers and distributors.

Rethinking first response: effects of the clean up and recovery effort on workers at the world trade center disaster site.

OBJECTIVE: We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site. METHODS: A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms. In one open-ended question, respondents shared any aspect of their experiences they wished; these 332 narrative responses were analyzed using qualitative techniques. RESULTS: Respondents reported suffering debilitating consequences of their work, including depression, drug use, and posttraumatic stress disorder. They felt poorly prepared to work in a disaster, lacked protective equipment and training, and felt overwhelmed by the devastation they faced. CONCLUSIONS: These workers' experiences were qualitatively similar to the experiences of the first responders. To protect workers in the future, the focus on preparing "first" responders should be reconsidered more broadly.