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The Healthy Project is hosted by Corey Dion Lewis, Clinical Health Coach fora safety net hospital. Because of his experience working directly with patients in underserved communities, Corey felt the need to speak up address the issues, and provide solutions to improve the healthcare experience for the ones that need it the most. The Healthy Project Podcast addresses topics related to health equity, prevention, diversity, and literacy for healthcare professionals addressing today's and tomorrow's biggest challenges. Thought leaders, entrepreneurs, and industry experts share their approaches to transforming healthcare into something meaningful and lasting.
Corey Dion Lewis (00:01.433)
Hello, everybody. Thank you for listening to the Healthy Project podcast. I am your host, Cory Dion Lewis. Today, I have a great guest. One, I actually been watching this person from your YouTube series. So it's been really, really cool to actually, I'm like, oh, like this is okay. This is gonna be dope. To really actually have a conversation about, for some very touchy subject, but a very important subject.
Oh, okay.
Corey Dion Lewis (00:29.881)
I have none other, Mighty Fine. He is the Associate Executive Director of Public Health Practice and Policy for the American Public Health Association. Mr. Fine, thank you so much for being here. I really appreciate it.
Absolutely, Corey. It's my pleasure to be here. And I've watched some of your work before, so I'm happy to be in good company.
Oh, I appreciate that. I appreciate that. So before we get into the conversation, can you tell us a little bit more about yourself and what gets you up in the morning?
Sure, so I am from Brooklyn, of West Indian parents, and that sort of centers a lot of who I am and how I show up in spaces. And part of my upbringing was really surrounded, not to sound too corny, I don't know, but love was such a constant part of who I was.
was a constant part of my upbringing and the folks around me in my community. And so it just really engendered a passion for people and community and connection. So that's what gets me up in the morning. How am I ensuring that I'm living life to my fullest purpose? And as Maya Angelou often says, not walking around with two catcher's mitts on your hands, right? But a catcher's mitts, I'm gonna catch some things, but I'm gonna throw some things back as well. So how do I live my life most often?
Corey Dion Lewis (01:42.969)
Mmm.
Mighty Fine (01:49.723)
most authentically in that manner.
Right. Taking action on life. And that's what sounds awesome. Cool. And that's a great way to get up, right? So, you know, Maite, today, you know, we're going to be talking about gun safety, which for some, like I said, can be a touchy emotional conversation. But from your experience, from your perspective, you know, how is gun safety viewed through the lens of public health?
Yes, yeah, so that's what gets me up in the morning.
Mighty Fine (02:08.793)
Sure.
Mighty Fine (02:18.617)
Sure. So in public health, we have a public health approach and it's a four prong approach.
And for those folks listening in who are familiar with public health, they know that we use this approach for a myriad of issues. And certainly we use it for gun violence prevention as well. So we define the problem. So what is the problem? What's happening? Who's dying? Who's at greatest risk and getting a sense of what's really going on. And then once we've defined the problem, we'll recognize that there's a huge issue happening like gun violence and epidemic, as some would say. We identify risk and protective factor. So what is caused?
causing this.
to happen and again thinking about why is it happening more in some communities and not in others. So looking at the risk and protective factors. What are the things that are exacerbating the likelihood of it happening and what are some things that are protective against it happening? So once we get that information then we move on to what is actually working. We have to develop and test prevention strategies and intervention strategies to see how best we can mitigate or prevent the problem from happening. And then once we learn from testing and
developing, we want to ensure widespread adoption and scaling it up so we're protecting more people and preventing these untimely deaths from occurring in the first place when speaking about gun violence prevention. And that's whether we're talking about homicide, suicide, mass shootings, unintentional shootings, and the like.
Corey Dion Lewis (03:46.265)
Right. So there's two things there. You know what? You touched on something that I don't, I think for the, I don't want to say the vast majority, but for a lot of people, when they think gun violence prevention or gun safety, it's all about mass, these, these really, you know, mass shootings are like really things that are, you see in the news. But what you're saying is from, from a public health lens, we're not just looking at.
Yes.
Corey Dion Lewis (04:15.929)
that's because there's more than that when we're talking about gun violence prevention.
Absolutely. And I'm always cautious when I talk about mass shootings because I don't want to undermine or underplay the lives that are lost in those incidences. But I also recognize that when you look at gun violence in totality, we know that suicides, it's the greatest burden among them. And then we know there's homicide, you know, more interpersonal violence. And those issues, for whatever reason, don't translate in the same way.
Right.
Mighty Fine (04:46.905)
that mass shootings do as far as the news coverage. And that's unfortunate, right? Because a life loss is a life loss. And sometimes when we focus on mass shootings, what undergirds the problem of gun violence prevention is sometimes not fully thought out and thought through. And it's sensationalized, honestly, in some ways. And we don't really get to unpacking the magnitude of the issue and what's causing it and happening in the first place.
Right. And I want to go off of what you know, unpacking the issue because of how I started the conversation today and understanding that gun violence prevention is such a, depending on how you feel about it, it can be a touchy subject. How can we have constructive conversations with everybody around, you know,
Sure, sure.
Corey Dion Lewis (05:44.217)
gun violence prevention and what is the bigger picture that might help inform these discussions.
Sure, I think firstly, we have to acknowledge that folks are coming at this issue differently, right? And I know sometimes I get in trouble for saying it's complex, but it is straightforward in some ways, certainly, right? But we know it's always complex when you bring emotion and feeling into it.
Man, yeah.
Mighty Fine (06:09.593)
And I think that's what we have to acknowledge that folks are coming to this work, this space differently. And for me coming from public health, I also recognize that there are some gun owners who are also proponents of a public health approach to gun violence prevention. So it's not a this or that, you know, I think we have to understand the totality of the issue. And again, not saying.
Right.
Mighty Fine (06:32.953)
pro -gun or anti -gun, but a corollary that we often use in public health is motor vehicle safety. So there was a point in time, still having some challenges now in that area, but there was a point in time when it was an extreme burden. And...
Again, this might be controversial to some. In order to remedy the problem, we didn't remove cars from the roadway. We figured out how to more safely engage and interact with cars because we knew that they were going to be a part of our society. And again, I say that not providing assessment on whether you should be pro -gun, anti -gun, I don't get into that debate, but more so just recognizing this is where we are. We know we have guns in circulation and what can we do to minimize and mitigate the
impact that they've been having on our communities.
Yes, because I believe the more that we can focus on what you're saying is just, okay, let's get to the solution the faster. Because I think we can get caught up in personal beliefs and things like that. I'm not going to get into that either. But I think it almost kind of slows down the progress towards finding a solution that everybody feels good about. And there will be those that don't feel good about it either way.
Yes.
Mighty Fine (07:35.065)
Yeah.
Mighty Fine (07:45.689)
Yes.
Sure.
But I think we could get to a place where everybody can be all right.
For sure, and one thing that comes to mind as you're speaking about that is normally it's packaged into like common sense gun laws or common sense gun legislation, but as you and I know, common sense ain't always that common.
Yes.
Mighty Fine (08:07.577)
You know, and, but the idea there is to think about who has access to weapons, the type of weapons that are in circulation, legislation around ammunition and how to regulate that, the purchase of that and limiting quality. So there's a host of ways to mitigate again, the toll that we were seeing on communities, whether we're talking about suicide or homicide for that matter.
Right. To your knowledge, are there any states, are there any, you know, gun violence prevention initiatives that, strategies that you've seen that have worked through the research that have really helped reduce violent crimes or whatever the things like that?
Sure, one program that I've been involved with tangentially is it's the ceasefire, but now it's cure violence and.
I believe that originated in Chicago, but I may be wrong there. And it's Gary Slutkin's work. And the idea was to look at violence as an epidemic or using the epi model and treating it like an infectious disease almost, you know, so you're familiar. And the idea there was to interrupt the violence before it occurred. And I know that program has been.
Right.
Mighty Fine (09:23.545)
disseminated and replicated across the country. And some of the cities that have employed some of those strategies are recognizing that they may have to modify it as well to address the local conditions in their communities. But that approach has been shown to be effective in many communities in reducing their shootings, homicides, and just violent interactions.
Nice, so it sounds like any community can use it. They just have to, they have a nice foundation to recreate it for their community.
Yes, there's a foundation there and obviously you need some fiscal support and you need some boots on the ground and you need even in some instances policies in place to support that. But yes, that is a program that has been replicated successfully outside of the place of origin.
Yeah.
Corey Dion Lewis (10:12.089)
Yeah. Can I touch on the policy piece just a little bit? One thing that I've been really focusing on lately, myself personally, is being an advocate for my community. Just like a personal advocate. Like how can I bring up whatever issue and support my community? And for a lot of people, you know, people, we were busy, we got lives, we got families, we just can't be sitting at...
Yeah.
at the Hill all day just talking to, we can't do that. So how can individuals in their communities, what's maybe one thing they can do to advocate for if they wanna see something around gun safety or gun violence prevention?
Sure.
Mighty Fine (11:01.465)
Sure, I was thinking of trying to distill it down to one thing. So if you allow me, I may give you a few if that's okay. But the first word that comes to mind is vote. And I don't want to like oversimplify that. But the reason why I say vote is because when I think about gun violence, I think about the social determinants of health. So I'm thinking about education, access to healthcare, all of the things, all the social factors that impact our health.
Multiple things, yeah.
Corey Dion Lewis (11:21.977)
Right.
Mighty Fine (11:29.657)
And with that, I recognize that a lot of our locally elected folks have power in those spaces. So when we're thinking about our school boards, when you're thinking about your local judges, you're thinking about your sheriffs, or all of those locally elected positions, I think we need to pay attention to them. And...
and as community members and making sure that these folks and their platforms align with our community values and the measures that we know that are going to be protective of us. One such thing that comes to mind immediately, it's a lot of great folks in the violence prevention space that have focused on green spaces and recognizing how having parks.
and places for folks to congregate and build social capital and social cohesion because we know when a community is connected, that's a deterrent for gun violence from happening. We know when there's not abandoned homes or derelict spaces. When you, for all intents and purposes, are able to take pride in your community and be a fixture within the community and blend with your community and community members, that's an effective strategy that I've seen communities employ.
and doesn't always cost a lot of money. And I'm not saying like, oh, do this and gun violence is gonna be solved. But when you think about all of the different approaches that we need to include to address such an issue of great magnitude like gun violence, but that's something that comes to mind.
Right.
Corey Dion Lewis (12:54.457)
Yeah, well, there's something to having a sense of pride and respect for where you're at in your community that the positive product of that is less, in my opinion, less of, or could be. The probability of that is really high.
Sure, sure.
Mighty Fine (13:12.793)
Yeah, I will always, it's probably from the 1990s when this came out, a report at the time it was the Institute of Medicine. And it often talked about how people want to engage in certain behaviors. And this is not, this is recognizing that we have individual factors. We have community level factors. We have a host of factors that contribute to violence, right? And with that in mind, understanding that sometimes the environment conspires against the change you want to make, right?
If you're living in a neighborhood that it's under -resourced, it's facing dereliction, I recognize that as an individual, there's only so much I can do, but those folks in power, policymakers, et cetera, have to ensure that those communities have the resources that they need so that they're creating an environment that's healthy and safe and well -intended for the folks that are living there.
No, absolutely. You know, Mighty, when another conversation that comes up when we're talking about gun safety is mental health. Lately, they go hand in hand. In your view, does linking gun safety to mental illness provide valuable insight, or does it divert attention from the broader issues?
Yeah. Yes.
Mighty Fine (14:33.817)
You know, I think it diverts attention because there is this false equivalence that's often.
reported in the media in these spaces, particularly around when we see mass shootings and are like this person, you know, the whole level of classification is that they're applying to this person, but linking it to some form of mental illness. And I think it oversimplifies the issue. It conflates to issues and it's a diversion tactic in some ways, and it doesn't provide space for us to really deconstruct.
Right.
Mighty Fine (15:08.633)
what's happening in gun violence. And it also stigmatizes folks who are living with mental illnesses. And it's an unfair intersection or connection that I think is often utilized and.
we know that folks with mental illness are actually more prone to violence and becoming victims of violence as opposed to how we're often seeing it being reported. And from what I understand, studies consistently are indicating that even among mass shootings, mental illness is a factor in a minority of those events. So even if it does happen, it doesn't happen at the greatest perspective.
No, that is good. And it's almost, you know, you hear it, it almost sounds like it's a way of not having the conversation. You know what I mean? And, sorry, go ahead, we're even say something.
Sure, absolutely, yes, yes. Yeah, no, not having the conversation and also it sort of ignites this idea that this is an insurmountable issue. It's like, oh, well, if people are mentally ill and they're just out getting guns and shooting people, there's nothing we can do about it. So I think it distracts from us having a very dedicated conversation about what we know is working.
what more we need to find out and ensuring that resources are put in places to prevent, again, these incidents from happening in the first place. And so, yes, it does stymie a true conversation around effective and comprehensive approaches to come by this prevention for sure.
Corey Dion Lewis (16:50.169)
Yes, no, absolutely. So, you know, like I said before, I knew about you before you knew about me. I was doing a nice little Google search about public health. What is health equity? And I was watching your health equity series. So I was like...
Hehehehehe
Okay. Yes, yes. Okay. That's good to know when I hear people say they watch it, I'm like, okay, good. So the message is getting out to folks. I love to hear it.
Yes, the message is getting out. But I would love to hear your thoughts on, you know, gun violence prevention and health equity. Is this a health equity issue? And if so, how do you feel like it is affecting the health inequities?
Sure, it most certainly is because so taking a step back, so I'm a social epidemiologist by training. And in our work, what we do is we look to see like, what are these social contextual, these other factors that are exacerbating again, the likelihood of a certain group being at risk for X disease or in this case, gun violence, right?
Mighty Fine (17:54.137)
And so when we look at those contextual factors, or sometimes we call them primordial factors, and linking it to the social determinants of health, there's no way we can have a full conversation about gun violence, particularly homicide, and not ensure that equity is a part of that conversation, because we know that homicides, unfortunately, are leading cause of death for young Black men. And, you know, thinking about a young segment of the population, and we know this is certainly preventable. And when we think about,
Mm -hmm.
Mighty Fine (18:24.091)
the lives that are lost and the lives that are connected to those lives. So we're thinking about community level trauma and all of the resounding impacts of violence that are soaked throughout the community. Also thinking about health equity, we also have to think about the conditions that support violence.
to occur and we know that it's in communities that are low resourced and we know that those oftentimes are communities of color and we know that this is not by happenstance. So to not introduce equity into the conversation we almost act as if this is the way it is and these people are prone or have a proclivity for violence and there's nothing that we can do. So it's a disservice to the field of work if we don't acknowledge that equity plays a major role.
your role in not just in the conversation but in our approach to addressing the issue.
Absolutely, that's awesome. Thank you for that. The American Public Health Association, are there any resources, if people want to learn more about gun violence prevention, are there, is there any resources on the APHA where people can go and find some stuff?
Yes, there are a ton of resources. If you go to our APHA web page and there is a, I can't think of what, issues page or something. I might be messing that up. Topics page, that's what it is. It's a topics page. And we have a topics page dedicated to gun violence. And that includes resources that we've developed, like fact sheets, but also any work that our partners have done, a host of tools and resources.
Corey Dion Lewis (19:51.737)
There you go.
Mighty Fine (20:08.921)
conferences, trainings. We published a book recently on a public health approach to gun violence prevention. So folks can go to APHA .org, go to our topics page on gun violence, and there's a wealth of resources there.
Oh dope and I'll make sure I'll have a lot of those linked into the description too. So I'll just make it easy for everybody.
Oh, perfect. Perfect. Yes, we definitely want. Yeah, yeah, we definitely want to make sure folks are utilizing those resources. Absolutely.
Yes. Well, you know, Mighty, thank you so much for being on the podcast. I really appreciate it. Yeah. If anybody wants to reach out to you and connect and learn more, where can they, where can they find you?
Of course, such a pleasure, everyone.
Mighty Fine (20:43.737)
Sure, please reach out to me at APHA, email is probably the best way. It's mighty .fine at apha .org. I'm on social media, but not on my APHA side. So if you want to get to know Mighty and not Mighty Fine, email me and we can talk about that later, but seriously.
Yeah.
Find me on our APHA web page, but again, that's my direct email address. And I would love to engage with folks as we think collectively how best to address this issue and take what we've learned and continue to learn from that because we know that this is preventable and it's not inevitable. And the other thing I want to say before I go is that we often think about...
Yeah.
disease prevention from an absence mindset, right? So you want the absence of violence, you want the absence of disease, you want the absence of injury. Yes, totally true. But we also have to think about the presence of opportunity and the buffers and all of the supports that we know are going to prevent violence from happening, prevent these cycles of violence, ensuring that folks and communities have an opportunity to live their life to its fullest potential and reach
Mighty Fine (21:55.353)
some sense of self -actualization. We have to, we can't forget the opportunity piece of that conversation where we're focusing on the absence of violence. Has to be the presence of opportunity too. Yeah. Of course, thank you as well for having me. I appreciate it.
can't forget the opportunity. Yeah, that's awesome. Again, that's awesome. Thank you so much. A mighty fine.
Yes. Again, thank you and everybody. Thank you for listening to the Healthy Projects podcast. I'll have at you next time.