Dr. Vivek Murthy’s Surgeon General nomination was cruising right along until the National Rifle Association decided “his agenda is to treat a constitutional freedom like a disease.” Nervous Senate Democrats started panicking and the White House decided to pull back, looking to “recalibrate” the confirmation strategy.

But the NRA doesn’t usually care much about medical issues and Murthy doesn’t seem especially interested in making gun violence a key component of his public-health agenda. So how exactly did we get to this point?

Much of the pushback is the result of a single tweet from the doctor: “Guns are a health care issue.” This six-word message, NRA executive director Chris Cox argued , is proof Murthy would “work to further a gun control agenda.”

Olga Khazan, however, raises a point that should probably matter: guns certainly seem to be a health care issue, in more ways than one.

According to the CDC, 19,392 people committed suicide with a gun in 2010, the latest year for which data are available. That same year, meanwhile, the FBI recorded only 230 justifiable homicides (the legal term) in which a private citizen used a firearm to kill a felon during the commission of a felony. Suicide is the second-leading cause of death for people under 35, and the Harvard School of Public Health has found that “suicide rates among children, women and men of all ages are higher in states where more households have guns.” […] Even if you don’t consider gun control to be a healthcare issue, suicide certainly is, and statistics show that the two are intertwined.

And this only considers the role of guns in suicides. If we consider the number of Americans who get shot every year, and we consider bullet holes part of public health, the connection seems even more obvious.

What’s more, Murthy’s views are hardly unique – up until recently, even some notable Republicans agreed with him.

Lucia Graves had a good piece on this yesterday in National Journal:

C. Everett Koop, President Ronald Reagan’s Surgeon General, made precisely Murthy’s point. Writing in the Journal of the American Medical Association in 1992, he called gun violence “a public health emergency” and proposed that owning and operating a firearm carry with it the same restrictions as owning and operating a car. Koop did eventually alienate himself from conservatives, but his stance on gun violence wasn’t the reason; it was primarily his aggressive advocacy on AIDs. That conservatives didn’t flare up over his position on gun voilence shows how things have changed. Such rhetoric isn’t merely been the province of surgeons general. Announcing an initiative to fight gun violence at the Pennsylvania Convention Center in 2001, then-President George W. Bush noted three out of four murder victims in Philadelphia were shot to death with handguns, adding the figure rises to nine out of 10 among youth. “In America today, a teenager is more likely to die from a gunshot than from all natural causes of death combined,” he told the gathered audience. The NRA heartily endorsed him in 2004. Louis W. Sullivan, President George H.W. Bush’s Health and Human Services Secretary spoke even more directly to the point, calling gun-related violence “a public health problem in addition to being a criminal justice problem.” He was particularly concerned about gun violence’s impact in the black community, where violence was cited as the primary cause of death for males between ages of 15 and 25, with 80 percent of the cases involving handguns. Sullivan wasn’t some freakish outlier: He was confirmed 98 to 1 with Republican Sens. Dan Coats, Thad Cochran, Chuck Grassley, John McCain, Mitch McConnell, and Richard Shelby voting “yes.”