Gun violence is a public health crisis, says the American Public Health Association.
The burden of gun violence in the United States vastly outpaces that in comparable countries:
Of all firearm deaths in nearly two dozen populous, high-income countries, including Australia, France, Italy, Spain, and the United Kingdom, 82 percent occur in the U.S., and 91 percent of children ages 0-14 killed by firearms in this group of nations were from the United States.
Each year, more than 39,000 people in the United States die because of gun violence, and tens of thousands more suffer non-fatal gun injuries.
Gun violence affects people of all ages and races in the U.S. but has a disproportionate impact on young adults, males, and racial/ethnic minorities:
Among U.S. residents ages 15-24, homicide is the fourth leading cause of death for non-Hispanic whites, the second leading cause of death for Hispanics, and the leading cause of death for non-Hispanic Blacks.
Guns are a weapon of choice for homicide and suicide:
Guns are the leading method of suicide in the U.S., accounting for half of all suicide deaths. Sixty percent of firearm-related deaths in the U.S. are suicides. Attempts of suicide by firearm result in death 85 percent of the time, compared to just 3 percent for other methods such as drug overdose. This is significant because nearly 90 percent of people who survive an attempted suicide do not attempt suicide a second time.
While most gun violence does not involve a mass shooting, in 2019, there were 418 mass shootings, killing 464 people and injuring another 1,710. According to The Gun Violence Archive, the U.S. witnessed 619 mass shootings in 43 different states (and Washington, D.C.) through the first 332 days of 2023.
Gun violence is an epidemic. One way to prevent gun violence is to treat it as a public health epidemic.
Dr. Deborah Prothro-Stith pioneered the idea of violence as a public health issue in the 1990s. Working in the emergency room in her medical school days, she kept seeing victims of violence treated and then released—unlike other patients—without any preventive care.
She began pushing prevention efforts in emergency rooms, doctor’s offices, and schools. And guns are increasingly a part of that conversation. Where stabbings were the issue when Prothro-Stith was in medical school, the picture has changed. More and more, it is guns.
To address this issue, Prothro-Stith advocates for the public health prevention approach.
The public health framework involves primary, secondary, and tertiary prevention. Primary prevention protects individuals to avoid disease before signs or symptoms of the disease. It includes activities, programs, and practices that operate fundamentally non-personally and alter the set of opportunities, risks, and expectations surrounding individuals.
Secondary intervention is the early detection of disease, followed by appropriate intervention, such as health promotion or treatment. Tertiary prevention aims to reduce the impact of the disease and promote rehabilitation of persons with the disease. This is often referred to as treatment.
Prothro-Stith uses the example of smoking and lung cancer to explain the public health prevention approach. “First, there’s primary prevention, which involves informing the public of the consequences of smoking. The secondary phase is helping smokers quit, and the third, or tertiary phase, is treatment for those who have lung cancer.”
Concerning gun violence, the primary phase is raising awareness and trying to increase safety, which, of course, involves gun control. Prothro-Stith argues for focusing on an assault weapon ban because it has worked before. There was a decrease in gun massacre deaths during the decade the federal ban was in place—from 1994 to 2004—and an increase when the ban expired.
The secondary phase involves understanding the risk factors. For youth violence, Prothro-Smith argues for addressing youth who are hurt by violence or because they have witnessed it. Tertiary prevention works with victims of violence to intercede in the cycle of violence.
The American Public Health Association, which takes its role as the advocate for Americans’ health seriously, issued a policy statement in 2018 proclaiming that violence is a public health issue and that public health is essential to understanding and treating violence in the U.S.
