Public Health Leaders Issue ‘Call to Action’ on Gun Safety
In an unprecedented call to action, public health leaders from Boston University and other top schools are urging consensus-building, rather than confrontation, on gun safety, writing that the election of President Donald Trump has “changed the national conversation on firearms” and made federal policy changes unlikely.
Writing in the AJPH, researchers from nine leading medical and public health schools—speaking for a larger group of 82 academics and advocates who convened at the School of Public Health in November to discuss gun violence—present an “agenda for action” that seeks to engage gun owners and manufacturers in discussions about reducing the public health ills associated with firearm ownership, rather than continuing what they called a polarizing debate.
“In the United States, nearly 10 times more guns are in civilian hands than in the next closest country, with up to 300 million guns in circulation…. The country also has a significant gun culture,” they write. “This situation suggests that there will be no easy solutions that will garner widespread popular support, and that any comprehensive approach to the problem will require the engagement of partners across many sectors.”
The researchers issue a five-point “agenda for action” that includes calling on private foundations and the business community to fund and support research to mitigate gun violence, as a step to turn the tide on a crisis that they said costs the US an estimated $229 billion annually.
The experts note that Congressional action in 1996 effectively ended federal funding for gun research, stymying “a generation of researchers in the field.”
The paper grew out of a November 14 meeting of more than 80 representatives of 42 schools of public health and medicine from 22 states, and 17 advocacy organizations, convened at SPH by Dean Sandro Galea. The meeting featured presentations by prominent researchers, including Daniel Webster of Johns Hopkins Bloomberg School of Public Health and David Hemenway of the Harvard T.H. Chan School of Public Health, as well as Massachusetts Attorney General Maura Healey.
The group also calls for:
- Focusing on state-level initiatives. They write that the expected lack of federal action on gun regulation in the coming years “elevates the importance” of state and local initiatives, especially those rooted in “non-threatening messaging” about gun safety. They note that three states—California, Nevada and Washington—approved ballot initiatives in November promoting gun safety. A state-level strategy creates “a range of opportunities” for academic leaders around the country to develop state-specific strategies and policies, they write.
- Promoting discourse around gun safety versus gun control. The researchers acknowledge that few issues are as polarizing as guns, and that the gun lobby has been “extraordinarily successful” in framing the discussion as one that pits “deeply held views about individual rights” against concerns about public health. To alleviate that conflict, public health advocates must play a role in re-framing the debate “around the need for gun safety, rather than a blanket call for banning guns.”
- Engaging private industry, starting with healthcare entities. The researchers say industry involvement is needed for evidence-based initiatives to reduce gun injuries and deaths, citing research findings that firearm violence depresses business growth and harms neighborhood economics. They note that the total social cost of gun-related injuries is more than that of obesity, and roughly the same as annual spending on Medicaid.
- Building collaborations with opponents. The group proposes convening an “inclusive group” of firearm owners, manufacturers, police, pro-gun advocates, and public health scholars to develop “common ground” around the issue of reducing violence, rather than assailing gun ownership.
Galea, the paper’s senior author, says that public health leaders have a responsibility to speak with a “clarity of voice” about an issue that claims more than 30,000 lives a year in the US, and that he hopes academia could be a catalyst for action.
Others who attended the meeting said academic health researchers need to take an active role in establishing gun violence as a public health priority.
“In the 21st century alone, more than 1 million people have survived a gunshot injury and are living compromised lives resulting in disability and various debilitating diseases,” says Bindu Kalesan, assistant professor of medicine at the School of Medicine and of community health sciences. “The urgency of action in academic and political circles should focus not only on gun deaths, but on gun violence survivorship, which has a long-term burden on individuals, families and society.”
Emily Rothman, associate professor of community health sciences and an expert in domestic violence, says public health advocates need to push for changes in state law that will protect abuse victims.
“Gun control is a critically important issue for domestic violence prevention. Abused women are five times more likely to be killed by their abuser if the abuser owns a firearm, and there are legal and procedural loopholes that mean scores of abusers are able to obtain or keep firearms, even after they have come to the attention of the criminal justice system,” she says. “Advocating for changes that will keep victims of domestic violence safe from firearm violence is a public health priority.”
Co-authors on the report are: Charles Branas, professor at the University of Pennsylvania Perelman School of Medicine; Andrew Flescher, associate professor at the Stony Brook Medicine Program in Public Health; Margaret Formica, assistant professor at the State University of New York Upstate Medical University; Nils Hennig, director of the Graduate Program in Public Health at the Icahn School of Medicine at Mount Sinai; Karen Liller, professor at the University of South Florida College of Public Health; Hala Madanat, director and professor at the San Diego State University Graduate School of Public Health; Andrew Park, assistant professor of emergency medicine at the University of Kansas School of Medicine; John Rosenthal, president of Meredith Management and founder of Stop Handgun Violence; and Jun Ying, director of the MPH program at the University of Cincinnati College of Medicine.