A call for an end to the gun violence epidemic

Research highlights the gun violence epidemic as a global issue, offering insight and opportunity to underpin strategies to address the crisis.

With the increasing public health threat of firearm violence in the United States, the publication calls for a US Surgeon General’s Annual Report on Firearm Deaths. It is part of a collection of papers, published in Current Trauma Reports, led by Peter Masiakos, co-director of the Massachusetts General Hospital Center for Gun Violence Prevention.

Drawing attention to the startling figures of nearly 40,000 firearms deaths and over 100,000 gun injuries annually in the United States, the authors from the Institute of Global Health Innovation (IGHI) argue that gun violence should be perceived as a public health threat.

By examining global insights and preventive approaches used in different countries to tackle the epidemic, the review aims to stimulate improved understanding in the US of the underlying factors fuelling the situation.

Professor Ara Darzi, author and Co-Director of IGHI, said: “Only by studying the trends of firearm violence, and improving the public’s understanding of this threat, can we seek to reduce the magnitude of this issue. A US Surgeon General’s report is critical to achieve this and for informing long overdue conversations on the ongoing crisis.”

A global view

The authors examined worldwide experiences with firearm injuries, focussing on the US, Japan, Honduras, Brazil, India, and Germany. The authors underscore a range of social and economic factors driving the gun violence epidemic in the US. These include long-term public disinvestment in education, job training, and the social safety net, persistent structural racism and discrimination, poverty, and a legal framework that both eases access to firearms and increases their lethality.

By taking a global perspective, the authors also identified a number of trends in regards to firearm ownership and injury. The UK has a total ban on handguns; however, the literature has demonstrated that when a specific type of weapon is banned by law, a new alternative often fills the void.

Training and certification was also noted to reduce firearm violence in some countries. Japan that has one of the lowest rates of firearm deaths, and has a stringent training and certification programme. Americans own more guns per capita than any other nation, and this has a direct correlation with police shooting. In the UK since 1990, there have been 73 fatal police (metropolitan police and other forces) shootings in comparison to the 689 fatalities last year alone in the US.
 
Internationally, a range of responses to mass shooting incidents have been observed, including proactive legislative changes and research into the personalities of mass shooters. By understanding those individuals better, Germany has introduced crisis intervention teams, and trained teachers to help identify those in schools who may be at risk. This is a community public health intervention which can be adopted more widely, the authors suggest.

Knowledge gaps

The review also identified a paucity of nations studying ways to reduce their domestic levels of firearm violence. The authors therefore conclude that no one legislative change or level of training is solely capable of totally minimising firearm deaths, and that transnational partnership and global collaboration is necessary.

Dr Natalia Kurek, author and IGHI Clinical Advisor, said: “This piece of work set off to find a country that leads the way in studying firearm injuries and deaths from a public health perspective. However, it became apparent that there is no country leading the way with such an annual public health report. This paper and the wider collaboration calls for the U.S, the country that needs it the most at the present time, to lead the way by commissioning the first US Surgeon General’s report in firearm violence prevention.”

Back in 1964 the US Surgeon General produced a seminal report on Smoking and Health, which has been followed since then with a number of updated more recent reports. It has continued to highlight the public health threat of smoking, and has been known to improve the public’s understanding of the implications of smoking. It spurred policy changes worldwide on smoking, including the banning of smoking in public spaces and the workplace, which has resulted in a huge drop in the numbers of smokers in countries that it has been implemented.

It is therefore hoped that by prompting action by the US Surgeon General, this series of publications will ultimately empower the USA to better understand this ongoing crisis and reveal new solutions to the epidemic.