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Journal Article

Citation

Betz ME, Harkavy-Friedman J, Dreier FL, Pincus R, Ranney ML. Am. J. Public Health 2021; 111(12): 2105-2110.

Copyright

(Copyright © 2021, American Public Health Association)

DOI

10.2105/AJPH.2021.306525

PMID

34878863

Abstract

For decades, discussions of the prevention of firearm injury have been stalled by the debate between gun rights and gun control. Over time, even the terms used can develop unintended connotations, such that word choice might promote trust or derail a conversation.1 "Gun violence" is a common term but may be viewed by some as code for "gun control" because it is often used by groups supporting firearm regulations.2 A 2019 survey of gun owners showed that approximately half saw "gun control" advocates as disrespectful to gun culture and aiming to confiscate all guns,3 and many gun owners said they felt blamed for "gun violence" by gun control advocates.

"Firearm injury" is a term used within academic and public health publications and programs because of the impression that it is more neutral and encompasses all types of injury, but it may be less well understood by the general public. These differences in terminology have implications for public health interventions, patient care, and participation in research because the message--and messenger--helps shape narratives about what firearm injury is, who is affected, and what can or should change.

Firearms are used in a large proportion of suicides, homicides, and nonfatal assaults in the United States, and firearm-involved injury and death has been identified as a significant public health problem.4 With newly available funding from federal agencies and foundations, clinicians and researchers are developing and studying public health approaches to preventing firearm suicides, firearm homicides, and unintentional shootings. This work has, however, been limited by the lack of a shared language as well as by institutional barriers.

Sensitivity over language is not a new challenge, and words matter throughout public health, clinical care, and advocacy. As part of their training, physicians, nurses, and other health professionals learn how to talk about death, how to approach discussions of substance use disorder, and how to have respectful conversations about gender identity and sexual orientation. Informed health care providers and public health professionals generally know the importance of engaging with patients and communities in ways that are aligned with patient-relevant values and preferences. The same should hold true for conversations about firearms.

Challenges related to language used in discussions and interventions for preventing firearm injury and death extend beyond clinical care to research, training, prevention, and policy efforts. Importantly, programs or messaging from one discipline's approach to preventing firearm injuries or deaths may inadvertently have consequences for another field. For example, public and media discussions of "gun violence" often omit or downplay deaths from self-inflicted violence (suicide),5 contributing to public misperceptions that firearm homicide is more common than firearm suicide...


Language: en

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