In the aftermath of the mass shotting at a social services center in San Bernardino, California, in 2015, President Barack Obama suggested that the relationship between firearm ownership and gun injuries might be as strong as the connection between cigarette smoking and lung cancer. The full extent of the burden of firearm injuries is incompletely understood because of historical restrictions on federal funding for research on firearm violence by the Centers for Disease Control and Prevention (CDC). But recent increases in the frequency and lethality of mass shootings in the United States — and the approximately 90 gun deaths that occur each day — argue for efforts to reframe the national debate about firearms as a public health issue. The 5-year anniversary of the Newtown, Connecticut, school shooting arrived in the shadow of mass shootings in Las Vegas and Sutherland Springs, Texas, in 2017, and shootings in Parkland, Florida, and Santa Fe, Texas, served as additional reminders of the risks for children attending school. As the United States came to understand a different set of health hazards — those associated with cigarette smoking — and the burden of smoking-related diseases on the health care system, a major step was the 1964 Surgeon General’s report on smoking and health.1 This publication was the first of several Surgeon General’s reports on tobacco control, and similar reports on AIDS, mental health, and substance use disorders have influenced national discussions. A powerful step now would be a Surgeon General’s report to fully characterize the complex problem of firearm injuries and violence in the United States and to sharpen efforts to identify new solutions by revealing how the country got to its current state. Objective data on the history, epidemiology, health effects, and financial costs of firearm violence, as well as the factors that contribute to it, could inform this discussion by conveying the full scope of the problem. The nearly 20,000 gun suicides and estimated 760 gun deaths related to domestic violence in the United States each year would be worthy areas of focus for such a report, given the programs already supported by the CDC and other federal agencies that are aimed at preventing suicide and intimate-partner violence. A definitive statement could also summarize the overwhelming scientific evidence that having a firearm in the home increases the risk of suicide. The report could serve as an urgent call to action for professional medical organizations and federal authorities. International leaders could help by describing the changes in both gun laws and social norms that have reduced firearm violence in their countries ...
Language: en
", language="en", issn="0028-4793", doi="10.1056/NEJMp1803295", url="http://dx.doi.org/10.1056/NEJMp1803295" }