Public health joining with new partners to fight gun violence: More than 33,000 US deaths in 2014
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* Lindsey Wahowiak

In the fight to end gun violence, advocates are turning outside the public health world to put a stop to the epidemic that ends thousands of lives every year.

In 2014, the Centers for Disease Control and Prevention reported there were more than 33,000 firearm-related deaths in the United States. According to the Gun Violence Archive, nearly 3,000 of those deaths involved children. Another nearly 23,000 people were injured in shootings in 2014.

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[Figure1](http://www.thenationshealth.org/content/45/4/1.2/F1)

Audry Miller is comforted by community activist Andrew Holmes during a July 2014 memorial service in Chicago for her granddaughter, Shamiya Adams. Adams, 11, was killed when a stray bullet entered a home through an open window July 18. Public health advocates are working with new partners to prevent gun violence injuries and deaths in the U.S.

Photo by Scott Olson, courtesy Getty Images

“We know violence is not inevitable and it is preventable,” said Mighty Fine, MPH, CHES, deputy director of APHA’s Center for Professional Development, Public Health Systems and Partnerships. “That’s the message that we need to lead with, because experience tells us so. Recognizing that public health alone can’t address this issue, we have to…think more broadly about who has a stake and a role in preventing those who shouldn’t have guns from accessing them.”

In March, APHA teamed up with the Brady Campaign to Prevent Gun Violence to host the Firearm Injury-Gun Violence Prevention Partner Forum, bringing together players from public health, policy, research, law enforcement, pediatrics and beyond to discuss how each sector might collaborate to reduce instances of gun violence.

Dan Gross, president of the Brady Campaign to Prevent Gun Violence, said there is precedent to believe collaboration will lead to success: A concentrated effort between law enforcement, public health, community leaders, researchers and policymakers has helped to make reduction of drunken driving a major issue nationally. And according to the U.S. Department of Transportation’s Bureau of Transportation Statistics, that effort has worked. Alcohol-related fatalities decreased from 50.6 percent of all traffic crashes in 1990 to 42 percent in 2009.

“We’re looking for solutions as a whole, greater than the sum of our parts,” Gross told *The Nation’s Health.* “The idea that globalization from across disciplines (is) starting to come together to look at this issue as the urgent issue of public health…that’s what I’m most excited about.”

Many public health advocates say that reducing gun violence is twofold: keeping guns away from those who should not have them and promoting healthy behaviors.

Lawmakers are perhaps the most visible part of the equation to end gun violence. Gross noted that since the Brady law was signed by President Bill Clinton in 1993, 2.4 million gun sales have been blocked to people who did not pass a background check. Named for Jim Brady, press secretary to President Ronald Reagan, who was shot during an assassination attempt on Reagan, the law requires background checks for buyers at federally licensed firearms stores.

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[Figure2](http://www.thenationshealth.org/content/45/4/1.2/F2)

A student writes on a University of California-Santa Barbara memorial for six people who were killed May 27, 2014, by a shooter in Isla Vista, California. Public health advocates are working with partners to help stem gun violence and injuries.

Photo by David McNew, courtesy Getty Images

To give gun laws teeth, there must be buy-in from law enforcement, said Daniel Webster, ScD, MPH, professor and director for the Center for Gun Policy and Research at Johns Hopkins Bloomberg School of Public Health. He said that because police are the officials who enforce the laws, they need to be part of the conversation.

“How well (the laws) work really depends on how well they’re enforced,” Webster said. “You need people with credibility in fighting crime. That has been something I think has been really missing, even in states with stronger laws.”

A 2013 report from the Pew Research Center showed that 37 percent of Americans said they or someone in their household owned a gun. That number dropped from 49 percent in 1973.

Part of the buy-in needs to come from gun owners, Webster said. To keep firearms out of the hands of “the wrong people,” including people convicted of felonies and domestic assault as well as children, tough laws must be enacted. And in fact, Webster said, research shows that many gun owners do support tougher gun laws. But that majority is not as vocal as the gun lobby, he said.

“I don’t think there will be huge political change until more of this large majority of gun owners who want these stronger laws speak up and are heard,” Webster told *The Nation’s Health.* “The opposition has been able to very effectively portray these laws as attacks against gun owners and their ‘way of life.’ To be effective, you are going to need to see more gun owners who are fed up with the gun lobby saying stuff they don’t really agree with.”

That does not have to be difficult, Gross noted. He compared the issue of gun violence prevention to the public health improvements made through mandatory seat belt laws.

“Our goal is not to ban guns any more than the goal of automobile safety is to ban cars,” Gross said. “It’s simply to make the products as safe as possible and keep them out of the hands of…the wrong people. With just those things, we can save thousands of lives each year.”

Mental health education can also play a part in reducing gun violence. About two-thirds of all fatalities involving guns are suicides. CDC reported that in 2013, more than 21,000 people died by suicide involving a firearm. That number accounts for more than half of all suicides that year.

“What some people are missing in the gun violence issue is the suicide piece,” Fine said. “We can’t ignore that the majority of these deaths are from those who access these guns and kill themselves. We should be working to increase access to mental health services and suicide prevention efforts. We have to pay attention to the interpersonal piece, with homicide, and we can’t ignore the suicide aspect of gun violence.”

It will take collaboration from beyond public and mental health to achieve a safer world and reduce gun violence, he said.

APHA and the Brady Campaign will continue to pursue how leaders from a variety of sectors can work together to reduce gun violence at an October summit and lobby day in Washington, D.C. Groups represented at the March forum included the American Academy of Pediatrics, American College of Physicians, American Foundation for Suicide Prevention, Association of State and Territorial Health Officials, Avielle Foundation, Children’s Defense Fund, Coalition to Stop Gun Violence, Dartmouth’s Koop Institute, Everytown for Gun Safety, International Association of Chiefs of Police, Prevention Institute, Sandy Hook Promise, U.S. Department of Justice’s Bureau of Justice Statistics and Violence Policy Center, as well as representatives from several schools of public health.

“It’s working across sectors to develop these partnerships and engage in these conversations that spark new ideas and better outcomes for public health,” said Susan Polan, PhD, APHA’s associate executive director for public affairs and advocacy. “When we work together to make violence prevention a priority, we can save countless lives and make America a healthier place for everyone.”

To learn more about what APHA is doing to prevent violence, visit [bit.ly/APHAviolenceprevention](http://bit.ly/APHAviolenceprevention). For more on the partnership, email mighty.fine{at}apha.org.

*   Copyright The Nation’s Health, American Public Health Association