Firearm violence is a major public health and public safety problem, associated with nearly 40,000 deaths and nearly 100,000 emergency department visits in 2017. Mass public shootings are changing the character of American public life, and more than 40% of Americans are concerned that they might become victims of firearm violence. Rates of firearm homicide, firearm suicide, nonfatal firearm injury, and mass shootings are all increasing. Emergency physicians are uniquely positioned to study firearm violence and take action to prevent it.
The presentation will illustrate why it is appropriate to view firearm violence as a health problem and then provide an overview of the basic epidemiology of firearm violence for adults and children, including mass shootings, homicide, and suicide. It will emphasize differences between risk-and population-based epidemiologic approaches and points on which common understandings are incorrect. It will include an overview of data on how firearm injuries stack up to other common causes of death, trends over the past 20 years, comparisons to our global peers, and health disparities. It will discuss what is known about the effectiveness of common risk- and population-based policy interventions, including those directed at firearm violence specifically and those with broader impact. The presentation will address our relative lack of knowledge about firearm violence, as compared with other comparable health and social problems, and detail the reasons why little research has been done. It will briefly review opportunities for research, in clinical settings and otherwise. It will close by reviewing opportunities for risk screening and direct preventive action in clinical settings, based on the What You Can Do initiative for physicians for adults developed by emergency physicians at UC Davis, as well as the FACTS video trainings developed for pediatric patients. Throughout, reference will be made to particularly salient events in recent years that have shaped our understanding of firearm violence or our ability to conduct research and intervene effectively.