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Crit Care Med. 2020 Mar;48(3):391-397. doi: 10.1097/CCM.0000000000004147.

Beyond Band-Aids for Bullet Holes: Firearm Violence As a Public Health Priority.

Author information

1
Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
2
Penn Injury Science Center, Philadelphia, PA.
3
Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, PA.

Abstract

OBJECTIVES:

To review the public health approach to preventing and treating firearm violence.

DATA SOURCES:

Peer-reviewed, published scholarship and federal data systems.

STUDY SELECTION:

English-language, indexed research articles on the epidemiology, risk, prevention, and consequences of firearm violence.

DATA EXTRACTION:

This narrative review includes findings related to the epidemiology and impact of firearm violence, focusing on short- and long-term outcomes. Evidence supporting interventions at the individual, agent, and environmental level to reduce firearm-related harm was examined.

DATA SYNTHESIS:

Firearm violence is a major public health challenge in the Unites States. The consequences of firearm violence reach beyond the nearly 40,000 firearm-related deaths and 90,000 firearm-related injuries each year. Firearm violence, including self-harm, assault, and unintentional injury, affects the health of individuals, families, communities, and health systems. Data sources remain inadequate, however, to fully capture these impacts. Treating firearm violence as a disease and taking a public health approach to prevention and treatment is key to reducing the harms of firearm violence. Using a public health framework not only recognizes the physical and mental consequences of firearm violence but also focuses our attention on underlying causes and on innovative, multi-level interventions to reduce the harms of firearm violence.

CONCLUSIONS:

The public health approach positions clinicians to change the conversation from political diatribe of pro-gun and anti-gun to systematically reducing injury and death. To achieve comparable success, we must design, test, and implement effective interventions at the environmental, policy, technological, and individual levels to prevent firearm violence. We must collect robust data on firearm violence and its consequences. And we must reckon with the conditions of inequality and disadvantage that feed violence through all means.

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