gun violence

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Etiology

  • substance use is a risk factor for adolescent firearm homicide[7]
  • gun violence may be propagated through networks of people by social interaction[7]
  • exposure to gun use in movies, television, & other forms of media may influence how children interact with guns whenthey find them[8]
    • watching gun use associated with significantly more gun holding & trigger pulls[8]

Epidemiology

  • firearm deaths now leading cause of death from trauma is U.S. exceeding deaths from motor vehicle accidents[33]
  • firearm fatality rates in the United States reached a 28-year high in 2021[35]
  • in 2013, more than 33,000 people in the United States died from gunshot injuries[3]
  • in the United States, the National Rifle Association (NRA), the legislators it has funded, & a certain breed of gun owners have stood in the way of research to determine what policies might help[3]
  • very few existing state-specific firearm laws are associated with reduced firearm mortality[4]
    • of 25 state firearm laws, 9 associated with reduced firearm mortality, 9 were associated with increased firearm mortality, & 7 had an inconclusive association
    • 3 state laws most strongly associated with reduced overall firearm mortality included:
  • Australia has had no mass fatal shootings since it banned semi-automatic weapons in 1996[6]
    • the ban included guns already owned by citizens & mandated government buyback of all prohibited firearms[6]
    • from 1979-1996 in Australia, there were 13 mass fatal shootings, with 104 deaths, none afterwards[6]
    • total firearm deaths in Australia also declined after the ban, from 3.6 per 100,000 population to 1.2 per 100,000
  • 37,000 deaths from firearms in U.S. in 2016, 2/3 being suicides[27]
  • 6 countries accounted for half the global firearm deaths in 2016, Brazil, U.S., Mexico, Colombia, Venezuela, & Guatemala[27]
  • death rate from gun violence was 12.0 per 100,000 population in 1st quarter of 2017, higher prior year (11.4 per 100,000)[16]
  • firearm homicide in 2020 at highest in 25 years[34]
  • young adult males from zip codes with the most violence in Chicago & Philadelphia in 2020-2021 had a higher risk of firearm-related death than US military personnel who served during the wars in Afghanistan & Iraq[36]
  • from 2014 to 2020, mortality from firearm homicides increased by 7% annually[38]
  • from 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, & homicide due to firearms & all other injuries[38]

Management

  • SaFETy score predicts risk for firearm violence in youth with substance abuse
  • evidence-based laws compliant with the 2nd amendment work[26]
    • prohibit dangerous individuals from purchasing firearms
    • enforce prohibited purchase laws
    • safe storage, smart guns, & child protection
    • ban hazardous weapons
    • permissive right-to-carry laws significantly increase violent crime, including homicides
    • crime detection[26]
    • stricter state gun laws are associated with safer schools[30]

Clinical trials

  • of 43 pairs of children who found a planted (disabled) handgun, 22 (51%) handled it, & 14 (33%) alerted researchers to its presence[8]
    • children who watched gun scenes held the handgun longer (53.1 vs 11.1 seconds) & pulled the trigger more times (2.80 vs 0.01)
    • children watching gun scenes played more aggressively, shot at their play partners & people passing by outdoors[8]

Notes

  • research on gun violence has been underfunded compared with research on other major cause of death[7]
  • with background checks for firearm purchases, firearm- related mortality would decline from 10.35 per 100,000 to 4.46; with ammunition background checks to 1.99; with firearm identification* to 1.81
  • 22% of current U.S. gun owners who acquired a firearm in 2014-2015 did so without a background check[21]
  • unregulated gun shows (i.e. in Nevada) may increase gun violence in neighboring states (i.e. in California)[15]
  • large increases in handgun purchases may occur after mass shootings (40-50%)[20][24]
  • exposure to violence increases likelihood of carrying a firearm[22]
  • Supreme Court allows for firearms regulation within the context of the second ammendment[25]
  • assessment of Mass Attacks in Public Spaces[37]

* microstamping or ballistic fingerprinting given as examples of firearm identification

  • general engagement guidelines for physicians[14]
    • educate yourself & regularly contact their elected officials about this public health threat
    • meet with your institution's leaders to find ways to work with the government at all levels
    • ask patients about guns in the home
    • not be silent

More general terms

Additional terms

References

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