The Urgent Call to End the Firearm Injury Epidemic

Since Surgeon General Everett C. Koop first called public attention to the epidemic of gun violence in 1985 during the Reagan Administration, some 620,000 Americans have been killed by firearms. This is about the same number as those who died in the Civil War and roughly 7 times the number of combat deaths in Korea and Vietnam combined.

Major American medical and public health societies-including the American Medical Association, the American College of Physicians, the American College of Surgeons, the American Academy of Pediatrics, the American Public Health Association and many others-agree that:

• Gun injuries are a major medical concern
  
• Access to firearms at the individual, household, state and national level is directly related to the risk of gun injury and death in the United States
  
• Gun injuries and deaths are preventable by a specific series of public policy and public education measures.

As leaders in the medical and public health professions dedicated to protecting and preserving life and preventing harm to our fellow citizens, we call upon President George W. Bush and Senator John F. Kerry - and all current candidates for public office - to include in your campaigns a detailed and comprehensive plan to substantially reduce and ultimately end the epidemic of injury and death in the United States caused by firearms.

Each year, nearly 30,000 Americans-men, women, and children from all walks of life-are killed by firearms. The majority of those deaths are suicides, mostly affecting youth and the elderly. About twice as many Americans sustain nonfatal firearm injuries annually. And each year shootings lead to health care and other costs amounting to over $100 billion. These stark figures cannot capture the full range of adverse medical, psychological, family and social consequences that follow in the wake of death or injury by firearms.

Deaths from firearms are now the second leading cause of injury mortality in the United States. While all Americans are adversely affected, firearm deaths and injuries disproportionately affect minority and inner city families, with devastating effects on health, well-being and productivity. Most homicides, suicides and domestic violence deaths involve guns. Such a huge epidemic must not be held hostage to partisanship, politics, and polarization. Yet it is clear that those are the very factors that have resulted in inattention by our political leaders to the urgency of reducing the public health burden posed by firearm injuries. The ongoing toll demands that ending the firearm injury epidemic find its place among the leading imperatives of our time, along with access to health care, economic policy, environmental protection and, indeed, terrorism and the war in Iraq.

There is great irony in the fact that US policy is currently consumed by efforts to deal with small arms violence abroad, yet appears to ignore it at home. This occurs despite consistent popular support for policies to reduce firearm death and injury, which is clear in poll after poll, including polls of gun owners. In 2001, the Surgeon General's National Strategy for Suicide Prevention called for public information about reducing access to lethal means of self-harm in the home. What is lacking to allow us to effectively address this problem is political leadership.

We call on you fill the leadership void on this issue now. We suggest that you build your leadership plan to end the epidemic of firearm death and injury on the foundation of overwhelming consensus among the nation's major medical and public health societies and associations on what needs to be done. A plan based on that consensus can be implemented by the Administration and U.S. Congress that take office in January 2005.

A recent study has documented that medical and public health groups agree on the themes that must be addressed to reduce the toll of firearm injuries. These include reducing the access to firearms that fosters their misuse, addressing aspects of gun commerce that facilitate misuse, research to clarify the risk factors and causal sequences that lead to firearm injuries, and both public and clinical education to inform Americans about the dangers posed by firearms and how to avoid them. Several specific measures should be undertaken to address these themes:

• Enforce current laws restricting access to firearms
  
• Further restrict access to firearms: at the point of sale and by children
  
• Carry out Federally-backed research on prevention programs and policies
  
• Mount a public education campaign on the health risk of guns in the home, highlighting risks for children and teenagers, and adults experiencing depression or domestic violence
  
• Require that all new firearms manufactured in the U.S. include basic safety features
  
• Renew and strengthen existing prohibitions on assault weapons

These steps will complement those aimed at reducing all violence, focusing on the firearm injuries that cause most violent deaths and hospitalizations. Because of the critical and urgent nature of this matter, we call upon you to meet with us as representatives of the medical and health professions before the election. We will look forward to working with you to finally address one of the worst public health disasters in US history.

Sincerely,

Ambulatory Pediatric Association
American Academy of Child and Adolescent Psychiatry
American Academy of Pediatrics
American Association for the Surgery of Trauma
American Association of Suicidology
American College of Emergency Physicians
American College of Physicians
American College of Preventive Medicine
American College of Surgeons
American Medical Women's Association
American Public Health Association

Jeremiah Barondess, M.D., Founder,
Doctors Against Handgun Injury
President, The New York Academy of Medicine

Katherine Kaufer Christoffel, M.D., M.P.H., Founder and Board President
The HELP Network
Professor of Pediatrics and Preventive Medicine
The Feinberg School of Medicine, Northwestern University

National Hispanic Medical Association
National Medical Association

Michael McCally, M.D., Ph.D., President
Physicians for Social Responsibility
Professor, Mt. Sinai School of Medicine

Robert K. Musil, Ph.D., M.P.H., Executive Director and CEO
Physicians for Social Responsibility

Günter Blobel
Nobel Laureate, Physiology and Medicine 1999

Barry R. Bloom, Dean
Harvard School of Public Health

G. Clarkson, M.D. Senior Vice President for Medical Affairs and Dean
University of Miami School of Medicine

Glenn Craig Davis, M.D, Dean
Michigan State University College of Human Medicine

J. Kevin Dorsey, M.D., Ph.D.
Dean and Provost
Southern Illinois University School of Medicine

William D. Phillips
Nobel Laureate, Physics 1997

Allan Rosenfield, MD, Dean
Mailman School of Public Health
Columbia University

Linda Rosenstock, MD, MPH, Dean
UCLA School of Public Health

Larry J. Shapiro, M.D.
Spencer T. and Ann W. Olin Distinguished Professor
Executive Vice Chancellor for Medical Affairs and Dean
Washington University School of Medicine

Stephen M. Shortell, Ph.D., M.P.H., Dean
University of California at Berkeley School of Public Health

Alfred Sommer, Dean
Johns Hopkins Bloomberg School of Public Health

Patricia W. Wahl, PhD, Dean
School of Public Health and Community Medicine
Professor of Biostatistics
University of Washington

Zane Robinson Wolf, Ph.D. R.N., Dean
LaSalle University School of Nursing