Health and Well-Being Matter is the monthly blog of the Director of the Office of Disease Prevention and Health Promotion.
Firearm-related injuries and deaths in the United States are a public health crisis. High-profile mass shootings, localized episodes of violence, suicides, and gun-related accidents all-too-frequently stimulate our personal and collective grief and outrage. But — contrary to response and recovery patterns after other crises — effective follow-on adaptations to mitigate further harm are often thwarted by cultural, legal, and political barriers. Even more disconcerting, we often remove safeguards or lessen regulations such that we engender greater risk. Inevitably, new incidents of firearm violence, accidents, or suicide overshadow previous ones — and the cycle continues.
Despite the senselessness of unending recurrences of such tragedies, HHS remains committed to reducing the number of firearm-related injuries and deaths. As with other public health challenges, that means openly acknowledging the scope of the problem, updating the public on what we’re doing to reduce firearm-related injuries and deaths, and providing the most up-to-date available guidance to help the broader public navigate the crisis.
The Centers for Disease Control and Prevention (CDC) offers the following sobering statistics: Firearm-related injuries are a major cause of death in the United States, including deaths from homicides, suicides, and unintentional injuries. In 2020, there were 45,222 firearm-related deaths in the United States. That’s about 124 people dying each day from a firearm-related injury. Tracking firearm-related deaths in the Healthy People 2030 objective Reduce firearm-related deaths, IVP-13 shows that the problem is only getting worse. Firearm-related deaths increased from 11.9 firearm-related deaths per 100,000 people in 2018 to 13.6 per 100,000 in 2020.
According to the Institute for Health Metrics and Evaluation at the University of Washington, among high-income countries with populations greater than 10 million, the United States has by far the greatest firearm homicide rate. The U.S. rate is 13 times greater than that of France, 22 times greater than the European Union’s rate, and 23 times the rate in Australia. And, most disturbing, the U.S. has markedly higher child deaths due to gun violence than all of its peer nations.
There are also disparities in firearm-related deaths by age, sex, and race/ethnicity. Men account for 86 percent of all firearm deaths, while firearm homicide rates are highest among teens and young adults ages 15 to 34 years and among Black or African American, American Indian or Alaska Native, and Hispanic or Latino populations. Firearm suicide rates are highest among adults age 75 years and older and also among American Indian or Alaska Native and non-Hispanic White populations.
Comprehensive state- and community-level prevention strategies are critical for reducing the risk of violence that leads to firearm-related injuries and deaths. Several federal agencies offer evidence-based guidance that can help. Notably, the Department of Justice (DOJ) recently updated rules to help enable federal firearms licensees (FFLs) to safely and securely storee firearms. Such rules improve upon systems intended to ensure that only law-abiding owners have the opportunity to purchase firearms.
For individuals, the Department of Veterans Affairs (VA) has produced a toolkit providing guidance on safe firearm storage for suicide prevention. The toolkit not only offers suggestions and recommendations for safe storage but also outlines the warning signs of individuals who may be considering suicide.
CDC also offers a number of resources and fact sheets — all based on a public health approach — to increase safety and lessen incidents of violence that may lead to firearm-related injuries and deaths. Amongst these resources are the latest research on firearm injuries and deaths, information for those most at risk, violence prevention information, and safe storage guidance.
All this valuable information is for naught if we don’t use it to better understand the crisis, have substantive dialogue that includes diverse perspectives, and take action to make our nation safer.
Firearms in the United States are part of our reality. They are present in homes and businesses across the country. In some regions, people openly carry them in public, shared spaces. Everyone from industry to individuals shares responsibility for solving this crisis. That begins with familiarizing yourself with the guidance and resources presented here and continues with applying the knowledge to intentionally engage others — be it through clinical care settings, policy or program development, or ordinary conversation — to reduce injuries and deaths.
There are too many tragedies, and the time for debating whether this is a public health crisis has long since passed. Though higher-order policy solutions may be stalled and the various factions in the debate about gun safety appear to be dug in, we still have many tools at our disposal to reduce firearm-related injuries and deaths. And despite the protestations of some, it’s always the right time to discuss this crisis and find innovative ways to resolve it. We will continue to do so. Lives depend upon it.
Wishing you and your loved ones peace, health, and safety this season.
Yours in health,
Paul Reed, MD
Rear Admiral, U.S. Public Health Service
Deputy Assistant Secretary for Health
Director, Office of Disease Prevention and Health Promotion
In Officio Salutis — In the Service of Health