Gun Violence in America Is a Public Health Crisis
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As Trauma Surgeons, We See Gun Violence for What It Is: A Public Health Crisis

Mass shootings like the one in Lewiston, Maine are the tip of the iceberg when it comes to gun violence in America. It doesn’t have to be this way.
As Trauma Surgeons, We See Gun Violence for What It Is: A Public Health Crisis
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On a beautiful summer night in Baltimore City, a pregnant woman lay in the trauma bay of a hospital emergency room — pulseless, lifeless.

Our healthcare team at the Johns Hopkins Hospital made all the right lifesaving maneuvers, but it wasn’t enough. The young Black mother became the third victim of gun violence to die within those walls in less than an hour.

Working as trauma surgeons in a large city, we witness the deadly consequences of America’s weak gun policies every day. One of us has even experienced them firsthand, as a survivor of gun violence. So we can say with certainty: The best medical treatment for gun violence is prevention.

Which raises the question: What are we as a society doing to stop gun violence before it starts?

Gun Violence Is a Public Health Crisis

At least 566 mass shootings have taken place so far across the U.S. this year, with four or more people shot excluding the shooter, according to the Gun Violence Archive.

The mass shooting in Lewiston, Maine, on October 25 is the deadliest since the one that took place last year in Uvalde, Texas, during which 19 elementary-school children and two teachers were killed.

It’s crucial to acknowledge that the problem isn’t simply mass shootings, which account for less than 2 percent of firearm-related deaths. Every day, young brown and Black men are slaughtered on our streets, and their stories often go untold or unnoticed.

Deaths are only one part of the equation: In Baltimore City, we saw 687 nonfatal shootings in 2022.

RELATED: How to Treat a Gunshot Wound Until Emergency Help Arrives

Structural violence has much to do with this. People of color are more likely to live in poorer neighborhoods with underfunded public services, few economic opportunities, and limited healthcare access. This is why we must address both the social and political determinants of health.

But gun violence transcends race: For the first time in 40 years, gun-related incidents (including homicides, suicides, and unintentional injury) have surpassed motor vehicle crashes to become the leading cause of death among children and teens regardless of race.

The intensity of gun violence is also drastically increasing. An investigation published by The Baltimore Sun in 2016 called "Shoot to Kill" showed that in 2015, 62 percent of homicide victims were shot in the head, up from 40 percent in 2000. In addition, the number of homicide victims shot multiple times increased from 59 percent in 2005 to 70 percent in 2015.

As trauma surgeons, we have witnessed this firsthand. It’s not uncommon for victims to show up at the hospital with 10 or 20 gunshot wounds.

Gun Violence Is a Uniquely American Issue

The United States has a gun homicide rate 26 times that of other high-income countries, according to the research and policy organization Everytown. There are more than 400 million guns in this county — more guns than people.

The porous nature of our state borders has resulted in the easy passage of illegal firearms from areas with looser gun laws to areas with stricter gun laws through the so-called iron pipeline. The trafficking of these firearms contributes to the multitude of guns on our streets and is an ongoing, pressing problem.

Despite attempts by law enforcement to seize thousands of guns off the streets, there has been no discernible impact on the ease of access to guns. In addition, the U.S. Bureau of Alcohol, Tobacco, Firearms, and Explosives has been grossly underfunded and understaffed to meet the demands of overseeing the more than 88,000 active federal firearms license holders.

Add to this the rise of so-called ghost guns, which are self-assembled and lack serial numbers, and the complexity of tracking these weapons — let alone trying to keep them off the streets — and it’s easy to see why violence is surging.

We Can Do More to Prevent Gun Violence

Communities across the nation are demoralized and have simply had enough. The trajectory of gun violence in our nation is terrifying, but we can and must take action. And as with any other public health problem, there is no one solution.

Community organizations and hospitals can create, sustain, and expand their violence intervention programs and ensure a trauma-informed approach to delivery of care.

Public health officials can initiate programs focused on communities and individuals that are at high risk of becoming victims of gun violence.

Congress must pass commonsense gun legislation that reduces easy access to firearms and regulates military-style assault weapons and high capacity ammunition magazines.

The Biden administration should commission a report on gun violence prevention through the Office of the Surgeon General, and direct the secretary of Health and Human Services to declare gun violence a public health emergency.

As events have shown, we know what will happen if nothing changes.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health.

Joseph Sakran

Joseph V. Sakran, MD, MPH

Author
Dr. Joseph V. Sakran is a trauma surgeon, coalition builder, policy advisor, public health expert, and nationally recognized advocate for gun violence prevention. He is currently director of emergency general surgery, associate professor of surgery, and associate chief of the division of acute care surgery at Johns Hopkins Hospital in Baltimore. He also is a senior fellow at the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta.

A survivor of gun violence himself, Sakran’s interest in medicine and trauma surgery began after a stray bullet nearly killed him during his senior year of high school. He has subsequently dedicated his life to treating the most vulnerable, reducing health disparities among marginalized populations, and advancing public policy that alleviates structural violence in low-income communities.
Katherine Florecki

Katherine L. Florecki, MD

Author
Dr. Katherine L. Florecki is currently a trauma surgeon at The Johns Hopkins Hospital in Baltimore.