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February 13, 2013

Curbing Gun Violence: Lessons From Public Health Successes

Author Affiliations

Author Affiliations: Division of Cardiovascular Medicine and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Mozaffarian); Departments of Epidemiology (Dr Mozaffarian), Health Policy and Management (Dr Hemenway), and Nutrition (Drs Mozaffarian and Ludwig), Harvard School of Public Health, Boston, Massachusetts; and New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts (Dr Ludwig).

JAMA. 2013;309(6):551-552. doi:10.1001/jama.2013.38

The tragic slaughter of innocents in Newtown, Connecticut, has horrified and refocused the nation on the burden of gun violence. Each year in the United States, more than 30 000 individuals are killed by guns1 (homicides, suicides, and unintentional fatalities)—85 deaths per day plus many hundreds of nonfatal injuries. Gun homicide alone causes 11 000 deaths each year,1 more than all US troops killed throughout the last decade in Iraq and Afghanistan. Remarkably, the 26 deaths in Newtown represent fewer gun homicides than the daily US average.

The Newtown shooting has rekindled a national discussion about gun policy. Most proposals focus on gun ownership such as a ban on rapidly firing assault weapons, piercing bullets, and high-capacity ammunition clips; waiting periods for firearm purchases; and universal background checks for all gun sales and transfers. This focus on gun ownership has been controversial due to Second Amendment interpretations and regional, partisan, and personal preferences. Although such commonsense regulations on ownership warrant implementation, a broader public health perspective is imperative. Gun violence arises from sociocultural, educational, behavioral, and product safety issues that transcend gun ownership alone. Addressing this crisis will require a comprehensive, multidimensional strategy. Toward that end, much can be learned from prior public health successes in changing the prevalence, social norms, and cultures of harmful behaviors.2-6 These major achievements—in the realms of tobacco, unintentional poisoning, and motor vehicle safety—provide a set of evidence-based, successful tactics for immediate application to gun violence (Table).