Citation

Cook N, Sills M. J. Am. Med. Assoc. JAMA 2023; 329(6): 514.

Copyright

(Copyright © 2023, American Medical Association)

DOI

10.1001/jama.2022.21997

PMID

36786795

Abstract

To the Editor We submit this Letter in response to the recent Viewpoint1 about a national surveillance system for firearm violence. Dr Cook is an epidemiologist whose children witnessed the Parkland, Florida, mass shooting; Dr Sills is an emergency physician-scientist who has worked in trauma centers for 25 years.

Although the Viewpoint authors noted the breadth of firearm injury and provided an important call to action, their recommendations would be strengthened by encompassing the effect of firearm violence on health more equitably and completely. Limiting physical injury data to hospital-based and mortality-related sources underrepresents its prevalence. For example, at least 2 students grazed by bullets in the Parkland shooting did not seek hospital-based care. We have not identified any studies that quantify the proportion of firearm injury survivors who did not seek hospital-based care and consequently are excluded from firearm injury prevalence calculations. To develop comprehensive data on firearm injury, we recommend including ambulatory care data (ie, urgent care, primary care) in surveillance. This inclusion would better account for acute injury episodes and capture the longitudinal physical and behavioral health sequelae of firearm injury.

Language: en

Keywords

Humans; *Firearms; *Wounds, Gunshot