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Abstract
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Is the USA finally taking the issue of guns more seriously? A new White House Office of Gun Violence Prevention has been formed, overseen by Vice President Kamala Harris. It will help to implement legislation to curb the major harms to health and wellbeing done by shootings and provide leadership on an issue that has long plagued the country. This development comes 4 years after the US CDC and the National Institutes of Health received their first federal funds in decades to study gun violence, following relaxation of the restrictions around the 1996 Dickey Amendment, which long prevented such grants. The sum is still far too small in relation to the burden of gun violence (firearm-related injury is the leading cause of death of Americans aged 1-19 years), and any efforts at gun control continue to face stonewalling by Congress. But these are at least positive steps.
The political, cultural, and constitutional aspects of gun control in the USA--along with a series of horrific mass shootings--have meant that the popular discourse around gun violence has become dominated by a country that is in many ways an outlier. Guns are a health issue of global, often unappreciated, importance. Estimated mortality rates are high in the USA (4 deaths per 100 000 people) compared with other high-income countries, but similar to many parts of Africa and southeast Asia. However, central and South America have the highest mortality rates, particularly Brazil (21·9 deaths per 100 000), Mexico (16·4), Guatemala (29·1), Venezuela (33·3), and El Salvador (36·8). These overall statistics mask many disparities and complexities, but the over-riding health effects are clear. As well as causing death and reducing life expectancy, gun violence causes long-term physical and mental ill health. The trauma of gun violence impacts families and communities, impeding human flourishing and having intergenerational effects on social mobility worldwide.
The need for a public health approach to guns--with a suite of evidence-based policies based on prevention and harm reduction principles--has long been recognised, if not always embraced. A paper in The Lancet Public Health described the uncertainty around the effects of many individual gun laws in use. Policy making is still too often knee-jerk and not based on the best evidence; there is a dire need for further study of gun violence, especially in low-income and middle-income countries. However, sufficient evidence exists that targeting multiple firearms regulations--including use, sales, ownership, and storage--can reduce firearm-related mortality. Australia is a classic example: a series of reforms introduced in 1996, after a mass shooting that killed 35 people, were associated with a reduction in homicides and suicides involving guns...
Language: en |