Every day in the United States, health professionals confront the effects of firearm injury. In emergency rooms, trauma centers, ambulatory offices, and acute care and rehabilitation facilities, health professionals and the health systems they work within attempt to heal the wounds that firearms can inflict on individuals and their families. Thus, hospitals and health systems are in a position to grasp the scope of the issue and find opportunities to prevent firearm injury and death. In 2016 and 2017, the physicians and nurses at Kaiser Permanente treated more than 11,000 gunshot victims. These 11,000 patients—from a single health system among the hundreds that operate across the United States—are a sobering reminder of the toll of firearm injury. Firearm injury—including other-directed, self-directed, and unintentional injury and death—is a broad-based public health issue. In 2016, more than 38,000 people were killed by firearms.1 In the same year, half of those who died by suicide used a firearm, and three quarters of homicides involved a firearm.1 Firearm death is the third leading cause of death for children under age 17 in the United States. A social network analysis by Kalesan and colleagues2 showed that almost everyone in the United States, at some point, will know someone injured or killed by a firearm. The nature of the injury varies—homicide is the more likely cause of a firearm death in an urban area, whereas suicide is more likely in a rural area—but every community in every geographic region and every socioeconomic stratum is affected.3 When we think of how many people will know someone who is injured or killed by a firearm in their lifetime, and how many will be injured directly, it is difficult to determine who or what can mitigate the impact of this massive issue. Yet hospitals and health systems will touch nearly every life in the United States at some point and are dedicated to advancing well- being. Few societal systems have as many touch points with an individual as health care does. Every touch point can serve as a potential intervention before injuries occur. For instance, regular screening for depression can identify those who may be at risk of suicide. These opportunities occur in pediatrics, primary care, gynecology, geriatrics, and other specialties, as well as at different sites of care, such as hospitals, medical offices, and emergency departments. Addressing social determinants to improve the health of patients and communities also can provide a chance to protect patients from firearm injury. To be effective, health professionals need to know how to identify those at a higher risk of firearm injury, and they need to have the tools to intervene effectively ...
Language: en
LA - en SN - 0031-4005 UR - http://dx.doi.org/10.1542/peds.2019-1701 ID - ref1 ER -