Key Takeaway

  • The authors call on public health officials, policymakers and legislatures to take a role in curbing a crisis that kills nearly 40,000 and injures more than 100,000 Americans each year.

Our nation is now at a pivotal moment in history. A sense of loss infuriates and scares us. We live in a post 9/11 world where partisanship defines us, world economies and governments are being tested, 18 years of war continues, natural and manmade disasters challenge us, and domestic terrorism and mass killings have become the norm.

Richard Carmona, MD, MPH, FACS
Former Surgeon General of the United States
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BOSTON -- Led by Massachusetts General Hospital (MGH) physicians, injury prevention experts, including the 17th Surgeon General of the United States Richard Carmona, MD, MPH, FACS, call on legislators to address the gun violence epidemic and support public health-based approaches to research and prevention efforts. 

Writing in a series of perspectives articles appearing in the latest edition of Current Trauma Reports, section editor Peter Masiakos, MD, co-director of the MGH Center for Gun Violence Prevention, writes that government led reporting “can help dispel myths, advance the conversation, and better educate the public about the burden of the firearm injury and death in America and may also help guide our policy makers to increase funding from federal organizations (CDC, NIH, DOJ) to study this public health problem at a level proportional to its magnitude of injury.”

Joined by colleagues in law enforcement, nursing, medicine, public health research and education, Carmona writes in his call to action: “Our nation is now at a pivotal moment in history. A sense of loss infuriates and scares us.  We live in a post 9/11 world where partisanship defines us, world economies and governments are being tested, 18 years of war continues, natural and manmade disasters challenge us, and domestic terrorism and mass killings have become the norm.” He describes how churches “are no longer safe havens and children in schools are trained in immediate action drills in the event of an active shooter.”

In this comprehensive collection of 12 perspective pieces, the authors call on public health officials, policymakers and legislatures to take a role in curbing a crisis that kills nearly 40 thousand and injures more than 100,000 Americans each year.

Law enforcement officers are the first line of protection against gun violence. Traditionally, officers respond to violence and pursue those responsible but are now increasingly “tasked with delivering life-altering news to a victim’s family or to provide comfort to a parent at these horrible moments of loss. Unfortunately, this task has become too common for us in communities across America,” write the authors.

Instituting community policing programs and implementing cutting edge technologies, like weapons tracking and ballistics, connects authorities with the communities they serve and the trauma surgeons who care for victims. However, they “can neither arrest nor operate our way out this current public health crisis,” and call for a formalized plan to address this issue that considers demographics, politics, and economics.

The health care system offers an additional touch point to educate the public on the dangers of gun violence and offer guidance on how to avoid tragedies in their homes and communities. “Gun violence is an urgent and devastating public health threat, and as both counselors and first responders, clinicians carry a responsibility to work to prevent it. Nowhere is this more critical nor its effect more immediate than at the bedside…,” they say, and reference the 1960s initiative to decrease motor vehicle crash injuries and deaths. In that effort, clinicians worked with the public, advocates, the automobile industry and legislators to mitigate crashes and all believe a similar approach to gun violence prevention, education and law enforcement would produce positive results. Legislative action was paramount to the driving campaign and must be instituted in gun violence prevention efforts as well.

The authors describe how active shooter drills have transformed school curriculums to incorporate costly training programs including hyper-realistic scenarios with rubber bullets and recorded gunfire that can cause anxiety and unintended trauma to children “rather than instilling confidence, security or safety as a response to gun violence.” Though conducted in 95% of U.S. schools, “little to no actual outcomes, data exists to validate that these methods are effective means of protection from an active shooter.” School nurses, as front-line health care providers, can provide insight into the developmental and mental health implications and call for research that will determine how best, and at what cost, to keep kids safe in their classrooms.

“After decades of repeated mass shootings, we collectively cry for leadership to emerge and act, yet with each mass event, we only see elected officials, expert in their respective non-scientific, partisan scripts, resorting to the usual divisive nonproductive self-serving rhetoric or evasiveness,” adds Carmona. “Meanwhile the world looked at us in awe as to how the continued carnage could be tolerated in the world’s greatest democracy that holds itself out to be the protector of its citizens and the promulgator of best practices in science technology and policy.”

This collection of papers appears in the 2019 and 2020 digital editions of Current Trauma Reports

Masiakos is the director of Pediatric Trauma Services at MassGeneral Hospital for Children and is an associate professor of Surgery at Harvard Medical School and the Co-Director of The MGH Center for Gun Violence Prevention which serves the hospital’s mission to improve the health and safety of our local and national communities through clinical care and education, community engagement and research.