Objectives:

• Explain what it means to view firearm violence as a public health problem.
• Describe the roles of the emergency physician in addressing firearm violence.
• Recognize that access to firearms make suicide attempts more likely to succeed.
• Identify barriers to conducting research on firearm violence

Resources:

• Provider resources:

  • What Can You Do: UC Davis Violence Prevention Research Program: https://www.ucdmc.ucdavis.edu/vprp/WYCD.html
  • American Association of Pediatrics: Addressing Gun Violence https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Unintentional-Injury-in-Practice.aspx
  • Resources for talking to patients about gun safety: Office of the Attorney General of Massachusetts. https://www.mass.gov/lists/resources-for-talking-to-patients-about-gun-safety

• Firearm research and publications

  • Wintemute GJ, Betz M, Ranney M. Yes, You Can: Physicians, Patients and Firearms. Ann Intern Med. 2016;165(3):205-213. http://annals.org/aim/fullarticle/2522436/yes-you-can-physicians-patients-firearms
  • Carter PM, Walton MA, Zimmerman MA, Chermack ST, Roche JS, Cunningham RM. Efficacy of a Universal Brief Intervention for Violence Among Urban Emergency Department Youth. Acad Emerg Med. 2016 Sep;23(9):1061-70. doi: 10.1111/acem.13021. Epub 2016 Sep 7. https://www.ncbi.nlm.nih.gov/pubmed/27265097
  • Ranney ML, et al. A Consensus-Driven Agenda for Emergency Medicine Firearm Injury Prevention Research. Ann Emerg Med. 2017 Feb;69(2):227-240. https://www.ncbi.nlm.nih.gov/pubmed?term=A+consensus-driven+agenda+for+emergency+medicine+firearm+injury+prevention+research&TransSchema=title&cmd=detailssearch
  • Pallin R, Spitzer S, Ranney M, Betz M, Wintemute GJ. Preventing Firearm-Related Death and Injury. Ann Intern Med. 2019;170(11):ITC81-ITC96.

  https://annals.org/aim/fullarticle/2735389/preventing-firearm-related-death-injury

• Transcript

Take-home points:

• As emergency physicians, we are directly exposed to the toll of firearm violence, but also uniquely positioned to address it.
• Although mass shootings are a serious problem and attract a lot of media attention, the majority of firearm deaths in the USA are actually suicides.
• Firearm violence is a public health problem like drunk driving, and needs to be addressed on multiple levels of prevention.
• Research has been limited by political constraints on funding, and more data is needed to find the most effective solutions.

Contributors:

• Risha Cohen
• Vidya Eswaran
• Erik Kramer
• Aislinn D. Black

Guests:

Dr Marian Emmy Betz is an Associate Professor of Emergency Medicine and in the School of Public Health at the University of Colorado. You may have seen her TedX talk on how to talk about guns and suicide which highlights her interests in both suicide prevention and injury prevention. She also has an extensive research background.

Dr Megan Ranney is an Associate Professor of both Emergency Medicine and Health Services Policy and Practice at Brown University. She has an extensive research background and is the chief research officer for Affirm (The American Foundation for Firearm Injury Reduction in Medicine).