From ATPM & ACPM
The American College of Preventive Medicine Policy Recommendations on Reducing and Preventing Firearm-Related Injuries and Deaths

https://doi.org/10.1016/j.amepre.2016.09.023Get rights and content

The American College of Preventive Medicine Policy Committee makes policy guidelines and recommendations on preventive medicine and public health topics for public health decision makers. After a review of the current evidence available in 2016, the College is providing a consensus-based set of policy recommendations designed to reduce firearm-related morbidity and mortality in the U.S. These guidelines address seven general areas pertaining to the public health threat posed by firearms: gun sales and background checks, assault weapons and high-capacity weapons, mental health, research funding, gun storage laws, and physician counseling.

Introduction

In 2002, the American College of Preventive Medicine (ACPM) issued its first statement that raised concern about the firearm violence epidemic in the U.S. and advocated for policies to reduce this leading cause of injury and death among the American public. The 2002 statement focused on handguns; this statement expands ACPM’s recommendations to include all firearms and provides an updated public health and legislative context for these recommendations.

Gun violence is a public health problem. Firearm-related deaths in the U.S. remain the highest in the industrialized countries.1 Firearms were involved in the deaths of more than 33,500 people in the U.S. in 2013, including homicides, suicides, and unintentional deaths, accounting for more than 17% of the injury deaths that year.2 Unintentional injury is the leading cause of death in Americans aged 1–44 years.3 Firearm injury is the third leading cause of injury-related death in the U.S., only after poisonings and motor vehicle crashes.2 There were 11,000 homicides and 21,000 suicides that involved firearms in 2013,2 and there were more than 81,000 non-fatal firearm injuries in 2014.4 Collectively, Americans own between 270 million and 310 million firearms, approximately 101.05 per 100 people.5 In 2014, a total of 13,576 children aged <20 years were treated in emergency rooms for nonfatal firearm injuries, and adolescents aged 15–19 years were more than twice as likely to have nonfatal firearm injuries than the general population.4 Children playing with guns in the absence of their parents account for 89% of the unintentional shooting deaths of children at home.6, 7 Gun violence costs the country approximately $174 billion annually in lost work, health care, emergency systems, policy and criminal justice, claims processing, and decreased quality of life.8 It results in more than $48 billion in medical and work loss costs each year by annual estimates.9

Fatal and nonfatal firearm violence seriously threatens the safety and welfare of Americans. Since 1966 when Charles Whitman, an ex-Marine sniper, killed his wife, mother, and 14 more people at the University of Texas before police shot him, there have been more than 125 events in the U.S. in which a lone shooter has shot four or more individuals.10 Although these highly publicized mass shootings make up less than 1% of firearm-related deaths, they have had significant physical and psychological impacts on individuals in both physical and virtual proximity.10 These violent acts have increased the public’s interest in protecting children, communities, and law enforcement from the harmful effects of gun violence.

As a national organization of physicians dedicated to prevention, ACPM believes in a comprehensive public health approach to addressing the issue of gun violence. ACPM supports effective policies and legislation at all levels of the government that are intended to prevent and reduce injuries and deaths related to firearms.

Section snippets

Methods

The ACPM’s Policy Committee, which is charged with recommending legislative initiatives and policy positions, developed these recommendations. The committee reviewed available literature through May 2016 on the relationship between gun sales and background checks on firearm-related mortality, the relationship between mental health and gun violence, and the impact of firearm safety measures on health outcomes. The ACPM Prevention Practice Committee reviewed the draft recommendations, after which

Policy Recommendations

The following statements represent the official policy positions and recommendations of ACPM. The evidence base for each policy recommendation follows.

Gun Sales and Background Checks

Guns are sold in both primary and secondary markets. Primary markets include licensed gun dealers who follow mandated background check procedures. However, up to 40% of gun sales take place in secondary markets where people are allowed to sell from their personal supply without the involvement of licensed dealers or background checks.17 These secondary markets include sales online and at gun shows.17 Secondary markets and theft are responsible for the majority of guns supplied to criminals.17

Conclusions

Firearm-related injuries and deaths continue to pose a significant public health threat in the U.S. Since 2002, ACPM has officially advocated for research to characterize the public health burden associated with firearms, policies to reduce the rate of firearm injuries and deaths in the U.S., and action to implement firearm policies in order to reduce the associated public health impact. Recommendations on gun violence prevention have been established by other professional organizations and are

Acknowledgments

We acknowledge American College of Preventive Medicine (ACPM) Policy Committee members Gregory Holzman (Chair), Linda Hill, Samuel Peik, Robert Gilchick, Kevin Piggott, Halley Faust, Marielena Velez Brown, Srivani Kanumuri, Laura Johns, Emilie Prot, Brany Liu, Andrew Karasick, and Daniel Blumenthal for developing and approving these recommendations. We also thank ACPM Associate Director of Policy and Government Affairs Paul Bonta for his helpful insight and manuscript input; Susan P. Baker of

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