In the past 25 years, the U.S. has seen more than 800,000 deaths from gun violence, and another 2 million or more injuries. A new report offers a roadmap to reduce the human toll of this crisis by 2040.
Sixty leading experts from a range of fields, including medicine, public health, criminology, law and the technology sector, convened earlier this year to create an action plan to address the problem. The report was published in JAMA on Monday.
"For too long, I think we've treated this as inevitable," says Dr. Joseph Sakran, a co-author of the study, trauma surgeon and executive vice chair of surgery at Johns Hopkins Medicine.
Gun violence is now the leading cause of death in children and teens, although the vast majority of firearm deaths are among adults. And nearly 60% of all deaths from firearm injuries are suicides.
"We do have a body of science that can inform and reduce the burden of injuries from firearm violence," says Dr. Sandro Galea, dean of the school of public health at Washington University in St Louis, and study co-author.
"For example, through laws that make sure that there is appropriate screening, that guns do not fall in the hands of people who have a history of violence."
The authors support alternatives to the typical approach to addressing firearm violence, which has been through the criminal justice system.
"We are not saying we don't need any arrest or any incarceration," says study co-author Daniel Webster, a professor at the Center for Gun Violence Solutions at Johns Hopkins Bloomberg School of Public Health. "That's still necessary for public safety purposes. But you need to invest in programs that prevent violence."
The roadmap outlined by the study includes taking a community-wide approach to prevention by addressing socioeconomic inequalities.
"Firearm harm is a symptom of deeper structural issues when you think about poverty and segregation and trauma and lack of opportunity," says Sakran, who is himself a survivor of gun violence. When he was 17 years old, he was critically injured at a shooting after a high school football game.
Studies show that addressing those "upstream" factors can prevent gun violence, says Sakran.
"Things like housing stability, having a strong educational system, a pathway for jobs, access to health care, which are as essential to violence prevention as maybe perhaps any other law enforcement strategy," he adds.
One such community violence intervention in Chicago, called Create Real Economic Destiny, uses community organizations to identify the individuals most at risk of being involved in violent crime and recruit them to receive supports such as mental health care, mentorship, education and job training.
A 2023 study found that alumni of this program had a 73% lower chance of being involved in a violent crime in the following two years.
Webster and his colleagues have found that a similar program in Baltimore, called Safe Streets, led to a 32% reduction in homicides and a 23% reduction in non-fatal shootings.
State gun laws also make a difference, says Webster. For example, a recent study in JAMA Pediatrics showed that states with more restrictive gun laws have fewer pediatric deaths from firearms.
Webster and his colleagues have shown that firearm licensing laws "can reduce firearm homicide roughly 30% or possibly more. "And similar effects on reducing firearm suicide," he says.
Overall, the report calls for a multi-pronged approach to prevention.
"In America, the burden [of addressing gun violence] has often been placed on the shoulders of a few people," says Sakran. "What this report is talking about is the collective action that is so critical in order to move the needle forward."
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