Leaders issue 'call to action' on gun safety; urge consensus vs. confrontation

In an unprecedented call to action, public health leaders from some of the nation's top universities on Thursday urged consensus-building on gun safety, rather than confrontation, saying that the election of President Donald Trump had "changed the national conversation on firearms" and made federal policy changes unlikely.

Writing in the American Journal of Public Health on the eve of Trump's inauguration, researchers from nine leading medical and public health schools—speaking for a larger group of 82 academics and advocates who convened at the Boston University School of Public Health (BUSPH) in November to discuss gun violence—presented an "agenda for action" that seeks to engage gun owners and manufacturers in discussions about reducing the public health ills associated with firearm ownership, rather than continuing what they called a polarizing debate.

"In the United States, nearly 10 times more guns are in civilian hands than in the next closest country, with up to 300 million guns in circulation . . . The country also has a significant gun culture; guns are seen as a foundational right," they wrote. "This situation suggests that there will be no easy solutions that will garner widespread popular support, and that any comprehensive approach to the problem will require the engagement of partners across many sectors."

The researchers issued a five-point "agenda for action" that includes calling on private foundations and the business community to fund and support research to mitigate gun violence, as a step to turn the tide on a crisis that they said costs the U.S. an estimated $229 billion annually.

The experts noted that Congressional action in 1996 effectively ended federal funding for gun research, stymying "a generation of researchers in the field."

The paper grew out of a Nov. 14 meeting of more than 80 representatives of 42 schools of public health and medicine from 22 states, and 17 advocacy organizations, convened in Boston by BUSPH Dean Sandro Galea. The group heard from Massachusetts Attorney General Maura Healey, Speaker of the Massachusetts House of Representatives Robert DeLeo, and gun research experts from BUSPH, Harvard University's T.H. Chan School of Public Health, Johns Hopkins Bloomberg School of Public Health, and the University of Iowa College of Public Health.

The group also called for:

• Focusing on state-level initiatives. They said the expected lack of federal action on gun regulation in the coming years "elevates the importance" of state and local initiatives, especially those rooted in "non-threatening messaging" about gun safety. They noted that three states - California, Nevada and Washington - approved ballot initiatives in November promoting gun safety. A state-level strategy creates "a range of opportunities" for academic leaders around the country to develop state-specific strategies and policies, they said.
• Promoting discourse around gun safety, vs. gun control. The researchers acknowledged that few issues were as politically polarizing as guns, and that the gun lobby had been "extraordinarily successful" in framing the discussion as one that pits "deeply held views about individual rights" against concerns about public health. To alleviate that conflict, public health advocates must play a role in re-framing the debate "around the need for gun safety, rather than a blanket call for banning guns."
• Engaging private industry, starting with healthcare entities, in developing evidence-based initiatives to reduce gun-related injuries and deaths. Citing research findings that firearm violence depresses business growth and harms neighborhood economies, they said the total social cost of gun-related injuries is more than that of obesity, and roughly the same as annual spending on Medicaid. "This situation represents an enormous economic challenge ... that should engage not only the public health community, but also sectors of private industry with an interest in maximizing productivity."
• Building collaborations with opponents. The group proposed convening an "inclusive group" of firearm owners, manufacturers, police, pro-gun advocates and public health scholars to develop "common ground" around the issue of reducing violence, versus assailing gun ownership.

Galea, the paper's senior author, said public health leaders have a responsibility to speak with a "clarity of voice" about an issue that claims more than 30,000 lives a year in the U.S.

"We have not capitalized on the mass of academic public health coming together to push ideas forward," he said. "Part of our intention is to be that catalyst."