Surgeon General declares gun violence a public health crisis

The US Surgeon General, Dr. Vivek Murthy, on Tuesday declared gun violence in America a public health crisis, recommending a series of preventive measures that he likened to previous campaigns against smoking and road safety.

The step follows Years of calls from health officialsincluding four from Dr. Murthy’s predecessors, to view gun deaths through the lens of health rather than politics.

The National Rifle Association strongly opposed this scheme and introduced legislation that ended federal funding for gun violence research for a quarter century.

Dr. Murthy’s 32 pages advisory calls for an increase in funding for research into gun violence prevention; advises healthcare professionals to discuss firearm storage with patients during routine medical visits; and recommends safe storage laws, universal background checks, “red flag” laws and a ban on assault rifles, among other things.

“I have long believed that this is a public health problem,” he said in an interview. “This issue has been politicized, has been polarized over time. But I think when we understand that this is a public health issue, we have an opportunity to take it out of the realm of politics and put it into the realm of public health to place.”

Gun rights groups were scathing about the new advice, sometimes even mocking it unprintable language, as justification for restricting the rights of law-abiding gun owners. An NRA spokesperson called it an “extension of the Biden administration’s war on law-abiding gun owners.”

“America has a crime problem that is caused by criminals,” said Randy Kozuch, the organization’s chief lobbyist. “The unwillingness to prosecute and punish criminals on the part of President Biden and many of his allies is a primary cause of that. That’s a simple fact.”

In the United States, gun policy reform has proven to be a difficult task in terms of public health. The political parties in the United States have reached a stalemate over many of the measures recommended in the report, including bans on assault rifles and background checks for gun buyers.

For decades, opposition from groups advocating the right to own guns had a chilling effect on scientists. They feared Congress would cut their budgets if they were accused of doing “advocacy research,” said Andrew Morral, a senior behavioral scientist at RAND.

But that barrier is falling now that the Centers for Disease Control and Prevention is resuming funding for gun violence research. “There’s a huge interest,” says Dr. Morral, RAND’s Greenwald Family Chair in Gun Policy. “There’s a sense that this is low-hanging fruit that hasn’t been studied yet.”

He said he was confident that, as on tobacco and climate change, public opinion on gun violence would respond to “a slow and ultimately insurmountable mass of evidence.”

Dr. Murthy said he was spurred to action by a rising gun death toll, especially among children. In 2020, gunshot wounds surpassed car accidents as the leading cause of death for children and adolescents in the United States.

In recent years, there has been an increase in the number of new gun owners, and with it an alarming rise in youth gun suicides. In cases where children and adolescents died from gun violence, accidental gunshot woundsResearch by the Centers for Disease Control and Prevention found that about three-quarters of firearms used were loaded and stored unlocked.

“We now need to look at this for what it is: a problem for children,” said Dr. Murthy. As he traveled around the country, he said, he had frequently heard from students who feared being shot in their neighborhood or at school.

“As a country, we are actually more united than I think we understand,” he said.

Dr. Murthy’s advice on gun violence was his second splashy move in two weeks, coming on the heels of announcing that he would push for a warning label on social media platforms, advising parents that use of the platforms could harm adolescents’ mental health.

The surgeon general’s position largely functions as a bully pulpit, charged with communicating scientific findings to the public. Occasionally, warnings from the surgeon general have succeeded in changing the national conversation, as in a groundbreaking 1964 report on the health risks of smoking.

After that announcement, Congress voted to require printed health warnings on cigarette packages, and smoking began a 50-year decline. In 1964, about 42 percent of adults smoked daily; by 2021, that number was 11.5 percent.

Dr. Murthy said he saw a public health campaign against gun violence as a similar challenge, requiring a combination of education and awareness campaigns, culture changes and policy. “There was no one strategy that ultimately worked with tobacco,” he said. “That’s what I think here, too.”

Jonathan M. Metzl, a professor of sociology and psychiatry at Vanderbilt University in Nashville, argued in a recent book that public health strategies from “the tobacco wars, the belt wars, or other profit-versus-citizen contests of the last century” were ill-suited to the national debate over guns, which is so deeply rooted in political identity.

Dr. Metzl said he interviewed thousands of gun owners while researching his book, “What We’ve Become: Living and Dying in a Country of Arms,” ​​and concluded that they saw guns not as a health risk, but as a form of protection.

“Guns are not just a health problem, they are a democratic problem, a racial problem and a pluralistic problem,” he said. “The public health framework doesn’t address that. The framework is too limited for the problem we face.”

Dr. Mark Rosenberg, a gun violence researcher who helped found the CDC’s National Center for Injury Prevention and Control, said he consulted Dr. Murthy about the recommendation and welcomed it. Dr. Rosenberg said he was fired in the late 1990s amid pressure from Republicans opposed to the center’s research.

“Was I disappointed that it took 40 years for this idea to come to market? Yes, I was disappointed,” said Dr. Rosenberg, president emeritus of the Task for Global Health.

But he added that it often takes a long time for scientific work to be translated into policy. He said two centuries passed before preventive treatments for scurvy and smallpox were spread among the population and the diseases were eradicated.

“I am very pleased that the surgeon general has been able to release this report,” he said. To translate the recommendations into law, he added, “we have a huge battle ahead of us.”