Public health approach needed to reduce firearm injuries

Joseph V. Sakran, MD, MPH, MPA, FACS
Joseph V. Sakran, MD, MPH, MPA, FACS

Joseph V. Sakran, MD, MPH, MPA, FACS, was just a teenager when an errant bullet entered his throat. The life-changing and life-threatening event ignited his passion to curb gun violence.

On Monday, Dr. Sakran and a panel of experts urged attendees—gun owners and non-gun owners alike—to put politics aside and take a public health approach to reducing firearm-related injuries and death at the session, Firearm Injuries in the United States: A Public Health Approach Centered Upon Partnership and Engagement.

“This is a large, complex problem,” said co-moderator Ronald M. Stewart, MD, FACS, chair, department of surgery, University of Texas Health Science Center, San Antonio, who noted that on average 102 intentional violent deaths from firearms happen each day in the U.S. “We need to implement a public health approach. This requires engagement, responsibility, and partnership across disciplines, across geographic regions.”

Catherine W. Barber, MPA, directs the Means Matter Campaign at the Harvard T.H. Chan School of Public Health’s Injury Control Research Center. The initiative is designed to increase the number of suicide prevention groups that promote activities to reduce a suicidal person’s access to lethal means and to develop active partnerships with gun owner groups to prevent suicide.

“Thirty years ago, people had never heard of ‘designated driver’ or ‘friends don’t let friends drive drunk,’” she said. “Those concepts are ubiquitous now. How do we get that same kind of social norm, that same reach, the same ‘friends helping friends’ mentality applied to this issue?”

Ms. Barber described efforts to make lethal means counseling more comfortable for clinicians and gatekeepers within the gun community, embedding suicide prevention as a basic tenant of firearms safety.

Deborah A. Kuhls, MD, FACS, FCCM, Chair, American College of Surgeons (ACS) Committee on Trauma (COT) Injury Prevention and Control, provided an overview of firearm injury and intentional violence in the U.S. In 2016, there were 63,979 intentional violent deaths, and 58 percent of those were firearm-related, according to data she cited from the Centers for Disease Control and Prevention.

Selwyn O. Rogers, MD, MPH, FACS, professor of surgery, University of Chicago, IL, pointed to statistics in Chicago that shed light on structural violence. He said the average life expectancy in the Chicago Loop is 85 years of age, while the average life expectancy is only 69 in Washington Park, a neighborhood on Chicago’s South Side often associated with gun violence. Dr. Rogers also noted that 57 percent of gun homicide victims in the U.S. are African American, and African-American men are 10 times more likely to be shot and killed than white men.

Mass shootings covered in the press elevate the topic of gun violence, but they are only the “tip of the iceberg,” said Dr. Sakran, co-moderator of the session and director, emergency general surgery, and assistant professor of surgery, Johns Hopkins Medicine, Baltimore, MD. Statistically, 2 percent of gun deaths in the U.S. are the result of a mass shooting, according to data presenting during the session.

One in four women will experience intimate partner violence (IPV) over the course of their lifetime, according to Carrie A. Sims, MD, PhD, FACS, associate professor, University of Pennsylvania, Philadelphia. “Intimate partner violence is a real silent epidemic. We don’t talk about it,” said Dr. Sims, who is part of the ACS IPV Task Force designed to raise awareness in the surgical community of the incidence of IPV.

Brendan T. Campbell, MD, MPH, FACS, Donald Hight Endowed Chair of General Pediatric Surgery, Connecticut Children’s Medical Center, Hartford, discussed initiatives to prevent pediatric firearm injuries, and Gary L. Timmerman, MD, FACS, a general surgeon in Sioux Falls, SD, presented nine action steps to reduce firearm injuries created by the newly formed COT Firearm Strategy Team. To learn more, visit