Why it matters that the Surgeon General called firearm violence a public health crisis

The U.S. Surgeon General issued a warning this week about the deadly and profound toll gun violence takes on American communities. It's the first time the Office of the Surgeon General has issued a publication focused on guns.

Dr. Vivek Murthy's advisory published on Tuesday could draw more resources and attention to preventing firearm violence and influence public policy, experts and gun violence prevention advocates say.

The advisory "outlines the urgent threat firearm violence poses to the health and well-being of our country," Murthy said in a video statement announcing the advisory.

Surgeons general have historically used advisories to call attention to major public health issues and provide recommendations for how to address the issue, according to the office's website. Advisories are different from a full Surgeon General Report, which are longer, more comprehensive reviews conducted by experts on the surgeon general's behalf.

"A public health approach can guide our strategy and actions, as it has done in the past with successful efforts to address tobacco-related disease and motor vehicle crashes," the advisory reads.

In the 32-page advisory, Murthy calls firearm violence an "urgent public health crisis." He points to data showing an increase in gun deaths and injuries over the past two decades - noting results from a survey that found more than half of U.S. adults reported that they or their family members have experienced some kind of firearm violence.

"As a doctor, I've seen the consequences of firearm violence up close in the lives of the patients I've cared for over the years," Murthy said. "These are moms and dads, sons and daughters, all of whom were robbed of their physical and mental health by senseless acts of violence."

He also points out that firearm violence is the leading cause of death for adolescents ages 1 to 19. The advisory also outlines the cascading effects of firearm violence, such as trauma, that pervades beyond the wounded and the killed.

"There are many experts and leaders who work tirelessly each day to protect families and communities from the trauma and suffering that have become all too common in our country," the advisory reads. "But it will take more - the collective commitment of the nation - to turn the tide on the crisis of firearm violence in America."

The advisory notes a gun in the home puts all household members at a greater risk of being a victim of homicide and suicide. An unlocked gun in the home is associated with a higher risk of suicide and unintentional injury among children, according to the advisory.

Murthy also outlines in the advisory a public health approach to firearm violence "designed to prevent and reduce harm by changing the conditions and circumstances that contribute to risk of firearm violence … as well as the reverberating mental health and emotional impacts."

That includes:

• Research investments to improve data sources and collection and expand research that evaluates prevention strategies.
• Community risk reduction and prevention strategies to implement community violence interventions and address social determinants that increase the risk of firearm violence. Those determinants include housing, education, health care, and employment and economic opportunities.
• Laws that can prevent firearm violence such as secure storage, background checks, extreme risk prevention law, and bans on assault weapons and large-capacity magazines.
• Access to mental health care and other trauma-informed resources.

Why this matters

While the surgeon general doesn't have authority to enact policies, his recommendations can influence the government agencies that do.

"This action is far from merely symbolic," said Dr. Joseph Sakran, the chief medical officer for the gun violence prevention nonprofit Brady. "It will have real effects that help reduce the over 120,000 people each year who suffer gunshots, too many of whom tragically make their way into our nation's hospital beds, emergency rooms, and morgues each and every day."

Those real effects could include stronger gun laws, such as expanding background checks and banning assault weapons, Sakran said. He also pointed out that the advisory advocates for safe storage practices, which is something health care professionals can do with their patients.

"The report also calls for rigorous data collection and research to better understand root causes of gun violence and the impact on communities," Sakran said. "This kind of research, which is critical to inform solutions, has long been stalled because of the gun lobby's success in stifling federal funding."

The health care community and gun violence prevention movement has been calling for this declaration for years, Sakran said.

"As a trauma surgeon, I see firsthand the devastating impact gun violence has in my emergency room," Sakran said. "The Surgeon General's historic report recognizes that reality, and advances research-driven solutions to meet the scale of this public health crisis for our patients, communities, and country."

In 1964, the surgeon general issued a report highlighting the impact of smoking on health. That report led to the development of better policy and changes in public opinion and behaviors around tobacco use, Sakran said.

The American Academy of Family Physicians issued a statement in support of the Surgeon General's declaration. The Academy has characterized firearm violence as an epidemic for more than a decade.

"Since 2020, firearms have become the leading cause of death in children and adolescents in the U.S.," reads the statement. "We are alarmed firearm-related suicide rose by nearly 20% and that over half of American students worry about a school shooting. These are trends that cannot be allowed to continue and further point to the urgent need for policies that mitigate firearm violence."