Gun Deaths a Public Health Threat

More than 32,000 people die each year in the U.S. as a result of guns, making them the second leading injury-related cause of death after motor vehicle crashes. In response to the continued high number of gun fatalities and injuries, one of the nation’s largest physicians' groups has released recommendations aimed at preventing unnecessary deaths. The key, they say, is moving the conversation about gun violence beyond just politics and the courts.

“We concluded that firearm violence is not just a criminal justice issue, but also a public health threat that requires the nation’s immediate attention,” said Dr. Thomas Tape, chair of the American College of Physicians’ (ACP) Health and Public Policy Committee, in a press release. “As an organization representing physicians who have first-hand experience with the devastating impact of firearm-related violence, ACP has a responsibility to participate in efforts to mitigate needless tragedies.”

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Physicians Play a Role in Preventing Gun Violence

In a policy paper published today in the Annals of Internal Medicine, the ACP offered nine strategies for reducing firearm-related injuries and deaths, which include homicides, suicides, and accidental fatalities.

In addition to supporting universal criminal background checks prior to gun purchases and bans on the sale of automatic or semi-automatic weapons to civilians, the ACP sees a strong role for physicians in educating patients about gun safety.

“Physicians should counsel patients on the risks of having firearms in the home,” said Dr. Molly Cooke, president of the ACP, at a press conference, “particularly when children, teenagers, people with dementia, or people with mental illnesses or substance abuse disorders who are at increased risk of harming themselves or others are in that household.”

According to the ACP, one of the responsibilities of physicians is to counsel people to lead healthier lives—whether that means encouraging them to eat better and exercise more to reduce the risk of chronic diseases, or talking to them about gun safety to prevent accidental or intentional injuries.

This hinges on doctors' ability to speak openly with their patients. The ACP is also opposed to laws that inhibit this aspect of the physician-patient relationship, such as one passed in Florida—now pending a U.S. Court of Appeals decision—that would discourage physicians from starting conversations with their patients about gun ownership. 

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ACP Counsels Caution with Mental Health Restrictions

The ACP also emphasized the need for better treatment of people with mental health issues in order to reduce the risk of gun-related violence. 

“Reducing firearms-related violence requires keeping firearms out of the hands of those who may harm themselves and others,” said Tape, “but the College cautions against broadly including those with mental illness in a category of dangerous individuals.”

Certain mental health conditions—such as bipolar disorder, anxiety, and alcohol or other substance-abuse disorders—may increase the risk of violent behavior. However, because serious mental illness is relatively rare, the percentage of violent acts committed by people with mental health issues is low.

So the ACP recommends caution to avoid discouraging patients from seeking treatment out of fear of being labeled a potential threat to others, which can affect their ability to purchase guns.

“We’re talking about a very small proportion of people with mental illness, and so painting that entire group with a broad brush we feel is not a good idea,” said Tape. "It’s one of the areas that clearly begs for more research, so we need better predictors” for which patients may pose a threat.

These days, the conversation about gun violence is usually tied to mass shootings, such as those at Fort Hood, Sandy Hook Elementary School, and elsewhere. The ACP, however, emphasizes that death and injuries due to guns occur every day in the U.S. for a variety of reasons, and that warrants a multi-faceted approach to dealing with the issue.

“The mass shooting kinds of episodes are obviously horrible, attract our attention, and currently spark conversation about firearms violence,” said Cooke. “But one of the points that we make in the paper is that every day there are 88 firearm-related deaths.”