Violence is both a cause and consequence of social inequality. 7 With adequate federal budgetary allocations to fund and facilitate research on firearm injury, the public health community can work collaboratively with lawmakers to assemble a robust evidence base to direct the most appropriate policy directions, and develop the case for action.įraming firearm injury as a public health issue Research funding for firearm-related death, the leading cause of death in this age group, is not commensurate with the relative harm caused, and only US$12 million is allocated for it per year, compared with $88 million allocated for motor vehicle crashes and $335 million for neoplasms. 6 We recognise that the health impacts do not simply concern the loss of life longer term physical and mental health consequences for survivors are also relevant, yet often unmeasured, dimensions of the firearm-related burden.ĭespite this burden in young people, research agendas have not adequately aligned their funding and priority towards this area. 1 In 2017, more than 1 billion firearms were estimated to be in global circulation, 857 million (84♶%) of which were owned by civilians. The mortality rate from physical firearm-related violence only marginally decreased from 2♴1 deaths per 100 000 people (95% CI 2♳2–2♵2) in 1990 to 2♲9 deaths per 100 000 people (2♱2–2♴9) in 2019. The 30-year epidemiology of firearm violence across 204 countries and territories suggests little progress has been made during this time. This inaction is reflected at the global level. 5 Although many causes of death in adolescents and young adults have declined in the past four decades, deaths from firearms have remained stagnant, partly reflecting its neglect from public health policy and its framing as a primarily electoral affair coloured by partisan politics. In 2020, firearm-related injury became the leading cause of death in the USA among those aged 1–19 years (83% increase since 2013), surpassing motor vehicle crashes, malignant neoplasms, and drug overdose and poisoning. 4 Additionally, the causes of some firearm injuries might have been misclassified the role of social and cultural factors that determine suicidal use of firearms are usually not well captured and the extent to which homicide rates can be driven by illegal rather than legal ownership are poorly accounted for. For example, method-specific suicide and homicide data are only reported by a few countries, hence estimates are based on few data, inviting the potential for underestimation, especially in data-poor regions. 3Īlthough these data represent the most reliable epidemiological estimates, several factors create bias towards the under-reporting of firearm injuries. 2 Given that only 10% of firearm mortality occurs in conflict situations-a statistic that is likely to be an underestimation-this is a devastating toll from a preventable public health issue. 1 The highest rate of firearm ownership is also in the USA, accounting for 40% of global ownership. 1 Most of the lives lost were men (88%) in Brazil, Colombia, El Salvador, Guatemala, Mexico, the USA, and Venezuela. In the past decade, violent, suicidal, and unintentional uses of firearms have claimed more than 2♷5 million lives (95% CI 2 544 934–2 988 962). Without action, firearm-related injury will prevail as a post-pandemic epidemic that should not exist.
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