Firearm-violence public health crisis ‘a wake-up call,’ say experts

In a recent advisory, U.S. Surgeon General Vivek H. Murthy declared America’s firearm violence a public health crisis that requires the nation’s immediate awareness and action.

Since 2020, firearm‑related injury has been the leading cause of death for U.S. children and adolescents, surpassing motor vehicle crashes, cancer and drug overdose and poisoning, according to the advisory. In 2022, 48,204 total people died from firearm‑related injuries, including suicides, homicides and unintentional deaths.

The Firearm Violence Advisory cited the work of several Northwestern faculty, and Northwestern Now spoke to three of them about the impact of gun violence and potential solutions.

Community violence intervention

“This report is another wake-up call for solutions to address the staggering toll gun violence continues to inflict on Americans each year,” said Andrew Papachristos, whose research on secondary traumatic stress among community violence interventionists in Chicago was cited in the advisory.

“Our research points to a way forward. It starts with an investment in street outreach workers, who use their lived experiences with gun violence to help break the cycle of violence.”

“These unarmed workers work in community violence intervention, or CVI, programs in communities that see the most violence. In one Chicago CVI program, we saw a double-digit decline in violence-related arrests. The participants stopped carrying guns, getting into fights and robbing or shooting people—calming communities and saving lives.”

However, the high levels of trauma and violence on the job takes a “massive toll” on the outreach workers, Papachristos said.

“One of our studies revealed more of them were shot at while working on the job (12%) than police officers (1%). Another uncovered that 94% of outreach workers reported signs of secondary traumatic stress. So, to stop this public health crisis, we also have to take care of—and invest in—these critical frontline workers and build a community-focused violence prevention infrastructure to support them.”

Papachristos is also the director of the Institute for Policy Research, the John G. Searle Professor of Sociology and director of the Center for Neighborhood Engaged Research and Science.

Safe firearm storage

“We have things that work; we need to implement them and study them,” said Rinad Beidas, whose research on long-term consequences of youth exposure to firearm injury was cited in the advisory. The report calls out the need to conduct implementation research to improve effectiveness of prevention strategies.

Beidas has published work on implementing a safe firearm storage program via pediatrician visits and will do a larger trial with that program. “This is a non-political, relatively inexpensive and scalable approach to save lives.”

Beidas is chair of medical social sciences and the Ralph Seal Paffenbarger Professor of implementation in medical social sciences at the Feinberg School of Medicine.

Addressing compound issues

“While the nation’s youth and young adults are disproportionately affected by the daily occurrence of firearm deaths and non-fatal firearm injuries, our research shows youth who have been previously involved with the juvenile justice system had up to 23 times the rate of firearm mortality than the general population,” said Linda Teplin, whose research on crime victimization in adults with severe mental illness was cited in the advisory.

Teplin is vice chair for research and Owen L. Coon Professor of Psychiatry and Behavioral Sciences at Feinberg. She is also the primary investigator for the Northwestern Juvenile Project, the first large-scale longitudinal study of mental health needs and outcomes of delinquent youth after detention.

“To reduce firearm violence, a creative and multidisciplinary approach is needed, one that involves legal and health care professionals, street outreach workers and public health researchers. People who have been shot are more likely to be injured again or killed. Therefore, hospital emergency departments are ideal settings to implement violence prevention interventions.

“Poverty also begets violence. We need to address the compound issues that lead to urban blight, such as inadequate housing, unemployment and poor infrastructure.

“The public cares a great deal about mass shootings, but they comprise less than 4% of all firearm deaths. We need to focus on the other 96% of everyday violence that disproportionately affects poor, urban youth, especially people of color.”