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HANDGUN INJURY REDUCTION

Policy Date: 1/1/1998
Policy Number: 9818

The American Public Health Association,
Recognizing that handgun deaths and injuries-including suicides, suicide attempts, homicides, assaults, and unintentional shootings-constitute a major public health problem in the United States;1-20 and
Noting that the United States long history of weak federal gun laws and widely varying state and local laws has allowed a vast illicit gun market to flourish, greatly hindering gun violence prevention efforts;21 and
Understanding that the United States lacks a comprehensive licensing and registration system which would help to curtail the movement of handguns into the illegal market;22-23 and
Recognizing that the collection and analysis of detailed information about handgun injuries and the movement of handguns in the population is essential to the design and evaluation of injury prevention interventions;24-25 and
Acknowledging that handguns are the only consumer product made or sold in the United States, other than tobacco products,1 the manufacture and design of which is not regulated by any federal agency;26 and
Recognizing that handgun manufacturers, in the absence of any regulatory requirements, have failed to incorporate into the design of their products feasible, life-saving safety improvements which would prevent the discharge of handguns by any unauthorized user, thereby greatly reducing the number of deaths of and injuries to children in suicides and unintended shootings and the attractiveness of stolen and illegally acquired handguns;27 and
Acknowledging the lack of public awareness of the danger of guns at home and that a gun in the home28 is much more likely to be used to kill a family member or friend than to be used in self-defense;29 and
Understanding that the prevention of handgun-related injury and death, like other major public health problems, requires action at all levels of government and by all sectors of society;30 therefore,
1. Supports the enactment of federal, state, and local laws designed to limit access to handguns,31-33 to limit handgun purchases,34,35 including those at gun shows,36 to limit access to high-powered assault pistols with no legitimate sporting or hunting purpose,37,38 and to reduce access to permits-to-carry a concealed handgun;39-44
2. Recommends the creation and evaluation of comprehensive national, state, and local data collection systems to facilitate research on the prevention of handgun-related fatalities and injuries and the movement of handguns within the population;45-47
3. Recommends regulation of the gun industry in order to reduce handgun injury attributable to industry practices, including the design, marketing, and distribution of handguns;48-56
4. Encourages the creation and evaluation of community- and school-based programs (including coalitions) targeting the prevention of handgun injuries including suicides, homicides, and assaults;57
5. Recommends education on the dangers of handguns, especially in the home for public health and mental health professionals; and
6. Recommends that health and mental health providers advise their clients about the hazards of handguns.58-61

References


  1. In August 1996, a final rule was published in the Federal Register establishing that the Federal Drug Administration will regulate the sale and distribution of cigarettes and smokeless tobacco to children and adolescents. The regulation is currently on appeal. Source: http: www.cdc.gov/tobacco and the National Center for Tobacco-Free Kids.

  2. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: US Dept. of Health and Human Services, Public Health Service, 1990:226-247.

  3. Karlson TA, Hargarten SW. Reducing Firearm Injury and Death: A Public Health Sourcebook on Guns. New Brunswick, NJ: Rutgers University Press, 1997:1-11.

  4. Centers for Disease Control and Prevention. Rates of homicide, suicide, and firearm-related death among children-26 industrialized countries. MMWR Morb Mortal Wkly Rep. 1997;46:101-105.

  5. Anderson RN, Kochanek KD, Murphy SL. Report of final mortality statistics, 1995. Mon Vital Stat Rep. 1997:55 and 65.

  6. American College of Physicians. Preventing firearm violence: a public health imperative. Ann Intern Med. 1995;122:311-313.

  7. Adler KP, Barondess JA, Cohen JJ, Farber SJ, Foreman S, Gambuti G, et al. Firearm violence and public health: limiting the availability of guns. JAMA. 1994;271:1281-1283.

  8. Annest JL, Mercy JA, Gibson DR, Ryan GW. National estimates of non-fatal firearm-related injuries: beyond the tip of the iceberg. JAMA. 1995;273:1749-1754.

  9. Centers for Disease Control and Prevention. Suicide among children, adolescents, and young adults-United States, 1980-1992. MMWR Morb Mortal Wkly Rep. 1995;44:289-291.

  10. Cummings P, Koepsell TD, Grossman DC, Savarino J, Thompson RS. The association between the purchase of a handgun and homicide or suicide. Am J Public Health. 1997;87:974-978.

  11. Kellermann AL, Rivara FP, Somes G, et al. Suicide in the home in relation to gun ownership. N Engl J Med. 1992;327:467-472.

  12. Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP. The presence and accessibility of firearms in the homes of adolescent suicides. JAMA. 1991;266:2989-2995.

  13. Kellermann AL, Rivara FP, Rushforth NB, et al. Gun ownership as a risk factor for homicide in the home. N Engl J Med. 1993;329:1084-1091.

  14. Cook PJ. The technology of personal violence. In: Crime and Justice: A Review of Research. Chicago, IL: The University of Chicago Press; 1991.

  15. Saltzman LE, Mercy JA, O'Carroll PW, Rosenberg ML, Rhodes PH. Weapon involvement and injury outcomes in family and intimate assaults. JAMA. 1992;267:3043-3047.

  16. Kellermann AL, Reay DR. Protection or peril? an analysis of firearm-related deaths in the home. N Engl J Med. 1986;314: 1557-1560.

  17. Sinauer N, Annest JL, Mercy JA. Unintentional, nonfatal firearm-related injuries. JAMA. 1996;275:1740-1743.

  18. United States General Accounting Office. Accidental Shootings: Many Deaths and Injuries Caused by Firearms Could Be Prevented. Washington, DC: United States General Accounting Office; 1991.

  19. Miller TR, Cohen MA. Costs of gunshot and cut/stab wounds in the United States, with some Canadian comparisons. Accid Anal Prev. 1997;29:329-341.

  20. Kizer KW, Vassar MJ, Harry RL, Layton KD: Hospitalization charges, costs, and income for firearm-related injuries at a university trauma center. JAMA. 1996;273:1768-1773.

  21. Max W, Rice DP. Shooting in the dark: estimating the cost of firearm injuries. Health Aff. 1993;12:171-185.

  22. Sugarmann J, Rand K. Cease Fire: A Comprehensive Strategy to Reduce Firearms Violence. Washington, DC: Violence Policy Center, 2d ed., 1997.

  23. Karlson TA, Hargarten SW. Reducing Firearm Injury and Death: A Public Health Sourcebook on Guns. New Brunswick, NJ: Rutgers University Press, 1997:116-123.

  24. Cook PJ, Cole TB. Strategic thinking about gun markets and violence. JAMA. 1996;275:1765-1767.

  25. Committee for the Study of the Future of Public Health. Future of Public Health. Washington, DC: Institute of Medicine, 1988:113.

  26. Teret SP. The firearm injury reporting system revisited. JAMA. 1996;275:70.

  27. Sugarmann J, Rand K. Cease Fire: A Comprehensive Strategy to Reduce Firearms Violence. Washington, DC: Violence Policy Center, 2d ed., 1997:26.

  28. Karlson TA, Hargarten SW. Reducing Firearm Injury and Death: A Public Health Sourcebook on Guns. New Brunswick, NJ: Rutgers University Press, 1997:130.

  29. Johns Hopkins Center for Gun Policy and Research and National Opinion Research Center. 1996 National Gun Policy Survey: Questionnaire with Weighted Frequencies. Baltimore, MD: Johns Hopkins Center for Gun Policy and Research; March 1997:3.

  30. Kellermann AL, Reay DR. Protection or peril? an analysis of firearm-related deaths in the home. N Engl J Med. 1986;314: 1557-1560.

  31. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: US Dept. of Health and Human Services, Public Health Service, 1990:85-88.

  32. Cummings P, Grossman DC, Rivara FP, Koepsell TD. State gun safe storage laws and child mortality due to firearms. JAMA. 1997;278:1084-1086.

  33. Cook PJ, Cole TB. Strategic thinking about gun markets and violence. JAMA. 1996;275:1765-1767.

  34. Teret SP, Baker SP. Children shooting guns: a failure in product design. Inj Prev. 1995;1:139.

  35. Weil DW. Denying handguns to prohibited purchasers: quantifying the impact of the Brady Law. Washington, DC: Center to Prevent Handgun Violence. 1996.

  36. Weil DW, Knox RC. Effects of limiting handgun purchases on interstate transfer of firearms. JAMA. 1996;275:1759-1761.

  37. Rand K. Gun Shows in America: Tupperware Parties for Criminals. Washington, DC: Violence Policy Center, 1996.

  38. Roth JA, Koper CS. Impact Evaluation of the Public Safety and Recreational Firearms Use Protection Act of 1994. Washington, DC: The Urban Institute; 1997.

  39. Weil DW, Knox RC. The Maryland ban on the sale of assault pistols and high-capacity magazines: estimating the impact in Baltimore. Am J Public Health. 1997;87:297.

  40. McDowall D, Loftin C, Wiersema B. Easing concealed firearms laws: effects on homicide in three states. Journal of Criminal Law and Criminology. 1996;30:395-426.

  41. Lott JR, Mustard DB. Crime, deterrence, and right-to-carry concealed handguns. Journal of Legal Studies. 1997;XXVI:1-68.

  42. Webster DW, Vernick JS, Ludwig J, Lester KJ. Flawed gun policy research could endanger public safety. Am J Public Health. 1997;87:918-921.

  43. McDowall D, Wiersema B. The incidence of defensive firearm use by US crime victims, 1987 through 1990. Am J Public Health. 1994;84:1982-1984.

  44. Kleck G, Gertz M. Armed resistance to crime: the prevalence and nature of self-defense with a gun. Journal of Criminal Law and Criminology. 1995;86:150-187.

  45. Hemenway D. Survey research and self-defense gun use: an explanation of extreme overestimates. Journal of Criminal Law and Criminology. 1997.

  46. Teret SP. The firearm injury reporting system revisited. JAMA. 1996;275:70.

  47. Committee for the Study of the Future of Public Health. Future of Public Health. Washington, DC: Institute of Medicine, 1988:113.

  48. Bureau of Alcohol, Tobacco, and Firearms. Crime Gun Trace Analysis Reports: the Illegal Youth Firearms Market in 17 Communities. Washington, DC: US Dept. of Treasury, Bureau of Alcohol, Tobacco, and Firearms; 1997.

  49. Sugarmann J, Rand K. Cease Fire: A Comprehensive Strategy to Reduce Firearms Violence. Washington, DC: Violence Policy Center, 2d ed., 1997.

  50. Center to Prevent Handgun Violence. Policy Statement on Gun Industry Reform. Washington, DC: Center to Prevent Handgun Violence. 1997

  51. Wintemute G. The relationship between firearm design and firearm violence. JAMA. 1996;275:1749-1753.

  52. Children's Safety Network. A Consumer Protection Approach to Firearm Safety. Newton, MA: Children's Safety Network, National Injury and Violence Prevention Center; February 1997.

  53. Teret SP, Wintemute GJ. Policies to prevent firearm injuries. Health Aff. 1993;96-108.

  54. Polston MD, Weil DS. Unsafe by design: using tort actions to reduce firearm-related injuries. Stanford Law and Policy Review. 1997;8:13-24.

  55. Teret SP, Baker SP. Children shooting guns: a failure in product design. Inj Prev. 1995;1:139.

  56. United States General Accounting Office. Accidental Shootings: Many Deaths and Injuries Caused by Firearms Could Be Prevented. Washington, DC: United States General Accounting Office, 1991.

  57. Brady S. Perspective on handguns: a way to cut the deadly toll. Los Angeles Times. November 29, 1996:B7.

  58. Moermond M, Hertz L. Gun Violence Prevention: A Study of Program Options from Twelve Cities. Saint Paul, MN: Saint Paul City Council, Council Investigation and Research Center; August 1997.

  59. Bass JL, Christoffel KK, Widome M, et al. Childhood injury prevention counseling in primary care settings: a critical review of the literature. Pediatrics. 1993;92:544-550.

  60. Webster DW, Wilson ME, Duggan AK, Pakula LC. Firearm injury prevention counseling: a study of pediatricians' beliefs and practices. Pediatrics. 1992;89:902-907.

  61. Haught K, Grossman D, Connell F. Parents' attitudes toward firearm injury prevention counseling in urban pediatric clinics. Pediatrics. 1995;96:649-653.

  62. Webster DW, Wilson ME, Duggan AK, Pakula LC. Parents beliefs about preventing gun injuries to children. Pediatrics. 1992;908-914.