Standing AFFIRM for the public health approach to firearm injury

Those of us working on the frontline of emergency medicine are painfully aware that more than 100 lives are lost each day to firearm injury, and that for every life lost, two more are injured. Many of those injured face a lifetime of disability. Both firearm homicide and suicide have increased in recent years, with firearm suicides reaching their highest ever recorded level in 2017.

Firearm injury is an American epidemic. An epidemic for which we have no vaccine. Why? Because of the lack of the public health approach.

Our country faces an ongoing drought in federal funding for gun violence prevention research. Publications in both JAMA and Health Affairs highlight the dearth of federal funding for firearm injury prevention research: overall funding is less than 2% of what would be predicted given the burden of injury; and funding for pediatric firearm injury research is only 3% of what would be predicted (despite firearms being the 2nd leading cause of death for American children).

Without research, there is a corresponding absence of evidence-based practice. Although some studies point to promising screening and interventions, our work and others’ has shown that most physicians do not know how to reduce firearm injury risk among their patients. Among those who do know what to do, very few feel comfortable doing so. And even fewer actually take the simple actions (screening at-risk patients, providing linkages to resources) that are needed.

The American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) is a 501(c)(3) non-partisan non-profit led by healthcare professionals and researchers working together to change this epidemic through the public health approach. We are directly funding gun violence prevention research, including grants in collaboration with ACEP and the Emergency Nurses Association. We are funding work to develop best practices for curricula for health professionals. And we are disseminating the knowledge that we have: in collaboration with our 24 professional society partners and 40+ advisory board and research council members, we have trained thousands of professionals in best practices in firearm injury prevention. We are doing this in collaboration with not just healthcare and public health professionals, but also community groups and gun owners. To create change, we must all step up to the plate.

Together, we can move from reparative care to preventive care. At AFFIRM, we are honored to help spread this message beyond our individual professional societies and hospitals - and to create societal change. There may not be a vaccine for firearm injury – but we can help create one.

To learn more about the work of AFFIRM and how you can contribute as an emergency provider interested in firearm injury prevention, visit the organization’s website.

Megan L. Ranney, MD, MPH

Tracy Hauver, MPH