The Physician's Position in Gun Violence Prevention February 28, 2018 Public Health 964 The United States continues to struggle with an epidemic of firearm violence. In 2015, there were 34,997 deaths in the U.S. caused by firearms, with firearm-related suicide deaths outnumbering firearm-related homicides by a large margin. Suicide was the 10th leading cause of death in 2015, and firearms accounted for almost half of those deaths, with older white men at the highest risk. Homicide is the leading cause of death for male and female African Americans aged 10–34 years, and firearm-related homicide is highest among young African American men. When combined, suicide and homicide were the fourth leading cause of years of potential life lost in the U.S. in 2015, and they accounted for the second and third leading causes of death, respectively, among adolescents and young adults. Mass shootings account for a small percentage of the firearm violence deaths, yet result in unnecessary morbidity and mortality and capture media and the public's attention. The economic burden of firearm death and injury is substantial, reaching $229 billion in aggregate costs and representing about 1.4 percent of U.S. gross domestic product. As a result, in 2017, the California Medical Association (CMA) convened the Firearm Violence Prevention Technical Advisory Committee (TAC), composed of physician experts. The TAC performed a comprehensive review and analysis of existing CMA policy, epidemiological data and current scientific research and developed a CMA position statement on the prevention of firearm violence (adopted by the CMA Board of Trustees on July 28, 2017). Through the TAC's work, CMA has identified several opportunities and resources that may aid physicians in addressing firearm violence as a public health issue: Take the pledge. Make a commitment to ask your patients about firearms when, in your judgment, it is appropriate, and follow through with support and resources to keep patients safe. Click here to see what you can do, as physicians, to help stop firearms violence. Educate yourself and your patients. Expanded education and training are needed to improve clinician familiarity with the benefits and risks of firearm ownership, safety practices, and communication with patients about firearm violence. There is a growing body of literature and resources available to initiate patient discussions and support patient education on firearm safety and storage, including best practices to reduce injuries, deaths and psychological trauma related to firearm use: Yes, you can: physicians, patients, and firearms6 Preventing gun violence: Moving from crisis to action7 Firearm Violence and Its Prevention: From Scientific Evidence to Effective Policy8 Gun Violence—Risk, Consequences, and Prevention9 Support research. The suppression of firearm research has stripped federal and state funding for data surveillance, research, and analysis, and prevented the advancement of evidence-based policies as benefitting other major public health issues. Discover the latest from the UC Davis Violence Prevention Research Program. Recognize warning signs and respond appropriately to patients with mental illness – they are at higher risk for suicide and to be a victim of violence, and access to firearms is associated with increased suicide risk. Understand the physician's legal obligations to report. Physicians should know their legal obligations for reporting specified medical conditions and the clinical interventions that might restrict a patient's ability to own or possess a firearm. CMA ON-CALL #3667: "Psychiatric Inpatients: Reporting Firearms Prohibition" CMA ON-CALL #3653: "Reporting Injuries by a Deadly Weapon, Criminal Act, Health Facility Neglect, or Emergency Department Violence."