Preventing Firearm Injury Through Purpose and Policy: 2023 Review
Table of Contents
Author(s)
Taylor Rosenbaum
M.D., FAAPKatarina Reyes
Research Manager, Center for Health and BiosciencesNeha Kumar
M.D.Saathwik N. Saladi
Undergraduate student at Rice UniversityAsya Ardawatia
Social activist, journalist, and student at Dulles High School, Sugar Land, TXSaami Baig
Co-executive director of March For Our Lives Houston, youth advocateBindi Naik-Mathuria
Division Chief of Pediatric Surgery in the Department of Surgery at the University of Texas Medical Branch (UTMB)Sandra McKay
Huffington Fellow in Child Health PolicyShare this Publication
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Taylor Rosenbaum, Neha Kumar, Saathwik N. Saladi, Katarina Reyes, Asya Ardawatia, Saami Baig, Bindi Naik-Mathuria and McKay, Sandra. Preventing Firearm Injury through Purpose and Policy: A Review. (Houston: Rice University’s Baker Institute for Public Policy, December 20, 2023), https://doi.org/10.25613/8RTE-1T34.
Overview
On June 2, 2023, the Baker Institute Center for Health and Biosciences hosted its second annual Firearm Injury Prevention and Safety (FIPS) symposium. The symposium brought together Houston doctors, researchers, state legislators, and community partners, with the ultimate goal of highlighting local research efforts in firearm injury prevention. Presentations ranged from research findings and anecdotal evidence to legislative policies that can aid in firearm injury prevention.
This comprehensive report summarizes the topics discussed at the symposium and sets out policy recommendations that emerged from discussions held at the event.
Keynote 1 — Violence: Addressing the Root Cause
Dr. Rochelle Dicker was the first keynote speaker. She is a trauma surgeon at University of California San Francisco, founding director of the San Francisco Wraparound Project, and advisory board chair of the Health Alliance for Violence Intervention (HAVI). Her presentation delved into the profound impact of social determinants of health and outlined strategies for effective intervention. Dicker emphasized that individuals facing high-risk situations are often confronted with an array of socioeconomic disparities, such as a lack of access to stable housing, social support, and educational opportunities. The lack of access to these crucial resources directly contributes to adverse health outcomes. She also highlighted the three spheres of adverse childhood and community experiences: household, community, and physical environment. Together, these can foster the accumulation of toxic stress. When not addressed, this toxic stress negatively affects learning, behavior, brain development, and metabolic systems.
To effectively address these social determinants and meet the social needs of high-risk and vulnerable populations, Dicker stressed the importance of striving for community-wide change. Beyond attending to individual social needs, it is crucial to improve community conditions by implementing laws that create positive and empowering environments that support the overall health of all individuals. This can be accomplished through ISAVE (Improving Social Determinants to Attenuate Violence) strategies, which involve:
- Developing a curriculum for trauma-informed care.
- Integrating social care into the trauma system.
- Creating a roadmap for investment in disenfranchised communities.
Furthermore, community violence intervention programs with an approach grounded in equity should focus on high-risk individuals by using credible messengers — neighborhood leaders or individuals with relevant life experience whose role is to help transform attitude and behavior around violence — and include data from multiple sources vetted for bias. These methods will collectively contribute to creating a lasting impact on the well-being of the community. While achieving true equity will require time, we can work towards dismantling structural barriers through hospital-based violence intervention programs, increased investment aimed at reducing poverty, and a shift in the prevailing narrative that prioritizes survival over health. The Health Alliance for Violence Intervention (HAVI) is the only national organization that works to address the cycle of systemic and interpersonal violence in communities. Its efforts revolve around advancing hospital-based violence intervention programs (HVIPs) by conducting research, influencing policy making, and providing support for the expansion of this model across the communities most heavily impacted by violence. Dicker noted that by taking these measures, we can promote community health and sustain the progress we have already achieved. She ended with a quote by Vaclav Havel, the first president of the Czech Republic, “Hope … an orientation of the spirit, an orientation of the heart.”
Panel 1 — Community Gun Violence
Community gun violence refers to violence between individuals who are not intimately related. The first panel of the symposium featured research-based initiatives implemented in the Houston area that are directed at intervening in community gun violence. The moderator, Dr. Bindi Naik-Mathuria, a pediatric trauma surgeon, shared data-driven research showing how community gun violence has increased significantly throughout Harris County, with both pediatric and adult injuries and deaths due to firearms rising steadily since 2018. At the national level, suicide comprises the majority of deaths due to firearms — whereas in Harris County, homicide is the leading cause of mortality due to firearms.
To address this rise in community violence, a diverse expert panel offered recommendations for community violence intervention programs using multifaceted approaches.
Dr. Shiree Berry, a trauma surgeon and medical director in the Houston Area, noted an increase in recidivism — the same patients returning with another firearm injury — that have been exposed to firearm related injuries. She took the initiative to reduce firearm related trauma by starting one of the first hospital linked violence intervention programs. Partnering with the Harris County Public Safety Department, Berry was able to extend this program to over 90 patients, ranging in age from 15 to 65. She pointed out the importance of implementing a more centralized HVIP system, given that Houston is the fourth largest city in the nation.
Abbie Kamin, Houston city council member and chair of Houston’s Public Safety and Homeland Security Committee, works to amplify existing community violence intervention programs and strives to provide materials for parents that spread information regarding safe firearm storage. Kamin took note of a systematic problem: Witnessing gun violence or experiencing a threat instills residual trauma in civilians. She also pointed out that although mental health is heavily emphasized as the main cause of gun violence, it is only actually linked to 4% of violent cases. Kamin stressed that while there should still be efforts to address violence caused by mental health, substantial support is also needed for data systems that enable law enforcement to recognize and address patterns in firearm related crimes. In addition, she recognized considerable challenges to addressing gun violence through policy. The Texas court system has systematically upheld permitless carry and struck down red flag/emergency risk protection orders (ERPO) laws using reasoning that Kamin felt ignored the complex issues involved.
Houston City Deputy Inspector General Crystal Okorafor oversees the One Safe Houston Program and multiple Houston violence intervention programs. She recounted how the One Safe Houston Program aids law enforcement in addressing mental health related emergencies. By substituting officers with mental health clinicians, major crises can be averted through informed engagement. Okorafor also promoted Houston’s Gun Buyback program and emphasized that to develop a comprehensive approach to gun violence prevention, all members of the community must be integrated into the solution. If communities that frequently experience gun violence are not thoroughly engaged with violence intervention resources, then attempts to address gun violence would be heavily undermined.
Larry Satterwhite, executive assistant chief of the Houston Police Department (HPD), acknowledged that HPD is understaffed and is faced with increasingly troubling instances of gun violence: mass shootings, illegal gun modifications, and dangerous encounters. Satterwhite noted that low-income neighborhoods face significant crime that is becoming increasingly difficult to address. Finally, he mentioned that the court backlog considerably hampers Houston’s ability to seek justice on firearm related crimes — over 40,000 felony cases are waiting to be dealt with.
Finally, Dicker praised the idea of coalition building in generating solutions for gun violence. She delineated her experiences working in California on hospital violence intervention programs, noting that San Francisco had a lower number of trauma centers because of the city’s population density. She remarked that as Houston has multiple pockets of violence spread throughout the city, it needs violence intervention programs in small local hubs, each tailored to the specific area. Dicker further touched upon the importance of having a credible messenger program in Houston. Finally, she mentioned that drawing on principles of collaboration and data sharing is essential in creating strong violence intervention programs that are able to work in tandem to generate a stronger, longer lasting impact.
Panel 2 — Domestic Violence
This session began with an important statement from Dr. Chad Wilson, a trauma surgeon at Baylor College of Medicine, who likened domestic violence in this country to a disease that has not only an epidemiology to be studied but a way to be treated and controlled. The panelists then explored the Harris County data on firearms and intimate partner violence (IPV).
Amy Smith of the Harris County Domestic Violence Coordinating Council indicated that IPV is the leading cause of homicide death in women. In 2021, 204 Texans were killed by IPV and 75% of those deaths were due to firearms. Similarly, in Harris County, there were 46 deaths by IPV in 2021 and 74% of those involved firearms. Most of the firearms used in IPV homicides are stolen and are difficult to track. Her message was that we must do a better job of incentivizing the reporting of stolen guns and improving tracing mechanisms to help save lives. Smith also mentioned that while Harris County has some great resources, there are not nearly enough to serve those in need. For example, lack of bed availability leads to domestic violence shelters in Harris County having a 70% turn away rate.
Additionally, Smith advocated for having honest discussions with people who are in abusive relationships. Many do not know what a healthy relationship looks like and thus do not realize they are victims of abuse. Healthcare providers and community organizers should be teaching about healthy relationships, helping victims recognize they are in unsafe situations, and supporting them to safely leave the relationship. They should also impress upon victims that abusive relationships could end in their death and work with victims to help them safely leave the relationship.
Aimee Turney, who serves as the gun safety issue chair for the League of Women Voters of Texas, highlighted the importance of advocating for the survivors of IPV in the legislative setting, using non-partisan, fair, and evidenced based information. In politics, one must be both proactive and reactive:
- Proactive — seeking to enact laws that prevent easy access to guns.
- Reactive — the “raise the age” bill that was a response to the Uvalde mass shooting (it sought to raise the minimum age to purchase semiautomatic rifles from 18 to 21).
Another facet: Turney is a survivor of IPV. She shared poignant personal perspectives about the fear of reporting intimate partner violence because of concerns about a lack of resources or retaliation from the abuser. She encouraged community organizations and healthcare providers to be a source of knowledge about these resources. She also encouraged everyone, not just domestic violence prevention organizations, to advocate for better resources for victims and stronger firearms and IPV laws.
Christy Graves, director of operations and emergency medical services in Harris County, discussed the importance of recognizing signs of abuse in the clinical setting and advocating for victims. She highlighted how emergency medical services (EMS) are sometimes called to houses struggling with IPV for reasons other than the core issue of abuse. Those in healthcare need to be highly vigilant to recognize the subtle signs of abuse even if the primary concern of the visit seems unrelated. Especially for people who call EMS or often use other emergency services, responders should always consider the possibility of abuse, and directly ask about safety in the household multiple times. Graves supported keeping data on people using these services to gain better insight into those who might be in an abusive relationship.
The panelists all mentioned the economic burdens that IPV places on the community, which can include things like a victim losing wages from missing work, not being able to establish credit or to hold a steady job. In addition to saving lives, community resources for victims and interventions that prevent IPV could also save money.
Panel 3 — Unintentional Injury
Unintentional injuries by firearms are completely preventable, yet they cause around 430 deaths each year. Males aged 10–29 experience the highest rate of unintentional injuries — usually while playing with guns or hunting. Around 25% of these injuries and deaths are associated with alcohol. The panel members discussing unintentional injury ranged from community organization leaders to medical professionals and government leaders.
Sarah Beth Abbott is the injury prevention and outreach education coordinator at Children’s Memorial Hermann Hospital. As 75% of unintentional firearm deaths occur in the home and 47% result from playing with a gun, she focused on the importance of safe storage of firearms. With the support of her hospital, Abbott and her team created firearm safety kits for the community. Each kit contained:
- A firearm lock.
- A firearm safety fact sheet.
- Information about the suicide hotline number, 988.
- A notepad detailing questions to ask before playdates, including asking about firearms in the home.
The Houston community was very receptive, and 10,000 firearm safety kits were distributed within three months.
Nicole Golden is the executive director of Texas Gun Sense. She and her organization focus on preventing gun violence through policy actions. Many issues surrounding firearm violence prevention are non-partisan, and therefore it should be possible to make policy changes that can help keep Texans safe. She focused on the importance of Emergency Risk Protection Orders (ERPOs): For ERPOs to be effective we need safe and trustworthy places to temporarily store firearms when people are at risk to themselves or others. Golden encouraged the crowd to normalize conversations about gun safe storage and also to teach others to have these sometimes difficult conversations. Lastly, she acknowledged that during the recent legislative session there was some positive news: an amendment to the Texas Education Code by House Bill 3, requiring all school districts in Texas to be involved in providing firearm safe storage information to parents.
The main goal of the Honorable Kim Ogg, the Harris County district attorney, was deterring unsafe firearm storage practices through awareness and prosecution. Many of the firearms used in crimes are stolen, so increasing the amount of safe storage would reduce opportunities for theft. She felt that more public knowledge of the Firearm Access Prevention and Safe Storage Laws is needed and that people would be encouraged to follow firearm laws if they were aware of the penalties for not doing so.
Irma Ugalde is an associate professor of pediatric emergency medicine and the director of pediatric emergency medicine research at UTHealth Houston. She noted that since the COVID-19 pandemic, emergency rooms have seen a 30% increase in firearm injuries to children, but nevertheless there are real steps those in health care can take. Parents want to learn how to keep their kids safe and conversations about firearm safety with their healthcare providers can help. Ugalde urged that medical trainees be given instruction early in their training about how to have these conversations.
Keynote 2 — School Behavioral Threat Assessments
Shawna White, a senior lead in school safety for WestEd’s Justice and Prevention Research Center, presented on school behavioral threat assessments (BTA), which aim to address and identify concerning behavior before it escalates into more serious behaviors including the use of firearms and other weapons at school.
In addition to many BTA models, she noted that the National Threat Assessment Center (NTAC) and Comprehensive School Threat Assessment Guidelines (CSTAG) are widely used:
- Schools implementing the CSTAG model see fewer bullying incidents, more support services, and a more positive school climate.
- The NTAC model emphasizes behavioral indicators that demonstrate an individual may be escalating toward violence, while the CSTAG model emphasizes outcomes.
In NTAC's latest study of 173 attacks, they identified ideological bias, political beliefs, and psychotic symptoms as the top motives. White highlighted that 93% of attackers experienced at least one significant life stressor within the five years preceding the attack. The majority of attackers possessed illegal firearms, and 76% displayed behavior that prompted concern among family members or others close to them before the firearm incident.
White explained BTA processes, which include receiving reports, investigating and assessing situations, determining appropriate interventions, monitoring cases and interventions over time, and closing cases when appropriate. She then spoke about BTA in the Texas Education Code — the code dictates that districts adopt policies and procedures for BTA teams consistent with those developed by the Texas School Safety Center. Some key challenges in implementing BTA were creating buy-in and alignment among key stakeholders, documenting cases, and hiring or retaining staff with required expertise. Looking to the future, WestEd has partnered with eight organizations across the U.S. using a Bureau of Justice Assistance STOP School Violence grant to address these challenges by developing e-learning for training and creating a database for analysis. White ended her presentation by stating that WestEd will continue to provide dedicated technical assistance, resource development, and evaluation of the BTA.
Panel 4 — School Violence
Dr. Sandra McKay, Huffington Fellow in Child Policy at the Baker Institute, introduced the panel for school violence noting that, per the CDC, almost 10% of children in the United States will miss at least one day of school due to feeling unsafe. Additionally, close to 40% of parents will fear for their children’s safety at school. Therefore, creating a safer school environment for our students across the nation is an issue of utmost importance.
Geovanny Ponce, an assistant superintendent of the HISD school district, launched the discussion by describing how overwhelming it can be to balance creating an enriching education system while also dealing with the constant threats of violence. Ponce mentioned that one of the ideas they are emphasizing throughout their district is dedicating time and effort for teachers to develop relationships with their students to build more trust throughout their schools. By encouraging more communication throughout schools, the hope is that all students can feel connected. The aim is for students to find a special place where they feel comfortable at school, with useful resources when they encounter educational or social difficulties.
Shawna White discussed how school safety is usually talked about as a singular topic, when in reality, it is a multifaceted issue with many different moving parts. She detailed:
- The importance of creating and implementing hazard plans both during and before any threats to school safety.
- How it is essential to communicate the presence of these plans to parents and students so that the community is aware of the measures being taken to prioritize school safety.
- How increasing school safety isn’t a one-fix issue and instead must include a comprehensive approach. This includes both creating a safe and welcoming environment in schools, building trust and relationships between teachers and students, and implementing physical safety across schools.
Kenneth Brantley, the principal at Wisdom High School in Houston, discussed how creating a safer school environment is important not only for students’ safety in school but also beyond the school doors. Brantley mentioned how teachers are often underappreciated for the effort they put into their demanding jobs and discussed the importance of creating conversations around teachers’ mental health and providing resources to support them. In addition, he emphasized the importance of teaching self-regulation practices from a young age, so children can develop better mental health practices to draw on throughout the life course. School is one of the most important socializing institutions in our society: Many of the social values and norms that we learn and internalize are from school. Teaching positive mental health practices to our children will aid not just them but our society as a whole.
Jamie Freeny, the director of the Center for School Behavioral Health of Mental Health America of Greater Houston, provided data from Houston schools on how both staff and students report feeling — observations included depression, fatigue, aggression, and absenteeism. She highlighted how teachers and students often experience remarkably similar feelings at school. Further, Freeny emphasized that it is both unreasonable and inefficient to expect teachers to ignore or compartmentalize their mental health. It is important to provide teachers with the resources and time for their mental health and self-reflection: They can then help provide students with adequate mental health resources and support. Lastly, she discussed how it is vital to communicate with, and include, students in efforts to increase school safety, enabling them to contribute their own ideas and information. Including students in these discussions goes a long way in fostering a welcoming school environment by building relationships between students, teachers, and school administrative staff.
Panel 5 — Suicide Prevention
The next panel, moderated by Dr. Zoabe Hafeez, discussed firearm-related violence, especially as an impetus for suicide prevention in vulnerable populations. Ned Levine outlined his data collection efforts on suicide and homicide, contrasting data in Harris County to the national averages. The conversation then pivoted to focus on three vulnerable populations — children, veterans, and individuals with neurological disabilities — and the importance of suicide prevention and access to mental health counseling for these groups.
Children
The Texas Child Mental Health Consortium is a state resource that provides access to the:
- Child Psychiatry Access Network (CPAN), which primary care providers can use for behavioral health care for their child and adolescent patients.
- Texas Child Health Access Through Telemedicine (TCHATT), which extends into the far reaches of the community via telemedicine to assess behavioral health needs of children.
Dr. Taiwo Babatope, child and adolescent psychiatrist at UTHealth Houston, highlighted the extreme lack of child psychiatrists in Harris County and across the nation. While the World Health Organization (WHO) recommends 10 child psychiatrists for every 100,000 children, there are currently only 10,000 psychiatrists for 73 million children under the age of 18.
Veterans
The second highlighted group was veterans, who make up only 3% of the Harris County population but 11% of deaths by suicide. This amounts to one suicide every 5–6 days, noted Dave Lewis, Director of the Harris County Veteran Services Department. He discussed the importance of two ideas:
- The will — the will to take one’s life.
- The means — the means to be able to.
We must increase the space between will and means, and this can be achieved by safe storage of guns and longer waiting periods to obtain firearms, as emphasized by Dr. Cedric Dark.
Dr. Laura March of the Menninger Department of Psychiatry discussed the comorbidity of mood disorders with neurological disorders or disabilities. It is useful, she said, to understand psychiatric disorders and neurological disorders together rather than looking at them as two separate entities, Integration of psychiatric and neurologic care for this population will better serve their needs.
The panel concluded with a discussion of the types of firearm-related policies physicians would like to see. Dark noted that the current average waiting period to obtain a gun is only two minutes, which means that someone who is actively suicidal could almost immediately access the means to fulfill their will: There simply need to be longer waiting periods to obtain firearms. The involvement of firearms in suicides and violent crimes significantly underscores the two-fold need for more mental health resources for individuals and stricter firearm regulation.
Panel 6 — Policy Action
Texas state Reps. Vikki Goodwin and Ann Johnson spoke at the conference and both gave advice on being a successful legislative advocate. They noted that for a bill to become a law in Texas is a long and difficult journey. Of the 8,578 bills filed during the 2023 legislative session, only 1,353 went to the governor’s desk to be signed into law. Their major points were:
- It is important to recognize that 76% of Texans want common sense firearm violence prevention laws. However, there is a disconnect between public opinion and policy, largely stemming from the fear that many elected officials have of losing their government positions if they do anything to curb firearm violence.
- Advocacy work must be year-round. Although the legislative session in Texas only lasts 140 days every two years, advocates need to continue the conversations about the importance of policy for firearm violence prevention every day.
- The constant stream of misinformation and disinformation needs to be dispelled via one-on-one conversations with people in communities throughout Texas. We need to be talking with everyone, not just those in the government, community organizations, or lobbyists.
Ways to keep the conversations alive include:
- Building coalitions of people with different backgrounds to create drafts of bills, locating sponsors and supporters, and finding a representative and senator to file the bill before the legislative session.
- Testifying in front of a committee during the legislative session — stories, emotions, and the youth perspective can change hearts and minds in the government. Those unable to testify can be encouraged to call members of the committee to tell their stories.
Public pressure can work: two firearm violence prevention laws made it out of committee during the 2023 legislative session. This issue has the potential to be bipartisan; we just need to keep the conversations going.
Policy Recommendations
Four main policy recommendations emerged from the symposium:
- Invest in systems of action to prevent firearm injury.
- Create mechanisms to support teachers’ mental health and restore students’ school connectedness.
- Increase mental health provider capacity.
- Develop improved mechanisms to promote secure storage within communities and consider waiting periods after new purchases.
Below we outline the details of these recommendations.
Invest in Systems of Action to Prevent Firearm Injury
Systems with hospital- or community-based violence intervention programs have demonstrated decreased rates of recidivism, helping to break the cycle of violence. To fully realize their potential, however, these structures need to be supported by communities and legislatures. Funding support to Level 1 Trauma centers from the federal or state level can be leveraged to launch programs to counter this violence. When assessing those at risk for firearm violence, these programs need to address non-medical determinants of health — with the aim of reducing the factors that lead to recidivism. Support from multi-level investments can help hospitals, communities and cities reduce firearm injury and violence through a holistic and long-term approach.
As well as investing in hospitals and communities to respond to firearm victims’ injuries, it is also crucial to consider methods of primary prevention, before injury occurs. Knowing the impact of stolen firearms in crime and domestic violence, it is imperative to develop a system to readily report and identify firearms that have been lost or stolen. Currently the Bureau of Alcohol, Tobacco, Firearms and Explosives National Tracing Center is the only crime gun tracing facility in the United States. While they receive thousands of reports from firearm dealers annually of lost or stolen firearms, they do not take direct reports from firearm owners. Instead, firearm owners must file a report with local law enforcement to report a stolen or lost firearm, who must then report to the database. Obtaining records from the database can take up to ten days depending on the type of request. Ensuring that this system has adequate funding is essential to addressing the epidemic of stolen firearms. Development of a system to facilitate real time distribution of database-sourced information about “hot spots” of stolen firearms will enable coordinated responses across local law enforcement jurisdictions.
Finally, systems are needed to help understand the epidemiological landscape of firearm injury and allow improved utilization of scarce resources. The best way is to use local tracking tools to create “firearm injury databases” that not only identify the type of firearm injury in a region but also the distribution of that injury. This will empower a region to prioritize resources to meet the greatest community needs in a particular area. It will also allow cities to partner with health departments, hospitals, and community-based organizations to collaborate to address the real time needs of a population, and thus respond in a more proactive manner.
Create Mechanisms To Support Teachers’ Mental Health and Restore Students’ School Connectedness
In the aftermath of the COVID-19 pandemic and recent school mass shootings, a student mental health crisis has developed. Thus we need to focus on developing programs to improve resilience, increase school connectedness, assist in increasing social emotional learning, improve learning in school, and decrease truancy rates. Such programs can include peer mentoring systems, integrated resiliency classes, and having mental health professionals who are integrated into the school systems.
As school supports are developed for students, it is vital to also increase teacher and administrator support. When more services are provided within school facilities, this adds to the stressors for teachers and administrators. Interprofessional support and career development for teachers should be incorporated within school systems. Additionally, teacher mental health support should be equally valued and supported by providing teachers with access to a dedicated mental health professional. Adequate funding of both student and teacher mental health resources within all school systems will be a key first step toward restoring a feeling of safety and security within schools.
Increase Mental Health Provider Capacity
In the Houston area and country-wide there is a severe shortage of mental health providers: This is a critical gap in addressing the mental health needs of the population. Funding must be dedicated to support training and education for future mental health specialists to increase the community capacity for mental health provision and meet the future needs of the population. Programs should be developed to incentivize students to enter careers in mental health care, through loan forgiveness programs, subsidized education, and increased capacity at graduate training programs. If this gap is not addressed now, we will continue to face a critical workforce shortage for years to come.
Develop Improved Mechanisms To Promote Secure Storage Within Communities and Consider Waiting Periods After New Purchases
Secure firearm storage has been repeatedly cited as a first step in the prevention of unintentional injury and suicide. Promotion of secure firearm storage education to the general public needs to be a first priority. This should be followed by the provision of secure storage options in each region and through distributions of safety devices such as cable locks with each firearm sale. Additionally, any individual who requests a safety device should be given one at no cost without question.
Another need is for regional programs to develop local secure storage options for firearm owners who require temporary out of home storage during a time of crisis or need. For example, if someone in the home is struggling with mental health or if they are going to be out of town and are concerned about theft. Developing a network of trusted storage options for temporary out-of-home storage — either through federal firearm licensee or regional programs within veteran support organizations — will be another layer of secure storage options for firearm owners.
Finally, for new purchasers, waiting periods of as little as 24 hours can be pivotal in decreasing suicide and homicide rates. Instituting a short waiting period will allow the firearm owner to be safe and secure in their rights while at the same time decreasing firearm related deaths.
Conclusion
Firearm injury prevention needs a multifaceted approach to address the epidemic of injury and death. By investing in the workforce, improving resource utilization, creating systems to prioritize injury reduction, renewing focus on connections, and prioritizing security through storage and safety, we can begin to address the leading cause of death in children. Through partnerships with communities, health care providers, legislators, schools and researchers, we will continue to focus efforts on reducing the violence that every firearm injury brings and work collaboratively with firearm owners to keep security and safety to the fore.
This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.