The U.S. surgeon general on Tuesday declared firearm violence in America to be a public health emergency that “requires combining the best available scientific evidence with scientific judgment and expertise to take life‑saving action quickly.”

In a 39-page advisory, the nation’s top doctor outlined proposed prevention strategies and policies to curb gun violence, including increasing research funding to study and evaluate prevention strategies, investing in community-based interventions and educational programs, requiring safe and secure firearm storage and implementing universal background checks for all firearm purchases.

“Firearm violence is a public health crisis,” Dr. Vivek Murthy said Tuesday in a recorded statement. “Our failure to address it is a moral crisis. To protect the health and well-being of Americans, especially our children, we must now act with the clarity, courage and urgency that this moment demands.”

The advisory marked the first time that the surgeon general has addressed gun violence in America, though Murthy told The New York Times that he has “long believed this is a public health issue.”

“This issue has been politicized, has been polarized over time. But I think when we understand that this is a public health issue, we have the opportunity to take it out of the realm of politics and put it into the realm of public health,” he said.

In 2022, 48,204 people died from firearm-related injuries nationwide. The violence has had a particular impact on young people in recent years, rising to become the leading cause of death for children and adolescents aged 1 to 19. Since 2020, gun violence has caused more deaths in young people than motor vehicle crashes, cancer, drug overdoses and poisoning, officials said.

Beyond the deaths caused by the violence, “there are wider ripples of harm to those who are injured, who witnessed the incidents, who live in urban and rural communities where such violence take place and who constantly read and hear about firearm violence in the news,” Murthy said.

For years, the scope of the problem has been getting bigger, driven by rising numbers of firearm-related homicides and suicides. The number of firearm-related deaths reached a near three-decade high in 2021. In an April 2023 KFF poll, a majority of Americans said they had taken steps to protect themselves or their family members from gun violence, and 54% said they or their family members have grappled with a firearm-related incident like being threatened with a gun, having a family member killed by a firearm or witnessing a shooting.

The impact of gun violence particularly impacts Black Americans, who see the highest rates of firearm homicides, and older white and younger American Indian and Alaska Native people, who have the highest suicide rates.

“This isn’t just a law and order policing problem,” Alexander McCourt, who researches gun laws at the Johns Hopkins Center for Gun Violence Solutions, told The Washington Post. “We need a more public health approach to reducing and preventing gun violence.”

Officials noted Tuesday that the public health approach “must include everyone, from firearm owners to health workers to community leaders” to be successful. It was previously used to address cigarette smoking, contributing to a more than 70% decline from 1964 to 2021.

Murthy told the Times on Tuesday that tackling smoking posed a similar challenge to that of curbing gun violence, requiring education and awareness campaigns combined with cultural shifts and policies.

“There wasn’t one single strategy that ultimately worked with tobacco,” he said. “That’s what I’m thinking here too.”

In a recorded statement, he added, “Our children should not have to live in fear that they are going to get shot if they go to school. None of us should have to worry that going to a mall, or a concert, or a house of worship means putting our lives at risk, or that we’ll get a call that a loved one in a moment of crisis has taken their own life with a firearm.

“All of us, regardless of our background or beliefs, want to live in a world that is safe for us and our children.”

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