The Public Health Approach to Firearm Violence "What is it, Why Do We Need It?The Public Health...

The Public Health Approach to Firearm ViolenceWhat is it, Why Do We Need It?

Victor W. Sidel, MDDistinguished University Professor of Social Medicine

Montefiore Medical Center & Albert Einstein College of MedicinePast President: American Public Health Association, Physician for Social Responsibility,

International Physicians for the Prevention of Nuclear War

IANSA Public Health Network Panel on“Risk and Resilience: Understanding the Factors that Influence

Small Arms Violence”United Nations Church Centre -- July 16, 2008

UN Program of Action on SALW

The United Nations Program of Action to Prevent, Combat and Eradicate the Illicit Trade in Small Arms and Light weapons in all Aspects was initiated in 2001. It covers many of the approaches to preventing firearms violence but, despite the efforts of the World Health Organization, fails to recognize the role of the public health community in helping to solve the problem.

Approaches to Ending Firearm Violence

Legal and Regulatory Correctional Educational Economic Human Rights International Treaties Public Health

In 1996, the World Health Assembly identifies violence as a leading public health problem.

In 2001, the World Health Organization (WHO) prepares a document, Small Arms and Global Health, for the first UN Conference on Small Arms and Light Weapons.

In its document, WHO states “Violence is . . . an important health problem – and one that is largely preventable. Public health approaches have much to contribute to solving it.”

Public Health Approach to Firearm Violence

In 2003, the World Health Organization publishes its World Report on Violence and Health in Arabic, Chinese, English, French, Italian, Russian and Spanish.

The WHO Report classifies violence into three categories: Interpersonal Violence, Self-Directed Violence, and Collective Violence.

Firearms play an important role in all these forms of violence and WHO advocates an integrated public health approach to prevention of all of them.

Public Health Approach to Firearm Violence

Public Health Approach to Violence Prevention

Define the ProblemIdentify Risk and Protection FactorsDevelop and Test Prevention Strategies Implement Prevention Strategies Monitor the Effectiveness of Strategies

The Epidemiologic Model

Victim: Location and role Agent: Types of firearmsEnvironment: Vulnerable factors; protective factors; cultureInvolvement of health workers

Public Health Approach to Violence Prevention

FIREARM INJURY CENTER Medical College of Wisconsin   

The Global Gun Epidemic

The Epi Model: Victim

Of the 300,000 annual gun-related deaths approximately 80, 000-100,000 are direct conflict deaths

Over 200, 000 in non-conflict contexts

Disproportionate number of gun deaths occur in the Americas

The Global Gun Epidemic

The Epi Mode: Agent

Regardless of context, guns increase lethality

Reducing inappropriate access to guns reduces the risk of injury and death

Unregulated access to firearms fuels a culture of violence

The Global Gun Epidemic

The Epi Mode: Environment

Collective violenceInterpersonal violenceSelf-directed violenceCulture of violence

The Global Gun Epidemic

Multi-layered strategy (1)

Availability of current and reliable data Consideration of the entire gun supply chain, both legal and illicit Reduction of the culture of violence Post conflict demobilization, disarmament and reintegration

The Global Gun Epidemic

Multi-layered strategy (2)

International coordination and action Domestic violence and firearms legislation Implementation issues involving law enforcement and courts Political participation

The Need for Global Action

Coming together of different cultural, language and national traditions

Coming together of different advocacy movements

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