Champion the role of health system leadership in creating community safety


Violence with a firearm is a widespread and uniquely American problem. Our percentage of gun homicides is 25 times higher than that of equally large and rich countries, despite comparable crime rates in general.

Every year in the United States, approx 40,000 people they were killed by gunfire and more than 100,000 survived a gunshot wound; countless others experience violence with weapons indirectly, for example, due to the loss of a loved one, attending shootings or listening to gunshots. While mass public shootings dominate news headlines, daily incidents of armed violence (including firearm suicide) in homes and communities make up the bulk of the human tribute to this public health crisis.

By 2020, the destabilizing impacts of COVID-19 have contributed increased purchase of firearms, a breakdown of key social services, and the community’s inequitable conditions for security. While more research is needed, the result appears to be a historic peak in armed violence, with the highest annual death toll. in decades it increases in non-fatal shots in 73 of the 100 largest cities. As with COVID-19, a disproportionate share of deaths, injuries and trauma caused by armed violence are borne by black and brown communities left more vulnerable by historical and current structural racism and other systemic barriers. .


Health systems are at the forefront of epidemics of armed violence, and their leaders can help ensure that community safety is at the heart of the institutional mission. To meet this critical moment — at a time when long-standing racial injustices and police violence have sparked a nationwide protest movement, and the electorate has made unprecedented commitments to invest in intervention and prevention. violence — the role of health organizations cannot be limited to treating the physical injuries caused by armed violence. Care Systems should also leverage their clinical and non-clinical assets to reinforce community-led approaches to preventing violence with weapons, supporting healing and improving community safety. Such changes are easier when strong leadership comes from the top.

Fortunately, public health science and practice, combined with the wisdom of community members most affected by armed violence and injustice, have already taught us promising ways that health systems and their leaders can engage. fuller in this work:

  • Aligned and used and human and economic resources of the institution-Including procurement and procurement, workforce development, training, investment capital, education programs, research, data analysis, community health initiatives, environmental management and clinical prevention — to help create the conditions that neighborhoods must be safe. Such community-based anchoring initiatives they are designed to fundamentally alter the underlying determinants – such as income and wealth disparities, generational poverty and trauma, inferior housing, and general disinvestment in marginalized communities – that raise the risk for armed violence.
  • Normalize the practice of health professionals talking to patients on access to firearms, risk of injury with the weapon, and damage reduction strategies – including safe storage and temporary transfers of firearms during periods of high risk. National, less than 10% of adults in armed families they still receive safety advice for weapons from a clinician, though widespread public support, even among firearms owners, to engage in these conversations, especially when the patient or someone in their home demonstrates risk factors for firearm damage. When discussing gun injury prevention, caregivers should adopt a conversational and collaborative approach rooted in cultural humility trauma-sensitive practices, recognizing the complexity and fluidity of culture, identity, and generational experiences with health and legal-criminal systems.
  • Advocate and partner with community violence intervention (CVI) efforts, as well as violent intervention programs in the hospital (HVIP), transformative skill creation, and intensive peer mentoring, which actively support people at the highest risk of participating in violence. These person-centered approaches use well-connected and credible professionals from the community to help respond to complex needs in relation to the risk of violence. Healthcare system leaders can build relationships with CVIs and other community resources to provide referrals for patients, or as with HVIP, implement their own programs. Such strategies have recognized the potential to address armed violence and inequality: The U.S. Rescue Plan provides $ 350 billion to localities to mitigate the damage associated with COVID-19 and can be used for CVI. CMS has announced that violence prevention services are reimbursable for Medicaid. U Break the Cycle of Violence Act, reintroduced into Congress in June, will invest $ 5 billion over eight years in CVI programs.

Health systems are in a unique position to harness their social, economic and political power to advance the safety of the community, not just treat violent wounds. This is an essential moment for system leaders to understand its potential impact and engage in action – both within institutional walls and outside – to reduce armed violence.

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