- The National Bureau for Gun Safety is an evidence-based public health approach to gun violence prevention that builds on historical precedent.
- The NBGS will synergistically coordinate gun violence prevention strategies that currently comprise the public health agenda.
- The NBGS concept points to consensus and can be articulated efficiently to various audiences.
- The NBGS aligns well with DFA's core values.
Gun violence ranks among our country's most neglected health problems. It takes as many lives every year as do motor vehicle accidents1. Yet, in spite of persistent efforts to reduce gun violence over the past twenty years, deaths from gun injuries have increased by over 20%1. Doctors For America advocates the adoption of a novel public health-based approach to addressing the gun violence crisis, employing scientific methods and best practices: we support the creation of a National Bureau for Gun Safety.
The county's efforts to reduce motor vehicle deaths provide a useful parallel for considering gun violence prevention. In 1966, the government responded to the challenge of increasing mortality on U.S. roadways by passing the National Traffic and Motor Vehicle Safety Act, which established the National Highway Safety Bureau (NHSB). The NHSB (which later became the National Highway Traffic Safety Administration, NHTSA) addressed the problem systematically using a public health approach, promoting and implementing safety technology, supporting research into causes and contributing factors and fostering public awareness of safety practices, such as seat belt use. The NHSB coordinated its activities so they complemented each other, acting synergistically to reduce injuries. In the following decades the motor vehicle death rate fell by two-thirds2.
Efforts to date to reduce gun deaths, in contrast, have been pursued largely in the political sphere, driven by organizations with a political agenda and focus. Their goals, for the most part, have been to enact laws modifying access to firearms and to elect officials who advocate "gun control." Framed as a political issue, gun violence has been added as yet another item to debate in the ongoing culture war. This is not to say that progress has not been made, particularly at the state and local levels. But conversations around the causes and solutions to gun violence remain politically and culturally divisive. Nationally, gun deaths continue to rise.
Health professionals have actively participated in the effort to reduce gun violence, speaking out against "gag laws" that prevent doctors from talking to their patients about guns and against restrictions on gun violence research funding, as well as by adding support to proposed legislation aimed at preventing gun violence. Mozaffarian and colleagues outline a comprehensive, multidimensional strategy, setting down an extensive list of proposals designed to reduce gun violence. Similarly, eight health organizations and the American Bar Association recently published a series of recommendations as a united "call to action."
We agree with these public health-based approaches and history teaches that even better results can be achieved by a single agency coordinating multiple modalities. Take seat belts, for example, a technology, tweaked and perfected through research, which is credited with saving 15,000 lives a year in the US3. The life-saving potential of seatbelts has only been fulfilled with the synergistic use of media to increase public awareness of the importance of seat belt wearing and the added negative incentive of fines, which was added through legislation.
Analogously, we propose the creation of a single agency focused on preventing gun deaths: a National Bureau for Gun Safety (NBGS). The NBGS's mission, like that of the NHSB, would be to lead and coordinate a multidisciplinary, multifaceted campaign to reduce gun deaths based on proven public-health practice. It would be run by experts in public health, medicine, engineering, communications and law enforcement. Its inner workings would be transparent and nonpartisan. It would take the lead in setting the nation's research agenda and developing, testing and implementing safety technologies. It would set out legislative priorities for saving lives. It would oversee campaigns to encourage behaviors likely to reduce gun injuries. And, in concert with the Bureau of Alcohol, Tobacco, Firearms and Explosives, it would direct priorities for enforcing gun laws.
Of course, guns are not cars; the tools that will effectively reduce gun deaths and the challenges faced will be unique. Defining the precise structure and functions of a NBGS will require careful thought and the collaboration of experts in multiple fields. To this end an appropriate next step will be the formation of a working group tasked with developing a detailed proposal for the bureau.
Beyond its substantive merit, the NBGS concept is readily communicated. In the age of Twitter, an extensive list of policies is difficult to convey persuasively to the public. The NBGS, as a single proposal, can be convenient shorthand. Its safety orientation aligns with the goals of organizations such as the Second Amendment Foundation and the National Rifle Association, which have a strong history of advocating gun safety. As such, the idea of the NBGS emphasizes consensus over conflict, changing the national conversation on gun violence, pulling it in the direction of health. What is more, the NBGS concept embraces the advocacy work already being done by health professionals and, in addition, gives health professions a well-defined, concisely articulated idea around which to unify. In turn, the NBGS concept as a unified position of the health community would provide politicians with a policy choice that seriously addresses gun violence while avoiding divisive rhetoric.
Working toward creating a NBGS is the right policy for DFA. We are a physician advocacy group, health is our area of expertise, it is "our lane." Health is the sphere where our voices have the greatest authority and impact. The NBGS concept aligns with DFA core values; it is bold, creative and values the contributions of our colleagues. It offers new possibilities for consensus and collaboration. Championing the creation of a NBGS has the potential to distinguish DFA nationally in realm of gun violence prevention.
1) CDC National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/injury.htm
2) Centers for Disease Control and Prevention (CDC). Achievements in Public Health, 1900-1999 Motor-Vehicle Safety: A 20th Century Public Health Achievement. MMWR May 14, 1999 / 48(18);369-374.
3) National Highway Traffic Safety Administration (NHTSA). Seat Belts. https://www.nhtsa.gov/risky-driving/seat-belts