Reducing Gun Violence: Using an Upstream/Downstream Incremental and Public Opinion Approach

ABSTRACT Gun violence is a significant public health issue. The U.S. has more than one mass shooting a day in which four or more people are injured or killed. However, mass shootings are only the tip of the iceberg of gun violence. Among developed nations, the U.S. is an outlier in both gun possession and gun deaths. Gun deaths affect not only the victim but also have significant short and long term emotional and economic consequences on family, friends, the community and the psyche of the nation. Nationally, gun violence prevention remains elusive. History on many contentious issues, including smoking and automobile safety, suggest meaningful change can occur. Often these changes are associated with a triad of factors. These include sustained advocacy and education efforts, often over many years, incremental changes along the way using an upstream-downstream approach, accompanied by public education and supportive public opinion. Finally, and importantly, it suggests what health educators and citizens can do to address the gun violence problem.