The consultation: firearms violence More people are killed by guns in a single day in the USA than in a whole year in the UK. Rhode Island emergency medicine physician Megan Ranney leads research into widespread firearms violence – despite pressure from gun lobbyists to stay clear

The number of firearm injuries and deaths are increasing, across the USA. And the numbers ignore the huge ripple effect of each firearm injury and death on our society.

People with gunshot wounds are less likely to make it to emergency departments in the first place, compared to patients with any other type of injury. And if they do make it to my emergency department alive, I am less likely to be able to save them. Recent studies suggest that 25 to 35 per cent of patients with firearm injuries die after hospital arrival, versus only 5 to 10 per cent of patients injured in other ways.

Gunshot wounds are also scarier, for patients and their families, than other types of injury. The sheer terror in the eyes of my patients who have been shot is, frankly, unforgettable.

We cannot stay silent. It’s unconscionable for us as healthcare professionals – or for the public at large – to stand by. This epidemic is decimating our country not just physically, but also emotionally.

The science of firearm injury prevention has stalled. A law passed in 1996 prevents the Centers for Disease Control and Prevention from advocating gun control. It does not forbid federal funding of firearm-injury prevention but nonetheless it has had a chilling effect on the field. There has been a dramatic decrease in funding, researchers, publications and the quality of the science.

So we have committed to finding other ways forward. This was the motivation for the creation of AFFIRM Research (the American Foundation for Firearm Injury Reduction in Medicine). It is non-partisan, nimble, and committed to doing what healthcare does best: saving lives through evidence and action. Also, recently, I was one of a number of researchers across the USA who was part of a grant (based at University of Michigan) from the National Institute of Child Health and Human Development to restart the science of paediatric firearm-injury prevention. It’s a terrific first step.

WHAT THE PAPERS SAID: US newspapers in the days immediately following the school shooting at Sandy Hook in 2012

I have spent my career researching the overlap between violence and mental health, particularly as it intersects with technology. Some of my projects include automated text-message programmes to reduce fights and depression among youths with histories of fights; to evaluate social-media predictors of post-traumatic stress among youth exposed to school shootings; and to develop solutions to the cycle of bullying, physical fights, and gun violence that plague our youth.

What strikes me most about my work is the degree to which our youth feel lonely and scared. They are desperate for meaningful social connections. I’m honoured to get to provide some innovative solutions for these youth through my funded research.

I was warned by mentors to ‘stay away’ from the issue because it would doom my career. This attitude started to shift after Sandy Hook [the school shooting in 2012 in which 20 children were murdered], when many of us began to say ‘enough – it’s time to treat gun violence like the public health issue that it is’. This momentum has grown, year after year and tragedy after tragedy.

The #ThisIsOurLane Twitter response [to the National Rifle Association of America saying last November that ‘someone should tell self-important anti-gun doctors to stay in their lane’, after which emergency physicians tweeted pictures of the effect of treating firearms violence] occurred because of the long, hard work that many physicians and other healthcare professionals have been doing for years: this issue is about human lives, not political debates.

Approximately 40 per cent of American physicians are gun owners. Being a gun owner doesn’t negate a doctor’s commitment to public health and injury prevention. We are collaborating across the political spectrum to promote gun safety and common sense.

I predict that in five years, it will no longer be debated: the American public will fully accept that gun violence is a public health issue, and we will be well on our way to creating solutions.

The public already sees gun violence as the core issue of our time. It is destroying communities across the USA, physically and psychologically. As healthcare professionals, within and outside AFFIRM, we know there is hope.

Find out more about AFFIRM Research

Find about the BMA's policy on firearms licensing

Megan Ranney (pictured below) is an associate professor of emergency medicine at Brown University, Rhode Island, and chief research officer of AFFIRM Research



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