Integrating Firearm
Injury Prevention into
Health Care
Proceedings of a Joint Workshop of
the National Academies of Sciences,
Engineering, and Medicine;
Northwell Health; and PEACE Initiative
_____
Joe Alper, Rose Marie Martinez, and
Dara Rosenberg, Rapporteurs
Board on Population Health and
Public Health Practice
Health and Medicine Division
Proceedings of a Workshop
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by Northwell Health and the PEACE Initiative. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-69349-3
International Standard Book Number-10: 0-309-69349-7
Digital Object Identifier: https://doi.org/10.17226/26707
This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2022 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and National Academies Press and the graphical logos for each are all trademarks of the National Academy of Sciences. All rights reserved.
Printed in the United States of America.
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Integrating firearm injury prevention into health care: Proceedings of a joint workshop of the National Academies of Sciences, Engineering, and Medicine; Northwell Health; and PEACE Initiative. Washington, DC: The National Academies Press. https://doi.org/10.17226/26707.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.
Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.
Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release.
For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.
PLANNING COMMITTEE FOR THE WORKSHOP ON FACILITATING THE INTEGRATION OF FIREARM INJURY PREVENTION INTO HEALTH CARE1
ANDRE CAMPBELL, Professor of Surgery; Vice Chair for Diversity, Equity, and Inclusion; and Director, University of California, San Francisco Surgical Critical Care Fellowship; University of California, San Francisco School of Medicine; Attending Trauma Surgeon, Zuckerberg San Francisco General Hospital and Trauma Center
ERICA FORD, Founder and Chief Executive Officer, LIFE Camp, Inc.
KAYLA A. HICKS, Chief Executive Officer, Sustain Equity Group
KYLEANNE HUNTER, Assistant Professor of Military and Strategic Studies, Strategy and Welfare Center, U.S. Air Force Academy; RAND Corporation
SANDEEP KAPOOR, Assistant Vice President, Addiction Services and Director of Screening, Brief Intervention, and Referral to Treatment, Northwell Health; Assistant Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
PETER MASIAKOS, Director, Pediatric Trauma Services and Codirector, Center for Gun Violence Prevention, Massachusetts General Hospital; Associate Professor of Surgery, Harvard Medical School
MEGAN RANNEY, Academic Dean, School of Public Health, Brown University; Director of the Brown-Lifespan Center for Digital Health; Professor of Behavioral and Social Sciences and Endowed Professor of Emergency Medicine, Warren Alpert Medical School of Brown University
JOSEPH SAKRAN, Director of Emergency General Surgery, Vice Chair for Clinical Operations, and Associate Professor of Surgery and Nursing, Johns Hopkins University
CHETHAN SATHYA, Director, Center for Gun Violence Prevention, Northwell Health; Associate Medical Director of Trauma and Surgical Director of Pediatric Critical Care, Cohen Children’s Medical Center; Assistant Professor of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
Project Staff
ROSE MARIE MARTINEZ, Senior Board Director on Population Health and Public Health Practice, and Director, Roundtable on Health Literacy
GRACE READING, Senior Program Assistant
DARA ROSENBERG, Research Associate
Y. CRYSTI PARK, Program Coordinator
Consultant
JOE ALPER, Consulting Writer
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
STEPHEN W. HARGARTEN, Medical College of Wisconsin
JULIE PARSONNET, Stanford University
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by BOBBIE BERKOWITZ, University School of Nursing, University of Washington. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. We also thank staff member MEREDITH YOUNG, Associate Program Officer, for reading and providing helpful comments on this manuscript.
This page intentionally left blank.
Acknowledgments
The National Academies of Sciences, Engineering, and Medicine’s Board on Population Health and Public Health Practice wishes to express its sincere gratitude to the members of the planning committee, who collaborated to ensure a workshop complete with informative presentations and rich discussions. The planning committee also thanks the speakers and moderators, who generously shared their expertise and their time with workshop participants. Finally, a special thanks to staff members Grace Reading and Crysti Park for their support of workshop activities.
This page intentionally left blank.
Contents
2 FRAMING THE ISSUE: FIREARM INJURIES AND HEALTH CARE’S ROLE IN DEPOLARIZING A PUBLIC HEALTH CRISIS
3 HEALTH CARE STRATEGIES TO REDUCE FIREARM INJURY AND MORTALITY
Investigating the Pipeline Through Community Partnerships, Intentionality, and Collaboration
The American College of Surgeons Committee on Trauma’s ISAVE Initiative
Implementing Firearm Safety Promotion Programs in Pediatric Primary Care
Temple University Hospital’s Cradle to Grave Program
Acclivus Violence Prevention Services
The Bullet Related Injury Clinic
Walk the Talk America: At the Intersection of Guns and Mental Health
6 DEFINING A FIREARMS VIOLENCE PREVENTION ROAD MAP FOR HOSPITAL AND HEALTH SYSTEMS
How the Panelists Became Involved in Firearm Injury Prevention
Box, Figures, and Table
BOX
6-1 Firearms Violence Prevention Road Map Highlights
FIGURES
3-2 Federal Housing Authority mortgage lending map of Los Angeles County showing redlined areas
3-3 Social determinants of health
4-1 The implementation science subway
4-2 Firearm homicide rates by state per 100,000, 2020
TABLE
3-1 Individuals Seen for Gunshot Wounds or Stabbing by Hospital in Boston
This page intentionally left blank.
Acronyms and Abbreviations
| BMC | Boston Medical Center |
| BRIC | Bullet Related Injury Clinic |
| CDC | Centers for Disease Control and Prevention |
| HAVI | Health Alliance for Violence Intervention |
| HIPAA | Health Information Portability and Accountability Act |
| IOM | Institute of Medicine |
| ISAVE | Improving Social Determinants to Attenuate Violence |
| MUSC | Medical University of South Carolina |
| NIH | National Institutes of Health |
| USC | University of Southern California |
| VA | U.S. Department of Veterans Affairs |
| YAP | Youth Advocate Programs, Inc. |
This page intentionally left blank.
