resenha do livro "Gun Violence Prevention: A Public Health Approach, edited by Linda Degutis and Howard Spivak" (os destaques são nossos)
Pursuing an Evidence-Informed Approach to the Prevention of Gun Violence
Sonali RajanMS, EdD Author affiliations, information, and correspondence details
Accepted: February 15, 2022
Published Online: April 13, 2022
In an area that has historically been deeply underfunded,1 particularly in comparison with other areas related to public health, it is extraordinarily valuable to have a book available that serves as an accessible, clear, and well-researched reference on gun violence. Gun Violence Prevention: A Public Health Approach, edited by Linda Degutis and Howard Spivak, provides us with such a resource. Here I highlight the contributions of the book and the ways in which this body of work might serve as a foundational reference for the field of gun violence prevention, both for those pursuing research and for those looking to communicate accurately to the public about the issue. Indeed, the latter—accurate and evidence-informed public communication—is of particular importance in an era when misinformation has emerged as a public health threat.2 Also, given that this topic has long been politicized, we need a vernacular that stakeholders invested in addressing this social crisis can readily draw on.
Gun Violence Prevention aims to serve as a reference grounded in empirical evidence, and its premise assumes—correctly—that we must learn to safely coexist with firearms in the United States given their ubiquity and wide circulation in communities across the country. (This is especially the case as the number of firearms in circulation has increased precipitously during the COVID-19 pandemic, alongside increases in gun violence.3) It is formatted as a reference book in that it does not need to be read cover to cover and includes multiple contributions from well-known scholars.
The book largely focuses on solutions that can be implemented right away. Moreover, and in line with existing data and literature on prevention of gun violence, it underscores the need for a multifaceted prevention approach. The authors draw from other public health successes to provide their readers with a clear and tangible sense of what such an approach might actually look like. At times, the book adopts an encouraging and optimistic tone that empowers its readers to be active contributors to these solutions. There is something to be said for that kind of inclusive and inviting approach, particularly in the case of an issue in which community-based advocacy and civic engagement have contributed to meaningful progress. I appreciated that the editors included a chapter focused specifically on how to be an effective advocate.
MULTIFACETED AND MULTISECTORAL SOLUTIONS
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If advocacy is to be effective, however, a clear and evidence-informed framework for how to address and respond to gun violence in communities across the United States is needed. Of course, the very availability of reliable information serves as the foundation of such solutions. Gun Violence Prevention thus begins with a thoughtful review of existing data sources on firearm violence, including their respective strengths and weaknesses. The authors then identify clear gaps in existing public health surveillance (particularly as they consider different types of gun violence), and this discussion ends with a call for a coordinated data collection effort to be expanded to include nonfatal injuries from firearms.
This latter call is in line with recent literature discussing the different types of exposure to gun violence and their corresponding effects on short- and long-term health outcomes (particularly among children and other vulnerable subgroups).4,5 It is encouraging to observe this shift in thinking, that is, prevention of death from firearm-related injuries, although critical, is not sufficient. A true preventive public health approach must consider the ways in which both indirect (e.g., witnessing gun violence) and direct (e.g., being injured with a bullet) forms of exposure to gun violence affect the health and well-being of individuals and communities.4,5
Building off of this foundation, the predominant theme woven throughout the book’s subsequent chapters is the notion that multiple strategies across sectors and levels are needed to reduce the harms that stem from our national gun violence crisis. More specifically, Degutis, Spivak, and their contributors consider the ways in which risk factors at the individual and community levels, coupled with policies at the state and federal levels, are necessary components of a comprehensive solution. As the authors discuss throughout, this involves understanding the behavioral risk factors that exacerbate firearm violence; documenting the health effects of exposure to such violence; working with stakeholders from law enforcement, the criminal justice system, education, and other sectors to identify responses; investing in comprehensive data surveillance efforts at both the local and national levels; and investing in basic community-wide infrastructure (e.g., via increased access to mental health support and improved access to and availability of safe shelters).
Importantly, the authors also recognize that one cannot talk about these types of infrastructure investments without also considering this country’s history of systemic racism that has hindered access to some of these most fundamental resources. One of the most powerful chapters in the book is the contribution by Jennifer Bronson on “Social Justice and Institutional Racism,” which highlights the ways in which structural racism has perpetuated cycles of violence and has placed specific subgroups at heightened risk for gun violence. This understanding is critical to the pursuit of effective and equitable public health solutions.
As noted, there is also a call for the use of effective, clear, and accurate reporting of gun violence by the media. The book invites us to consider the following question: what does effective public messaging consist of, and why is attention to this so important? It is also worth observing the authors’ commitment to embedding firearm safety as a part of what they consider a comprehensive solution. For example, the authors include a section devoted to “firearms as a consumer product” (including details on product oversight as well as guns and technology). It is particularly interesting to see the idea of “firearm design” embedded as one example, of several, that could be part of a realistic firearm violence prevention strategy.
CONCLUSIONS
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Gun Violence Prevention highlights that—as with so many other public health problems—there is no one policy or practice that will “solve” this issue. Rather, a coordinated, well-resourced, and multifaceted response is needed. Encouragingly, with such a response, we can collectively achieve meaningful reductions in the persistence of gun violence in the United States. This resource provides thoughtful and evidence-informed guidance on how to realistically attain that goal.
REFERENCES
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References
1. Rajan S, Branas CC, Hargarten S, Allegrante J. Funding for gun violence research is key to the health and safety of the nation. Am J Public Health. 2018;108(2):194–195. https://doi.org/10.2105/AJPH.2017.304235 Link, Google Scholar
2. Murthy VH. Confronting health misinformation: the US surgeon general’s advisory on building a healthy information environment. Available at: https://www.hhs.gov/sites/default/files/surgeon-general-misinformation-advisory.pdf. Accessed January 11, 2022. Google Scholar
3. Schleimer JP, McCort CD, Shev AB, et al. Firearm purchasing and firearm violence during the coronavirus pandemic in the United States: a cross-sectional study. Inj Epidemiol. 2021;8(1):43. https://doi.org/10.1186/s40621-021-00339-5 Crossref, Medline, Google Scholar
4. Rajan S, Branas CC, Myers D, Agrawal N. Youth exposure to violence involving a gun: evidence for adverse childhood experience classification. J Behav Med. 2019;42(4):646–657. https://doi.org/10.1007/s10865-019-00053-0 Crossref, Medline, Google Scholar
5. Bancalari P, Sommer M, Rajan S. Community gun violence exposure among urban youth: an overlooked externality of the endemic of gun violence in the United States. Adolesc Res Rev. In press. Google Scholar
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