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The Public Health Approach to Firearm ViolenceWhat is it, Why Do We Need It?
Victor W. Sidel, MDDistinguished University Professor of Social Medicine
Montefiore Medical Center & Albert Einstein College of MedicinePast President: American Public Health Association, Physician for Social Responsibility,
International Physicians for the Prevention of Nuclear War
IANSA Public Health Network Panel on“Risk and Resilience: Understanding the Factors that Influence
Small Arms Violence”United Nations Church Centre -- July 16, 2008
UN Program of Action on SALW
The United Nations Program of Action to Prevent, Combat and Eradicate the Illicit Trade in Small Arms and Light weapons in all Aspects was initiated in 2001. It covers many of the approaches to preventing firearms violence but, despite the efforts of the World Health Organization, fails to recognize the role of the public health community in helping to solve the problem.
Approaches to Ending Firearm Violence
Legal and Regulatory Correctional Educational Economic Human Rights International Treaties Public Health
In 1996, the World Health Assembly identifies violence as a leading public health problem.
In 2001, the World Health Organization (WHO) prepares a document, Small Arms and Global Health, for the first UN Conference on Small Arms and Light Weapons.
In its document, WHO states “Violence is . . . an important health problem – and one that is largely preventable. Public health approaches have much to contribute to solving it.”
Public Health Approach to Firearm Violence
In 2003, the World Health Organization publishes its World Report on Violence and Health in Arabic, Chinese, English, French, Italian, Russian and Spanish.
The WHO Report classifies violence into three categories: Interpersonal Violence, Self-Directed Violence, and Collective Violence.
Firearms play an important role in all these forms of violence and WHO advocates an integrated public health approach to prevention of all of them.
Public Health Approach to Firearm Violence
Public Health Approach to Violence Prevention
Define the ProblemIdentify Risk and Protection FactorsDevelop and Test Prevention Strategies Implement Prevention Strategies Monitor the Effectiveness of Strategies
The Epidemiologic Model
Victim: Location and role Agent: Types of firearmsEnvironment: Vulnerable factors; protective factors; cultureInvolvement of health workers
Public Health Approach to Violence Prevention
FIREARM INJURY CENTER Medical College of Wisconsin
The Global Gun Epidemic
The Epi Model: Victim
Of the 300,000 annual gun-related deaths approximately 80, 000-100,000 are direct conflict deaths
Over 200, 000 in non-conflict contexts
Disproportionate number of gun deaths occur in the Americas
The Global Gun Epidemic
The Epi Mode: Agent
Regardless of context, guns increase lethality
Reducing inappropriate access to guns reduces the risk of injury and death
Unregulated access to firearms fuels a culture of violence
The Global Gun Epidemic
The Epi Mode: Environment
Collective violenceInterpersonal violenceSelf-directed violenceCulture of violence
The Global Gun Epidemic
Multi-layered strategy (1)
Availability of current and reliable data Consideration of the entire gun supply chain, both legal and illicit Reduction of the culture of violence Post conflict demobilization, disarmament and reintegration
The Global Gun Epidemic
Multi-layered strategy (2)
International coordination and action Domestic violence and firearms legislation Implementation issues involving law enforcement and courts Political participation
The Need for Global Action
Coming together of different cultural, language and national traditions
Coming together of different advocacy movements
Gunviolence9-7-16-08.Z7