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Gun Violence is Preventable Gun violence is not inevitable. It can be prevented through a comprehensive public health approach that keeps families and communities safe. A public health approach to preventing gun violence recognizes that violence is contagious and can become epidemic within a society.8,9 Primary prevention involves the use of core public health activities to interrupt the transmission of violence: (1) conducting surveillance to track gun-related deaths and injuries, gain insight into the causes of gun violence and assess the impact of interventions; (2) identifying risk factors associated with gun violence (e.g., poverty and depression) and resilience or protective factors that guard against gun violence (e.g., youth access to trusted adults); (3) developing, implementing and evaluating interventions to reduce risk factors and build resilience; and (4) institutionalizing successful prevention strategies.9,10 Importantly, prevention does not require predicting who will be violent. Just as aviation safety regulations make air travel safer for everyone, common-sense measures to prevent gun violence make communities safer for everyone. What is Needed? To enhance America’s public health response to gun violence, we need: • Better Surveillance. The National Violent Death Reporting System currently collects data from 40 states, the District of Columbia, and Puerto Rico. Information on firearm fatalities from all 50 states and the District of Columbia would provide a more complete picture of gun violence in the United States.11 The surveillance data collected would prove invaluable for the design of targeted gun violence prevention strategies. But to do that, it must expand from its current 40 states, D.C. and Puerto Rico. In fiscal year 2017, Congress provided almost $16 million in funding for NVDRS. This increase helped move the surveillance system closer to national implementation. • More Research. Several laws have effectively restricted federally funded research related to gun violence, as well as access to complete crime gun data.12,13,14 Yet information is needed to fill critical research gaps. For example, there is almost no credible evidence that right-to-carry laws increase or decrease violent crime, almost no empirical evidence to support dozens of violence prevention programs for children, scant data on the effects of different gun safety technologies on violence and crime, and scant data on the link between firearms policy and suicidal behavior.15,16 We must expand the collection of data and research related to gun violence and other violent crime deaths in order to better understand the causes and develop appropriate solutions. Congress should provide unrestricted funding to the Centers for Disease Control and Prevention for research into the causes of gun violence. • Common-Sense Gun Policies. APHA supports requiring criminal background checks for all firearms purchases, including those sold at gun shows and on the Internet. Currently unlicensed private firearms sellers are exempt from conducting criminal background checks on buyers at gun shows or over the Internet, giving felons, the mentally ill and others prohibited from owning firearms access to weapons. We also support reinstating the federal ban on assault weapons and high-capacity ammunition magazines, which expired in 2004. • Expanded Access to Mental Health Services. Funding for mental health services has been declining, and funding for the Substance Abuse and Mental Health Services Administration continues to be threatened by budget cuts including cuts due to sequestration. We must ensure that state, local and community-based behavioral health systems have the resources they need to provide much-needed care. • Resources for School and Community-Based Prevention. APHA supports comprehensive measures in community and school-based prevention, early intervention strategies and preparedness initiatives to prevent gun violence and prepare our communities and schools in the event of an emergency. We support providing on-site mental health services, including through school-based health centers, a common-sense approach to ensure that children and youth are able to access appropriate treatment and services. SBHCs also support all students’ mental health by creating school-wide programs that address bullying, violence, anger, depression and other social and emotional issues that impede academic achievement. • Gun Safety Technology. Although specialized gun trigger locks and safes are on the market today,17 more needs to be done; there is little ongoing investment and research into gun safety technology. APHA supports innovative technology that can prevent unauthorized gun access and misuse, including unintentional shootings.