'Pivotal Moment': US Surgeon General Declares Gun Violence a Public Health Crisis

U.S. Surgeon General Vivek Murthy issued a Surgeon General's Advisory on firearm violence on Tuesday, calling it a "public health crisis."

The advisory marks the first time that the nation's leading physician has published a warning on gun violence, which now joins the ranks of tobacco, skin cancer, and opioids as the subject of a surgeon general's publication.

"Firearm violence is a public health crisis," Murthy said in a video message announcing the report. "Our failure to address it is a moral crisis. To protect the health and well-being of Americans, especially our children, we must now act with the clarity, courage, and urgency that this moment demands."

The report comes after gun violence deaths in the U.S. reached their highest level in 30 years in 2021. According to the report, 54% of U.S. adults have either experienced a firearm-related incident directly or have a family member who has. Of those impacted, 21% were threatened with a firearm; 19% lost a family member to guns, including by suicide; 17% saw someone being shot; 4% used a gun to defend themselves; and 4% were injured by one.

Gun violence has been especially devastating for children. As of 2020, firearm injury overtook car accidents, cancer, drug overdoses, and poisoning as the leading cause of death for young people ages 1 to 19.

The U.S. stands out among similar nations for its level of gun violence. In 2015, the U.S. had 11.4 times the rate of gun-related deaths compared with 28 other high-income countries, and more than 90% of the children who died due to gun violence in those countries died in the U.S.

"I know it's been polarizing and I know it's been politicized, but if we can see it as a public health issue, we can come together and implement a public health solution."

While mass shootings grab headline attention and are on the rise, they only account for around 1% of gun-related deaths. The rise in gun-related deaths is in large part fueled by an increase in gun homicides over the past 10 years and gun suicides over the past 20. Still, mass-shootings take a disproportionate toll on the nation's mental health, with more than three quarters of U.S. adults reporting stress due to worries about experiencing one.

"Our children should not have to live in fear that they are going to get shot if they go to school. None of us should have to worry that going to the mall or concert, or house of worship means putting our lives at risk, or that we'll get a call that a loved one in a moment of crisis has taken their own life with a firearm," Murthy said. "All of us, regardless of our background or beliefs, want to live in a world that is safe for us and our children."

The issue of gun violence has been heavily politicized in recent years, something Murthy has both acknowledged and experienced. After comments he made about gun violence, the firearm lobby and some Senate Republicans opposed Murthy's confirmation as former U.S. President Barack Obama's surgeon general in 2014, The Associated Press explained. He was confirmed after promising not to use his office as a "bully pulpit on gun control."

Trump dismissed him as surgeon general in 2017 and, when President Joe Biden reappointed him, he again assured the Senate that gun violence would not be a priority during his tenure. However, Murthy also received counter-pressure to take up the issue from Democratic groups and other public health professionals, including four former surgeon generals.

"I want people to understand the full impact of firearm violence in our country, and I want them to see it as a public health issue," Murthy toldThe Washington Post. "I know it's been polarizing and I know it's been politicized, but if we can see it as a public health issue, we can come together and implement a public health solution."

Murthy toldKFF News that this approach helped the U.S. tackle other major killers, such as tobacco after the surgeon general's landmark warning in 1964 that smoking caused cancer and other ailments.

"We saved so many lives, and that's what we can do here, too," Murthy said.

"There are many powerful forces who downplay the threat of gun violence because the status quo benefits them financially or politically, and I'm grateful that Surgeon General Dr. Vivek Murthy had the courage to do what he knows is best for our nation's health."

That said, the report does include recommendations that will require a political compromise in Congress, including a ban on automatic rifles and large-capacity magazines, universal background checks, more restrictions on firearms in public spaces, more penalties for improper safeguarding of firearms, and regulating firearms like any other consumer product.

The report also calls for measures such as community violence prevention programs, improved access to mental health services, and additional research into the best ways to reduce gun violence.

The advisory was welcomed by members of the public health community as well as gun violence prevention advocates.

"Today marks a pivotal moment in public health as the surgeon general has issued a new advisory declaring gun violence a public health crisis. As a pediatric surgeon and advocate for safer communities, I am deeply moved and resolute in supporting this call to action," Dr. Chethan Sathya, vice president of strategic initiatives and director of gun violence at Northwell Health, wrote on social media.

Joseph Sakran, executive vice chair of surgery at John Hopkins Hospital in Baltimore and chief medical officer for Brady United Against Gun Violence, told KFF Health News that the advisory was a "historic moment that sounds the alarm for all Americans."

In a statement, Sakran continued: "Historically, we have seen how the release of surgeon general reports on public health issues such as the dangers of smoking ignited a wave of policy, legal, and public health initiatives that saved countless American lives and in this case led to deprogramming our nation from the tobacco industry's lies. We hope this report will have the same resounding impact on the gun violence epidemic."

Former U.S. Rep. Gabby Giffords (D-Ariz.), founder of gun control organization GIFFORDS, said: "I have seen firsthand how shootings are a major threat to Americans' lives and well-being, and our leaders must view the problem as the public health crisis it is. There are many powerful forces who downplay the threat of gun violence because the status quo benefits them financially or politically, and I'm grateful that Surgeon General Dr. Vivek Murthy had the courage to do what he knows is best for our nation's health. Policymakers at every level of government have a responsibility to heed the declaration and take urgent action to protect their communities."

March For Our Lives noted on social media that the advisory came after "years of activist pressure."

"The gun lobby fought hard, but data doesn't lie," the group wrote. "Our push for more research and tighter laws is paying off, and we're starting to win BIG."

Both Sakran and Sathya argued that the report was not an end in itself, but a gateway to more effective prevention efforts.

"Let's heed this advisory not as a mere recommendation, but as a clarion call to action," Sathya concluded. "Together, we can turn the tide on gun violence and create a healthier, safer environment for all."