Dennis Odhiambo

VIOLENCE AS A PUBLIC HEALTH ISSUE IN THE UNITED STATES INTRODUCTION The freedom to keep and bear arms, granted by the second amendment, is important to Americans as a beacon of democracy for the rest of the world (Carter & Kleck, 1999). The Supreme Court recognized that the amendment serves the purpose of protecting individual rights (Ciocchetti, 2013). Even though this right is deemed fundamental, healthcare experts are witnessing an increasing prevalence of gun violence-related mortality and injury. Further study of the data reveals that young individuals in the United States are several times more likely than those in any other industrialized country to be killed by a firearm (Elsevier, 2016). These occurrences aren't new as they've been happening for a long time. The phenomenon of citizens and young people dying and being injured is investigated in this study, with the conclusion that gun violence is a public health concern. Even though violence is now universally acknowledged as a public health issue, the words ‘violence’ and ‘health’ were rarely treated in a similar context just 3 decades ago(Edlig, 1997). A growing realization and acceptance that violence might be managed from a public health perspective were bolstered by several significant trends ("Suicide Contagion and the Reporting of Suicide: Recommendations from a National Workshop", 2021), ("From the Centers for Disease Control and Prevention. Homicides among 15-19-year-old males--the United States,-", 1994). GUN OWNERSHIP IN THE UNITED STATES Citizens in the United States own many more guns than citizens in other industrialized countries. Despite having roughly 5% of the world's population, the United States has an estimated 250-300 million guns owned by civilians or approximately one per person. The most fascinating aspect is that there is no consistency in the rules that govern the usage of guns throughout the United States. According to statistics, “in 2011, 88 Americans died on average every day from gun violence in this country, with another 202 seriously injured” (Wintemute, 2013). Drawing inferences from Witenmute's statistics, the United States loses 32,120 persons each year to gun violence, whereas another 73,730 are injured. This level of mortality and injuries has been consistent. In 2005, 30,694 persons died in our country as a result of gunshot wounds. Suicides accounted for 17,002 cases, homicides for 12,352, and accidental, police-related, or undetermined purpose for 1340 (Wintemute, 2008). Gunshot wounds in the United States in 1994 cost approximately $2.3 billion in lifetime hospital expenses, or, on average, $17,000 per injury,” according to the National Institute of Health (Eber et al. 1686). PROBLEM STATEMENT Suicide and suicide attempts, violent confrontations and disputes, intimate relationship violence, accidental fatalities and injuries, violent criminal activity, and violent actions while extremely disturbed, inebriated, or profoundly psychotic are all examples of firearm violence. Firearms play a substantial role in homicide and suicide deaths in the United States. Even though the Constitution grants individuals the freedom to bear guns, it has recently become a divisive subject due to an increase in public mass shootings ("U.S. Gun Policy: Global Comparisons", 2021). It is now clear that gun violence has become a serious public health problem. Contemporary entertainment has a substantial impact on society's attitudes toward gun violence; there are long-term and short-term lasting effects on loved ones in the event of injury or death; and there are consequences when one is raised or educated in an environment where gun violence has had a significant impact (Mercy et al., 2003). VIOLENCE AS A PUBLIC HEALTH ISSUE The consequences of gun violence are costly to the healthcare system as well as emotionally and financially to society as a whole (Prevention et al., 2021). According to data, homes with firearms are disproportionately more likely to experience an unintentional discharge of a firearm, resulting in death or bodily and mental damage for all parties involved ("Gun Violence", 2021). The figures do not lie, and it is the responsibility of healthcare to communicate this information to policymakers. Concerning gun violence, the problem of guns regulation, which must balance the civil rights guaranteed by the US Constitution with the health and safety of the community, is a policy matter for legislators, judges, and attorneys to address (Hoyert & Xu, 2012). Homicide and suicide have continuously been among the list of top causes of death in the United States since 1965 ("Crime Commission Report", 1967). During the 1980s, the risk of homicide and suicide among some sectors of the population, such as teenagers and members of minority groups, reached pandemic proportions. Between 1950 and 1990, the suicide rate among teenagers and young adults aged 15 to 24 years nearly tripled. Similarly, homicide rates among 15 to 19-year-old males skyrocketed by 154 percent between 1985 and 1991, a remarkable change from the prior 20 years (Butkus et al., 2018). WHY PUBLIC HEALTH APPROACH IS NEEDED When it comes to violence, the public health approach focuses on prevention by attempting to address the established factors that promote or minimize the probability of violence. Every engagement within the healthcare system is a chance to directly forestall violence. As a result, the public health system must play a key role in stemming the tide of violence, with the public health workforce engaged in core activities such as training, education, and evaluation, as well as an explicit focus on addressing inequities and reducing racial bias in the system's institutions. This strategy not only avoids injustice and inequity but also saves a great deal of money (Frattaroli, 2003). The following are some of the proposals for a public health strategy to primarily addressing acts of gun violence: Identifying risk variables such as depression and poverty that are linked to gun violence. Similarly, resilience variables that are known to protect against gun violence must be identified. Surveillance is required to keep track of gun-related injuries. This will give insight into the primary causes of gun violence, as well as aid in the evaluation of the effectiveness of the treatments adopted. Interventions are being developed, implemented, and evaluated in an attempt to minimize the identified risk factors and improve resilience. Prevention measures are becoming institutionalized (Christoffel, 2007). CONCLUSION According to a 2013 study, the number of firearms per capita per country was strongly related to and was an independent predictor of gun-related deaths. The authors observed that the United States, which owns the most firearms per capita in the world, has the highest prevalence of firearm deaths, while Japan, which owns the lowest percentage of firearms, has the lowest levels of firearm deaths. Findings comparing the quantity and type of gun laws enacted in states in the United States have discovered a link between stricter gun laws and lower firearm death rates ("Reducing Firearm Injuries and Deaths in the United States: A Position Paper From the American College of Physicians | Annals of Internal Medicine", 2021). The Giffords Law Center to Prevent Gun Violence, which assigns grades to states based on a points system, discovered that seven of the ten states with the strictest gun laws had the lowest rates of firearm deaths. The contrast between high levels of gun violence in California during the early 1990s and the relatively low rate of gun violence after the adoption of state laws and city and county ordinances aimed at reducing gun deaths demonstrates the correlation between stringent gun laws and reduction in firearm violence. California's gun violence rate was 15% higher than the national average in the early 1990s. Since then, the rate of gun violence in California has significantly decreased ("Gun Laws | Giffords", 2021). The availability of weapons in the United States is a public health risk, and appropriate controls must be put in place to prevent those who should not have firearms from obtaining them. REFERENCES Butkus, R., Doherty, R., & Bornstein, S. (2018). Reducing Firearm Injuries and Deaths in the United States: A Position Paper From the American College of Physicians. Annals Of Internal Medicine, 169(10), 704. https://doi.org/10.7326/m18-1530. Carter, G., & Kleck, G. (1999). Targeting Guns: Firearms and Their Control. Social Forces, 77(3), 1224. https://doi.org/10.2307/-. Ciocchetti, C. (2013). 2nd Amendment: The Right to Keep & Bear Arms -- Teaching D.C. v. Heller. SSRN Electronic Journal. https://doi.org/10.2139/ssrn-. Eber, G. B., Annest, J. L., Mercy, J. A., & Ryan, G. W. (2004). Nonfatal and fatal firearm-related injuries among children aged 14 years and younger: the United States,-. Pediatrics, 113(6),-. https://doi.org/10.1542/peds-. Edlig, C. (1997). Violence as a public health issue. Public Health, 111(5), 348. https://doi.org/10.1016/s-. Elsevier. (2016, February 2). Americans are ten times more likely to die from firearms than citizens of other developed countries. ScienceDaily. Retrieved September 27, 2021, from www.sciencedaily.com/releases/2016/02/-.htm. From the Centers for Disease Control and Prevention. Homicides among 15-19-year-old males--the United States,-. (1994), 272(20),-. https://doi.org/10.1001/jama-. Gun Violence. Amnesty International. (2021). Retrieved 28 September 2021, from https://www.amnesty.org/en/what-we-do/arms-control/gun-violence/. Hoyert, D. L., Xu, J. (2012). Deaths: Preliminary data for 2011. National Vital Statistics Reports,(61) 6, 11-51. Retrieved 28 September 2021, from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf Mercy, J., Krug, E., Dahlberg, L., & Zwi, A. (2003). Violence and Health: The United States in a Global Perspective. American Journal Of Public Health, 93(2), 256-261. https://doi.org/10.2105/ajph.93.2.256. Olson, L. M., Christoffel, K. K., & O'Connor, K. G. (2007). Pediatricians' involvement in gun injury prevention. Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention, 13(2), 99–104. https://doi.org/10.1136/ip-. Prevention, F., Health, B., Medicine, I., & Council, N. (2021). Direct and Indirect Costs of Violence. Ncbi.nlm.nih.gov. Retrieved 28 September 2021, from https://www.ncbi.nlm.nih.gov/sites/books/NBK189992/. Reducing Firearm Injuries and Deaths in the United States: A Position Paper From the American College of Physicians | Annals of Internal Medicine. Annals of Internal Medicine. (2021). Retrieved 28 September 2021, from https://www.acpjournals.org/doi/10.7326/m18-1530. Suicide Contagion and the Reporting of Suicide: Recommendations from a National Workshop. Cdc.gov. (2021). Retrieved 28 September 2021, from https://www.cdc.gov/mmwr/preview/mmwrhtml/-.htm. Wintemute, G. (2013). Tragedy's Legacy. New England Journal Of Medicine, 368(5), 397-399. https://doi.org/10.1056/nejmp-.