resource centers and professional organizations, which can enable them to work out means to affect various steps in the gun distribution chain. Community coalitions can bring together law enforcement, public health, child protective services, and numerous citizen groups to develop, implement, and monitor a local plan to reduce youth gun access. Such a plan might include a wide variety of interventions, such as police enforcement strategies designed to disrupt local gun markets and to keep guns off the streets and out of schools; interventions focused on altering the "ecology of danger" (Wilkinson and Fagan, 1996) and changing norms relating to gun carrying and violence among urban youths; public education regarding the risks of gun ownership and the responsibility of adults for their firearms; and public education and legal measures promoting secure storage of weapons in the home.

The committee recommends the development of a national policy on the prevention of firearm injuries directed toward the reduction of morbidity and mortality associated with unintended or unlawful uses of firearms. An immediate priority should be a strategic focus on reduction of firearm injuries caused by children and adolescents.

To ensure the success of a youth-centered prevention initiative, Congress and relevant federal agencies (e.g., the Departments of Health and Human Services and Justice) should set national goals for reducing assaultive injuries, suicide, and unintentional injuries by young people using firearms. As a long-term commitment to this goal, consideration should be given to appointing a high-level task force for implementing and evaluating such an initiative.

SUMMARY

A comprehensive approach to reducing firearm injuries is necessary. Strengthened firearm and firearm injury surveillance efforts and multidisciplinary research initiatives can bring the depth and breadth of scientific and engineering expertise that is needed to develop and evaluate innovative firearm injury prevention measures. Designation of a federal agency to have regulatory jurisdiction over firearm safety issues, enforcement of current regulations, particularly on access to guns by children and adolescents, and expansion of state and local prevention programs are all necessary components of an effective comprehensive approach. The federal role should not involve the establishment of new bureaucracies but rather should be to provide national leadership and coordination to leverage the related programs at state and local levels, to generate new knowledge, and to promote the application of new findings. The committee believes that progress can be made in preventing and reducing the adverse



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