A public health approach to preventing mass violence

The recent and tragic mass shootings in El Paso, Texas and Dayton, Ohio, shatter our sense of safety and security and force us all to ask how long events like this will continue before we find a solution. 

We believe that solutions are possible and that a public health approach will make a significant contribution toward addressing our nation’s epidemic of mass violence. Seven major medical societies and the American Public Health Association similarly endorsed the need for a public health approach in a recent policy statement calling on health-care providers, policymakers and political leaders to treat gun violence as a public health emergency and use tactics similar to prior campaigns to reduce tobacco use and prevent motor vehicle deaths.

But what is a public health approach? At its core, public health understands that complicated problems require complex solutions. A public health approach addresses the problem of mass violence by asking: What are the factors contributing to this crisis? What is leading to the outcomes we are seeing? What is the pattern of incidence, distribution, and possible control? What does the data say about the epidemic, and what are evidence-based strategies to prevent it? 

A public health approach also asks: Are we listening to the voices of all affected and impacted communities and engaging those voices in creating effective solutions?

In short, a public health approach moves away from treating these events as the diabolical behavior of a few unhealthy individuals and instead seeks to understand the broader conditions that contribute to these events, asking how they can be prevented. 

We believe that the problem of mass violence in the United States can and should be addressed in part from a public health perspective and that the tools of public health research and practice should be fully deployed to help end it.

Just as there is no single intervention to reduce tobacco use or obesity, there is no single solution or “silver bullet” to end our nation’s epidemic of mass violence. Instead, successful interventions will come from all of us working together with community leaders, business leaders, government leaders, and public health leaders to create workable and effective solutions within neighborhoods, communities, states, and across the nation.

Just as tobacco use prevention includes clinical interventions that support an individual’s behavior change and population-based policy change that reduces access to tobacco, preventing mass violence will require a combination of strategic interventions that protect and promote health and well-being at the individual and population levels. These include discussions about firearm safety and mental health, as well as community-wide conversations about how to prevent all kinds of violence.

Public health leaders have successfully solved complex problems in the past through a thorough understanding of the patterns of disease, a careful application of evidence-based interventions to prevent the disease at the individual and population levels, by engaging communities in authentic conversations about the problem, and by soliciting the active engagement of communities to implement effective solutions. 

Just as healthy and resilient individuals tend to make better decisions about their health, resilient communities that actively engage individuals in civic life and work to promote well-being across many sectors experience better health and well-being. 

This is the insight of a public health approach. The practical application of core public health concepts is truly an essential approach to help prevent mass violence events and the needless death and suffering of so many.

Nathaniel Smith, M.D., is the president of the Association of State and Territorial Health Officials (ASTHO). He is also the secretary of health and state health officer of Arkansas. Michael R. Fraser, Ph.D., M.S., is the chief executive officer at the Association of State and Territorial Health Officials (ASTHO).