July 1996 Bulletin

Position Statement

Firearms violence

The American Academy of Orthopaedic Surgeons believes that death, injury and disability resulting from firearm violence must be reduced.

Firearm violence is a significant public health problem. The Academy believes that the public should recognize the following information which outlines an epidemic of injury and death due to firearms.

• Firearms are involved in the deaths of more than 37,000 people each year, the second leading cause of injury-related death in the United States.

• Firearm deaths have increased 60 percent since 1968. During 1991, 5,356 young men and women under the age of 20 were killed by firearms, the leading cause of death for both African-American and Caucasian youth in America.

• Accidental shootings account for 5 percent of all firearm deaths in the United States each year. Youths in the home, under the age of 20, are involved in 84 percent of these cases. Firearm deaths involving children and adolescents have increased 143 percent between 1986 and 1992.

• The most common reason given for purchase of a gun is protection from crime, yet one study shows only two out of 398 firearm deaths in a home involved an intruder. Relatives and friends are 43 times more likely to die from a gun kept in the home for protection than is an intruder. Self-defense handgun shootings account for only 1.2 percent of homicides, according to the FBI.

• Medical costs for firearm violence surpass $4 billion yearly and total economic losses are estimated to exceed $14.5 billion each year. In 1993, the average estimated hospital cost of each firearm injury was more than $19,000.

The American Academy of Orthopaedic Surgeons believes that most deaths and injuries due to firearms are preventable. The Academy is committed to reducing death, injury and disability due to firearm violence through support of a comprehensive public health approach which includes the following:

Education, Prevention and Intervention

• Education of health professionals for the prevention, acute care and rehabilitation of firearm injuries.

• Public education programs designed to teach and encourage proper firearm use, lock and key storage and firearm safety.

• Supporting programs that educate patients and families about the dangers of firearms to children.

• Encouraging physicians to ask their patients about the presence of firearms in the home and encouraging proper storage to achieve a "childproof home."

• Scientific research, including social studies, aimed at identifying causes and solutions to the firearm problem.

Data Collection and Trend Monitoring

• Accurate and objective data collection and trend monitoring of firearm injuries to enable the development of sound public policy.

• Public funding for a national firearm injury and fatality reporting system of the Centers for Disease Control and Prevention.

Public Policy Strategies

• Safety intervention strategies to control firearm possession and use by unsupervised youth under age 18.

• Implementation of proper licensing fees.

• Enactment of a required national waiting period that allows for an expanded police background check.

• Banning the sale or manufacture of firearms that are not detectable by ordinary security devices.

• Creating a long-term goal to eliminate specific categories of firearms that have little or no legitimate utility.

• Stricter enforcement of present local, state and federal laws and the imposition of mandatory penalties for crimes committed with firearms.

• Prohibiting the presence of firearms in hospitals except for law enforcement officials.

• Encouraging the American Hospital Association and the Joint Commission on Accreditation of Healthcare Organizations to develop guidelines and standards regarding hospital security issues.

May 1996