When leaders choose to take action, gun deaths fall
The U.S. has among the highest firearm mortality rates in the world. Firearms are now the leading cause of death among children and youth and surpass motor vehicle fatalities for all ages. Youth suicide is on the rise, and youth are three to four times more likely to die in a suicide attempt when a firearm is in the house. Pregnant women are nearly 40% more likely to die by firearm homicide than nonpregnant women.
The U.S. has proven strategies to reduce firearm deaths. The findings of our recent Milbank Quarterly analysis of firearms as a market-driven epidemic and the 2024 JAMA Firearm Summit report make it abundantly clear that the US has developed a robust array of interventions shown to reduce gun-related suicides, homicides, and other firearm harms. These interventions include a wide range of gun safety laws, mental health and healthcare programs, community-based interventions, environmental initiatives, economic policies, and policing practices.
Despite the availability of effective tools to reduce preventable harms, there is a tenfold difference among states in their per capita deaths. Over the last three decades, California, New York, and Washington, D.C. led the nation in gun safety improvements, with reductions of up to 61% in their death rates. During the same period, Mississippi, Missouri, and New Mexico led in rising gun violence, with increases of as much as 63% in gun deaths. Reduced mortality was achieved by implementing proven gun safety strategies. States that experienced increased mortality rates implemented fewer such strategies, while enacting stand-your-ground laws and other policies shown to increase firearm violence.
At the local level, community violence interventions focused on high-potential violence transmitters have been implemented in Baltimore, Chicago, New York City, Philadelphia, and other major cities. While gun homicides remain a challenge in many cities, these programs have achieved reductions in gun homicides comparable to those achieved by the leading states.
Gun rights versus gun safety is a false choice. Reducing the human and economic burden of firearm violence should be a matter of public safety and effective governance. Over the last three decades, states and localities that achieved significant reductions in preventable firearm harm did so without infringing on constitutional rights.
The current burden of firearm harm is not the inevitable result of Second Amendment protections or the “American gun culture”. Leadership decisions by mayors, governors, and senior officials at the local, state, and national levels can have a profound positive impact on reducing preventable gun violence.
If every state and major city were to implement proven gun safety strategies while respecting gun rights, the excessively high rate of U.S. gun deaths could be much, much lower. The evidence is clear: when leaders choose to take informed action, firearm deaths fall.
