Understanding Gun violence as a Public Health Crisis

Written By: Diya Mool

Gun violence is often described as a political or legal issue; however, from a health

perspective, it is understood as a preventable population level health outcome. The Center for Disease Control and Prevention or the CDC identifies firearm injury and death as a leading cause of mortality.[1] Although firearms are often perceived as isolated events, epidemiological evidence has demonstrated patterns across geography, demographics and time.

Scope of the Problem

Firearms have been a leading cause of death in populations so much so that it was one

of the topics that SPHG 351 talked about last semester. While not everyone may be killed by

guns there are many who have long term physical and psychological consequences including but not limited to post traumatic stress disorder, anxiety, and chronic stress.[2] These are not outcomes that occur randomly; they are rooted in the social determinants of health. For example, those in urban, underserved areas, and racially segregated communities are subject to disproportionate amounts of gun violence.[3] This is a key indicator that neighborhood and built environment play a critical role in gun violence. Public health research demonstrates that exposure to violence clusters creates perpetual cycles of risk over time.

Social Ecological Framework

Examining gun violence as a public health issue makes it more multifaceted. This allows

for the recognition that there are multiple levels of influence that interact. Let us break it down into levels of the socioecological framework. At the individual level, there are factors like age, stress, and substance use that may play a role. At an interpersonal level, people’s family and people’s friends may contribute. At the community level, neighborhood divestment, lack of resources, or substance use may play a role. At the societal level structural racism, and firearm accessibility will play a role.

Biological and Behavioral Impacts

Another important consideration is risk amplification. If you are once exposed to un

violence, you have higher odds of experiencing it again and your body’s biology knows that. If you are chronically exposed to violence, your body’s stress pathways will try to prevent that through prolonged activation of the HPA axis. HPA Axis is the connection between the

hypothalamus, pituitary, and adrenal axis. This is linked to hypervigilance, anxiety, and cognitive functioning. At the same time, repeating exposure can normalize violence in social environments shaping health behaviors.[4] This reinforces risk cycles that go beyond individual events and highlight why intervention is critical.

Spatial Clustering and Structural Risk

One extremely overlooked dimension is the role of spatial clustering in firearm injury.

This is the idea that there are specific regions in the US where there tends to be higher rates of firearm injury. These regions experience disproportionate amounts of firearm injury due to structural disadvantages.

Conclusion

Framing gun violence also highlights why it is needed to keep data on the issue.

Tracking patterns, identifying risks, and evaluating interventions is what allows for us to make a tangible change as future public health professionals. Just as we treat infectious diseases with surveillance and prevention strategies, we should be treating gun violence as a public health issue. Ultimately, viewing gun violence through a public health lens does not take away form its political or legal dimensions. This allows the conversation to continue. The focus goes towards prevention and how to prevent future issues. I think most importantly it reflects upon the idea that gun violence should not be happening. This is something that is completely preventable and it requires action across multiple levels of the social ecological model.

References: 

1. Centers for Disease Control and Prevention. Firearm Injury and Death. CDC. Accessed

April 2026. https://www.cdc.gov/firearm-violence

2. Fowler KA, Dahlberg LL, Haileyesus T, Annest JL. Firearm injuries in the United States.

Prev Med. 2015;79:5-14.

3. World Health Organization. Social Determinants of Health. WHO. Accessed April 2026.

4. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med.

1998;338(3):171-179.