This week commemorates National Public Health Week, offering us in the Injury Prevention Center at Connecticut Children’s a chance to highlight the importance of the public health approach in addressing community gun violence.

Historically, communities have worked to address community gun violence, which refers to firearm incidents occurring outside homes involving individuals who may be familiar with each other or strangers. Typically, these efforts have relied on the involvement of law enforcement and the criminal justice system. More recently, there's been a growing recognition of mental health as a crucial factor in prevention efforts. Community gun violence is a complex issue with various underlying causes, demanding a diverse range of strategies to curtail the annual toll of injuries and fatalities. The public health approach provides numerous invaluable tools for comprehending and mitigating community gun violence.

What is the public health approach?

The public health approach includes four key steps:

Define and monitor the problem. Who is experiencing community gun violence?  Where is it happening most frequently? Is there a particular time of day or time of the year when violence increases?  What are the most common circumstances that lead to violent injury and death? Answering these questions - usually with data! - helps us figure out where to direct our prevention efforts. The Gun Violence Archive and Everytown For Gun Safety’s data tracker tools are excellent resources for federal, state, and city data on gun violence.

• Identify risk and protective factors. Risk factors are characteristics that make it more likely that violence will occur. Protective factors make violence less likely. 
Although further research is necessary to fully grasp the depth of risk and protective elements, it's evident that strong familial and peer connections, school engagement, and constructive conflict resolution within households act as shields against youth involvement in community violence. Prioritizing investments in programs and policies that enhance these protective factors is essential.

• Develop and test prevention strategies. With limited resources for violence prevention, it's crucial to prioritize investments in programs and policies proven to reduce the incidence of violent injuries and deaths in our communities. This requires a thorough evaluation of the effectiveness of our prevention strategies. Lacking concrete evidence that a strategy effectively prevents violence may result in wasting resources on programs that fail to make a difference or even worsen the problem. The example of the anti-drug program DARE highlights the necessity of evaluating our efforts rigorously.

• Assure widespread adoption. Once we know a particular strategy works, we implement it far and wide.  We must continue to assess whether our program or policy is making communities safer and be prepared to adjust if we find that something is not working.

Why the public health approach matters.

When we apply a public health approach to community gun violence, we also shift our thinking about violence.  Even making the identification that community gun violence is a public health issue helps us reframe the causes, consequences, and possible solutions to the problem. We prioritize prevention over blame and punishment, recognizing that societal factors play a significant role in reducing violence. Instead of fixating on individual actions, we focus on strategies such as safe firearm storage, increasing affordable housing, and improving access to mental health support for families.

The public health approach also emphasizes prioritizing prevention strategies that achieve the greatest impact for the largest number of individuals. In addressing community gun violence prevention, this entails allocating resources toward strategies that will result in the most significant reduction in violent injuries and deaths. Public mass shootings are uniquely distressing but make up a small percentage of violent gun injuries and deaths overall.  Assaults and homicides that occur interpersonally, or that are otherwise not part of a mass shooting event, attract much less media attention but deserve priority in terms of our prevention resources. Community violence intervention strategies, such as violence interruption, cognitive-behavioral interventions, and hospital-based violence intervention programs operate from this principle.  Rather than providing services to everyone, organizations that use community violence intervention strategies work with individuals at the highest risk for committing or experiencing gun violence.  Narrowing their scope to only work with high-risk individuals allows these organizations to see the largest impact possible with their limited resources.

This year, the American Public Health Association’s theme for National Public Health Week is, "We Are All Public Health". Whether you are working to prevent community gun violence, expanding access to safe housing, or increasing the number of social workers and other mental health providers in schools, a public health approach can sharpen and strengthen your prevention efforts.