The U.S. surgeon general has declared gun violence a public health crisis and called for a re-framing of gun violence as a public health issue and not a political one. 

In the 32-page advisory Tuesday, Dr. Vivek Murthy drew special attention to how firearms have become the leading cause of death of children and teenagers. “We have to look at this now for what it is, which is a kids’ issue,” Murthy told The New York Times. 

Murthy’s announcement on the two-year anniversary of the Bipartisan Safer Communities Act — the most significant piece of gun control legislation to have been passed by Congress in 30 years — signals an important moment in the politics and culture of understanding the gun violence epidemic in America, said policy and advocacy groups that have worked on gun violence. The declaration, these groups said, is also a call for better understanding not only the demographics most impacted by this violence, but the evidence-based solutions for preventing it. 

“This is a huge deal,” Emma Brown, the executive director of GIFFORDS and the GIFFORDS Law Center, told The 19th. “It is a major development in the arc of the fight to reduce gun violence in this country.”

A public health advisory from the surgeon general’s office is meant to draw the country’s attention to something “that is urgent, deadly and important,” Brown said. She points to the past usage of surgeon general’s advisories on the use of tobacco products, drunken driving and HIV/AIDS as major tipping points in how Americans understood systemic, societal issues. 

Ryan Barto, the communications manager for March For Our Lives, a student-led gun safety advocacy organization, called Murthy’s announcement “fantastic news” and said it was something his group had been asking for. “There are some kinds of products that are harmful to people and we should regulate them specifically because of their known detrimental impact on our children.” 

The report underscores that 56 percent of all unintentional firearms deaths among people 17 and younger happen while they are in their own home; 67 percent of shooters in these unintentional deaths were either playing with a firearm or showing it to others when it discharged.

It’s messaging that speaks to a core constituency in implementing larger societal change: parents. 

In the advisory, Murthy calls on public health leaders and policymakers to require safe and secure firearm storage, including child access prevention. 

Murthy’s advisory addressed the danger of school shootings — including the fear many American children fear at the possibility — as well as suicide. Firearm-related suicide has increased by 20 percent over the past decade — with the highest increases among younger people. It’s up 68 percent among people ages 10 to 14, and 45 percent among those who are 15 to 24. Eighty percent of youth who die by suicide use a firearm from their own home.  

Barto added that the firearm suicide rate for Black teens surpassed the suicide rate for White teens for the first time ever last year. “Guns increase suicide rates because when you have more access to guns — especially when young people have more access to guns in their home and there’s no safe storage of them — they are more likely to commit suicide because they have access to that weapon.”

Gun violence is having a fatal impact on women, as well. According to Everytown for Gun Safety, 31,510 women in the United States died from gun violence in the United States between 2018 and 2022, and overwhelmingly through either homicide or suicide. American women are 28 times more likely to be killed by guns than women in other high-income countries. Six thousand women die from gun violence every year, with women of color making up more than 60 percent of those deaths.

Twenty people are abused by an intimate partner every minute in the United States; when a gun is present during a domestic violence incident, the risk of death to the person being abused increases by 500 percent. Per Everytown, women of color are three to four times more likely to be fatally shot by an intimate partner compared with  their White peers. 

LGBTQ+ Americans also face heightened risks of gun violence. 

According to data from Everytown for Gun Safety, LGBTQ+ people, especially LGBTQ+ youth, are at a higher risk of contemplating and attempting suicide. Access to a firearm triples the risk of suicide death for the overall population. Per Everytown, cisgender queer boys and men report high levels of gun access — compared with their LGBTQ+ peers, this group has the highest rates of living in a home with a firearm, at 46 percent. About 2 in 5 transgender young people between the ages of 13 and 24 report living in homes with firearms.  

A data analysis from Everytown found that between 2017 and 2023, there were more than 263 homicides of transgender or gender expansive people;  73 percent were killed with a gun. During this same time span, more than 6 in 10 gun homicides of transgender and gender expansive people were of Black transgender women. Another one in 10 of those gun homicides were of transgender Latina women.  

Rob Wilcox, a deputy director of the White House’s Office of Gun Violence Prevention, said Tuesday’s announcement speaks to a long-standing charge given to his office by President Joe Biden to treat gun violence as a public health crisis — and think about solutions beyond solving any one given crime.

He pointed to a newly released report from the Office of Gun Violence Prevention on the work accomplished by the Bipartisan Safer Communities Act over the past two years: the funding of 100 organizations doing community violence intervention work, a $500 million investment by the federal government in evidence-based school safety, and a $1 billion investment in youth mental health services to hire and train 14,000 new school-based mental health professionals — counselors, social workers, and psychologists. But the Bipartisan Safer Communities Act has gone beyond prevention to deal with firearms in circulation in America, too, specifically regulating those who are selling guns without a license and cracking down on straw purchases as a result. 

This work is translating into real world results, Wilcox said. “Last year was the most historic decrease in gun violence and homicide in our nation’s history, a 13 percent reduction across the country. So far this year, we’ve seen a 26 percent reduction. On top of that, in some of our biggest cities with more than a million people, we have seen a 43 percent reduction.”  These steep drops in gun violence nationally coupled with the Murthy’s announcement underscores that evidence-based solutions matter — and are effective. “It’s not about looking at that reduction as points on a chart, but the difference between funerals and graduations.”

When it comes to school shootings in particular, something called out specifically in Murthy’s report, Wilcox stressed that intervention in acute moments of crisis is critical. “We know that the kids are showing warning signs before they show up at that school,” he said.

“We have to create ways for people with information to share it, to say something knowing that an individual in crisis is going to get wrapped in support and services and help because they haven’t committed a crime yet — but they’re clearly struggling in crisis,” Wilcox said. “We have to make sure that parents who choose to bring guns into the home keep them securely stored because we don’t need a gun that’s brought into the home to protect the family being pulled out to harm classmates.” 

Wilcox said that he hopes people will understand the surgeon general’s announcement as a sign that, as Biden has called for, “we have to do something — and we have been doing something.” Coupled with the report on the progress made to reduce gun violence since the passage of the Bipartisan Safer Communities Act in 2022, Wilcox says he would like people to see that despite a long-standing feeling that nothing can be done about gun violence in America, the work on the ground shows the opposite to be true. 

And for advocates like Brown, she takes the surgeon general’s announcement that more and more people are about to sign on to support these kinds of solutions, too. 

“I am a queer woman who is 30 years old,” Brown said. “I have seen this issue from a few different lenses and it’s a really meaningful moment that the surgeon general is recognizing — that the Biden administration is recognizing — that this is not a dangerous, scary political topic but that this is a public health crisis and treating it that way. When you’re looking at the arc of other major public health movements in this country, the Surgeon General’s advisory was always the first domino to fall. I think when we look back at this moment in two to three years, it will have been very significant in regards to everything that follows.”