Advocacy to improve firearm safety for childrenTo the members of the ASPN, Your Task Force on reducing pediatric gun violence has been quite busy. I am appreciative of everyone's willingness to meet and learn how we can all be better advocates for children. I wanted to take a moment and update the membership on the status of the Task Force and next steps as we approach the upcoming annual meeting. We have all seen the well-known graph from the 2022 New England Journal of Medicine correspondence showing the substantial rise in pediatric mortality from gun violence. Other than drug overdose and poisoning, all other causes were either stable or in a gradual decline since 2000. Since this publication, there have been a number of papers in our own journals (Sandi Lam's efforts in the red journal come to mind here) as well as in Pediatrics, general and pediatric surgery journals, and JAMA. We have had the opportunity to review our experience here in Tennessee and in a similar fashion found the results to be concerning. I would imagine that many of you have done the same. One aspect has become clear and that is that firearm injuries and fatalities are not "one sized". Homicide, suicide, and accidental injuries have different demographics, geography, causes, and solutions. I have learned through this Task Force that while there are some basic approaches that are similar, each of these subsets may require a different approach. Pediatric neurosurgery plays a critical role in the hospital and trauma communities. Many of us sit on various hospital trauma committees in an effort to serve our public health duty. I would venture to say however that there are many others within our field that do not. This may be because some of our members feel uncomfortable in or do not have the bandwidth to have a role in efficacy and community wellbeing. It is realistic to say that as a field we underperform on the topic of reducing firearm injury precisely because we do not have a strategy as a society. It is my hope that the effort by the Task Force will help us address this issue by building on the AANS/CNS position paper that was put forth in the last year. Concepts to keep in mind as we do so: 1) We should maintain the high ground. We can acknowledge that firearm injuries are one of the many means by which children are injured in the United States and that we support and participate in efforts to reduce injuries by other means as well. At the same time we can also acknowledge that while we are not experts on firearms, many of us actually are experts in exploring and helping to implement efforts related to public safety; 2) We should also state the obvious. By this I mean that we should view firearms differently than other public health issues and that our expertise in patient care and trauma systems does not necessarily provide technical expertise in firearms, ballistics, constitutional law, or Federal/State legislation. It is not a stretch to say that the geographic diversity of United States coupled with the current political climate makes the idea that the federal government will swoop down and legislate a solution is unlikely; and 3) We should devise and define an actionable strategy for our membership to engage in efforts to reduce firearm injuries. I am excited to hear from pediatric surgeon and American College of Surgeons topic leader Dr. Ronny Stewart at the upcoming meeting and believe his talk will be highly informative. The Task Force and I are hopeful that it will help the membership to ground the effort in the American College of Surgeons’ Common American Narrative. At its most basic this is a plan for all sides on this complex issue to work together to decrease firearm related violence while making firearm ownership as safe as possible. We as a Task Force have landed on safe storage as an appropriate area of focus. This should result in a broader impact on firearm death and injury while respecting individual rights for firearm ownership. I recognize that some of the membership may feel like this is not enough and some may feel like this may be too much. It will be necessary that we collaborate in order for this to move forward with some impact. In addition, we have also landed on developing a “how to” webpage for members to better engage in local and regional approaches to reduce firearm injuries within their current healthcare systems as well as local and state environment. In summary I am grateful for the work done to date. I believe a thoughtful approach now moving towards goals rooted in the concepts stated above plus what we will learn from Dr. Stewart should put us exactly where we need to be. I look forward to seeing you all in Aruba.
Dr. Jay Wellons, ASPN President with members of the ASPN Task Force on Firearm Violence
Resources for ASPN Membership to pursue local/regional advocacy to reduce firearm injuries in children
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