A new JAMA Summit Report, "Toward a Safer World by 2040," charts a path to reduce firearm deaths and injuries through coordinated, evidence-based action. Released Nov. 3, the report comes amid a staggering national toll - more than 800,000 people in the United States have died from firearm injuries since 2000, according to the Centers for Disease Prevention and Control. A growing consensus now views gun violence as a preventable public health crisis.
Sandro Galea, MD, DrPH, the Margaret C. Ryan Dean of the School of Public Health at Washington University in St. Louis and editor-in-chief of JAMA Health Forum, is among the 41 co-authors and one of eight national experts selected for their subject-matter expertise in firearm injury prevention, trauma and mental health.
Galea came to St. Louis from Boston, bringing national leadership in public health innovation to a city deeply affected by gun violence. He has written extensively on the mental and emotional toll of firearm injury and the systems that can prevent it.
"Public surveys have found time and again, that firearm violence is one of the most important health concerns for St. Louis residents," said Galea, who is also the Eugene S. and Constance Kahn Distinguished Professor in Public Health and vice provost for interdisciplinary initiatives. "This makes the issue particularly relevant to us, and a priority for the WashU School of Public Health."
The report grew out of the March JAMA Summit on Firearm Violence, which brought together 60 thought leaders from medicine, public health, law, history, public policy, epidemiology, engineering, sociology and community violence intervention. The summit aimed to identify actionable, science-based solutions to reduce firearm harms - part of JAMA's mission to advance progress on some of the most pressing issues in health and medicine.
The authors emphasized that violence may begin with people, but firearms multiply its toll - turning conflict into tragedy. When the act of using a firearm to injure another person is seen chiefly as an individual's bad choice, it shifts focus away from underlying social conditions or policy solutions that could prevent such harm.
The report highlights solutions that have already been shown to make communities safer. Numerous studies have identified a range of strategies, from firearm-specific interventions, such as background checks, safe storage laws and extreme risk protection orders, to broader community measures that improve safety, including economic opportunity, alcohol regulation and revitalizing neighborhoods through adding green spaces and improved lighting. For example, states with purchaser licensing and safe-storage laws have seen measurable declines in firearm deaths, while greening vacant lots in cities such as Philadelphia has reduced gun assaults and improved residents' sense of safety.
The authors outline five essential actions to drive progress in the coming years:
Invest in communities. Strengthen local programs that prevent violence before it starts, from youth mentorship and job opportunity initiatives to policies that improve housing stability, school funding and trust between residents and institutions.
Advance safer technology. Develop and test innovations that make firearms less deadly, including biometric "personally authorized" guns, passive detection systems that sense weapons before violence occurs and artificial intelligence tools that help identify and prevent risk. Treat firearms like other consumer products, ensuring these technologies are equitable, responsible and effective.
Change the narrative. Build public understanding that firearm injury is preventable - not inevitable - by shifting how people, policymakers and the justice system view and talk about gun violence. Highlight effective, community-based solutions and promote balanced, evidence-driven policing that focuses on prevention, respects community trust and works alongside public health strategies to save lives.
Coordinate action. Align efforts across federal, state and local levels to turn data into action and to sustain proven solutions - from federal models like the short-lived White House Office of Gun Violence Prevention to grassroots organizations building civic momentum for safer communities. Strengthen leadership, funding and data systems so innovation and evidence can translate into lasting change.
Expand the evidence base. Invest in rigorous research to understand what truly reduces firearm harms, from basic science and modeling to measuring real-world outcomes such as community well-being and civic trust. Build sustained federal and state funding, robust data dissemination and partnerships that help implement proven interventions across diverse settings.
"All participants at the JAMA summit recognize that this issue is fraught politically," Galea said. "The approach, though, is one based in the science: There are a range of potential approaches that can mitigate the human cost of gun violence, even while respecting constitutional rights to gun ownership.
"Firearm violence has long been a significant challenge to the health of the public in this country," he added. "The summit tackled potentially innovative approaches that, if implemented, could truly make a difference in reducing deaths and injuries from firearms."
