U.S. Surgeon General Issues Advisory on Public Health Crisis of Gun Violence

United States Surgeon General Dr. Vivek Murthy released a landmark Surgeon General’s Advisory on Firearm Violence, declaring gun violence in America a public health crisis.




According to the U.S. Surgeon General, firearm violence is pervasive, with more than half (54 percent) of U.S. adults or their family members having experienced a firearm-related incident in their lives. Over the last decade, the number of people who have died from firearm-related injuries, including suicides, homicides, and accidental deaths, has been rising, and firearm violence is now the leading cause of death among children and adolescents.

This new Advisory is the first publication from the Office of the Surgeon General dedicated to firearm violence and its consequences for the health and well-being of the American public. The advisory details the impact of gun violence beyond death and injury, describing the layers of cascading harm for youth, families, communities, and other populations. With nearly 6 in 10 U.S. adults worrying “sometimes,” “almost every day,” or “every day,” about a loved one being a victim of firearm violence, the effects of the public health crisis extend well beyond physical health – it has led to a collective trauma across society that warrants heightened attention.

“Firearm violence is an urgent public health crisis that has led to loss of life, unimaginable pain, and profound grief for far too many Americans,” said U.S. Surgeon General Dr. Vivek Murthy. “We don’t have to continue down this path, and we don’t have to subject our children to the ongoing horror of firearm violence in America. All Americans deserve to live their lives free from firearm violence, as well as from the fear and devastation that it brings. It will take the collective commitment of our nation to turn the tide on firearm violence.”

The rate of firearm-related deaths in our nation has been steadily rising, driven by both firearm-related homicides over the last decade and firearm-related suicides over the last two decades. Across all firearm-related deaths in 2022, more than half (56.1%) were from suicide, 40.8% were from homicide, and the remaining were from legal intervention, unintentional injuries, and injuries of unknown intent. Although firearm-related injury rates are difficult to measure due to challenges with collecting national injury data, studies suggest that there are at least twice as many nonfatal firearm injuries as fatal firearm injuries.




While firearm violence can affect anyone, it has a disproportionate impact on different communities. In 2022, for example, the Black community endured the highest firearm homicide rates in every age group, and Black youth accounted for about half of all firearm deaths among all youth, despite making up only 14% of the U.S. youth population. That same year, the firearm suicide rate for those 45 years of age or older was highest among White people, and the firearm suicide rate for people under age 45 was highest among American Indian or Alaska Native (AI/AN) people. Additionally, the firearm-related suicide rate in 2021 was 62.4% higher for Veteran men than for non-Veteran men, and 281.1% higher for Veteran women than for non-Veteran women.

Firearm violence also takes a significant toll on children in America. In 2020, firearm-related injury surpassed car accidents as the leading cause of death for U.S. children and adolescents. When measured over a decade (2012 to 2022), children and young adults experienced a staggering increase in firearm-related suicide rates (a 45% increase for 15-24-year-olds and a 68% increase for children aged 10-14). Fears and worries about firearm violence are highly prevalent among youth, especially regarding school shootings. A nationally representative survey found that half (51%) of 14-17-year-olds in the U.S. worry about school shootings and nearly six in ten report that they “have recently thought about what would happen if a person with a gun entered” their school or a school nearby. The effects of firearm violence and the threat that it poses to young people negatively affects their mental health.

The impact of firearm violence is felt beyond those who experience direct and immediate harm; rather, there is cascading harm across witnesses, family and friends, and the larger surrounding community. Research demonstrates that family members of victims of firearm violence experience increased risk of mental health challenges, including depression, anxiety, and post- traumatic stress disorder. For communities, high levels of exposure to firearm violence have a negative impact on the public’s perception of safety. More than three-quarters of adults (79%) in the U.S. report experiencing stress from the possibility of a mass shooting and one in three adults (33%) say fear prevents them from going to certain places or events.

The Advisory from the Surgeon General on gun violence outlines an evidence-informed public health approach to addressing the crisis of firearm violence. This approach involves critical research funding, implementation of prevention strategies, and increased mental health access and support including:

1. Critical research investments, such as:
   1. Improving data sources and data collection;
   2. Examining short-term and long-term outcomes of firearm violence; and
   3. Conducting implementation research to improve effectiveness of prevention strategies.
2. Community risk reduction and education prevention strategies, such as:
   1. Implementing community violence interventions;
   2. Incorporating organizational violence prevention and emergency preparedness elements into safety programs; and
   3. Encouraging health systems to facilitate education on safe and secure storage.
3. Firearm risk reduction strategies, such as:
   1. Requiring safe and secure firearm storage, including child access prevention laws;
   2. Implementing universal background checks and expanding purchaser licensing laws;
   3. Banning assault weapons and large capacity magazines for civilian use;
   4. Treating firearms like other consumer products, including requiring safety testing or safety features;
   5. Implementing effective firearm removal policies when individuals are a danger to themselves or others; and
   6. Creating safer conditions in public places related to firearm use and carry.
4. Mental health action and support, such as:
   1. Increasing access to affordable, high quality mental health care and substance use treatment; and
   2. Building on investments to enhance safety measures and evidence-based violence prevention efforts in learning settings.

While further research is needed to better understand firearm violence and its impacts, we can promote programs, policies, and practices right now that create safer conditions for the American people. This requires leveraging community leaders, working closely with at-risk populations, and educating the public on key protective actions. An all-of-society effort is required to help create safer conditions, build healthier communities, and save lives.




In concert with the Surgeon General’s Advisory, leaders at ten of the nation’s medical organizations and the YWCA issued supporting statements.

Surgeon General’s Advisories are public statements that call the American people’s attention to a critical public health issue. Advisories are reserved for significant public health challenges that require the nation’s immediate awareness and action. As the Nation’s Doctor, the 21st Surgeon General of the United States, Dr. Murthy, has issued Surgeon General’s Advisories on Loneliness and Isolation – PDF, Social Media and Youth Mental Health – PDF, Youth Mental Health, Health Worker Well-Being, and a Framework on Workplace Well-Being.

You can read the full Advisory from Surgeon General Dr. Murthy on gun violence online.