Public Health Approach to the Prevention of Gun Violence
New England Journal
David Hemenway, Ph.D., and Matthew Miller, M.D., M.P.H., Sc.D.

The public health approach has five key components.

First, the approach is population-based and rarely involves identifiable individuals.

Second, it focuses on prevention — usually as far upstream as possible. It is often more effective to change the agent and the environment in which the problem occurs than it is to focus on trying to change the individual with the last clear chance to prevent the problem

Third, borrowing from human-factors engineering, public health uses a systems approach — trying to create a system in which it is difficult to make mistakes or behave inappropriately and in which mistakes and inappropriate behavior do not lead to serious injury.

Fourth, the approach is broad and inclusive — it examines all possible interventions, including changing social norms and passing new laws, and it tries to engage as many people and institutions as possible in a multifaceted way.

Finally, the approach tends to emphasize shared responsibility over blame. Prevention works best when everyone is trying to help. By contrast, assessing blame can sometimes be counterproductive to the goal,2 which is to prevent the problem from occurring.

Canada needs to more aggressively adopt a Public Health approach to the reduction of firearms injury and death.

We would benefit from a dedicated Canadian research base.