Firearms deaths constitute an urgent and significant public health crisis. The overall death rate by firearms was up 21 percent and the rate of homicides by firearms was up 35 percent from 2019-2022. Additionally, firearm-related suicides increased to their highest ever recorded level in 2022, and firearms remain the leading cause of death for children and youth ages 1-19. Significant disparities by race, ethnicity, and poverty remain. For example, in 2022, firearm suicide rates among Black youth (ages 10-19) surpassed that of White youth for the first time.

The National Institutes of Health (NIH) supports scientific research to develop, evaluate, and implement effective public health interventions to better understand and prevent violence, including firearm violence, and the resulting trauma, injuries, and mortality. With $12.5 million in funding provided to NIH in the Fiscal Year (FY) 2023 Consolidated Appropriations Act (H.R. 2617) to conduct research on firearm injury and mortality prevention, NIH released two Notice of Funding Opportunities (NOFOs).

In order to expand the size, scope, and reach of the Community Firearm Violence Prevention Network (CFVP) that was funded in FY 2022, a reissue of a PAR-22-115 (PAR-23-066) called for additional research sites to develop, implement, and evaluate innovative community- level interventions to prevent firearm and related violence, injury, and mortality. In response to these NOFOs, NIH funded three additional research sites to join the existing three sites and the coordinating center. This expansion also allowed the National Institute of Nursing Research (NINR) to join the network as a participating NIH institute, along with the ongoing participation of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute on Minority Health and Health Disparities (NIMHD).

Both Dr. Zaller and Dr. McKay’s teams at the University of Arkansas for Medical Sciences in Little Rock, and the University of Texas Health Sciences Center in Houston, respectively, will be developing, implementing and evaluating multi-level hospital, community-based interventions designed to decrease repeat victimization and promote health equity among Black firearm injured individuals in their communities. Both teams bring a multi-disciplinary partnership of community, academic, policy, and practice participants to this research and each are poised to make a significant impact in their communities. This is critical work as Black men in both of these communities experience significant health disparities, bearing the largest burden of firearm injury and mortality, despite their proportionally smaller population numbers.

Dr. Wu and her team at Eastern Michigan University in Yspsilanti, will be working with Asian Americans in a number of communities across the state as an increasingly at-risk population given a rise in racism targeting this group and the corresponding increase in firearm ownership. The team will employ both Geographic Information Systems (GIS) and photovoice approaches to engage communities in identifying multi-level risks and protective factors for firearm-related violence. Using this information, the team will then develop, implement, and evaluate an intervention to decrease risk and advance health equity through a randomized clinical trial.

The CFVP network is developing, implementing, and evaluating community or organizational level interventions to modify characteristics of environments and settings and target structural causes of firearm and related violence. Community partnerships (included as key personnel) and a community-engaged research approach are a critical aspect of the network’s efforts. The network is an important addition to the current knowledge base, which has focused primarily on individual-level interventions among those at highest risk. The network structure allows for collaborations across research teams and supports data harmonization and sharing which will enhance the impact and generalizability of the study findings. With this expansion, the network will be better positioned to offer resources to communities, researchers, health and public health practitioners, and policy makers. This includes evidence-based information about best practices for prevention of firearm and related violence, access to datasets for secondary analysis, and training opportunities to encourage and support new investigators in this field.

In addition, two awards will be evaluating similar types of interventions but will be independent research projects. One is a trial to implement and evaluate a universal firearm injury prevention program in a trauma center setting. The other is a city-wide study on the impact of energy efficient street lighting on firearm incidents and related injuries and deaths.

The second NOFO solicited applications for increased workforce opportunities entitled, Career Enhancement Awards to Advance Research on Firearm Injury and Mortality Prevention (PAR-23-108). The NOFO focused on advanced training and career development for established NIH-supported investigators in related fields to obtain the skills and expertise to integrate firearm injury prevention work into their research. These projects are investigating critical questions on increasing suicide rates among Black men, the link between firearm injury and substance use among Medicaid-enrolled youth, and a state-wide assessment of attitudes about gun violence prevention laws. The awards also support career development of a new group of researchers who will be better positioned to provide innovative, impactful research and interventions to address firearm injury and mortality. This is a critical first step in expanding the field of qualified investigators and building research capacity.

Overall, these eight newly funded awards build on the research supported by the funding provided in the past few years. They continue to push the field of firearm injury prevention research to more effective and sustainable community-engaged solutions. Together they include efforts targeting different geographic areas (rural and urban), demographic populations (Black American, Asian American, youth), and intervention locations (hospital, community). This newly funded research has the potential to contribute to capacity-building efforts by ensuring that a new generation of researchers is well equipped to conduct community engaged and impactful research to prevent firearm injury and mortality. I am confident that the expanding CFVP network, along with these additional awards supporting innovative research, will contribute to the evidence base needed to address the increasing and urgent public health crisis of firearm violence injury and mortality.