Firearms deaths constitute an urgent and significant public health crisis. In 2020, 79% of all homicides and 53% of all suicides involved firearms. From 2019 to 2020, the firearm homicide rate increased about 35%, to its highest recorded rate in over 25 years. In addition, the firearm suicide rate remained consistently high from 2019 to 2020 with increases in some populations.¹ As such, in 2020, firearm-related injuries became the leading cause of death for children and youth ages 1-19.² The increase in firearm-related deaths from 2019-2020 further widened disparities by race, ethnicity and poverty. For example, firearm homicides among Black individuals increased by 39% and firearm suicide rate increased by 42% among American Indian and Alaska Native persons.¹

The National Institutes of Health (NIH) is committed to supporting 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 through the FY 2022 Consolidated Appropriations Act (H.R. 2471) to conduct research on firearm injury and mortality prevention, NIH released two Funding Opportunity Announcements (FOAs). The FOAs will support a network of research sites (PAR-22-115) that will develop, implement, and evaluate innovative community level interventions to prevent firearm and related violence, injury and mortality (CLIF-VP) and a Coordinating Center (PAR-22-120) that will provide cross-network coordination, communication, analytics, engagement, and dissemination efforts.

In response to these FOAs, the NIH used the Congressionally appropriated funding to support three research site grant awards and one coordinating center award:

This network of projects focuses on community or organizational level interventions to modify characteristics of organizations, environments, and settings and target higher order structural causes of firearm and related violence. These research projects will be an important addition to the current knowledge base which has focused more on individual level interventions among those at highest risk. The network structure will allow for collaboration across research teams and support data harmonization and sharing which will enhance the impact and generalizability of the study findings.

At the University of Mississippi Medical Center, the state’s only Level 1 trauma center, Dr. Zhang and his team will develop and implement optimized community-focused interventions through a comprehensive approach of screening, brief intervention, and referral for treatment (SBIRT), that are aimed at reducing the incidence of firearm injury, functional victim recovery, incidence of retaliation and reinjury, and economic impact at the community and individual levels in the greater Jackson, Mississippi metropolitan area. Mississippi had the nation’s highest firearm mortality rate in 2020. This project is well positioned to successfully engage with community partners to provide multilevel data about determinants and test community-based interventions for firearm violence injury in a community with a high burden of firearm mortality.

Dr. Mark Edberg and his team at the George Washington University in Washington DC will develop, implement, and evaluate a media-based youth-focused narrative intervention seeking to support the dissemination and community facilitated adoption of developmental trajectories that present viable alternatives to violence. The intervention is designed to prevent firearm violence among Black and other racial and ethnic minority youth in Wards 7 and 8 of Washington, DC which is a community with a high burden of firearm injury and mortality. This community-informed and developmentally focused approach is innovative and potentially scalable to other similar communities with a high burden of firearm violence among racial and ethnic minority youth.

Dr. Zakrison and her team at the University of Chicago’s Level 1 Trauma Center will develop and evaluate a novel and holistic intervention which combines Hospital Violence Intervention Programs (HVIP) with a Medical-Legal Partnership (MLP) as part of an effort to achieve equity in social and structural determinants of health. This project will be the first to measure the impact of combining an HVIP with an MLP for patients, families, and communities affected by firearm and other violence. If effective, this research strategy of incorporating the MLP component in the HVIP model has the potential of broadly benefiting all trauma centers with HVIPs throughout the country.

These sites, along with the Coordinating Center at the University of Michigan, led by Dr. Patrick Carter and his team, will serve as a key resource for the public, communities, community organizations, researchers, health and public health practitioners, and policy makers. This initiative (or program) will provide 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 early-stage investigators in this research field.

These projects are testing innovative approaches to the prevention of firearm related injury and mortality and include different geographic areas (rural and urban), populations, and intervention locations (e.g., hospital, community). I am confident that this research network will meaningfully contribute to the evidence-base needed to address the increasing and urgent public health crisis of firearm violence injury and mortality.

¹ https://www.cdc.gov/mmwr/volumes/71/wr/mm7119e1.htm?s_cid=mm7119e1_w
² https://www.nejm.org/doi/full/10.1056/NEJMc2201761