Gun Safety and Public Health Policy Recommendations for a More Secure America

Photo credit: National Physician’s Alliance and Law Center to Prevent Gun Violence
Photo credit: National Physician’s Alliance and Law Center to Prevent Gun Violence

In August 2013, the National Physician’s Alliance and Law Center to Prevent Gun Violence released a report on gun safety and public health. The report suggested ways to hold the gun industry accountable:


Regulating Gun Dealerships

Firearms initially enter the consumer market through gun dealers, who are the critical link between manufacturers or importers of firearms, and the general public. Research has found that the practices of gun dealers can significantly affect whether guns sold by those dealers end up in the hands of criminals.64 Law enforcement oversight of these businesses is therefore crucial.


Federal law requires a person or company to obtain a federal firearms dealer license to engage in the business of dealing in firearms. More than 60,000 individuals and companies are currently federally licensed firearms dealers and pawnbro­kers. Dealers’ access to large numbers of firearms presents a serious risk to public safety if they fail to monitor their inventory. Between 2004 and 2011, the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), discovered nearly 175,000 firearms missing from dealer inventories during compliance inspections.66 Although most gun dealers comply with the law, ATF has found that scofflaw gun dealers represent a major source of illegally trafficked firearms.


Despite these risks, federal oversight of dealers is minimal. ATF, which is charged with enforcing federal gun laws, is prohibited from conducting more than one unannounced inspection of each dealer per year; the burden of proof for prosecution and revocation are extremely high and the prescribed penalties for violations are low; and ATF has historically been underfunded and understaffed. A 2013 report by the U.S. Department of Justice’s Office of the Inspector General found that 58% of dealers had not been inspected within the past five years due, in part, to a lack of resources.


Because federal oversight of gun dealers is weak, state and local governments can play an important role in regulating gun dealers. About half of the states impose some regulations on firearms dealers, although only a handful of states comprehen­sively monitor these businesses. The states with the strongest laws require gun dealerships and ammunition sellers to obtain a state license, utilize security systems, conduct background checks on employees, maintain records of sales, submit to regular inspections, and fulfill other requirements.


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A 2009 study found that cities in states that comprehen­sively regulate retail firearms dealers and cities where these businesses undergo regular compliance inspections have significantly lower levels of gun trafficking than other cities. As stated by the International Association of Chiefs of Police, state and local governments should enact their own dealer licensing requirements because they can respond to specific community concerns, and because state and local oversight of licensees helps reduce the number of corrupt dealers.


The Gun Industry’s Immunity from Lawsuits


Tort liability plays an important role in injury prevention. In circumstances where legislators have been unwilling to enact regulations to improve safety, dangerous products and careless industry practices are normally held in check by the possibility of civil litigation that enables injured individuals to recover monetarily. As noted above, policies designed to hold gun sellers accountable can curtail the diversion of guns to criminals. Litigation can do the same thing. The firearms industry, however, has recently obtained unprecedented immunity from this long-standing system of accountability.


A series of lawsuits in the 1990s held certain members of the firearms industry liable for particularly reckless practices. As a result, the industry began to push legislation in statehouses that limited this avenue of relief. Then, in 2005, after intense lob­bying from the gun industry, Congress enacted and President Bush signed a law that gives gun manufacturers and sellers unprecedented nationwide immunity from lawsuits. This law, known as the “Protection of Lawful Commerce in Arms Act,” requires the dismissal of almost any lawsuit brought against a member of the gun industry for irresponsible or negligent behavior in the business of making or selling guns. This law enables gun makers and sellers to market their products in ways that are intended to appeal to criminals and other ineligible purchasers without facing any legal consequences. It also allows the industry to make available increasingly dangerous weapons and to fail to monitor inventory, even in the face of evidence that thousands of guns are being stolen from dealerships and end up in the hands of criminals.


In 2012, the gun industry made an estimated $11.7 billion in sales and $993 million in profits. There is no good reason for the firearms industry to receive special treatment in the hands of the law or to be immune from the same kind of civil lawsuits that are used to hold business practices accountable for the injuries they cause.


 The report’s  conclusions and recommendations were:


Medical professionals have always played a central role in solving public health crises. As witnesses to the traumatic nature of gunshot injuries, doctors and other health care providers can movingly testify to the physical severity of gun violence—and just as importantly, they can see this epidemic of violence through the lens of public health. Just as the medical community has historically championed substantive injury prevention policies in other areas, it is time again for health care providers to demand concrete actions to reduce gun violence. Examples include:


  • Extending gun purchase and possession prohibitions to people known to be at a high risk of committing firearms-related or violent crimes, such as violent misdemeanants, alcohol abusers, and serious juvenile offenders;
  • Banning assault weapons and high capacity ammunition magazines;
  • Establishing of a universal system of background checks for anyone buying a firearm or ammunition;
  • Regulating guns and gun safety devices as consumer products by requiring the inclusion of product safety features, such as loading indicators and magazine disconnect mechanisms, and testing these products for safety prior to sale;
  • Encouraging the development of new technologies that will increase gun safety, such as personalized guns;
  • Removing all gag rules that apply to clinical encounters, because patients and providers must be free to discuss any issue, including gun safety;
  • Building an evidence-based approach to gun violence prevention, which includes restoration of robust funding and training for epidemiological research in this area (e.g. through the National Institutes of Health and the Centers for Disease Control and Prevention) and gathering data that tracks gun-related deaths and injuries, safety interventions, and the impact of measures to reduce the incidence of gun violence over time;
  • Requiring law enforcement oversight of gun dealerships and ammunition sellers, who should be held accountable for negligence in the marketing or sale of these products; and 
  • Ensuring that violence prevention including gun safety is a core part of the training and continuing professional education of doctors, nurses, social workers, chaplains, teachers, and other professionals.


The full report, including references, is available here.