SHM Joins Multi-Stakeholder Letter Urging Funds to Conduct Public Health Research on Firearm Morbidity and Mortality

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The Honorable Patty Murray
Chair
Committee on Appropriations
U.S. Senate
Washington, DC 20510

The Honorable Susan Collins
Vice Chair
Committee on Appropriations
U.S. Senate
Washington, DC 20510

The Honorable Kay Granger
Chair
Committee on Appropriations
U.S. House of Representatives
Washington, DC 20510

The Honorable Rosa DeLauro
Ranking Member
Committee on Appropriations
U.S. House of Representatives
Washington, DC 20510

Dear Chair Murray, Vice Chair Collins, Chair Granger, and Ranking Member DeLauro:

As you consider appropriations for Fiscal Year (FY) 2024, the undersigned 408 national, state, and local medical, public health, and research organizations write to ask you to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. We also encourage Congress to explore opportunities for building out and further supporting this research at all other appropriate agencies, to ensure that federally funded research can explore the full scope of this public health issue. A rigorous 2021 report estimated that the federal government will need to spend approximately $100 million per year to fully fund a comprehensive research agenda on reducing gun violence.(1)

Across this country, communities are suffering from preventable firearm-related injuries and deaths. Suicide, violent crime, and accidental shootings cause trauma to families, communities, and children affected by these preventable tragedies. In 2021, the most recent year for which we have data, firearm-related injuries led to 47,286 total fatalities.(2) The overall U.S. firearm homicide and firearm suicide rates in 2021 were the highest documented since 1993 and 1990, respectively.(3)

We need a comprehensive, evidence-based approach to reducing firearm-related suicides, violent crime, and accidental shootings. Rigorous prevention research that can accurately quantify and describe the roots of gun violence, inform strategies for responsible gun owners to avoid preventable injuries and deaths, and identify non-partisan opportunities for reducing the related morbidity and mortality is the foundation of such an approach.

We would like to thank Congress for its continued support for this public health research in FY23, providing $12.5 million each to the CDC and NIH for the fourth consecutive fiscal year, and for the new $1 million in funding for the NIJ. These initial investments are a crucial step toward applying a public health approach to increasing gun safety and reducing firearm-related injuries and deaths, and we are excited to see these funds contributing to important research projects that are now underway. The CDC has made 22 awards for two- and three-year projects to improve scientific understanding of firearm-related violence and to rigorously evaluate the effectiveness of prevention strategies.(4) Several of these projects will conclude this year and provide insights on how to reduce suicide risk in U.S. Army soldiers and veterans, how to improve efforts to reduce urban firearm injuries, and the relationship between firearm access and opioid-related harm on firearm suicide risk, among other topics. The NIH is funding research on the determinants of firearm injury, the identification of those at risk, and the evaluation of innovative interventions.(5, 6, 7)

These initial investments are important, but increased funding is still needed to overcome the decades-long lack of federal funding that set back our nation’s response to the public health issue of firearm-related morbidity and mortality. The agencies have received many more quality proposals than they are able to fund, and additional funding can generate research into important issues, such as the best ways to prevent unintended firearm injuries and fatalities among women and children; the most effective methods to prevent firearm-related suicides; the measures that can best prevent the next shooting at a school or public place; and numerous other vital public health questions.

Our groups strongly urge Congress to increase the funding level to $35 million for the CDC, $25 million for the NIH, and $1 million for the NIJ for firearm morbidity and mortality prevention research as part of FY 2024 appropriations. Continued and expanded funding could support the creation of additional, large, multi-year studies and accelerate the rebuilding of a research community that shrank in the decades before Congress restored this federal funding. Robust and sustained research on motor vehicle crashes and subsequent legislation has helped save hundreds of thousands of lives through public health interventions, including seat belts and other safety features. The same approach can help reduce firearm-related injuries in our communities, including ensuring that the CDC, NIH, and NIJ are able to adequately fund non-biased, evidence-based research into this public health priority. Exploring additional agencies to fund for this work would also ensure this research can address all necessary areas of inquiry and move us closer to the approximately $100 million necessary annually to fully support this research field.

Our organizations stand ready to work with you to support this critical effort. Thank you for your consideration.

Sincerely,

National Organizations:
AANS/CNS Joint Section on Neurotrauma & Critical Care
AANS/CNS Section on Pediatric Neurological Surgery
Academic Pediatric Association
AFT Nurses and Health Professionals
American Academy of Addiction Psychiatry
American Academy of Child and Adolescent Psychiatry
American Academy of Family Physicians
American Academy of Neurology
American Academy of Nursing
American Academy of Pediatrics
American Anthropological Association
American Association of Colleges of Nursing
American Association of Colleges of Pharmacy
American Association of Neurological Surgeons
American Association of Public Health Physicians
American Clinical Neurophysiology Society (ACNS)
American College of Emergency Physicians
American College of Neuropsychopharmacology
American College of Obstetricians and Gynecologists
American College of Physicians
American College of Preventive Medicine
American College of Surgeons
American Educational Research Association
American Foundation for Suicide Prevention
American Medical Association
American Medical Student Association
American Mental Health Counselors Association
American Muslim Health Professionals
American Nurses Association
American Osteopathic Association
American Pediatric Society
American Pediatric Surgical Association
American Physical Therapy Association
American Professional Society on the Abuse of Children (APSAC)
American Psychiatric Association
American Psychoanalytic Association
American Psychological Association
American Public Health Association
American School Counselor Association
American Society for Clinical Pathology
American Society for Surgery of the Hand
American Society of Addiction Medicine
American Society of Pediatric Nephrology
American Society of Pediatric Neurosurgeons
American Society of Pediatric Otolaryngology
American Society of Transplant Surgeons
American Sociological Association
American Thoracic Society
Association for Prevention Teaching and Research Association for Psychological Science
Association of Academic Physiatrists
Association of American Medical Colleges
Association of Asian Pacific Community Health Organizations (AAPCHO)
Association of Clinicians for the Underserved (ACU)
Association of Departments of Family Medicine
Association of Maternal & Child Health Programs
Association of Medical School Pediatric Department Chairs
Association of Pediatric Program Directors (APPD)
Association of Population Centers
Association of Program Directors in Radiology
Association of Rehabilitation Nurses
Association of Schools and Programs of Public Health
Association of State and Territorial Health Officials
Big Cities Health Coalition
Brain Injury Association of America
Center for the Study of Social Policy
Child Injury Prevention Alliance
Child Neurology Foundation
Child Welfare League of America
Children's Health Fund
Children's Hospital Association
Coalition for the Promotion of Behavioral Health
Congress of Neurological Surgeons
Consortium of Social Science Associations
Council of Pediatric Subspecialties
Council of State and Territorial Epidemiologists
Council on Social Work Education
Doctors for America
Education Development Center
Emergency Nurses Association
Family Centered Treatment Foundation
Federation of Associations in Behavioral and Brain Sciences
First Focus Campaign for Children
Futures Without Violence
GLMA: Health Professionals Advancing LGBTQ+ Equality HealthConnect One
Healthy Teen Network
International Association of Forensic Nurses
Jewish Federations of North America
Jewish Women International
Kids and Car Safety
MomsRising
National Alliance on Mental Illness (NAMI)
National Association of County and City Health Officials
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
National Association of School Psychologists
National Association of Social Workers
National Association of State Emergency Medical Services Officials
National Coalition Against Domestic Violence
National League for Nursing
National Network of Public Health Institutes
National Organization for Women
National Organizations for Youth Safety (NOYS)
National Prevention Science Coalition to Improve Lives
National PTA
National Resource Center on Domestic Violence
National Safety Council
Network of Jewish Human Service Agencies
North American Primary Care Research Group
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Pacific Institute for Research and Evaluation
Pediatric Endocrine Society
Pediatric Orthopaedic Society of North America
Pediatric Policy Council
Population Association of America Prevention Institute
Public Health Institute
Research!America
Safe States Alliance
Sandy Hook Promise Save the Children
Scrubs Addressing the Firearm Epidemic, Inc. (SAFE)
Society for Adolescent Health and Medicine
Society for Advancement of Violence and Injury Research (SAVIR)
Society for Developmental and Behavioral Pediatrics
Society for Pediatric Anesthesia
Society for Pediatric Radiology
Society for Pediatric Research
Society for Prevention Research
Society for Public Health Education
Society for Research in Child Development
Society for Women’s Health Research
Society of Hospital Medicine
Society of Laparoscopic and Robotic Surgeons
Society of Nuclear Medicine and Molecular Imaging
Society of Teachers of Family Medicine
Stop Abuse Campaign
The Health Alliance for Violence Intervention
The National Alliance to Advance Adolescent Health
The Society of Thoracic Surgeons
The Triological Society Trinity Health
Trust for America's Health
Ujima Inc., The National Center on Violence Against Women in the Black Community
ValorUS®
YMCA of the USA Youth Villages
Zero Suicide Institute

State and Local Organizations:

Alabama
Alabama Chapter of the American Academy of Pediatrics
Baobab Birth Collective
National Association of Pediatric Nurse Practitioners – Alabama Chapter
VOICES for Alabama's Children

Alaska
Alaska Chapter, American Academy of Pediatrics

Arizona
Arizona Chapter of the American Academy of Pediatrics
Arizona Public Health Association
Prevent Child Abuse Arizona

Arkansas
Arkansas Chapter, American Academy of Pediatrics

California
American Academy of Pediatrics California Chapter 1
American Academy of Pediatrics California Chapter 2
American Academy of Pediatrics California Chapter 3
American Academy of Pediatrics - Orange County Chapter
California Alliance of Child and Family Services
California Chapter, American College of Emergency Physicians
California Neurology Society
John Burton Advocates for Youth
National Association of Pediatric Nurse Practitioners – San Diego Chapter
National Association of Pediatric Nurse Practitioners – San Francisco/Bay Area Chapter
Southern California Public Health Association
The California Alliance of Academics and Communities for Public Health Equity
University of California, Davis
University of California, Los Angeles

Colorado
American Academy of Pediatrics, Colorado Chapter
Colorado Children's Campaign
NAMI Arapahoe/Douglas Counties
National Association of Pediatric Nurse Practitioners – Colorado/Rocky Mountain
Chapter The Kempe Foundation

Connecticut
Connecticut Chapter of the American Academy of Pediatrics
Connecticut College of Emergency Physicians

Delaware
Delaware Academy of Medicine and the Delaware Public Health Association
Delaware Chapter of the American Academy of Pediatrics

District of Columbia
DC Action / DC Action for Children
D.C. Chapter of the American Academy of Pediatrics
District of Columbia Public Health Association
National Association of Pediatric Nurse Practitioners – Washington, DC Chapter
Trinity Washington University

Florida
Florida Chapter of American Academy of Pediatrics
Florida College of Emergency Physicians
Florida Society of Neurology
Lee County Chapter of NOW
National Association of Pediatric Nurse Practitioners – Florida Gulf Coast Chapter
Pasco County National Organization for Women, Inc.

Georgia
Georgia Chapter of the American Academy of Pediatrics
Georgia Neurological Society
National Association of Pediatric Nurse Practitioners – Georgia Chapter

Hawaii
American Academy of Pediatrics, Hawaii Chapter
Hawaiʻi Children's Action Network
Hawaii Public Health Association

Idaho
Idaho Chapter of the American Academy of Pediatrics
Idaho College of Emergency Medicine
Idaho Public Health Association

Illinois
Ann & Robert H. Lurie Children's Hospital of Chicago
Children's Home & Aid
Illinois Academy of Family Physicians
Illinois Chapter of the American Academy of Pediatrics
Illinois Public Health Association
Illinois State Neurological Society
Legal Council for Health Justice
NAMI Kane-South, DeKalb, and Kendall Counties
National Association of Pediatric Nurse Practitioners – Illinois Chapter
NORC at the University of Chicago
Prevent Child Abuse Illinois
Will County NOW

Indiana
Covering Kids & Families of Indiana
Indiana Association of School Nurses
Indiana Chapter of the American Academy of Pediatrics
Indiana Public Health Association
Marion County Commission on Youth
Marion County Youth Violence Prevention Coalition
National Association of Pediatric Nurse Practitioners – Indiana Chapter

Iowa
Iowa Chapter of the American Academy of Pediatrics

Kansas
Brain Injury Association of Kansas and Greater Kansas City
Kansas Chapter, American Academy of Pediatrics

Kentucky
Brain Injury Association of America - Kentucky Chapter
Kentucky Chapter of the American Academy of Pediatrics
Prevent Child Abuse Kentucky

Louisiana
Louisiana Chapter of the American Academy of Pediatrics
Louisiana Policy Institute for Children
Louisiana Public Health Association
VIA LINK and Prevent Child Abuse Louisiana (PCAL)
Violence Prevention Institute at Tulane University

Maine
Maine Chapter, American Academy of Pediatrics
Maine Children's Alliance
Maine Children's Trust
Maine Neurological Society
Maine Public Health Association

Maryland
Johns Hopkins University & Medicine
Maryland Chapter, American Academy of Pediatrics
Maryland Psychiatric Society
Montgomery County Federation of Families for Children's Mental Health, Inc.
Moore Center for the Prevention of Child Sexual Abuse
NAMI Howard County, Maryland
National Association of Pediatric Nurse Practitioners – Maryland Chesapeake Chapter
The Family Tree

Massachusetts
Brain Injury Association of Massachusetts
Harvard T.H. Chan School of Public Health
Massachusetts Chapter of the American Academy of Pediatrics
Massachusetts College of Emergency Physicians
Massachusetts Neurologic Association
Massachusetts Public Health Association
NAMI Central Middlesex Massachusetts
National Association of Pediatric Nurse Practitioners – Massachusetts Chapter

Michigan
Brain Injury Association of Michigan
Michigan Chapter, American Academy of Pediatrics
Michigan College of Emergency Physicians
Michigan Council for Maternal and Child Health
National Association of Pediatric Nurse Practitioners – Michigan Chapter
Physicians for the Prevention of Gun Violence
University of Michigan

Minnesota
Minnesota Chapter of the American Academy of Pediatrics
Minnesota Coalition Against Sexual Assault
Minnesota Public Health Association
National Association of Pediatric Nurse Practitioners – Minnesota Chapter

Mississippi
Mississippi Chapter of the American Academy of Pediatrics
NAMI Vicksburg, Mississippi

Missouri
Missouri Chapter of the American Academy of Pediatrics
Missouri KidsFirst
Missouri Public Health Association
NAMI St. Louis
National Organization for Women, Columbia Area
National Organization for Women, Missouri

Montana
Montana Chapter of the American Academy of Pediatrics

Nebraska
National Association of Pediatric Nurse Practitioners – Midwest Chapter
Nebraska Chapter of the American Academy of Pediatrics
Nebraska Neurological Society

Nevada
Nevada Chapter of the American Academy of Pediatrics
Nevada Public Health Association
Nevada Public Health Institute

New Hampshire
New Hampshire Academy of Family Physicians
New Hampshire American College of Physicians
New Hampshire Chapter of the American Academy of Pediatrics
New Hampshire Psychiatric Society

New Jersey
Bellevue Pediatrics
NAMI Essex/Passaic NJ
NAMI New Jersey
New Jersey Chapter, American Academy of Pediatrics
New Jersey Department of Children and Families - Division of Child Protection and Permanency (DCF-DCPP)
New Jersey Gun Violence Research Center – Rutgers School of Public Health
New Jersey Health Care Quality Institute
New Jersey Local Boards of Health Association
New Jersey Public Health Association
New Jersey Society for Public Health Education (NJSOPHE)
Prevent Child Abuse New Jersey

New Mexico
NAMI New Mexico
New Mexico Pediatric Society
Santa Fe NOW

New York
American Academy of Pediatrics New York Chapter 1
American Academy of Pediatrics New York Chapter 2
American Academy of Pediatrics New York Chapter 3
American Professional Society on the Abuse of Children, New York State Chapter
Cohen Children's Medical Center/Northwell
Columbia University Irving Medical Center
Gitenstein Institute for Health Law and Policy at Hofstra Law Hofstra University
NAMI Buffalo & Western New York
NAMI Capital Region NY
NAMI Huntington, New York
National Association of Pediatric Nurse Practitioners – E-Chapter
National Association of Pediatric Nurse Practitioners – Greater New York Chapter
National Association of Pediatric Nurse Practitioners – Long Island Chapter
National Association of Pediatric Nurse Practitioners – New York Western Chapter
New York Society for the Prevention of Cruelty to Children
New York State Neurological Society
New York State Public Health Association
Prevent Child Abuse New York
Scientific Union for the Reduction of Gun Violence at Columbia University

North Carolina
Atrium Health – Charlotte
Atrium Health Levine Children's Hospital - Hemby Pediatric Trauma Program
Duke Health
NAMI Cabarrus
National Association of Pediatric Nurse Practitioners – North Carolina Chapter
North Carolina College of Emergency Physicians
North Carolina Pediatric Society
North Carolina Public Health Association
Prevent Child Abuse North Carolina
Safe Kids Cleveland County

North Dakota
North Dakota Chapter of the American Academy of Pediatrics
North Dakota Public Health Association

Ohio
Begun Center for Violence Prevention Research and Education – Case Western Reserve University
Cleveland Peacemakers Alliance
Ohio Alliance to End Sexual Violence
Ohio Chapter, American Academy of Pediatrics
Ohio Chapter, American College of Emergency Physicians

Oklahoma
NAMI Oklahoma
Oklahoma Chapter of the American Academy of Pediatrics
Oklahoma Public Health Association

Oregon
NAMI Yamhill County
National Association of Pediatric Nurse Practitioners – Oregon Chapter
Oregon Chapter of the American College of Emergency Physicians
Oregon Coalition of Local Health Officials
Oregon Health and Science University
Oregon Health and Science University - Portland State University Gun Violence as a Public Health Issue Advisory Committee
Oregon Pediatric Society
Oregon Public Health Association
Pediatric & Young Adult Oncology
Portland State University
University of Oregon

Pennsylvania
Children's Hospital of Philadelphia
NAMI Centre County PA
NAMI Keystone Pennsylvania
National Association of Pediatric Nurse Practitioners – Delaware Valley Chapter
National Association of Pediatric Nurse Practitioners – Three Rivers Chapter
Penn Injury Science Center, University of Pennsylvania
Pennsylvania Chapter of the American Academy of Pediatrics
Pennsylvania Public Health Association
University of Pennsylvania

Puerto Rico
Puerto Rico Chapter of American Academy of Pediatrics

Rhode Island
Rhode Island Chapter of the American Academy of Pediatrics
Rhode Island Public Health Association

South Carolina
Institute for Child Success
NAMI South Carolina
National Association of Pediatric Nurse Practitioners – South Carolina Chapter
South Carolina Chapter of the American Academy of Pediatrics
South Carolina Coalition Against Domestic Violence & Sexual Assault

South Dakota
South Dakota Chapter of the American Academy of Pediatrics

Tennessee
National Association of Pediatric Nurse Practitioners – Blues City Chapter
National Association of Pediatric Nurse Practitioners – Music City Chapter
Tennessee Chapter of the American Academy of Pediatrics
Tennessee Public Health Association

Texas
NAMI Guadalupe County
NAMI Texas
National Association of Pediatric Nurse Practitioners – South Texas Alamo Chapter
Texas Neurological Society
Texas Pediatric Society

Utah
American Academy of Pediatrics, Utah Chapter
Utah Public Health Association
Voices for Utah Children

Vermont
American Academy of Pediatrics Vermont Chapter
Prevent Child Abuse Vermont
Vermont Public Health Association

Virginia
Families Forward Virginia
Virginia Chapter, American Academy of Pediatrics
Virginia Commonwealth University and VCU Health System
Virginia Public Health Association

Washington
Children’s Alliance (Washington)
National Association of Pediatric Nurse Practitioners – Washington State Chapter
Public Health-Seattle & King County
University of Washington
Washington Chapter of the American Academy of Pediatrics
Washington State Coalition Against Domestic Violence
Washington State Public Health Association

West Virginia
West Virginia Chapter of the American Academy of Pediatrics
West Virginia College of Emergency Physicians
West Virginia Foundation for Rape Information and Services

Wisconsin
Children's Wisconsin
NAMI Chippewa Valley
NAMI Northwoods
National Association of Pediatric Nurse Practitioners – Wisconsin State Chapter
Supporting Families Together Association
Wisconsin Association of Osteopathic Physicians & Surgeons
Wisconsin Chapter of the American Academy of Pediatrics
Wisconsin Chapter, American College of Emergency Physicians
Wisconsin Coalition Against Sexual Assault
Wisconsin Neurological Society
Wisconsin Psychiatric Association
Wisconsin Public Health Association

Wyoming
Wyoming Chapter of the American Academy of Pediatrics
Wyoming Public Health Association

(1) Health Management Associates. Cost Estimate of Federal Funding for Gun Violence Research and Data Infrastructure. https://assets.joycefdn.org/content/uploads/CostEstimateofFederalFundingforGunViolenceResearch.pdf. Report prepared for Arnold Ventures and the Joyce Foundations. Published July 13, 2021.
(2) Thomas R. Simon, et al. “Notes from the Field: Increases in Firearm Homicide and Suicide Rates – United States, 2020-2021.” Centers for Disease Control and Prevention. Available at: http://dx.doi.org/10.15585/mmwr.mm7140a4.
(3) Id.
(4) Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Firearm Violence Prevention: Funded Research. Available at: https://www.cdc.gov/violenceprevention/firearms/funded- research.html.
(5) National Institutes of Health, Office of Behavioral and Social Sciences Research. NIH awards grants for firearm injury and mortality prevention research. September 30, 2020. Available at: https://obssr.od.nih.gov/nih-awards- grants-for-firearm-injury-and-mortality-prevention-research/.
(6) National Institutes of Health, Office of Behavioral and Social Sciences Research. NIH awards 10 grants addressing firearm violence prevention. September 17, 2021. Available at: https://obssr.od.nih.gov/news-and- events/news/director-voice/nih-awards-10-grants-addressing-firearm-violence-prevention.
(7) National Institutes of Health, Office of Behavioral and Social Sciences Research. NIH Research to Prevent Firearm Injury and Mortality. September 15, 2022. Available at: https://obssr.od.nih.gov/news-and-events/news/nih-research-prevent-firearm-injury-and-mortality.