Data consistently shows that firearm violence affects minority populations disproportionately. In the 1970s, firearm injury related death was the 13th leading cause of death in America. The problem has only worsened, costing the US economy almost $230 million a year and is now the second-leading cause of injury related death. Gun violence should be considered a public health crisis given its costs in terms of morbidity, mortality, and economics, but also can be considered a social determinant of health as it contributes significantly to minority populations’ medical histories and health outcomes. Homicide is the leading cause of death in Black males between the ages of 15 and 34, with 91% of these deaths being the result of firearm injury. However, the way gun violence is portrayed in the media inaccurately generalizes White populations fulfilling the victim role while Black populations in the criminal role. The media considers shootings involving Black populations as “commonplace,” and therefore these incidents receive less attention from media sources. The constant impact of firearm violence places on healthcare providers is also significant, as the incidence of post-traumatic stress disorder is three times higher for trauma surgeons than the general population. Many healthcare organizations have recognized the devastating impact of firearm injury by coming out with position statements, developing patient education and advocacy resources, and community engagement initiatives to help support populations most affected. While more is to be learned in terms of research about the impact of this public health issue, we need to take a multifaceted approach to work towards equitable care for our most vulnerable populations. / Urban Bioethics

A modern version of the Hippocratic Oath instructs physicians that, “prevention is preferable to cure.” As healthcare providers, physicians promote healthy behaviors to prevent social issues from becoming health issues. Firearm violence is a social issue that has led to significant morbidity and mortality making firearm related-injuries and deaths a major health crisis of our time. If physicians have a role as credible messengers and advocates for firearm injury prevention, the educational institutions that form them must have a role as well. Unfortunately, firearm injury prevention education is rare in undergraduate medical education curricula. This poses an ethical dilemma. Undergraduate medical education without firearm injury prevention education misses the opportunity to equip trainees to discuss firearm violence as a health issue. As a result, physicians’ agency to advocate, educate patients, and thus fulfill ethical obligations may be limited. In this paper, physician codes of ethics are briefly presented. A case study of educational inquiry for medical students regarding firearm injury epidemiology, violence as a public health issue, the role of physicians in firearm policy, as well as clinical bedside skills related to firearm safety and injury is described. A case for firearm injury prevention education in undergraduate medical education curricula is made. / Urban Bioethics