By Keith Darby, CAE, IOM The following article was originally published in the San Mateo Daily Journal on February 8, 2023 Following the Jan. 23 mass shootings in Half Moon Bay and Oakland as well as countless other firearm tragedies across the nation, physicians in San Mateo County have come together to urge the surgeon general to commission a report on firearms violence with recommendations on how it can be decreased. The San Mateo County Medical Association — representing more than 1,500 physicians — has concluded that the time is ripe to push for national-level public health focus on this issue in the aftermath of these tragedies that have occurred here in Northern California. The principal objective of the medical profession is to render service to humanity and physicians have an oath to prevent death and suffering for our patients. As mass shootings and illegal guns continue to increase, a hidden statistic in the gun violence epidemic is that gunshot wounds account for the majority of deaths by suicide. Gunshot wounds are also the primary cause of femicide in victims of domestic violence with a nexus to many mass shootings. A 2021 study in the Injury Epidemiology Journal revealed that between 2014 and 2019, 59% of all mass shootings were related to domestic violence and in 68% of mass shootings, the shooter had a history of domestic violence or killed a family member or intimate partner. Young Americans have also been affected by the firearm epidemic, as the surgeon general recently shared that firearms are now the leading cause of death for Americans under the age of 25. A study in July of 2022 by the Centers for Disease Control on social determinants in homicides and firearms injuries found that “Monitoring firearm injury in emergency department visits by county-level social vulnerability can help guide tailored prevention efforts that address inequities in social and structural conditions that contribute to risk for violence, including creating protective community environments, strengthening economic supports, and intervening to reduce harms and prevent future risk.” California has existing statutes such as “Red Flag Laws” to enable public safety authorities to remove guns to protect vulnerable people. California has emergency medical services and statutes enabling the evaluation and treatment of serious mental health issues such as suicidal and homicidal depression. Yet, despite these firearm safety laws in California, localized efforts will continue to fall short without a comprehensive national strategy. Public health action is long overdue. For decades, the surgeon general has been unable to confront this politically charged topic due to a 25-year ban imposed by Congress. In fact, it wasn’t until 2021 that the CDC resumed research on gun violence. Acknowledging the political dynamics of this issue and the broad and varied opinions Americans have about gun rights and restrictions, a surgeon general report could be a means to identify common ground based on evidence to create a framework for changes that most Americans could support. As noted in a perspective piece in the New England Journal of Medicine, a report from the surgeon general “might stimulate new ways of thinking, shifts in societal norms, and development of new social programs related to firearms safety.” The ability for a surgeon generals’ report to create change is apparent, as evidenced by prior reports on smoking and health that ultimately helped drive the smoking rate in American down from 42% in 1964 to 12.5% in 2020. We call on the president to commission Surgeon General Vivek Murthy to write a report within the next two years, as we are confident that it will be as impactful as those that have been completed in the past. To help support this public health initiative, you should contact your local congressional representative. Keith Darby, CAE, IOM is the executive director of the San Mateo County Medical Association and has proudly served the physician community since 2017.