Doctors who treat gunshot victims rushed into emergency rooms have long stepped beyond their clinical roles, advocating publicly, working in schools, publishing research and speaking out about what they witness daily in trauma centers. And their public stance on gun violence intensified after a tweet from one of the nation’s most powerful lobbying groups.
Dr. Cedric Dark, an associate professor of emergency medicine at Baylor College of Medicine and physician who works in a Houston area ER describes the ER as “organized chaos” in a Cronkite News’ Pathways to Equity podcast episode.
“We have to cover the department 24/7/365, which obviously means not every person can do nine-to-five jobs,” he said. “ We are entering our holiday block between Thanksgiving, Christmas and New Years. Around those days you have to work one, you are guaranteed one off and who knows what happens on the third one.”
The catalyst for Dark’s activism began with a widely criticized National Rifle Association tweet in 2018 that told medical professionals to “stay in their lane.”
“And then it wasn’t me, but the doctors around the country within the next two weeks sent out 30,000 tweets with a hashtag saying, ‘This is our lane,’” Dark said.
The tweet came in as a response to a position paper from the American College of Physicians calling for stronger gun safety measures.
“The NRA tweet helped to galvanize the movement, recognizing that it is not enough to treat but prevent,” said Dr. Garen Wintemute, an emergency medicine physician at UC Davis.
Gun violence in the U.S. has dropped to its lowest level in decades, with hundreds of cities, both red and blue, showing steep declines over roughly the last four years, according to newly released data from the Gun Violence Data Hub, a year-old project of The Trace, a nonprofit news organization dedicated to covering gun violence in the United States.
The decline has occurred alongside major shifts in federal gun policy.
In recent years, the Biden administration expanded background checks and increased enforcement. This year, the Trump administration rolled back several gun safety measures: from legalizing forced reset triggers that allow semiautomatic rifles to fire like fully automatic weapons, to closing the Office of Gun Violence Prevention and revoking the surgeon general’s advisory that called gun violence a public health crisis.
“Everything we’ve seen indicates this steep drop hasn’t happened ever before. … The highest levels of gun violence ever recorded occurred in 2021, during the pandemic,” said George LeVines, the editor at the Gun Violence Data Hub, adding that the sharp pandemic-era rise contributed to the recent downward outcomes.
The Trace analyzed public reports of shootings from multiple sources, including city crime dashboards. The dataset reflects adjusted counts of people killed or injured by gunfire and excludes suicides involving firearms.
The findings show a significant drop in gun violence in roughly three-quarters of U.S. cities, with each following its own trajectory. Tucson, for example, has recently seen one of the sharpest declines in the Southwest.
Yet not all communities benefit from this trend.
“Racial disparities are limited to data from 2018-2023 and are often suppressed or marked ‘unreliable’ at the state level, for privacy or statistical reasons, respectively,” LeVines points out. “However, we can still see that gun death rates are consistently highest for Black people in each state, with only a few exceptions.”
Dr. Christina Colosimo, assistant professor of surgery at the University of Arizona, said effective gun violence prevention often requires a multisystem approach. In Tucson, she said, the rate of violent crime is roughly twice the national average and communities of color are disproportionately affected.
“The population of Black Americans in Tucson is 4.8%, and (as) victims of gun violence are 22.7%. In terms of Hispanic or Latino, we have about 45.8% in the population, victims of gun violence are 47.5%,” she said.
The Gun Violence Data Hub reported that in 2023, Black people died by gun violence at a rate of 29 per 100,000 people, more than double the rate for white Americans, and more than triple the rate for people identifying as Hispanic or Latino.
“At the age where risk is highest – (during) teenage, young adult years – the rate for Black men is about 30 times higher than the rate for white, non-Hispanic men,” Wintemute said.
The Trace reports that youth gun violence in the Southwest is slightly higher than the national average, though LeVines said the picture is harder to assess because the most recent data ends in 2023. New Mexico stands out, he added, consistently ranking above the national average.
“Youth gun deaths in New Mexico outranked the U.S., including being the second leading cause of death in 2023,” LeVines said.
Dark, who is also a gun owner, believes that gun violence should be treated through a public health model built on primary, secondary and tertiary prevention – an approach he describes in his book, “Under the Gun: An ER Doctor’s Cure for America’s Gun Epidemic.”
“Primary meaning doing things for the entire community: Building walking trails so people could exercise. … The secondary prevention being screening: Checking people for breast cancer, colon cancer. Tertiary prevention is once somebody actually has a disease, what do you do to prevent it from recurring?”
This approach is applicable to firearms, Dark said, with primary prevention as doing “background checks to make sure someone that owns a gun from a community standpoint is safe.” Secondary, “so if you are a domestic abuser, maybe we should take your firearm away from you as opposed to just preventing you from buying another one. And tertiary prevention: Let’s say you’ve been shot, how do we prevent you from retaliating against the person that shot you or getting your friends or colleagues from retaliating?”
For Colosimo, a key to prevention is education. She goes into schools and talks with students: “We need to have better firearm curriculum — we need to be going into schools and talking about gun violence in elementary school, in middle school.”
Dark said mitigation requires breaking what he calls a “cycle of transmission.”
“The violence component is what’s being transmitted. That’s the disease agent that we have to deal with,” Dark said in the podcast.
For Dark, there are ways to manage gun violence case -by -case, and the focus should be on safe firearm use.
The physician-in-chief of Dartmouth Health Children’s, Dr. Keith J. Loud, echoed the sentiment.
“We need to keep firearms out of the hands of the wrong people – those who intentionally or incidentally want to hurt someone else or themselves, or are too young or otherwise unable to handle them properly,” Loud said. “Common sense approaches and policies can do that while still preserving constitutionally protected access for responsible gun owners.”
Andrew George, Grant Johnson and Mario Medina contributed to the story.