Learning From the Evolving Conversation on Firearms: A Public Health of Consequence, July 2018

THERE IS A LAG IN CRISIS RECOGNITION The number offirearm deaths in the United States was largely unchanged for about 17 years. [...]insofar as the 34 000 or so annual deaths from firearms are alarming to the public consciousness, they have been so for nearly two decades. KNOWLEDGE IS POWER Congressman Jay Dickey, who sponsored the amendment to an omnibus spending bill in 1996 that is broadly credited with having a profound influence on firearm research (see Rostron, p. 865) regretted his decision before he died,5 recognizing that, absent data about the firearm epidemic, we were consigned to generate collective heat about the issue, but little light. POPULATION HEALTH EMERGES FROM COMPLEX SYSTEMS Populations are complex systems, characterized by multiple heterogeneous actors, interacting often randomly, with feedbacks loops and nonlinearities.6 This has been borne out clearly in the firearm discussion.