The U.S. surgeon general on June 25 declared gun violence a public health crisis, driven by the fast-growing number of injuries and deaths involving firearms in the country.

The advisory issued by Dr. Vivek Murthy, the nation’s top doctor, came as the U.S. grappled with another summer weekend marked by mass shootings that left dozens of people dead or wounded.

“People want to be able to walk through their neighborhoods and be safe,” Murthy told The Associated Press in a phone interview. “America should be a place where all of us can go to school, go to work, go to the supermarket, go to our house of worship, without having to worry that that’s going to put our life at risk.”

To drive down gun deaths, Murthy calls on the U.S. to ban automatic rifles, introduce universal background checks for purchasing guns, regulate the industry, pass laws that would restrict their use in public spaces and penalize people who fail to safely store their weapons.

None of those suggestions can be implemented nationwide without legislation passed by Congress, which typically recoils at gun control measures. Some state legislatures, however, have enacted or may consider some of the surgeon general’s proposals.

Surgeon General Murthy said there is “broad agreement” that gun violence is a problem, citing a poll last year that found most Americans worry at least sometimes that a loved one might be injured by a firearm. More than 48,000 Americans died from gun injuries in 2022.

Doctors quickly praised Murthy’s advisory. The American Academy of Family Physicians, for example, has considered gun violence a public health epidemic for over a decade.

“Family physicians have long understood, and have seen first hand, the devastating impact firearm violence has on our patients and the communities we serve,” the group’s president, Steven Furr, said in a statement.

Murthy’s advisory, however, promises to be controversial with the gun lobby and will certainly incense Republican lawmakers, most of whom opposed his confirmation — twice — to the job over his statements on gun violence.

The National Rifle Association promptly rebuked Murthy’s advisory.

“This is an extension of the Biden Administration’s war on law-abiding gun owners,” Randy Kozuch, the organization’s president, said in a statement on X.

It was the NRA, and Republicans who enjoy the powerful gun lobby’s support, that almost derailed Murthy’s confirmation as surgeon general a decade ago. Murthy became quieter on the issue of gun violence after his past statements almost cost him the job. He ended up promising the Senate that he did “not intend to use my office as surgeon general as a bully pulpit on gun control.”

Then-President Donald Trump dismissed Murthy in 2017, but President Joe Biden nominated him again to the position in 2021.

Murthy has published warnings about troubling health trends in American life, including loneliness and social media use. In an opinion piece in “The New York Times” in June, he said social media has contributed to a mental health crisis among the country’s young people and asked Congress to require warning labels on social media platforms similar to those on cigarette boxes.

But he also has faced mounting pressure from some doctors and Democratic advocacy groups to speak out more. A group of four former surgeon generals asked the Biden administration to produce a report on the problem in 2022.

“It is now time for us to take this issue out of the realm of politics and put it in the realm of public health, the way we did with smoking more than a half century ago,” Murthy told the AP.

It was a 1964 report from the surgeon general that raised awareness about the dangers of smoking is largely credited with reducing tobacco use and precipitating regulations on the industry.

Murthy now hopes his advisory on guns will shift the conversation, too, on this issue. He has been encouraged by some developments in Congress, including the passage of the Bipartisan Safer Communities Act in 2022 that enhanced background checks for firearms.

A White House report obtained by The Associated Press says that more thorough background checks have stopped roughly 800 sales of firearms to people under age 21. Additionally, more than 500 people, including some linked to transnational cartels and organized crime rings, have been charged with gun trafficking and other crimes under the landmark gun safety legislation.

Children and younger Americans, in particular, are suffering from gun violence, Murthy notes in his advisory called “Firearm Violence: A Public Health Crisis in America.” Suicide by gun rates have increased by nearly 70% for those between the ages of 10 to 14. Children in the U.S. are far more likely to die from gun wounds than children in other countries, the research he gathered shows.

For pediatricians, talking with families about locking up their guns away from their children has become a routine part of well visits, said Benjamin Hoffman, the president of the American Academy of Pediatrics. When children can’t get access to a gun, it prevents a large chunk of gun deaths and injuries — accidental shootings and suicides.

“Having access to a firearm for a child who is experiencing a behavioral health crisis is an absolute recipe for the most tragic things you can imagine,” Hoffman said.

Even when children are not direct victims of a gun shooting, they may suffer from mental health blowback of gun violence, the report says. About half of teens in the U.S. worry about a school shooting. And in areas that have been exposed to a fatal shooting at a school, youth antidepressant use jumps by more than 20%.

In addition to new regulations, Murthy calls for an increase in gun violence research and for the health system to promote and educate patients about gun safety and proper storage during checkups.

Amanda Seitz

Associated Press

WASHINGTON, DC

Andrew Selsky (AP), Johnny Hanson (AP), Susan Walsh (AP), and Eric Gay (AP)