Introductions
Firearm-related injury surveillance: An overview of progress and the challenges ahead

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Abstract

Firearm-related injuries pose a serious public health problem in the United States and are increasingly the focus of public health concern. Despite the magnitude of this problem, ongoing and systematic collection of data on firearm-related injuries to help guide research and policy development has been lacking. The further development of firearm-related injury surveillance systems can provide an objective source of information for policy. Beginning in the mid-1980s, the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control began to support the development of firearm-related injury surveillance systems by augmenting existing national- and state-level data collection systems and establishing cooperative agreements with state and local health departments to identify optimal firearm-related injury surveillance practices. Some progress has been made in improving the capacity to undertake firearm injury surveillance at national, state, and local levels for mortality, morbidity (including disability), and risk/protective factors, but much work remains to be done. The development of state and local firearm-related injury surveillance systems provides the clearest potential for linking basic information on firearm-related injuries to action, given the critical role that states have in both public health surveillance and regulation of firearms. Broader application of external cause-of-injury codes, increased standardization and validation of definitions and data-collection instruments, improved methods for identifying firearm characteristics and types, and the identification of efficient techniques for linking health and criminal justice data sources are among the key challenges we face as we try to build a more uniform system for monitoring firearm-related injuries in the United States.

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Rationale

The reasons for establishing firearm-related injury surveillance systems at the national, state, and local levels in the United States are clear and compelling. First, the public health impact of the problem is substantial. Second, objective data are needed to guide and evaluate policy decisions. Third, existing injury data collection systems are inadequate to monitor firearm-related injury. Finally, lessons learned during the development of firearm-related injury surveillance systems can

A framework for firearm injury surveillance

Ideally, a comprehensive firearm-related injury surveillance system should provide data coverage along two key dimensions: the system should have the capacity to monitor firearm-related injuries at the national, state, and local levels; and it should provide information on three types of health indicators: mortality, morbidity (including disability), and risk/protective behaviors. We have made progress in improving our capacity to undertake firearm-related injury surveillance at the national,

CDC state and local firearm-related injury surveillance projects

In the United States, the legal and regulatory authority for public health surveillance resides primarily with state and local governments.34 The Institute of Medicine, in its report The Future of Public Health, argued that the assessment of health problems was a core governmental function of public health and that a key responsibility of state and public health agencies was the assessment, monitoring, and surveillance of health problems.1 Given the critical role and responsibility of state and

Conclusions

Progress in preventing the huge toll of firearm-related injuries that plagues our nation depends, in part, on the availability of objective and reliable information on the magnitude and characteristics of this problem. Although tangible progress has been made in improving the availability of routinely collected information at the national, state, and local levels, much work remains to be done. In looking toward the future, we must now build on what has been learned to establish and evaluate a

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