What We Talk About When We Talk About “Gun Safety”

The BulletPoints Project October 18, 2022


David Yamane, PhD, M.S.

Professor of Sociology & Author

Wake Forest University Department of Sociology


“Everyone who is opposed to gun safety, please raise your hand.” In the many years I have made this request to the students in my Sociology of Guns course at Wake Forest University, no one has ever raised their hand. From the purest Second Amendment supporter to the staunchest gun abolitionist, people on all sides of America’s Great Gun Debate agree “gun safety” is important. 

But what do we talk about when we talk about gun safety? 

I argue there are two different views of what constitutes gun safety, driven by fundamentally different underlying views of the role of guns in American society and Americans’ lives. 

Those who view guns as having a net positive influence in American society and recognize the normality of firearms for tens of millions of gun owners are concerned about safety with guns. The emphasis of parents and firearms trainers and gun groups is on how to safely handle, use, and live with guns. This is evident in the gun culture’s well-known “rules of gun safety” hunter education and other firearm training courses, Range Safety Officer certifications, and so on. 

Those who view guns as having a net negative influence in American society and focus on harmful gun owner behaviors are concerned about safety from guns. Viewing guns primarily as a risk factor for injury or death, from this perspective the safest approach to guns is to avoid them altogether. This orientation marks medical and public health approaches to guns and has for some time. 

In the landmark 1993 article, “Gun Ownership as a Risk Factor for Homicide in the Home,” Arthur Kellermann and colleagues concluded, “In light of these observations and our present findings, people should be strongly discouraged from keeping guns in their homes.”1 Adopting the approach that there is no safe use of guns any more than there is safe smoking, Kellerman later hoped, “Perhaps, one day, fewer Americans will choose to keep or carry a handgun, and the rate of death from firearm-related injuries will decline.”2

Although public health scholars today are more cautious in their pronouncements than Kellerman, the safety from guns approach is still sometimes spoken out loud. As I was writing this post, JAMA (Journal of the American Medical Association) published a special issue on “Firearms and Violence.” On the “Patient Page,” Senior Editor Kristin Walter advised, “Keeping firearms out of the house may decrease the risk of firearm injury at home.”3 The American Academy of Pediatrics has also declared, “The absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents.”4  

We rarely see this all-or-nothing approach with respect to other common risk factors for injury and death. Can you imagine a professional medical association stating, “The absence of swimming pools and cars from children’s homes and communities is the most reliable and effective measure to prevent drownings and driving-related injuries in children and adolescents”? I cannot. 

As someone who comes from a safety with guns perspective, here are a few suggestions to clinicians who may be disposed to a safety from guns approach. 

(1) Assume Normality: Public health scholarship focuses on the relative risk of firearms ownership. The relative risk for negative outcomes of having a firearm in the home is real, but in a society with 75+ million gun owners and 400+ million guns, the absolute risk of a gun owner or family member being shot with their own gun is small. And there are offsetting benefits to firearms that are real to gun owners that should be accounted for. If you think of guns first and even solely as a risk factor for injury or death, you may create a barrier to the kind of rapport you need with patients to have important conversations if the need arises. 

(2) Avoid Abstinence-Only Thinking: Assuming the normality of gun ownership also negates abstinence-only approaches to firearms. This is in line with managing other risky behaviors people routinely engage in, from swimming to driving to having sex. The best approach is not to counsel avoidance of these behaviors altogether but to suggest how to do them more safely. (Not safely, as that is an illusion, but in ways that reduce risks.) Gun owners themselves or the gun community more broadly should be thought of as resources not impediments to this end. 

(3) Adopt Appropriate Language: Safe storage is an area in which the gun owning community can be a valuable partner. But just as “gun safety” means different things to different people, so too does “safe storage.” The BulletPoints Project itself offers one common understanding: “To reduce the risk of firearm-related harm for everyone in the home, all firearms should be stored locked up, unloaded, and separate from ammunition.”5 But many in the gun community would add a clause to the end of this sentence, “when not in use.” As gun culture has shifted from a focus on hunting, recreational shooting, and collecting (Gun Culture 1.0) to self-defense (Gun Culture 2.0), what constitutes “in use” has also changed.6 And language regarding safe storage needs to change along with it. A recent editorial in the American Journal of Public Health suggests language that may be more adequate to the present reality: Gun owners should prevent unauthorized access through responsible “staging” of defensive firearms and “storage” of other firearms.7 

Nobody is opposed to gun safety, but there are different understandings of what constitutes safety. Recognizing this is an important first step toward bridging divides between clinicians and gun-owning patients in the interest of better health outcomes. 


Clinical tools for preventing firearm injury

  1. Kellermann, A.L., Rivara, F.P., Rushforth, N.B., et al. (1993). Gun Ownership as a Risk Factor for Homicide in the Home. New England Journal of Medicine.
  2. Kellermann, A.L. (1997). Gunsmoke--changing public attitudes toward smoking and firearms. American Journal of Public Health.
  3. Walter, K. (2022). Firearm Violence in the US. JAMA.
  4. Dowd, M.D., Sege, R.D., et al. (2012). Firearm-Related Injuries Affecting the Pediatric Population. Pediatrics.
  5. BulletPoints Project. Accessed September 27, 2022. Guns 101.
  6. Yamane, D. (2017). The Sociology of U.S. Gun Culture. Sociology Compass.
  7. Betz, M.E., Harkavy-Friedman, J., Dreier, F.L., Pincus, R., Ranney, M.L. (2021). Talking About “Firearm Injury” and “Gun Violence”: Words Matter. American Journal of Public Health.
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