Community Gun Violence

Community gun violence affects individuals as well as the social, physical, and economic environments in which they live, learn, work, and grow.

Community gun violence describes intentional acts of interpersonal gun violence committed in public places by individuals who are not intimately related to each other.¹ This form of violence disproportionately impacts communities of color, and especially youth and young adults.^2,3 Historical factors, present-day policies, and social and economic inequities rooted in structural racism and other systemic barriers shape the community conditions that contribute to gun violence.⁴ An expanded understanding of the root causes and far-reaching consequences of community gun violence can help clinicians support individuals at increased risk for violence involvement and work to reduce the associated adverse health effects.

The Numbers

Community gun violence is a significant public health issue in the United States, especially among youth of color. In 2019, there were 14,414 firearm homicides in the US (excluding law enforcement encounters) and another estimated 440,830 nonfatal violent incidents in which someone possessed, showed, or used a firearm.^5,6 Every year, on average, nearly 47,000 people are treated in emergency departments for assaultive firearm injuries.⁷ Nationwide, approximately 8% of children and youth know at least one friend and/or family member who has been killed in a homicide.⁸ Only a small percentage of firearm homicides and assaults occur in high-profile mass shootings— many are the result of daily incidents of community gun violence.

Although public mass shootings dominate news headlines, everyday gun violence in systematically marginalized communities is far more common.

Even when incidents of community gun violence involve multiple casualties, news coverage is often limited, creating an incomplete picture of the unequal burden of firearm violence on under-resourced communities.^9,10 Furthermore, the media’s framing of community violence often spreads assumptions that community violence is inevitable and re-enforces stereotypes about victims and perpetrators. This framing may discourage positive action and devalues the meaningful violence prevention work taking place in both community and clinical settings.¹¹

Who’s at Risk

Community gun violence disproportionately affects communities of color, particularly young Black men. Homicide is the leading cause of death among Black males ages 15-24, and the second and third leading causes of death for Black females and Hispanic males, respectively, in the same age group.⁵ Black children and teens are 14 times more likely to be murdered with a firearm than white children and teens.^12,13

Community gun violence is more common in urban than rural areas: in 2015, half of all gun homicides occurred in cities comprising less than a quarter of the US population. ¹⁴ Within cities, firearm violence is further concentrated in specific neighborhoods and among a small number of individuals. For instance, a 2012-2013 analysis of Oakland, CA found that only about 400 individuals—or 0.1% of the city’s population—were responsible for the majority of the city’s homicides. ¹⁵ These individuals were also at greatest risk for being victims of gun violence. Often, the people who commit violent acts have experienced extensive trauma, poverty, substance misuse, and justice system involvement.¹⁶ 

Hurt people hurt people: Most individuals who cause violent harm have previously been victims of violence themselves.^4,17

The disproportionate burden of community gun violence is the result of historical and contemporary underinvestment in communities of color that affects the root causes of violence (also known as the social determinants of health), such as lack of access to quality jobs, public housing, social services, and quality public education. Research has found that neighborhood disadvantage, increased Black-white segregation, and income inequality are each significantly associated with increased risk of fatal and nonfatal firearm violence.¹⁸

Consequences of Community Violence

In places that frequently experience violence, both individuals and whole communities can be impacted and traumatized. In addition to the acute physical and punitive consequences of direct violence involvement—e.g., death, injury, and punishment by the juvenile or criminal justice system—individuals may also experience trauma in the form of PTSD, hypervigilance, depression, anxiety, and substance misuse.¹⁹ Even indirect exposure to violence, including seeing, hearing, or knowing someone involved in a violent incident, can have negative physical and mental health consequences, especially when firearms are involved.^20,21 Exposure to violence has been linked to chronic diseases such as heart disease, asthma, stroke, and cancer as well as mental health issues across the life course.²² In a nationally-representative study, youth who had witnessed or who were victims of violence with a weapon were 44% and 73% more likely, respectively, to develop hypertension in adulthood as their unexposed peers.²³ Children who witness violence also experience higher rates of behavioral and mental health problems, challenges in school, and delayed development of cognitive skills, which can have long-term adverse effects on their health and life chances.²⁴

Trauma from community gun violence doesn’t end when the physical wounds heal.

Additional health risks associated with experiencing or witnessing violence include smoking, physical inactivity, sexual risk taking, and suicide attempts. Exposure to violence also increases the risk of future violence victimization and perpetration. ²²

Acts of community violence that an individual has no involvement in, exposure to, or knowledge of can still have consequential and long-term impacts on their health and wellbeing by affecting their social, physical, and economic environments. ^25-27 Neighborhood-level effects of community violence may include increased police presence, metal detectors at schools, sidewalk memorials, shuttered businesses and other disinvestments in the local economy, and disrupted social relations.²⁸ Sustained exposure to violence has a ripple effect throughout affected neighborhoods, which may contribute to cycles of violence, increased gun carrying, and a perception of decreased safety. Residents in neighborhoods experiencing high rates of community gun violence may limit their outdoor recreation, shopping, use of green space, and nighttime work. These modifications lead to fewer people on the streets, further reducing safety for all those in the area, and a decrease in overall quality of life. ^26,27

What You Can Do

Clinicians can help reduce the burden of community violence on their patients by taking a culturally humble, harm reduction approach and working with credible messengers, such as violence intervention specialists with local knowledge and/or lived experience. It is important for clinicians to consider that even vicarious exposure to gun violence can have substantial impacts on one’s health and wellbeing.

Violence prevention work is being done every day by frontline workers, violence intervention specialists, and community organizations. Violence intervention programs, such as Advance Peace and Cure Violence, focus on identifying, interrupting, and mediating conflicts in the community using trained and culturally-affirming violence intervention and outreach workers. These professionals engage with individuals at the highest risk for gun violence, discuss the costs of using violence and changing social norms around the use of violence to resolve conflicts, and connect them with social services like job training, substance use treatment, and housing. Violence intervention specialists also work with community leaders, service providers, and residents after a shooting occurs to de-escalate community tension and prevent retaliation.

Recent federal support for community- and hospital-based violence intervention programs is promising, and efforts to rebuild economies in communities hard hit by community violence are underway.²⁹

In order to reduce the risk of re-injury and retaliation, clinicians can connect their violently injured patients to hospital-based violence intervention programs (HVIPs) and local violence intervention services. Clinicians can get involved in their institution’s HVIP and become familiar with available local resources that offer culturally-affirming mental health, youth development, and social services.

Dr. Nicole Kravitz-Wirtz and Dr. Shani Buggs from the UC Davis Violence Prevention Research Program contributed to this content.

Page last updated July 2021. 

For more information, see these peer-reviewed articles.

Corburn, J., Boggan, D., Muttaqi, K. et al. (2021). A healing-centered approach to preventing urban gun violence: The Advance Peace Model. Humanities and Social Sciences Communications.

Leibbrand, C., Hill, H., Rowhani-Rahbar,A., et al. (2020). Invisible wounds: Community exposure to gun homicides and adolescents’ mental health and behavioral outcomes. SSM Population Health.

Benns, M., Ruther, M., Nash, N., et al. (2020). The impact of historical racism on modern gun violence: Redlining in the city of Louisville, KY. Injury. 

Turner, H.A., Mitchell, K.J., Jones, L.M., et al. (2019). ) Gun Violence Exposure and Posttraumatic Symptoms Among Children and Youth. Journal of Traumatic Stress.

Fowler, P.J., Tompsett, C.J., Braciszewski, J.M., et al. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology.