The U.S. surgeon general is charged with monitoring the public health of the nation. In an advisory issued at the end of June, Surgeon General Dr. Vivek Murthy identified a threat we’ve long discussed on these pages: gun violence. Murthy pointed out that guns have for a few years been the leading cause of death for children and adolescents in the United States, outpacing even motor vehicles. Tens of thousands of people are killed every year.

The surgeon general also honed in on an impact often ignored in conversations around guns, which is the heavy toll extending beyond violence itself. You don’t need to have directly experienced U.S. gun violence for this violence to have colored your life, as you sit in a movie theater and eyeball the exits or consider picking shoes you can run in as you head to a concert or a parade.

In the grand scale of U.S. K-12 and postsecondary education, school shootings are rare, yet there’s hardly a student of any age who hasn’t wondered if it’ll be their turn next, or spent the days after an active-shooter drill unable to focus on their schoolwork.

This is all a choice that we’ve made, not all at once but over time, as gun manufacturers moved from selling weapons as tools to representations of independence and masculinity, with guns once reserved for military use modified slightly to be sold hand-over-fist to civilian consumers.

It’s a choice made by right-wing politicians, who have decided that no amount of carnage will dislodge their desire to use gun fanaticism as a political pressure point and pressure groups like the NRA, which has at this point abandoned support for even the mildest gun restrictions. And it’s a choice made by judges, including those on the Supreme Court, who have conjured up an individual right to firearms that was not really set forth in the Constitution and chipped away at democratically enacted limitations.

The advisory by itself cannot change public perceptions or policy, but it does bring the weight of the nation’s top health official down solidly on one side, which cannot as easily be dismissed as pure politics. These types of advisories have moved the needle on all sorts of other issues that were once considered matters of significant public controversy and have since been all but settled, from the danger of cigarettes to the benefits of seat belts.

Still, for maximum effect, we need significant political will followed by concrete action. This action shouldn’t just be reactive to the next big headline-grabbing public tragedy, as sadly likely as the next one is to come soon. It must come from a place of making an affirmative case that it is in the best interests of all – including responsible gun owners and law enforcement – for much more concrete regulation of firearms.

Despite its various missteps on this issue, the Supreme Court at least left the door open for lawmakers to keep guns out of the hands of clearly dangerous people with its recent ruling upholding a federal law blocking sales to people convicted of domestic violence. Let’s have more of that, more bans on guns in certain sensitive areas, more red flag processes, more time limits and background checks, fewer guns in fewer hands.

It’s a matter of public health, after all.

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