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Home , Cure Violence, Gun violence, March For Our Lives

A NATION OF SURVIVORS THE TOLL OF GUN VIOLENCE IN AMERICA WOULD LIKE TO ACKNOWLEDGE ALL GUN VIOLENCE SURVIVORS, ESPECIALLY THOSE WHO SHARED THEIR PERSONAL STORIES FOR THIS REPORT.

Cover photo by Jodi Miller March for Our Lives Columbus, OH, March 24, 2018 everytownresearch.org/nationofsurvivors 1 “THE FACT IS GUN VIOLENCE HAS TAKEN SO MANY LIVES. AND NOT JUST IN OR D.C. OR . GUN VIOLENCE IS EVERYWHERE AND, AS A NATION, WE NEED TO BE PAYING MORE ATTENTION TO THE PROBLEM.”

ZION, GUN VIOLENCE PREVENTION ADVOCATE TABLE OF CONTENTS

INTRODUCTION 4 EXECUTIVE SUMMARY 5 GUN 6 GUN 8 GUN INJURIES 10 GUN VIOLENCE AND CHILDREN AND TEENS 12 AND GUNS 14 HATE CRIMES WITH GUNS 16 CONCLUSION: IT DOESN’T HAVE TO BE THIS WAY 18

everytownresearch.org/nationofsurvivors 3 INTRODUCTION

America’s gun death rate is tragic and unique — 10 times higher than other high-income countries.1 In other words, by early February more Americans are killed with guns than are killed in our peer countries in an entire calendar year. Every year, over 36,000 Americans are killed in acts % of gun violence3 and approximately 100,000 more are shot and injured.4 With death and injury tolls this high, America is undeniably a nation of gun violence survivors. But the impact of gun violence 58 extends far beyond those killed or injured. OF AMERICAN ADULTS Gun violence in any form — whether a person witnessed an act of gun violence, was threatened OR SOMEONE THEY or wounded with a gun, or had someone they know or care for wounded or killed — can leave a lasting CARE FOR HAVE impact on individuals. Forms of gun violence can EXPERIENCED GUN include, but are not limited to: gun suicides, gun homicides, domestic violence involving a gun, and VIOLENCE IN unintentional shootings. Defined this way, a recent national poll estimated that 58 percent of American THEIR LIFETIME. adults responded that they or someone they care for have experienced gun violence in their lifetime.5 Yet, as a country we do not talk enough about the lifelong impact of these many forms of gun violence. In addition to the emotional toll, gun violence THE U.S. GUN DEATH RATE IS 10 TIMES can also be financially devastating, affecting both THAT OF OTHER HIGH-INCOME COUNTRIES.2 individuals and communities. While survivors bear direct costs such as healthcare and lost income, gun violence also hurts local economies by lowering property values, slowing new business creation, 10.2 and reducing available jobs,6 thereby creating the very economic and social conditions that are associated with higher violence.7,8

3.6 3.0 2.8 2.3 1.8 1.8 1.8 1.8 1.8 1.6 1.5 1.3 1.2 1.1 1.0 1.0 0.9 Per 100,000 Population 0.6 0.5 0.2 0.0 0.0 Italy Spain France Ireland Austria Finland Sweden Belgium Slovakia Portugal Hungary Australia Denmark Netherlands New Zealand United States Czech Republic Republic of Korea

everytownresearch.org/nationofsurvivors 4 EXECUTIVE SUMMARY

The United States is a nation of survivors. In a recent national poll, 58 percent of adult respondents reported that they or someone they care for have experienced gun violence in their lifetime. Everytown for Gun Safety has compiled scientific research on the impacts of gun violence on this country coupled with stories of gun violence from Americans of all backgrounds, to demonstrate the magnitude of such violence and its lasting impacts on Americans and the communities we call home. This report covers the following topics:

| GUN SUICIDES More than 22,000 Americans die | DOMESTIC VIOLENCE AND GUNS Approximately of every year, leaving countless 4.5 million American women alive today have been Americans to grieve the death of their loved ones. threatened with a gun by an intimate partner. | GUN HOMICIDES The burden of gun falls | HATE CRIMES WITH GUNS In an average year over heaviest on communities already facing structural 10,300 violent hate crimes involve a gun — more disadvantages. Within cities, gun homicides are than 28 each day. The vast majority of hate crimes most prevalent in racially segregated neighborhoods are directed against communities of color, religious with high rates of poverty and low educational minorities, and LGBTQ people. attainment. As a result, homicides disproportionately | COSTS OF GUN VIOLENCE The various costs paid by affect people of color. victims, communities, businesses, taxpayers, and | GUN INJURIES Every year, approximately 100,000 every American who feels the pain, fear, and distress Americans survive a and are faced from the increasing frequency of gun violence with a life-long process of physical and emotional amount to tens of billions annually and impact healing, as well as heavy economic costs for both people in every community across the country. survivors, communities, and society as a whole. | GUN VIOLENCE AND CHILDREN AND TEENS are the second leading cause of death for children and teens and the first leading cause of death for Black children and teens in the U.S. Every year, nearly 3,000 children and teens are shot and killed and approximately 15,600 are shot and injured. AVERAGE YEARLY GUN DEATHS 9 AVERAGE YEARLY GUN INJURIES 10

SUICIDE 22,274 76,258

HOMICIDE 12,830 TOTAL TOTAL 36,383 100,120 UNINTENTIONAL 18,362

487 UNINTENTIONAL DEATHS SELF-HARM 4,149 SHOOTINGS BY LAW ENFORCEMENT 496* SHOOTINGS BY LAW ENFORCEMENT 1,350 UNDETERMINED 295

*This intent category is believed to be underreported and is likely being misclassified as homicide.The Post’s database is widely cited and estimates that 986 civilians are fatally shot by police in an average year—nearly twice as many as recorded by the CDC.

everytownresearch.org/nationofsurvivors 5 GUN SUICIDES

“EVERY DAY I HAVE WORKED TO MAKE OUR FAMILY WHOLE AND BRING SOME JOY AND NORMALCY TO THEIR LIVES.” JENNIFER

Scott was the smartest person Jennifer ever met.11 Scott soon convinced Jennifer to return his firearm. He was a great father to their two daughters. He They were planning a trip to the family’s vacation loved the outdoors and hiking in the mountains of home in the mountains of , and he and Nevada. He also struggled with depression. told her that shooting would make him “feel normal” Scott had a handgun, which he kept for protection again. Months later, Scott’s depression returned, and sport. They argued about it — Jennifer didn’t and he used his gun to kill himself. want to live in a home with a firearm, but he “He left behind two beautiful daughters, and every managed to convince her by offering a compromise. day I have worked to make our family whole and The gun would be kept locked in a safe, and he bring some joy and normalcy to their lives. The pain would only take it out when they went to the woods never goes away and I constantly worry about the in North Carolina, where he liked to set up targets long-term effects on them.” and practice his aim. Until a couple of years ago, Jennifer never At the age of 42, Scott made a suicide attempt using considered herself a survivor of gun violence. alcohol and pills. He was taken to the emergency But over the years, she learned about the room, treated in an intensive care unit, and held relationship between suicide risk and access for supervision. “Then they send you home with a to firearms — and how it leaves so many families bunch of worksheets encouraging you to seek help. like hers grieving a loved one who might be alive It’s all very overwhelming and you don’t really know if it weren’t for easy access to a gun. what to do.” One of the worksheets directed family members to remove all firearms. Jennifer bought a different safe for the gun, and hid it inside the house. When Scott arrived home, he was furious at her. “He said he was fine now, and why didn’t I trust him? It became a thing.” Three weeks later, Scott made another suicide attempt with pills. This time, when Scott woke up in the hospital, he was “his old self” again. “He asked me to go to the bookstore and get him all of these books on depression. He felt sure that if he could just learn enough about what was going on, he could solve it.”

Jennifer attending a national conference of gun violence prevention advocates. , GA, August 10, 2018

everytownresearch.org/nationofsurvivors 6 GUN SUICIDES

Like other forms of gun violence, this country suffers disproportionately from firearm suicide — the firearm suicide rate in the U.S. is eight times that of other high-income countries.12 Firearm suicide is a significant crisis that leaves countless Americans to grieve the death of their loved ones. Nearly two-thirds of firearm deaths are suicides — over 22,000 Americans every year.13 MOST PEOPLE WHO ATTEMPT Firearm suicide victims are typically white, older SUICIDE DO NOT DIE — males, and those who live in rural areas. In fact, white men represent 74 percent of firearm suicide UNLESS THEY USE A GUN. victims in the United States.14 Access to a gun increases the risk of suicide, but there are steps that can be taken to mitigate risk. A meta-analysis of 14 different scientific studies concluded that having access to a firearm triples one’s risk of death by suicide. This elevated risk applies not only to the gun owner but everyone in the household.15 States with higher rates of household gun ownership also have higher rates of firearm suicide: people who live in these states are almost four times more likely to die by firearm suicide than in states where fewer households own guns. This relationship remains strong even when controlling for other factors associated with suicide, SUICIDES SUICIDE like poverty, unemployment, serious mental illness, ATTEMPTS ATTEMPTS and substance abuse.16 And these tragic deaths carry high economic costs as well. Estimates from one BY GUN BY ALL study suggest that each suicide by firearm results in OTHER MEANS $1.0 million in lost productivity due to the deceased's inability to work in the labor market or the home.17 Most people who attempt suicide do not die — % % unless they use a gun. Across all suicide attempts < not involving a firearm, less than 5 percent will result in death.18 But for gun suicides, those statistics are flipped: approximately 85 percent of gun suicide 85 5 attempts end in death. And the vast majority of all those who survive do not go on to die by suicide.19 RESULT RESULT This suggests that a reduction in suicide attempts IN DEATH IN DEATH by firearm would result in an overall decline in the suicide rate.20,21 Given the unique lethality of firearms as a means of suicide, addressing firearm suicide is an essential element of any strategy to reduce gun violence in this country. However, mental illnesses and suicide are often stigmatized, leaving many survivors feeling alone.22 In a recent poll, 16 percent of respondents — or an estimated over 40 million American adults — reported that someone they care for attempted or died by suicide with a gun.23 everytownresearch.org/nationofsurvivors 7 GUN HOMICIDES

“WE WILL BE THE CHANGE.” ZION

Zion still gets chills thinking about his speech to the violence that affects his community. During his crowd of 850,000 at the March for Our Lives rally in March for Our Lives speech, Zion asked the crowd Washington, D.C.24 “Zaire was the outgoing twin. He to raise their hands if they had been affected by was the kind of person who would light up a room. gun violence. The sea of hands that went up was I was always more reserved. I didn’t like a lot of astonishing. “I really didn’t know what to expect, attention or being in the spotlight.” But ever since but I wanted to prove a point. It didn’t matter if his twin brother Zaire was killed on September 20, it had been 20 hands or 200 or 2,000. The fact is 2017, Zion has become his voice. “Before he died, gun violence has taken so many lives. And not I never would have spoken to a small crowd. But just in Florida or D.C. or Chicago. Gun violence is now I try to seize every opportunity to speak my everywhere and, as a nation, we need to be paying mind, like he did. In that way, Zaire continues more attention to the problem.” to live on through me.” Since his brother’s death, Zion has done everything Growing up in Northeast Washington, D.C., Zion he can to keep Zaire’s name alive. “Zaire was had heard about gun violence, but it wasn’t until captain of the track team, running for student high school when he saw the effects up-close. government president, and a youth council member. “It was pretty prevalent. D.C. had once been the He was a leader, an inspirer, not just another capital. We all knew kids who were robbed statistic.” In the summer of 2018, Zion received the at gunpoint or shot and killed. Just a month before Washington, D.C. Attorney General’s Right Direction my brother was killed, a 17-year-old girl was struck Award honoring youth who have overcome difficult by a stray bullet just a half mile from my home.” challenges and are making a positive difference in But nothing could have prepared Zion for the their communities. His brother had received the death of his twin brother. Zion, who was sixteen same award in 2017, just one month before his at the time, was walking home from school when death. Zion told the crowd in his acceptance speech, a suspicious man tried to mug him. Zion ran the “We will be the change.” few hundred feet to his house, told his mother, and texted his brother, warning him to be careful. On his way home, Zaire was shot in the head by the man police believe to be the same attacker who tried to rob Zion hours before. Zaire’s death affected every aspect of Zion’s life. He didn’t want to ride public transportation or walk anywhere, constantly looking back to see who was coming. He couldn’t focus on his schoolwork, and when he tried to study, his mind would wander and he’d think about his brother or someone else getting shot. After meeting with a group of students from Marjory Stoneman Douglas High School, Zion was Zion speaking at a March for Our Lives rally in memory of his brother, Zaire, who inspired and determined to raise awareness of the was killed in Northeast Washington, D.C. Washington, D.C., March 24, 2018 Associated Press

everytownresearch.org/nationofsurvivors 8 GUN HOMICIDES

The disparity between the United States and other Gun homicides can also have severe economic high-income countries is most stark when it comes consequences on cities and towns. Residents of to gun homicides. While the overall gun death rate communities impacted by gun violence experience of the United States is 10 times that of other high- lower property values, fewer business startups, and income countries, the gun homicide rate is 25 times loss of jobs. One study estimated that surges in higher than these peer countries.25 In the United gun homicides slowed home value appreciation States, homicides account for one-third of gun by 4 percent relative to communities which did not deaths — over 13,000 per year.26 experience a surge in violence.38 In Washington, D.C., Gun homicides happen disproportionately in each gun homicide in a given year was associated cities. One analysis found that in 2015, half of the with two fewer retail and service establishments the 39 more than 13,000 gun homicides in the U.S. took next year. In , each homicide in a given 40 place in just 127 cities, which contain less than a year led to 80 fewer jobs the following year. quarter of the population.27 The burden of gun homicide falls heaviest on communities already facing structural disadvantages. Within cities, gun homicides are most prevalent in racially segregated neighborhoods with high rates of poverty and low BLACK MALES ARE educational attainment.28 Hence, gun homicide disproportionately affects people of color.29 Black Americans represent the majority of gun homicide victims30 and are 10 times more likely than white Americans to die by gun homicide.31 Young Black men in particular are even × more at risk as they are 19 times more likely than young white men to die by gun homicide.32 This has a lasting impact on the thousands of families and communities impacted by gun homicides — 23 percent of Black American adults and 22 percent of Hispanic American adults report that someone they 16 cared for has been killed with a gun.33 MORE LIKELY THAN WHITE Gun violence is further concentrated in small social MALES TO BE SHOT networks.34,35 Within these social networks, the spread of violence looks much like the spread of AND INJURED IN a contagious disease — when an individual is INVOLVING GUNS. victimized by or exposed to violence, it increases the likelihood that they will be victimized again or resort to gun violence themselves.36,37

IN THE UNITED STATES, HOMICIDES ACCOUNT FOR ONE-THIRD OF GUN DEATHS – OVER 13,000 PER YEAR.

everytownresearch.org/nationofsurvivors 9 GUN INJURIES

“HE INSPIRES ME EVERY DAY TO HELP OTHERS.” DEANDRA

DeAndra often jokes she’s a mother who won’t shut up.41 That’s because she’s on a mission to prevent other mothers from burying their children or providing total care as she does to her 18-year- old son, Dre. “Children don’t deserve to be gunned down in our streets, mothers don’t deserve to feel the raw pain of having a child taken, fathers don’t deserve to cry through sleepless nights, and siblings shouldn’t have to live in fear for their lives.” Her oldest son, Dre (short for DeAndre) was shot in on February 1, 2014 by a stray bullet at DeAndra tabling at the Black Expo Summer the tender age of 13. Dre wasn’t at the wrong place Celebration. Indianapolis, IN, July 2017 Eric Dycus at the wrong time, in fact, he was doing what any teenager should be safe doing — celebrating at a “The cost of surviving a gunshot wound is friend’s birthday party. “Because of one bullet, one astronomical.” Dre’s initial hospital stay was 37 pull of a trigger, my son is a quadriplegic who is days — that’s 37 days of missed work for DeAndra. unable to speak.” She lost her job after he was hospitalized another Before he was shot, Dre was a high-honor roll time for 21 days. In the five years since Dre was student and an outstanding football and basketball shot, DeAndra estimates their medical bills to be player whose smile would light up a room. “People in the millions. Even with Medicare, it costs her say to me all the time, ‘You are so lucky he is alive.’ approximately $1,000 per month out-of-pocket to Yes, I’m blessed my son was not killed. But there is have Dre in rehab, which she had to weigh against nothing lucky about Dre’s condition. He’s not the quitting her job to provide full-time care for him same Dre.” at home. “People don’t think about everything the Since the shooting, Dre has survived eight strokes, family goes through. I’d love to get him out in the a traumatic brain injury, multiple seizures, and nine community and improve his quality of life, but Dre surgeries, including one to replace the right side of needs a van with a wheelchair lift to transport him.” his skull. He lives in a youth rehabilitation facility Raising the $25,000 in funds to replace their old one about a half hour from home and is still learning to that broke down is DeAndra’s goal for 2019. communicate. But he has gone back to public school DeAndra calls Dre her hero. “Dre’s fight for survival where he receives speech and physical therapy, and has touched so many lives. His spirit and smile will graduate on time with his class in 2019. remain and give me strength I never knew I had. The mom in me will never give up on him, and he inspires me every day to help others who have suffered great pain to find purpose.”

everytownresearch.org/nationofsurvivors 10 GUN INJURIES

Every year, approximately 100,000 Americans survive a gunshot wound and face a life-long ONE STUDY PUT THE OVERALL process of healing.42 The overwhelming majority of non-fatal gunshot wounds — three-quarters — are SOCIETAL COST FOR EACH caused by assaults.43 According to a recent national poll, 4 percent of American adults alive today, or GUN-RELATED ASSAULT AT an estimated 10 million people, have been shot and injured in their lifetimes. Beyond physical injuries, another 12 percent of American adults, or an estimated over 30 million people, report having been shot at, but not physically injured. Overall, one quarter of American adults say they have been threatened or intimidated with a gun. And one in $ five reported that they personally know more than one person who has been shot.44 As with other forms of gun violence, firearm assaults 1.2M and victimization are strongly connected to race and locality. Black males are 15 times more likely to short or long-term disability in the recovery than white males to be shot and injured in assaults phase — totals an average of $28,478 for each 45 involving guns. And there is evidence that those survivor of an assault by firearm.51 These with firearm assault victims in their social networks productivity losses do not include additional 46 are more likely to be victimized as well. One study productivity lost by family, friends, and found that 70 percent of non-fatal gunshot injuries professionals caring for the injured, as well in Chicago occur within social networks containing as time spent investigating, prosecuting, and only 6 percent of the city’s population. Even small punishing violent perpetrators. One study put amounts of direct and indirect exposure to the overall societal cost for each gun-related gunshot victimization significantly increase the assault at $1.2 million.52 odds of being a victim.47 Of course, the challenges of surviving a gunshot Survivors of gunshot injuries experience difficulties extend beyond financial cost. In a study of children ranging from psychological trauma, loss of work, and young adults who were hospitalized for nonfatal and steep medical costs. One study estimated firearm-related injuries, nearly half of patients that between 2003 and 2013, there was an annual were discharged from the hospital with some average of 30,617 hospital admissions for firearm disability.53 Among those who were discharged injuries in the United States. For each admission, with short-term disability, the cause was mostly average costs ranged from $19,175 per handgun attributed to wounds of the extremities, while injury 48 injury to $32,237 per assault weapon injury. Even to the central nervous system was the main cause after the immediate hospital costs, for survivors of of long-term disability. It is estimated that over gunshot injuries, there are lifetime medical care 3,200 children develop a disability as the result costs including readmission(s) to the hospital and of a firearm-related injury each year.54 And the nursing care. Several studies have found that the disabilities sustained from firearm-related injuries lifetime costs of providing care following a gunshot are not limited to physical disabilities. For example, injury are more than twice the costs of providing many gun injury survivors are left to live with bullets acute care; one study put the lifetime costs of retained inside their bodies, which may serve as treating gunshot injuries incurred in a single a constant physical reminder of the traumatic 49,50 year at $2.3 billion. injury. One study of Black male gunshot survivors Gun violence continues to financially burden in , PA found that those with retained survivors by diminishing wages and productivity. bullets experienced more adverse psychological Estimates suggest that productivity loss — the sum consequences, such as severe depressive symptoms, of the value of wage and household work lost due than those who had their bullets removed.55 everytownresearch.org/nationofsurvivors 11 GUN VIOLENCE AND CHILDREN AND TEENS

“I WANT EVERYONE TO BELIEVE THEY HAVE THE ABILITY TO MAKE A DIFFERENCE ON THINGS THAT MATTER MOST TO THEM.” SARI

February 14, 2018 started off as a normal day for Sari, a junior at Marjory Stoneman Douglas High School in Parkland, FL.56 Her mom dropped her off at school and a fire drill during second period was routine. But when another alarm sounded two periods later, she and her classmates looked at each other in confusion. “We were lined up on the grass when I heard five sounds. They sounded like gunshots. But I didn’t want to believe my school was under attack.” Parkland had been voted Florida’s safest city the prior year. No one thought something like a would ever happen there. Sirens and police cars descended on the campus. A screenshot of Sari, a student from Marjory Stoneman She was told to run. At the same time, she was Douglas High School, in a video speaking at a March for getting from friends still inside the Our Lives rally. Parkland, FL, March 24, 2018 school — two people dead, then three, then four. Someone saw one of her friends taken out on a new sense of awareness. If a book dropped in class, stretcher. “We were told to keep running because it would be startling. Lockdown drills would cause they didn’t know where the shooter was.” students to break down in tears. Two months before the at her high Sari and a friend threw themselves into organizing school that gripped the nation and sparked a new the Parkland, FL March for Our Lives. “We needed a generation of student activists, Sari debated the way to channel the negative energy into something policy of background checks on gun sales for her positive.” They organized every aspect of the event, debate team. “I had to argue both sides and we reaching out to voter registration organizations threw out a lot of statistics. But I learned the hard and the media. “The month before, I was at the way; gun violence is not all about statistics. It’s lowest point in my life. But that day, I looked out about the impact on human life.” into the crowd and saw my friends’ faces. And the Sari knew she wanted to be part of the solution, crowd kept going and going.” Thirty-five thousand so a week after the shooting she traveled to people turned out for the event and there were Tallahassee to meet with state legislators, urging hundreds of cameras. For the 15-year-old, it was an them to pass sense gun safety legislation. overwhelming sense of accomplishment. A few weeks after that, she went to Washington, D.C. Sari gets calls and text messages daily from students Coming back to school was another challenge Sari across the country who want to get involved in the had to face. The empty desk in her math class effort to end gun violence. “I want to increase voter where one of the victims sat was covered in flowers education and participation for high school and left there by the girl’s best friend. “We didn’t really college students. But above all, I want everyone to know how to react. We were all just trying to figure believe they have the ability to make a difference on out a new way to be.” The shooting also brought a things that matter most to them.” everytownresearch.org/nationofsurvivors 12 GUN VIOLENCE AND CHILDREN AND TEENS

Every year, nearly 3,000 children and teens FIREARMS ARE THE SECOND LEADING CAUSE (ages 0 to 19) are shot and killed 57 and OF DEATH FOR AMERICAN CHILDREN AND TEENS.65 approximately 15,600 are shot and injured58 — an average of 51 American children and teens Motor Vehicle 3,669 shot every day. Firearms are the second leading cause of death for children and teens and the first Firearm 3,430 leading cause of death for Black children and teens Cancer 1,740 in the U.S.59 Indeed, gun violence disproportionately Suffocation 1,633 impacts Black children and teens, who are 14 times Deaths in 2017 more likely than white children and teens of the Poisoning 1,064 same age to die by gun homicide.60 This level of violence on youth amounts to a younger generations of students. In a recent national staggering financial cost and burden on the nation’s poll, 75 percent of high school students aged 15 healthcare system. Over a period of nine years in to 17 cited mass shootings as a primary source of the United States, over 75,000 youths were sent stress, and more than one in five reported that the to the emergency room as a result of firearm possibility of a shooting at the school is a source of injury, averaging more than 8,300 kids per year. stress on a day-to-day basis.66 An analysis of school For each of these emergency room admissions, lockdowns in 31 of the nation’s largest cities by inpatient charges averaged $44,966 — reaching an found that in the 2017-2018 average cost of nearly $60,000.61 school year alone, more than 4.1 million American But the impacts of gun violence on children and students, including more than 1 million elementary- teens stretch far beyond just those who are shot: gun age children, endured at least one lockdown. These violence shapes the lives of the millions of children lockdowns were reactions to various threats, such as who witness it, know someone who was shot, or live bombs or police manhunts, but at least 61 percent in fear of the next shooting. An estimated 3 million of school lockdowns were a result of a shooting 67 American children witness gun violence every year,62 or the perceived danger of one. which can have a devastating impact. Children Stress related to gun violence affects student exposed to violence, crime, and abuse are more likely performance and wellbeing in schools. In Chicago, IL, to abuse drugs and alcohol; suffer from depression, one study found that exposure to a local homicide anxiety, and posttraumatic stress disorder; fail or have was associated with significant decreases in reading difficulties in school; and engage in criminal activity.63,64 scores, awareness, and concentration for two to 30 Instances like the Marjory Stoneman Douglas High days after the incidence. The study estimated that School shooting have created new anxieties for 15 percent of Black children in the sample spend a month each year functioning at low concentration, and that Black children in Chicago’s most violent neighborhoods spend at least a week out of every month functioning at lower concentration levels % due to local homicides.68 Another study found that following spikes in neighborhood violence, students in Chicago reported feeling less safe, experiencing more disciplinary problems, and having less trust in teachers.69 In Syracuse, NY, test scores were 50 percent lower in elementary 75 schools located in areas with high concentrations OF HIGH SCHOOL STUDENTS of gunshots than elementary schools in areas with CITED MASS SHOOTINGS a low concentration of gunshots. Elementary schools in high gunshot areas also had higher rates of AS A PRIMARY standardized test failure.70 When neighborhoods and schools are no longer safe from gun violence, entire SOURCE OF STRESS. generations of American children are impacted. everytownresearch.org/nationofsurvivors 13 DOMESTIC VIOLENCE AND GUNS “WE’VE CHANGED LAWS TO PROHIBIT DOMESTIC ABUSERS FROM POSSESSING FIREARMS — LAWS THAT WILL SAVE LIVES. AND THAT GIVES ME HOPE.” GIOVANNA

Giovanna’s hands were shaking as she sat in front of Her breaking point came on a drive home from the Rhode Island State Senate Committee on Judiciary, searching for a new house when a passing comment preparing to share intimate details of the physical and sent him into a fit of rage. When she got home, mental abuse her family suffered at the hands of her she knew it was time to leave — for good. She abuser.71 “It’s never easy to tell my story and to relive looked in the mirror and didn’t recognize herself. what happened, but I have more work to do. “I knew it was me in there, but I was completely lost.” I have seen so much change in the short time since Eight years later, Giovanna and her two sons still I’ve been speaking out. We’ve changed laws to suffer the lasting impact of mental and emotional prohibit domestic abusers from possessing firearms — abuse. All diagnosed with PTSD, they have trouble laws that will save lives. And that gives me hope.” sleeping and suffer from anxiety and depression. “I don’t have a mark on my body, but the emotional Giovanna was a single mother raising her 10-year-old scars haven’t gone away. And I don’t know if they son when she met the man who would come ever will.” to fill her life with torment and terror. She recalls every incident of abuse with painful, vivid detail. Working alongside other survivors to advocate for The controlling behavior and relentless intimidation. policies that keep guns out of the hands of domestic The physical violence that began as soon as she told abusers has given Giovanna the confidence she had him she was pregnant with their child. This was how all but lost during those terrifying years. “People ask Giovanna existed, in a perpetual state of fear and pain. me all the time why I keep speaking out, why I keep fighting for change. Sure, there are days when it’s There were so many times throughout their difficult, when I don’t want to get out of bed or let relationship she wanted to leave, and many times my son out of my arms. But then I think about the she did. There were times the police came to her change that has happened. I think about the other home and took a report, and even times he was survivors who are fighting alongside me, and the subject to a restraining order or arrested. But leaders who have the courage to make this change she couldn’t bear the thought of her sons growing possible, and I get right back up.” up without a father in the house, so she kept trying to make it work. “He’d come home from work at midnight, and if dinner wasn’t hot on the table or he wanted to be intimate, I would wake up with a gun to my head.” The gun was always on the kitchen table like a centerpiece — a constant reminder that at any moment he could kill her, leaving her children without a mother. “That was my worst fear. Most of the time I lived day to day. I went to bed not knowing if I would live to see the next day … Giovanna speaking on behalf of Everytown's endorsement That I would die at the hands of an abuser and my of Gina Raimondo for Governor of Rhode Island. Providence, RI, September 7, 2018 Steve Ahlquist children would be next when I wasn’t there anymore.”

everytownresearch.org/nationofsurvivors 14 DOMESTIC VIOLENCE AND GUNS

Women in the U.S. are 16 times more likely to be killed with a gun than women in other high- income countries. Put another way, 90 percent IN AN AVERAGE YEAR, OVER of all women killed with guns in high-income countries in 2010 were from the United States.72 In an average year in this country, over 600 women are shot to death by an intimate partner,73 and many more are injured. In fact, nearly one million American women alive today have been shot or shot at by an intimate partner.74 And while domestic abuse of any kind is devastating, the mere presence of firearms makes a violent situation more likely to turn deadly. Research shows that access to a gun in a domestic violence situation makes it five times more likely that a woman will be killed.75 This type 600 of violence disproportionately affects Black women, AMERICAN WOMEN ARE who are twice as likely to be fatally shot by an intimate partner than white women.76 SHOT TO DEATH BY AN Of course, a gun does not need to be fired to INTIMATE PARTNER, AND inflict fear and abuse. The mere presence of a gun in a threat, even if the gun is never fired, can be MANY MORE ARE INJURED. terrorizing. Approximately 4.5 million American women alive today have been threatened with a gun by an intimate partner.77 One study of domestic violence and coercive control found that women who had been threatened with a gun — or feared that their partner would use one against them — had more severe psychological symptoms than APPROXIMATELY women who had endured other types of abuse, such as psychological or physical threats.78 According to the author, “the fear of a firearm threat — just the fear of the threat, not even the actual threat — is significantly associated with PTSD. It’s stronger even than the link between physical or sexual abuse and PTSD.” 79 4.5M AMERICAN WOMEN ALIVE TODAY HAVE BEEN THREATENED WITH A GUN BY AN INTIMATE PARTNER.

everytownresearch.org/nationofsurvivors 15 HATE CRIMES WITH GUNS

“I CHOOSE TO CHANGE THE WORLD BY HELPING, NOT HURTING.” CHERYL

On election night in 2014, Cheryl felt elated Determined to make a difference, she became the as the election was called for Washington state’s citizen sponsor of Washington’s ballot initiative background checks ballot initiative, Initiative 594, requiring background checks on all gun sales — of which she was the citizen sponsor.80 “Watching which passed with 59 percent of the vote. the election results come in, and knowing I was “This has been a huge journey for me — to triumph part of this effort to save lives, was one of the over the daily physical and emotional pain that most rewarding experiences of my life. I had comes and goes, and to keep going. Sometimes taken such a traumatic experience and turned it it can be overwhelming. Each time I share my into something positive.” story, it’s like two sides of the same coin. My body Eight years earlier, Cheryl was flat on her stomach remembers and hurts when I go back to that day, with her arms covering her head. She couldn’t those weeks, those years. But on the other side, hear anything but the overwhelming ringing in her I experience the exhilaration of optimism for our ears. She couldn’t see anything because her face future, healing our communities, and making was pressed to the floor of her office in the Jewish a difference. It can be exhausting, but I always Federation of Greater . get back up again ... when I’m ready.” That afternoon, she had been expecting her 14-year-old niece, Kelsey, to show up at her office for a ride home. Instead, an armed stranger appeared in the hallway outside her office shouting hate-filled words about Israel, Jews, and wanting to get on CNN. One of Cheryl’s colleagues was killed and four others were wounded. Cheryl didn’t see Kelsey until she woke up in the hospital a week later from a medically induced coma. She spent the next six weeks there, recovering from the hollow-point bullet that tore through her abdominal organs. Over the following three years, Cheryl underwent 20 surgeries and ongoing PTSD therapy to learn to deal with the psychological and emotional aftershocks. She testified at the shooter’s two trials, proclaiming, “I choose to change the world by helping, not hurting.” And that’s exactly how she has persevered. Cheryl speaking at an election night party for Initiative 594. Cheryl saw him sentenced to life plus 120 years with Seattle, WA, November 4, 2014 Associated Press no parole for what was called the worst hate crime in Washington’s history.

everytownresearch.org/nationofsurvivors 16 HATE CRIMES WITH GUNS

In an average year, over 10,300 violent hate crimes involve a gun — more than 28 each day.81 The vast majority of hate crimes are directed against IN AN AVERAGE communities of color, religious minorities, and LGBTQ people.82 In 2017, about 58 percent of YEAR, OVER 10,300 reported hate crimes were motivated by racism, VIOLENT HATE CRIMES nearly half of which were motivated by bias against Black people. Twenty-two percent of hate INVOLVE A GUN. crimes were motivated by religious bias, most often anti-Semitism. And anti-LGBTQ bias motivated 17 percent of hate crimes in 2017.83 THAT’S MORE THAN Hate crimes against each of these groups increased in 2017, contributing to a 17 percent rise overall from 2016.84 These incidents not only impact individual lives, but they also have reverberating effects on entire communities. For individuals struggling against bias, news of a violent hate crime targeting members of a shared identity group can feel like a personal attack. Following the Pulse Nightclub shooting in Orlando, FL, LGBTQ individuals who were not personally 28 present during the attack reported experiencing EACH DAY. higher levels of emotional distress and stated they would be less likely to attend safe spaces like LGBTQ nightclubs.85,86 More than twelve years after the anti-Semitic shooting in Seattle that Cheryl survived, another HATE CRIME INCIDENTS hate-fueled attack at the Tree of Life Synagogue BY BIAS MOTIVATION, 2017 in Squirrel Hill, PA targeted members of ’s Jewish community. This shooting, OTHER which left six people wounded and 11 dead, 3% presents a terrifying reality for those seeking ANTI-LGBTQ RACIAL to assemble within their communities. When safe spaces no longer feel safe, entire 17% 58% communities suffer.

RELIGIOUS 22%

everytownresearch.org/nationofsurvivors 17 CONCLUSION: IT DOESN’T HAVE TO BE THIS WAY

With more than 36,000 Americans shot and killed every year,87 and approximately 100,000 more shot and injured,88 much of this country is left with pervasive grief from our nation’s gun violence epidemic. Though the reach of gun violence in the United States is vast and impacts all communities, most Americans do not view themselves as gun violence survivors. While the statistics paint a grim and complex picture of America’s gun violence problem, it doesn’t have to be this way. While there are no simple solutions to an epidemic this complex, there are several clear, common-sense policies that we can adopt to break the pattern. Some of these policies include: • Strengthen the background check system • Combat daily gun violence • Protect kids and communities • Hold the gun industry accountable • Disarm domestic abusers STRENGTHEN THE BACKGROUND CHECK SYSTEM DISARM DOMESTIC ABUSERS Background checks on gun sales are the foundation Because of the risk that firearms pose when they of any effective effort to reduce gun violence because intersect with domestic violence, a series of federal they are designed to keep guns away from people and state laws are in place to help keep guns out who are legally prohibited from possessing them. But of the hands of domestic abusers. However, while federal law does not require individuals who are not the federal prohibitions apply to current and former licensed gun dealers to conduct background checks spouses and certain other domestic abusers, they before selling a gun, and the Internet has emerged generally do not apply to abusive dating partners, as a massive, unregulated marketplace, where or stalkers who have not yet been convicted of a hundreds of thousands of gun sales take place with no felony. The strongest state laws prohibit the same background check and no questions asked. Without group of domestic abusers prohibited by federal a background check, individuals may unknowingly law, as well as abusive dating partners and stalkers sell firearms to felons, convicted domestic abusers, convicted of misdemeanor stalking, and require that people convicted of violent hate crimes, or people these dangerous people turn in guns already in their with violent misdemeanor convictions. These types of possession. Evidence shows that when these laws are legal prohibitors require a comprehensive background in place and enforced properly, they work to reduce check system without loopholes that let dangerous domestic-violence related homicides.95, 96 purchasers through the cracks.

PROTECT KIDS AND COMMUNITIES Research shows that policies like Red Flag laws work to reduce gun suicides,89,90 and may help keep our children safe from mass shootings.91 Red Flag laws empower family members and law enforcement to take action to stop warning signs from escalating into tragedies. They enable family members and law enforcement to ask a judge to temporarily block a person’s access to guns if the court finds that they pose a risk to themselves or others by having a firearm. Further, we can reduce gun violence by Survivors raising their hands in recognition of being limiting easy access to firearms and accessories that personally affected by gun violence at national conference are capable of inflicting mass casualties, such as of gun violence prevention advocates. Atlanta, GA, high-capacity magazines and assault weapons,92 and August 10, 2018 Kristin Bell Gerke require safe and responsible storage of all guns.93,94

everytownresearch.org/nationofsurvivors 18 COMBAT DAILY GUN VIOLENCE Gun violence intervention programs that focus on community-level violence have been shown to reduce gunshot victimization in the neighborhoods most impacted by gun violence.97,98,99 Programs like Cure Violence employ a localized public health approach to fighting violence by using street outreach workers to mediate conflicts and prevent retaliatory violence.100 Hospital-based violence intervention programs provide case management to individuals who have been seriously injured and who are at higher risk of engaging in retaliatory violence or suffering an additional violent injury after leaving the hospital.100,102,103 While the evidence shows that these and other local programs reduce gun violence in their Christopher speaking at the Youth Over communities, they require sustainable government Guns March across the Brooklyn Bridge. funding to maintain their successful operations. City, NY, June 2, 2018 Joe Quint

HOLD THE GUN INDUSTRY ACCOUNTABLE Unlike any other major industry, the gun industry is largely shielded from accountability for business practices that directly threaten public safety and put American lives at risk. This lack of accountability is primarily due to the Protection of Lawful Commerce in Arms Act (PLCAA), a federal statute that prohibits certain lawsuits against gun manufacturers and retailers. Without legal accountability, the gun industry has no incentive to adopt reforms, such as developing safer gun technology or ensuring more responsible sales and marketing practices. Lawmakers can help mitigate the harms of gun violence by repealing PLCAA. Repealing this harmful law, along with similar state laws, will give survivors and victims of gun violence the ability to seek accountability and compensation in court against companies and individuals whose irresponsible behavior has caused great harm. Just like lawsuits Protesters march at a March for Our Lives rally. Columbus, OH, March 24, 2018 Jodi Miller against the tobacco and auto industries in the latter half of the previous century, litigation against the gun industry can force the gun industry to adopt safer technology and responsible business practices.

everytownresearch.org/nationofsurvivors 19 1. Grinshteyn E, Hemenway D. Violent death rates: The U.S. compared 18. Miller M, Azrael D, Barber C. Suicide mortality in the United with other high-income OECD countries, 2010. The American Journal States: The importance of attending to method in understanding of Medicine. 2016; 129(3): 266-273. population-level disparities in the burden of suicide. Annual Review of Public Health. 2012; 33: 393-408. 2. Ibid. 19. Owens D, Horrocks J, House A. Fatal and non-fatal repetition 3. Centers for Disease Control and Prevention. National Centers for of self-harm: Systematic review. British Journal of Psychiatry. Injury Prevention and Control. Web-based Injury Statistics Query and 2002; 181: 193-199. Reporting System (WISQARS) Fatal Injury Reports. A yearly average was developed using five years of most recent available data: 2013 20. Soffen K. To reduce suicides, look at guns. The Washington Post. to 2017. July 13, 2016. https://wapo.st/29SfvVY 4. Centers for Disease Control and Prevention. National Centers for 21. Yip PS, Caine E, Yousuf S, Chang SS, Wu KC, Chen YY. Means Injury Prevention and Control. Web-based Injury Statistics Query restriction for suicide prevention. The Lancet. 2012; 379(9834): 2393- and Reporting System (WISQARS) Nonfatal Injury Reports. A yearly 2399. average was developed using five years of most recent available 22. Carpiniello B, Pinna F. The reciprocal relationship between suicidality data: 2013 to 2017. and stigma. Front Psychiatry. 2017; 8: 35. 5. SurveyUSA Market Research Study. Data collected from December 7, 23. SurveyUSA Market Research Study. Data collected from December 7, 2018 to December 11, 2018. https://bit.ly/2ExxpyZ. See question 39. 2018 to December 11, 2018. https://bit.ly/2ExxpyZ. See question 36. 6. Irvin-Erickson Y, Lynch M, Gurvis A, Mohr E, Bai B. A neighborhood- 24. This narrative is derived from an interview with Zion Kelly, a gun level analysis of the economic impact of gun violence. https://urbn. violence prevention advocate. is/2GQ18oA. Urban Institute. June 2017. 25. Grinshteyn E, Hemenway D. Violent death rates: The U.S. compared 7. Beyer K, Wallis AB, Hamberger LK. Neighborhood environment with other high-income OECD countries, 2010. The American Journal and intimate partner violence: A systematic review. Trauma, Violence, of Medicine. 2016; 129(3): 266-273. & Abuse. 2015; 16(1): 16-47. 26. Centers for Disease Control and Prevention. National Centers for 8. Haynie DL, Silver E, Teasdale B. Neighborhood characteristics, Injury Prevention and Control. Web-based Injury Statistics Query and peer networks, and adolescent violence. Journal of Quantitative Reporting System (WISQARS) Fatal Injury Reports. A yearly average . 2006; 22: 147-169. was developed using five years of most recent available data: 2013 9. Centers for Disease Control and Prevention. National Centers for to 2017. Analysis includes gun deaths by homicide, including legal Injury Prevention and Control. Web-based Injury Statistics Query and intervention. Reporting System (WISQARS) Fatal Injury Reports. A yearly average 27. Aufrichtig A, Beckett L, Diehm J, Lartey J. Want to fix gun violence was developed using five years of most recent available data: 2013 to in America? Go local. . January 9, 2017. 2017. While it is broadly considered to be the most comprehensive https://bit.ly/2i6kaKw. firearm fatal injury source, two of the intent categories – Shootings by law enforcement and Unintentional Deaths – are estimated 28. Ibid. to be greatly underreported. This underreporting is largely due 29. Everytown for Gun Safety. Gun Violence in America. to missing information on death certificates, which may result in https://every.tw/2pRcld6. August 8, 2018. misclassification of intent. Multiple media sources and nonprofit groups have tracked shootings by law enforcement but no reliable 30. Centers for Disease Control and Prevention. National Centers public database captures unintentional shootings. Intent category for Injury Prevention and Control. Web-based Injury Statistics Query averages may not total to yearly average due to rounding. and Reporting System (WISQARS) Fatal Injury Reports. A yearly See also: Fatal Force. The Washington Post. Fatal Force. Data reflects average was developed using five years of most recent available a 4-year average (2015 to 2018) of deaths attributed to police data: 2013 to 2017.Analysis includes gun deaths by race among all shootings. https://wapo.st/2QlEZOo. ages, non-Hispanic only, and homicide including legal intervention. 10. Centers for Disease Control and Prevention. National Centers for 31. Ibid. Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Nonfatal Injury Reports. A yearly 32. Ibid. Analysis includes gun deaths by race among men ages 18 to 34, average was developed using five years of most recent available non-Hispanic Black only, and homicide including legal intervention. data: 2013 to 2017. Intent category averages may not total to yearly 33. SurveyUSA Market Research Study. Data collected from December 7, average due to rounding. 2018 to December 11, 2018. https://bit.ly/2ExxpyZ. See question 35. 11. This narrative is derived from an interview with Jennifer Lugar, 34. Papachristos AV, Wildeman C, Roberto E. Tragic, but not a volunteer with the Everytown Survivor Network and Moms Demand random: The social contagion of nonfatal gunshot injuries. Action for Gun Sense in America. Social Science & Medicine. 2015; 125: 139-150. 12. Grinshteyn E, Hemenway D. Violent death rates: The U.S. compared 35. Corsaro N. Most challenging of contexts: Assessing the Impact of with other high-income OECD countries, 2010. The American Journal focused deterrence on serious violence in . Criminology of Medicine. 2016; 129(3): 266-273. and Public Policy. 2015; 14(3). 13. Centers for Disease Control and Prevention. National Centers for 36. Tracy M, Braga AA, Papachristos AV. The transmission of gun and Injury Prevention and Control. Web-based Injury Statistics Query and other weapon-involved violence within social networks. Epidemiology Reporting System (WISQARS) Fatal Injury Reports. A yearly average Review. 2016; 38(1): 70-86. was developed using five years of most recent available data: 2013 to 2017. 37. Green B, Horel T, Papachristos AV. Modeling contagion through social networks to explain and predict gunshot violence in Chicago, 14. Ibid. Analysis includes gun deaths by suicide among males of all 2006 to 2014. JAMA Internal Medicine. 2017; 177(3): 326-333. ages. White defined as non-Hispanic only. 38. Irvin-Erickson Y, Lynch M, Gurvis A, Mohr E, Bai B. A neighborhood- 15. Anglemyer A, Horvath T, Rutherford G. The accessibility of firearms level analysis of the economic impact of gun violence. https://urbn. and risk for suicide and homicide victimization among household is/2GQ18oA. Urban Institute. June 2017. Study analyzed data from members: A systematic review and meta-analysis. Annals of Internal Baton Rouge, Minneapolis, Oakland, , and Washington, Medicine. 2014; 160(2): 101-110. D.C. 16. Opoliner A, Azrael D, Barber C, Fitzmaurice G, Miller M. Explaining 39. Ibid. geographic patterns of suicide in the U.S.: The role of firearms and antidepressants. Injury Epidemiology. 2014; 1(1): 6. 40. Ibid. 17. Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR. Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. American Journal of Preventive Medicine. 2007; 32(6): 474-482.

everytownresearch.org/nationofsurvivors 20 41. This narrative is derived from an interview with DeAndra Yates, a 61. Gani F, Canner JK. Trends in the incidence of and charges associated volunteer with the Everytown Survivor Network and Moms Demand with firearm-related injuries among pediatric patients, 2006-2014. Action for Gun Sense in America. JAMA Pediatrics. 2018; 172(12): 1195-1196. 42. Centers for Disease Control and Prevention. National Centers for 62. Fowler KA, Dahlberg LL, Haileyesus T, Gutierrez C, Bacon S. Injury Prevention and Control. Web-based Injury Statistics Query and Childhood firearm injuries in the United States. Pediatrics. 2017; Reporting System (WISQARS) Nonfatal Injury Reports. A yearly average 140(1): e20163486. Everytown analysis derives the 3 million number was developed using five years of most recent available data: 2013 to by multiplying the share of children (ages 0 to 17) who are exposed 2017. to shootings per year (4.2%) by the total child population of the U.S. in 2016 (~73.5M). 43. Ibid. 63. Finkelhor D, Turner HA, Ormrod R, Hamby S, Kracke K. Children’s 44. SurveyUSA Market Research Study. Data collected from December 7, exposure to violence: A comprehensive national survey. Washington, 2018 to December 11, 2018. https://bit.ly/2ExxpyZ. See question 37. D.C.: U.S. Department of Justice, Office of Juvenile Justice and 45. Centers for Disease Control and Prevention. National Centers Delinquency Prevention. https://bit.ly/PwXoZN. 2009. for Injury Prevention and Control. Web-based Injury Statistics Query 64. Morris E. Youth violence: Implications for Posttraumatic and Reporting System (WISQARS) Nonfatal Injury Reports. Data Stress Disorder in urban youth. National Urban League. reflect a five-year average (2013 to 2017) of gun deaths by intent. https://bit.ly/2KBpOyg. March 2009. Analysis includes males of all ages, non-Hispanic white and Black only, and assault including legal intervention. 65. Centers for Disease Control and Prevention. National Centers for Injury Prevention and Control. Web-based Injury Statistics Query 46. Papachristos AV, Wildeman C, Roberto E. Tragic, but not random: and Reporting System (WISQARS) Leading Causes of Death, 2017. The social contagion of nonfatal gunshot injuries. Social Science Analysis includes children and teenagers aged 1 to 19, number of & Medicine. 2015; 125: 139-150. deaths by known intent (homicide, suicide, unintentional deaths). 47. Ibid. Age 0 to 1 calculated separately by the CDC because leading causes of death for newborns and infants are specific to the age group. 48. Peek-Asa C, Butcher B, Cavanaugh JE. Cost of hospitalization for firearm injuries by firearm type, intent, and payer in the United 66. American Psychological Association. Stress in America: Generation Z. States. Injury Epidemiology. 2017; 4: 20. https://bit.ly/2JrCisG. October 2018. 49. Cook PJ, Lawrence BA, Ludwig J, Miller TR. The medical costs of 67. Rich S, Cox JW. School lockdowns: How many American children have gunshot injuries in the United States. Journal of the American Medical hidden from gun violence? The Washington Post. Association. 1999; 282(5): 447-454. December 26, 2018. https://wapo.st/2F5Mw1T. 50. Peek-Asa C, Butcher B, Cavanaugh JE. Cost of hospitalization for 68. Sharkey P. The acute effect of local homicides o children’s cognitive firearm injuries by firearm type, intent, and payer in the United performance. Proceedings of the National Academy of Sciences of the States. Injury Epidemiology. 2017; 4: 20. United States of America. 2010; 107(26): 11733-11738. 51. Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR. Medical 69. Burdick-Will J. Neighborhood violence, peer effects, and academic costs and productivity losses due to interpersonal and self-directed achievement in Chicago. Sociology of Education. 2018; 91(3): 205-223. violence in the United States. American Journal of Preventive Medicine. 70. Bergen-Cico D, Lane SD, Keefe RH. Community gun violence as a 2007 Jun; 32(6): 474-482. social determinant of elementary school achievement. Social Work 52. Cook PJ, Ludwig J. The benefits of reducing gun ownership: in Public Health. 2018; 33(7-8): 439-448. evidence from contingent-valuation survey data. The Journal 71. This narrative is derived from an interview with Giovanna Rodriguez, of Risk and Uncertainty. 2001; 22(3): 207-226. a volunteer with the Everytown Survivor Network and Moms Demand 53. DiScala C, Sege R. Outcomes in children and young adults Action for Gun Sense in America. who are hospitalized for firearms-related injuries. Pediatrics. 2004; 72. Grinshteyn E, Hemenway D. Violent death rates: The U.S. compared 113(5): 1306-1312. with other high-income OECD countries, 2010. The American Journal 54. Ibid. of Medicine. 2016; 129(3): 266-273. 55. Smith RN, Seamon MJ, Kumar V, et al. Lasting impression of violence: 73. Uniform Crime Reporting Program: Supplementary Homicide Retained bullets and depressive symptoms. Injury. Reports (SHR), 2013-2017. Washington, D.C.: Department of Justice, 2018; 49(1): 135-140. Federal Bureau of Investigation. While the FBI SHR does not include data from the state of Florida for the years 2013 to 2017, 56. This narrative is derived from an interview with Sari, a volunteer with Everytown obtained data directly from the Florida Department of Students Demand Action and the Everytown Survivor Network. Law Enforcement (FDLE) and included the reported homicides in the 57. Centers for Disease Control and Prevention. National Centers analysis. Whereas SHR includes both current and former partners for Injury Prevention and Control. Web-based Injury Statistics Query in its relationship designations, FDLE does not include former and Reporting System (WISQARS) Fatal Injury Reports. A yearly partners. As a result, Florida’s intimate partner violence data only average was developed using five years of most recent available includes current partners. data: 2013 to 2017. Analysis includes children and teens defined as 74. Sorenson SB, Schut RA. Nonfatal gun use in intimate partner 0 to 19. violence: A systematic review of the literature. Trauma, Violence 58. Centers for Disease Control and Prevention. National Centers for & Abuse. 2016; 1524838016668589. Injury Prevention and Control. Web-based Injury Statistics Query 75. Campbell JC, Webster D, Koziol-McLain J, et al. Risk factors for and Reporting System (WISQARS) Nonfatal Injury Reports. A yearly femicide in abusive relationships: Results from a multisite case average was developed using five years of most recent available control study. American Journal of Public Health. 2003; 93(7): data: 2013 to 2017. Analysis includes children and teens defined 1089-1097. as 0 to 19. 76. Uniform Crime Reporting Program: Supplementary Homicide Reports 59. Centers for Disease Control and Prevention. National Centers for (SHR), 2012-2016. Analysis includes homicides involving an intimate Injury Prevention and Control. Web-based Injury Statistics Query and partner and a firearm, and compares the crude death rates for Black Reporting System (WISQARS) Leading Causes of Death, 2017. Analysis women (0.63 per 100,000) versus white women (0.34 per 100,000) includes children and teenagers aged 1 to 19, Black defined as (all ages included; Hispanic and non-Hispanic women included). non-Hispanic, Age 0 to 1 calculated separately by the CDC because leading causes of death for newborns and infants are specific to the 77. Sorenson SB, Schut RA. Nonfatal gun use in intimate partner age group. violence: A systematic review of the literature. Trauma, Violence, & Abuse. 2016; 1524838016668589. 60. Centers for Disease Control and Prevention. National Centers for Injury Prevention and Control. Web-based Injury Statistics Query and 78. Sullivan TP, Weiss NH. Is firearm threat in intimate relationships Reporting System (WISQARS) Fatal Injury Reports. A yearly average associated with Posttraumatic Stress Disorder symptoms among was developed using five years of most recent available data: 2013 to women? Violence and Gender. 2017; 4(2). 2017. Analysis includes gun homicides including legal intervention by 79. Mascia J. No shots fired. The Trace. September 12, 2018. non-Hispanic race among children and teens aged 0 to 19. https://bit.ly/2QAOSg7. everytownresearch.org/nationofsurvivors 21 80. This narrative is derived from an interview with Cheryl Stumbo, 98. Heller SB, Shah AK, Guryan J, Ludwig J, Mullainathan S, Pollack HA. a staff member at Everytown for Gun Safety and member of the Thinking, fast and slow? Some field experiments to reduce crime and Everytown Survivor Network. dropout in Chicago. National Bureau of Economic Research Working Paper Series. 2015; 21178. 81. Everytown for Gun Safety analysis of Special Report: Hate Crime Victimization, 2004-2015, BJS. June 2017. https://bit.ly/2KrFyoe. 99. Branas CC, South E, Kondo MC, Hohl BC, Bourgois P, Wiebe DJ, To obtain the annual and daily average of violent hate crimes MacDonald JM. Citywide cluster randomized trial to restore blighted involving a firearm, Everytown used a 10-year average of violent hate vacant land and its effects on violence, crime, and fear. Proceedings crime victimizations (2006 to 2015) combined with the proportion of the National Academy of Sciences of the United States of America. of violent hate crimes involving firearms (4.5%). Analysis was limited 2018; 115 (12). to violent hate crimes perpetrated against a person or persons 100. Delgado SA, Alsabahi L, Wolff K, Alexander N, Cobar P, Butts JA. and does not include hate crimes against property (such as defacing The effects of Cure Violence in the South Bronx and East New York, a victim’s home, burglary, and vehicle theft). Brooklyn. Denormalizing Violence: A series of reports from the John 82. Everytown for Gun Safety. Disarm Hate. Jay College Evaluation of Cure Violence Programs in . https://every.tw/2A3M4xZ. June 12, 2018. Research and Evaluation Center, John Jay College of Criminal Justice, City University of New York. October 2, 2017. 83. Hate Crime Statistics, 2017. Federal Bureau of Investigation. https://bit.ly/2CeBZ2M. 101. Cooper C, Eslinger DM, Stolley PD. Hospital-based violence intervention programs work. The Journal of Trauma. 2006; 61(3): 84. Ibid. 534-537. 85. Jackson SD. “Connection is the antidote”: Psychological distress, 102. Juillard C, Cooperman L, Allen I, et al. A decade of hospital-based emotional processing, and virtual community building among LGBTQ violence intervention. Journal of Trauma and Acute Care Surgery. 2016; students after the Orlando shooting. of Sexual Orientation 81(6): 1156-1161. and Gender Diversity. 2017; 4(2): 160-168. 103. Bell TM, Gilyan D, Moore BA, et al. Long-term evaluation of a 86. Croff JM, Hubach RD, Currin JM, Frederick AF. Hidden rainbows: hospital-based violence intervention program using a regional Gay bars as safe havens in a socially conservative area since the health information exchange. Journal of Trauma and Acute Care Pulse Nightclub massacre. Sexuality Research and Social Policy. 2017; Surgery. 2017; 84(1): 175-182. 14(2): 233-240. 87. Centers for Disease Control and Prevention. National Centers for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. A yearly average was developed using five years of most recent available data: 2013 to 2017. 88. Centers for Disease Control and Prevention. National Centers for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Nonfatal Injury Reports. A yearly average was developed using five years of most recent available data: 2013 to 2017. 89. Kivisto AJ, Phalen PL. Effects of risk-based firearm seizure laws in and Indiana on Suicide Rates, 1981-2015. Psychiatric Services. 2018; 69(8): 855-862 90. Swanson JW, Norko M, Lin H, et al. Implementation and effectiveness of Connecticut’s risk-based gun removal law: Does it prevent suicides? Law and Contemporary Problems. 2017; 80: 179-208. 91. Everytown for Gun Safety. Mass Shootings in the United States: 2009-2017. https://everytownresearch.org/reports/mass-shootings- analysis/. December 2018. 92. DiMaggio C, Avraham J, Berry C, et al. Changes in US mass shooting deaths associated with the 1994-2004 Federal Assault Weapon Ban: analysis of open data. Journal of Trauma and Acute Care Surgery. 2019 Jan; 86(1): 11-19. 93. Grossman DC, Mueller BA, Riedy C, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. The Journal of the American Medical Association. 2015; 293(6): 707-714. 94. Azrael D, Cohen J, Salhi C, Miller M. Firearm storage in gun-owning households with children: Results of a 2015 national survey. Journal of Urban Health. 2018; 95(3): 295-304. Study defined children as under the age of 18. 95. Zeoli AM, McCourt A, Buggs S, Frattaroli S, Lilley D, Webster DW. Analysis of the strength of legal firearms restrictions for perpetrators of domestic violence and their associations with intimate partner homicide. American Journal of Epidemiology. 2018; 187(11): 2365-2371. 96. Díez C, Kurland RP, Rothman EF, et al. State intimate partner violence-related firearm laws and intimate partner homicide rates in the United States, 1991-2015. Annals of Internal Medicine. 2017; 167(8): 536-543. 97. Papachristos AV, Kirk DS. Changing the street dynamic: Evaluating Chicago’s group violence reduction strategy. Criminology & Public Policy. 2015; 14(3): 525-558.

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