Public health approaches are needed to reduce the epidemic of gun violence.

The Newtown, Conn., massacre has caused a nationwide debate on guns and the protection of our vulnerable and beloved children from senseless violence caused by mentally impaired individuals. While the debate rages and the outcome remains blurry, everyone agrees that guns must be kept out of the hands of criminals and those with mental illness.

While mass shootings remain sporadic, homicide, suicide and injuries from guns are an epidemic, particularly among teenagers, the most affected being black teens and young adults under the age of 25. According to the nonprofit child-advocacy group Children's Defense Fund, 18,270 children or teens were injured or died by gunfire in 2010. Three times as many children were injured by gunfire than the number of soldiers injured in Afghanistan that year.

And the societal costs of treating and caring for those with gun-related injuries are estimated to be $32 billion annually, almost equaling revenue from gun sales.

Women are far less likely to be the victim or to commit violent crimes. The statistics highlight racial and age disparities. A disproportionate number of homicide victims and perpetrators are black males in general, and black male teens and young adults in particular. A report by Dr. Manshi Sethi published in the Journal of Emergency Medicine showed that two-thirds of the 2,668 gunshot victims treated at Vanderbilt University over a six-year period were black, most between 14 and 25. In 2010, firearm deaths from homicide, suicide and accidents totaled 52.7 per 100,000 black male teens compared to 9.4 per 100,000 for white male teens. Today, the leading cause of death among black male teens and young adults is gun related.

This frightening trend must be addressed as an overall strategy to improve the health and well being of all of us. In a recent perspective published in the New England Journal of Medicine, Drs. David Hemenway and Matthew Miller make a strong plea to focus on public health solutions to gun-related deaths. To accomplish this, the authors state, the problem must be carefully defined, risk and preventive factors identified, strategies tested to prevent gun deaths and the approaches widely adopted.

As an example of how public health strategies can be effective, they point to the successful reduction in the number and severity of automobile accidents and deaths. Beginning in the 1960s, manufacturers did much to make cars safer, installing collapsible steering wheels and air bags and changing designs to prevent damage during rollovers. Speed limits were reduced, and roads have been made safer. Drivers wear seat belts and better education has limited those who drive impaired.

In the New England Journal article, the authors make an urgent plea for a nationwide database on gun violence. There is already a National Violent Death Reporting System in 18 states that must be extended nationwide. We must also do more to understand why guns are so readily available to teenagers and what can be done to provide opportunities that steer young people away from violence.

The authors say gun manufacturers can do much to help without impinging on individual rights. Guns should have unique serial numbers that cannot be erased, and technology is available to personalize a gun so that only its rightful owner can use it. Like more than 90 percent of Americans, they strongly support background checks.

Clearly everyone must get involved. Better policing and greater involvement in communities played an important role in reduction in gun violence between 1990 and 2000. Just as the "Marlboro Man" created the macho image of smoking, the entertainment industry must realize they do much to romanticize guns among young people. Better education, improved opportunities for inner-city young people and an investment in their future can contribute.

Gun control is only one part of the solution. We must do much more to improve the stability, education and job opportunities for families and communities most affected by gun violence.

While gun rights and the Second Amendment are indelibly ingrained in our culture, there is no excuse for not aggressively seeking solutions to the firearm violence that is a major health threat in inner cities, snuffing out the futures of so many teens. Failure to do so is a national scandal.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at:

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