Unpacking Violence: Examining Socioeconomic, Psychological, and Genetic Drivers of Gun-Related Homicide and Potential Solutions

Abstract

Background: Gun-related homicide remains a persistent public health crisis in the United States, with over 48,000 firearm-related deaths reported in 2022, including 19,651 homicides and 27,032 suicides. Despite frequent calls for tighter gun control, firearm access alone does not explain the complexity of violence. Objective: This commentary aims to unpack the socioeconomic, psychological, and biological drivers of gun-related homicide and propose integrative, evidence-based solutions that extend beyond legislative reform. Methods: We synthesized data from peer-reviewed literature, national crime and health databases (e.g., Centers for Disease Control and Prevention and Federal Bureau of Investigation), and international reports. We examined patterns related to poverty, trauma, male aggression, neurobiology, and firearm acquisition, as well as cross-national comparisons with countries like Switzerland and Mexico. Findings: Young males, particularly those aged 10–29, accounted for 50% of homicide offenders in 2022. African Americans experienced homicide rates of 23.1 per 100,000, ten times the rate among Whites. Up to 56% of incarcerated men report childhood physical trauma, and over 40% of those in prison exhibit symptoms of serious mental illness. While firearm legislation varies widely, analysis reveals that over 90% of crime guns are acquired illegally or through informal sources. International comparisons show that poverty and weak rule of law, more than gun laws alone, correlate with elevated homicide rates. Conclusions: Reducing gun violence sustainably requires a multifaceted approach. Authors advocate for investments in trauma-informed mental health care, focused deterrence programs, early childhood interventions, and improved enforcement against illegal gun trafficking. A public health strategy that integrates social reform with targeted regulation holds the greatest promise for long-term change.

1. Background

ABC News reported that 11,600 people had died from gun violence in the United States (U.S.) in 2024 alone, noting that mass shootings have more than doubled over the past decade [1]. However, a Forbes article highlighted that the first six weeks of 2024 saw a three-year low in mass shootings [2], illustrating how differences in definitions, data sources, or timeframes can lead to contrasting interpretations of the same issue. Amid these conflicting reports, U.S. Surgeon General Vivek Murthy, MD, issued an advisory labeling gun violence as a “public health crisis”, and urging an evidence-based approach to address it. His 40-page advisory advocates for increased federal funding for research, greater community investment in education and mental health resources, and policy changes such as an assault weapons ban, universal background checks, and magazine capacity limits [1,3,4].

Behind these headlines lies a multifaceted issue that requires thoughtful and nuanced solutions. The underlying causes of violence and the realities of how firearms are acquired for crimes are often overlooked. Developing effective solutions requires a more evidence-based and comprehensive examination of the issue to inform strategies beyond merely tightening existing gun regulations. First, it is important to consider the historical context of this gun-related violence, followed by its origin, factors, and its intricate mechanisms to fully reveal the complex interplay of societal, psychological, and systemic influences that drive this issue. This commentary synthesizes peer-reviewed research, government datasets, and international reports to provide a multidisciplinary perspective on gun-related homicide. Sources were selected based on relevance to the topic, methodological rigor, and citation frequency in public health, criminology, and policy literature. While no original statistical analyses were conducted, descriptive data from the Centers for Disease Control and Prevention [CDC], Federal Bureau of Investigation [FBI], Department of Justice [DOJ], and published studies are integrated to highlight key patterns. Future research with primary data and inferential analyses is encouraged to build on the hypotheses and associations explored here.

1.1. Historic Violence

Despite the eye-catching headlines, violence and murder rates are not at all-time highs. Historically, as civilizations have advanced, rates of homicidal violence have declined. Recent analyses by the CDC and FBI highlight this downward trend in modern crime data [5,6]. For instance, the homicide rate in medieval Oxford was estimated at 60–75 per 100,000, roughly 50 times higher than current rates in 21st-century English cities (Figure 1). Historical studies also show that common drivers of violence, such as group affiliations, weapon access, and male honor persist across time and cultures [7,8,9]. The Netherlands saw a reduction from 50 per 100,000 in the fifteenth century to about one per 100,000 in the nineteenth century [10]. In the Middle Ages, serious interpersonal violence was not confined to any one social class, and nearly all homicides in medieval London involved weapons like swords, fighting knives, and staffs.

As overall levels of violence declined through the early modern age, it became more associated with lower social classes. Historically, the highest number of offenders were young men aged 20–29 years [9].

To the benefit of all, civilization has progressively left less room for the warrior mentality. Norbert Elias, whose theories on the civilizing influence of the modern state are foundational to current thought, proposed that both macro-level (societal) and micro-level (personal) changes occur simultaneously. As state power, legal institutions, and economic conditions improve, people become increasingly economically interdependent, fostering a greater emphasis on long-term planning, rational living, and decreased impulsivity on a personal level [11,12].

Empirical research shows that in modern society, violent and serious crimes are closely linked to the desire for instant gratification, a propensity for risk-taking, high impulsivity, and a disregard for others’ needs. Long-term factors that predict violent behavior include biological influences, individual traits (such as impulsivity and low intelligence), family issues (such as inadequate supervision, harsh discipline, exposure to violence, a young mother, and broken homes), peer delinquency, low socioeconomic status, living in urban areas, and being in high-crime neighborhoods. Immediate situational factors include the offender’s motivations (like anger) and behaviors that lead to violent outcomes, such as the escalation of minor conflicts [13,14].

Worldwide, approximately 500,000 people a year die from intentional homicide, not including deaths from war. Over 90% of the homicide perpetrators are male with little variation across societies. Most are associated with populations which are economically and socially marginalized and often committed along with another crime such as robbery or as part of the defense or dominance activities of gangs over turf or illegal markets [15,16].

The root causes of homicidal violence are clearly more complicated than the mere availability of weapons.

1.2. Violent Crime in the U.S.

In 1980, the homicide rate reached a peak of 10.2 per 100,000. Since 1991, the rate has decreased by at least 40%, reflecting a broader decline in violent crimes such as assault, robbery, rape, and child abuse [17,18]. According to the FBI, in 2022, over 11 million criminal offenses were reported to the Uniform Crime Reporting Program (UCR). Regarding rates per 100,000 population, “All Crimes” occurred at a rate of 2500, violent crime, 380; assault, 268; robbery, 66; rape, 40; homicide, 6.3; and mass shootings causing death at a rate of 0.03 (Figure 2 [19]. A total of 48,117 (14.4 per 100,000) people died of gunshot wounds in 2022 [5], a 1.5 percent decrease from 48,830 in 2021. Of these, gun homicides accounted for 19,651 or 41% of gun-related deaths (and 24,849 of all homicides or 80%) while there were 27,032 suicides by gunshot, of nearly 50,000 total suicides (14.8 per 100,000) and accounting for 56% of the gun-related deaths for that year [5]. It is important to note that clarifying definitions and understanding data limitations is essential when analyzing violence trends. Homicide refers to the unlawful killing of one person by another, while firearm homicide is a specific subset involving guns. For instance, the CDC reported 48,117 gun-related deaths in 2022, but only 41% were homicides; the remainder were primarily suicides. FBI data similarly shows that most but not all homicides involve firearms. Importantly, reporting reliability varies across jurisdictions due to differences in classification, infrastructure, and community-police dynamics. These factors may result in underreported or misclassified cases, particularly in historically marginalized communities. As Schleimer et al. (2025) emphasize, firearm research must address these limitations by selecting appropriate confounders and using administrative data with transparency and caution [20].

1.3. Ethnicity of Homicide

The ethnic distribution of both offenders and victims of homicide weighs heavily on the African American community, as reported in

Table 1. Homicide offender ethnicity distribution as reported by the Federal Bureau of Investigation Crime Data (2022).

Offender Ethnicity	%	per 100k	per 100k of That Race
White	22%	1.19	2.0
African American	52%	2.89	21.2
Hispanic	12%	0.79	4.2
Asian	1%	0.06	0.9
American Indian	1%	0.07	5.1
Unknown	11%	0.92	NA

Note: % = percentage; per 100k = per 100,000 people; NA = not available. Source: Federal Bureau of Investigation Crime Data Explorer [6].

and

Table 2. Homicide vVictim eEthnicity dDistribution as rReported by the Federal Bureau of Investigation Crime Data (2022).

Victim Ethnicity	%	per 100k	per 100k of that Race
White	25%	0.96	2.3
African American	56%	3.14	23.1
Hispanic	14%	0.01	5.1
Asian	1%	0.08	1.2
American Indian	2%	0.08	5.9
Unknown	2%	0.14	NA

Note: % = pPercentage; per 100k = per 100,000 people; NA = nNot aAvailable. Source: Federal Bureau of Investigation Crime Data Explorer [6].

below. As shown in Table 1, African Americans accounted for the largest share of offenders at 52%, with a general population rate of 2.89 per 100,000 and a significantly higher rate of 21.2 per 100,000 within their own population, indicating a disproportionate burden. White offenders made up 22% of the total, with relatively lower rates of 1.19 per 100,000 in the general population and 2.0 per 100,000 within their group. Hispanics represented 12% of offenders, with a general population rate of 0.79 per 100,000 and 4.2 per 100,000 within their community. Although Asians and American Indians each contributed only 1% of offenders, their intra-group rates differed significantly; the rate for Asians was 0.9 per 100,000, while American Indians had a higher rate of 5.1 per 100,000 [6].

As shown in Table 2, African Americans account for the majority of victims at 56%, followed by Whites (25%) and Hispanics (14%) with Asians and American Indians at 1% and 2%, respectively. African Americans as victims of homicide are particularly overrepresented both within the general population (3.14 per 100,000) and within their own ethnicity (23.1 per 100,000).

The notion that homicide is predominantly intra-racial in the U.S., meaning offenders and victims are typically of the same race, is supported by FBI and U.S. Department of Justice data in cases where the ethnicity of both the offender and the victim is known. Over the last two decades it has been consistently found that most White homicide victims are killed by White offenders (83%), and most Black homicide victims are killed by Black offenders (91%) [21]. This trend of intra-racial violence extends to other violent crimes, including assault and robbery. Factors like social proximity and segregation often explain this pattern, as individuals tend to interact most frequently with others of their own racial or ethnic communities. Since homicide often occurs between individuals who know each other, this increases the likelihood of intra-racial violence.

1.4. Biological and Social Factors in Male Violence

In 2022, young men in urban settings constituted the majority of both homicide offenders and victims. Offenders aged 10–29 years accounted for 50% of cases, while victims in this age range made up 41%. Gender played a significant role, with males representing 80% of offenders and 77% of victims. Many homicides stemmed from group rivalries, conflicts over respect, reputation, and territorial disputes, with 64% of identified motives related to such disputes [21]. Weapons used to commit homicide in 2022 included firearms (77%), knives or cutting instruments (9%), blunt instruments (2%), and hands (3%), as well as other weapons (7%) [6].

Men have historically been the predominant perpetrators of homicide and violence. While we like to believe we are free from the instincts that govern the animal kingdom, hormones and genes still exert a powerful influence. Testosterone has been correlated with aggressive behavior in both animals and humans. Testosterone levels in violent prisoners is higher than normal, and the degree itself may be influenced by exposure to aggression in the environment. Under basal conditions, the correlation between a man’s testosterone level and his aggressive behavior is weak. However, when an aggressive man becomes angry, his testosterone rises more than in a non-aggressive man. Testosterone levels also fluctuate according to physical and social conditions, with significant short-term changes being particularly impactful [22,23]. Studies show that juvenile delinquents with higher salivary testosterone levels tend to commit more violent crimes, particularly if their cortisol levels are low, indicating a simultaneous decrease in anxiety and stress [24]. Older age and higher educational level are positively correlated with lower testosterone levels [25].

The roots of human aggression also have a genetic basis. Two genes that influence neurotransmitter metabolism, catechol-O-methyltransferase (COMT) and monoamine oxidase A (MAOA) have been implicated. The “warrior/worrier” polymorphism involves two alternative amino acids at position 158 in the protein sequence, Valine158 or Methionine158. The effects of the alleles counterbalance each other and as a result both alleles are maintained at high frequencies (from 40% to 60%) in populations worldwide for COMT [26]. Both genes have been found to influence aggression [27]. Others have found support for the role of low-activity MAOA allelic variants as a prominent genetic determinant for criminal violence, which may in turn be modulated by the type of parenting a child is exposed to [28]. The biological basis of violence is multifactorial. These factors include male gender, young age, cortisol and testosterone, at least two genes, with environmental exposure having an influence as well. The endpoint, toxic masculinity, is a subset of male behaviors associated with harm to society. These extreme aspects of traditional masculinity result in violence among men but also include domestic violence and sexual assault.

1.5. The Origins of Violence—Childhood Trauma and Poverty

According to the Congressional Research Service, the official poverty rate for non-Hispanic Whites rose from 8.1% (15.8 million people) in 2021 to 8.6% (16.7 million people) in 2022. Over the same period, the poverty rate for African Americans fell from 19.5% (8.6 million) to 17.1% (7.6 million). Among Hispanics in 2022 it was 16.9%; American Indian/Alaskan Native, 25%; Asian, 8.6%; and the total poverty rate was 11.5%. The largest affected age group was under 18 years, and the southern United States had the highest poverty rates [29]. These figures parallel the ethnic distribution of violent crime.

The correlation between socioeconomic status and violent crime is well-documented, with factors ranging from systemic discrimination and lack of opportunity to the necessity of adopting an aggressive stance in dangerous neighborhoods. Additionally, impoverished individuals may resort to violent crime to address grievances when they lack access to the legal system [30]. High rates of drug and alcohol abuse, child abuse and differences in parental oversight in poor communities are also contributory factors. Research in the U.S. has shown that poverty is a consistent predictor of homicide [31,32]. This is true internationally as well, where studies evaluating poverty show that low-income levels, and not merely income inequality, are associated with high homicide rates—even in China, which is predominantly composed of one ethnic group, Han Chinese, which constitutes about 91–92% of the population [30,33].

In 2012, over 6 million children in the U.S. were referred to child protective services, with black children disproportionately represented among those investigated for abuse and neglect. They accounted for 21% of child maltreatment victims, despite making up only 14% of the child population. The overall prevalence of maltreatment from birth to age 18 is estimated to be 21% for Black children, 13% for Hispanic children, and 11% for White children. Poverty and child maltreatment are consistently linked across racial and ethnic groups, with children of single teenage mothers being disproportionately affected [34]. According to the 2020 Health and Human Services Report on child maltreatment, the victimization rate per 1000 children by racial and ethnic groups was as follows: American Indian or Alaska Native, 15.5; African American, 13.2; Multiple Race, 10.3; Pacific Islander, 9; Hispanic, 7.8; White, 7.4; and Asian, 1.6. Three-quarters (76.1%) of victims are neglected, 16.5% are physically abused, 9.4% are sexually abused, and 0.2% are sex trafficked [35].

The rates of child abuse and neglect reflect the ethnic distribution of poverty and violent crime, underscoring the link between abuse, poverty and subsequent criminal behavior.

Rates of both childhood and adult trauma are notably elevated among incarcerated men. In the United States, over half of male inmates (56%) reported experiencing childhood physical trauma [36]. The connection between childhood trauma and behavioral health, including aggressive behavior in adulthood, is well-established. Trauma exposure is positively associated with psychopathology, and all types of traumas—whether experienced in childhood or adulthood significantly predict interpersonal and self-regulation problems among incarcerated men. All types of traumas, experienced in childhood or adulthood, independently and significantly predicted interpersonal and self-regulation problems among incarcerated men [37]. Childhood or adolescent abuse significantly increases the risk of violent and aggressive behavior and criminality in adulthood [38]. A study employing the Adverse Childhood Experiences (ACE) instrument found that 64.39% of sex offenders and 42.7% of low-risk prisoners reported experiencing four or more traumatic events. This figure is significantly higher than the 15.2% of female and 9.2% of male respondents in the national average [39].

Untreated mental health conditions among incarcerated individuals worsen the issue. Estimates from 2005 indicate that 56% of state prisoners, 45% of federal prisoners, and 64% of jail inmates had mental health problems. Regarding specific diagnoses, over two-fifths of state prisoners (43%) and more than half of jail inmates (54%) reported symptoms that met the criteria for mania. Around 23% of state prisoners and 30% of jail inmates experienced symptoms of major depression. Approximately 15% of state prisoners and 24% of jail inmates showed symptoms consistent with a psychotic disorder. Furthermore, 74% of state prisoners and 76% of local jail inmates with a mental health issue also met the criteria for substance dependence or abuse. Untreated mental health conditions lower employability and raise the likelihood of recidivism for released inmates. An estimated 47% of state prisoners with a mental health issue were violent recidivists, compared to 39% of those without such issues [40]. While most prison systems offer some mental health services, these are often inaccessible or not sought after upon release.

Addressing the long-term effects of childhood trauma requires not only awareness but structured intervention. Programs like the Nurse–Family Partnership, which pairs trained nurses with low-income first-time mothers, have shown sustained reductions in child maltreatment and adolescent criminal behavior. Similarly, Child–Parent Psychotherapy (CPP) offers trauma-informed support to caregivers and children exposed to violence, improving emotional regulation and family stability. As Williams (2024) notes, these interventions have matured in both evidence and infrastructure, making them increasingly scalable within public health systems. Incorporating such frameworks into national violence prevention strategies could meaningfully disrupt the intergenerational cycle of trauma and violence [41].

1.6. Gun Ownership, Violence, and Poverty: A Comparative Global Perspective

Switzerland has a deeply ingrained gun culture characterized by a sense of collective responsibility. It starts relatively early in life, with a mandatory shooting competition for teenagers. The winner is crowned the king or queen of shooting. Military service is obligatory for all men, and citizens are required to have access to a shooting range. The government gives its citizens guns and trains them how to shoot. Historically, Switzerland’s neutrality and reliance on a well-regulated militia, rather than regional forces conscripted by a lord, have shaped this community approach to gun culture. This approach dates back to the 1600s, when the Swiss people formed a confederacy to protect themselves from outside invaders. Swiss culture promotes responsible gun ownership as a duty to the community, and this contrasts with the U.S. philosophy, in which guns are seen as a right to individualistic self-defense. In 2022, the overall homicide rate in Switzerland was 0.5 per 100,000 and the assault rate was 6.9 cases per 100,000 population [42]. In contrast, for the same year, the U.S. homicide rate was 7.1 (6 per 100,000 due to gunshot) and the assault rate was 268 per 100,000.

Globally, the highest rates of gun-related deaths per 100,000 in 2016 were seen in Venezuela (38.7), Guatemala (32.3), Brazil (19.4), Colombia (26.9), Mexico (11.8), and the United States (10.9). Canada had a rate of 2.1, and Switzerland 2.8 [43].

Gun ownership in the U.S. peaked in the 1970s at 50%. As of 2018, this has fallen to 35.8% of men and 10.5% of women, but the number of guns per owner has risen [44]. In the 1970s, there were 94 million firearms in the possession of civilians, with most gun owners owning a single firearm. In this decade, this has risen to over 400 million firearms or about 120 guns per 100 people, with an average of 5 guns per owner. In Switzerland there are about 2 million guns for a population of roughly 8.5 million. This translates to approximately 24 guns per 100 people. Just across our northern border, Canada also has a significant number of firearms, with about 33 guns per 100 people [45,46].

In 2022, Mexico had a violent crime rate of 1692 per 100,000 people and a homicide rate of 23.8—both significantly higher than the U.S. [47,48]. Gun ownership in Mexico is heavily regulated by the government. Civilian ownership of firearms is much lower compared to the United States, with most gun owners in Mexico typically own a single firearm. Estimates suggest there are around 2.5 million firearms in civilian hands in Mexico, with a population of about 130 million, translating to approximately 2 guns per 100 people [45]. Mexico presents a compelling example of how structural factors, rather than gun laws alone, shape the dynamics of violence. Despite relatively strict gun regulations, the country continues to face high rates of firearm-related violence, much of it driven by extortion, gang activity, and systemic impunity. As Calderón, L.Y., et al. (2021) note, the pervasive influence of organized crime, coupled with weak legal enforcement, undermines the effectiveness of formal firearm restrictions. This highlights that without institutional integrity and strong rule of law, even robust legislation can fail to curb violence, reinforcing the broader point that systemic and cultural conditions are central to understanding and addressing gun-related harm [49].

An analysis of international statistics shows no clear connection between civilian gun laws, firearm ownership levels, and violent crime or homicide rates. However, poverty seems to align more closely with violence statistics (Figure 3). In 2022, the official poverty rate in the United States was 11.5%, affecting 37.9 million people [50]. In Canada, the poverty rate for 2022 was 9.9%, impacting around 702,000 individuals [51]. In Switzerland, the rate was 8.2% [52]. Mexico’s poverty rate decreased from 49.9% in 2018 to 43.5% in 2022, though extreme poverty slightly increased from 7% to 7.1% during the same period [53].

1.7. Sources of Crime Guns

Guns purchased at the counter of a gun dealer, while posing a potential risk for gun violence and a known risk for those who are suicidal, are not the primary source of guns used in violent crimes. More than twenty years after its last report, the U.S. Department of Justice published the National Firearms Commerce and Trafficking Assessment (NFCTA) Volumes 2 and 3, which provide a comprehensive examination of firearms commerce and the diversion of firearms to illegal markets. This study analyzed crime gun evidence recovered by law enforcement between 2017 and 2021 and submitted to ATF for tracing. During the study period, 1,922,5771 crime guns were recovered and submitted [54]. The vast majority of these guns were trafficked or stolen. A total of 1,026,538 of all firearms reported stolen (96%) from 2017 to 2021 were from private citizens. The weapons are generally sold and trafficked locally, with half of traced crime guns purchased and recovered within three years of the last known sale and within 25 miles of where the gun was purchased. This is an underestimate, as there is no national requirement for private citizens to report firearm theft. Only 3% of traced crime guns were acquired from FFLs at gun shows, so while limiting sales between private citizens may help, gun shows are a comparatively minor source of crime guns.

Crime guns are obtained through illegal means, such as straw purchasers, unlicensed dealing, and private personal theft. FFL theft and illegal export numbers are vanishingly small by comparison [54]. Studies surveying convicted criminals reveal a similar pattern. About 30% of violent offenders possessed a firearm during their offense, with handguns being the most common type of firearm [55]. The majority of guns used in crimes are obtained through social connections, such as family and friends, rather than through direct purchase from a gun store. Most of the transactions (70%) are with social connections (friends and family) or with “street” sources. The latter may include fences, drug dealers, brokers who sell guns, and gangs. Gang networks play a role in organizing gun buys and distributing guns to members. Only 3% of primary crime guns and no secondary guns were purchased directly from a gun store [56].

In a related study, Alper et al. discovered that 90% of prisoners who had a firearm during their offense did not acquire it from a retail source. Only 0.8% obtained it at a gun show. Among state prisoners who had a firearm, 27% used it to kill someone, 12% injured someone, 7% fired it without causing harm, and 54% had not discharged it. Overall, 21% of all prisoners reported having a firearm during the crime for which they were incarcerated. This percentage rose to 29% among state prisoners and 36% among federal prisoners involved in violent crimes. For homicide and robbery, the rate approached 45%. Furthermore, an estimated 287,400 prisoners had a firearm during their offense. Of these, more than half (56%) either stole it (6%), found it at the crime scene (7%), or acquired it from the street or black market (43%). Another 25% obtained it from a family member, friend, or as a gift, while a small group (7%) bought it from a licensed dealer under their own name. Therefore, additional regulation at the point of sale by licensed dealers is unlikely to affect the sourcing of the majority of firearms used in crimes [57].

1.8. Understanding Mass Shootings: Patterns, Causes, and Prevention Challenges

The problem of mass shootings is a different category altogether. A 20-year review (2000–2019) of active shooter incidents in the United States was recently completed by the FBI which found a total of 333 active shooter incidents. These occurred in 43 states and the District of Columbia, and resulted in 1062 killed and 1789 wounded. In the year 2000 there was a low of 3 incidents, which climbed to 50 incidents in 2022 [58,59]. Roughly half would qualify as mass shootings, with three or more people killed. Among those killed were 29 law enforcement officers and 10 security guards. California had the highest number of active shooter incidents with 42, followed by Florida with 27, Texas with 25, and Pennsylvania with 21. Shooters are, again, predominantly male (4% were female) and nearly 60% of these events are associated with domestic violence. In 68.2% of mass shootings, the perpetrator either killed at least one partner or family member or had a history of domestic violence [60]. Domestic violence already disqualifies potential gun buyers during background checks.

Active shooters cause 0.5% of all gun-related homicides. Yet, perhaps because the victims can be anyone from any level of society, public perception is disproportionately influenced by these events. An estimated 71% of adults experience fear of mass shootings as a source of stress in their lives, causing one out of three people to avoid certain public places [61,62].

Mass murders are typically planned in advance and are often motivated by a desire for revenge or retribution for perceived offenses. A profound sense of hopelessness is frequently present, which may help explain why nearly half of mass murderers either commit suicide or are killed by law enforcement shortly after the event. Unlike other gun homicides, the racial distribution of perpetrators in mass murders is more representative of their proportions in the general population, in contrast to the higher representation of Black individuals in gun homicides overall [63].

Recent studies suggest that 25–50% of mass murderers had exhibited a mental illness or other significant psychological issue, but most of them had not appeared on the radar of either the mental health or law enforcement system [64,65]. Silver et al. looked at the sequences of events which lead to mass shootings and found the following: (1) family problems are a key factor (childhood problem or a work/school problem) and this is closely followed by (2) antisocial behavior (violence, aggressive behavior, social isolation, and interest in past mass killings), as well as (3) planning/preparation behavior (firearm acquisition) [66]. Currently no comprehensive system exists for compiling and sharing this type of information for use in the prevention of mass shootings.

1.9. Modern Challenges in Gun Violence Prevention

In 1993, Congress passed the Brady Handgun Violence Prevention Act, which established the National Instant Criminal Background Check System (NICS), operational since November 30, 1998. This system allows Federal Firearms Licensees (FFLs) to initiate a background check, searching three nationally held databases to exclude certain individuals from purchasing firearms. The list of prohibited individuals is comprehensive, including those with felony convictions punishable by imprisonment exceeding one year, misdemeanors punishable by more than two years, fugitives from justice, unlawful users of controlled substances, individuals adjudicated as mentally defective or found not guilty by reason of insanity, those involuntarily committed to a mental health institution, persons dishonorably discharged from the military, those who have renounced their U.S. citizenship, subjects of protection orders, persons convicted of domestic violence, and illegal or unlawful aliens [66]. As it has not been amended or modernized, it does not include, for instance, use of a database of individuals suffering from mental illness, depression, suicidal ideation or those expressing interest in mass shootings.

Efforts to regulate semi-automatic rifles and magazine capacity are important policy considerations, though evidence suggests they may not fully address the predominant sources of firearms used in violent crimes, which often enter circulation through illegal means. Enforcing existing laws against straw purchases by a third party may address a small segment of the illegal gun market. A system from the 1990s which was designed primarily to combat handgun violence cannot address the underlying causes of violent crime today. While our commentary emphasizes social and systemic contributors to violence, we acknowledge that certain firearm regulations have demonstrated effectiveness. For instance, studies have found that universal background checks and permit-to-purchase laws are associated with reductions in firearm homicides [67,68,69], and it is also observed that there are significantly lower gun death rates in states with more firearm laws. These findings suggest that legal interventions, when thoughtfully designed and implemented, can complement broader public health and social efforts to reduce violence. Our aim is not to dismiss regulatory measures, but to advocate for integrative strategies that address both access and root causes.

Effective solutions may not be popular due to the expense and effort required. Programs focused on young men involved in gangs have had their successes. In Boston, a focused deterrence program to directly communicate consequences for violence to at-risk gang members combined with an increased law enforcement effort against illicit firearm traffickers who supplied youths with guns saw a 63% decline in homicide among youths following its implementation [70]. Other programs which have seen real success in reducing gun violence have used a two-pronged approach of increased and immediate policing of gang violence on the deterrent side combined with social programs which address unemployment and job-readiness while addressing antisocial behaviors and teaching non-violent conflict resolution [71].

In 2022, there were 27,032 gun-suicides compared to 24,849 gun-murders. Any measure seeking to improve the gun-death metric should therefore include an expansion of access to mental healthcare and funding for shared databases so that people experiencing acute crises can temporarily be restricted from owning a firearm.

Over the centuries, violence has generally declined as civilizations progressed, with improvements in living standards and criminal justice systems, supported by effective policing and the establishment of more legitimate states. Societies with high homicide rates, such as those in Central and South America, often face dysfunctional law enforcement and justice systems, characterized by high levels of impunity, corrupt and ineffective policing, and limited options for reintegrating and rehabilitating former prisoners. It could be argued that the U.S., despite being a well-established nation with a developed economy, essentially operates two justice systems, with outcomes varying based on income level.

2. Conclusions

The U.S. stands out as a first-world country with homicide statistics comparable to those of third-world nations. Historically, men—especially young men defending notions of male honor—have been the primary perpetrators of homicidal violence. Despite the influence of our basest instincts, some of which are hardwired in our DNA, we have shown continuous and positive change in reducing violence over time. This progress is driven by the civilizing influence of a legitimate state, improving economic conditions for all, and ensuring access to a fair justice system with enforcement by a police force that provides security for all members of society.

Firearm-specific regulations like magazine capacity limits may play a role in broader prevention strategies, but their impacts may be limited without concurrent efforts to address underlying causes such as poverty, trauma, and mental health. Addressing child abuse and youth violence in a nationwide, comprehensive, and sustained manner, particularly in large urban areas and impoverished communities, would be expensive, but could significantly reduce violence by including this neglected population in the social contract.

Improving access to mental healthcare and sharing databases of such information to temporarily limit access to guns could significantly reduce suicides and mass shootings. This approach trades some privacy for enhanced security—a common equation in any formulation of a safe society.

Policy Recommendations

To move beyond ideological debates and toward practical solutions, we propose several actionable strategies for violence prevention. Focused deterrence programs, such as Boston’s Operation Ceasefire, have demonstrated success by combining direct engagement with at-risk individuals and targeted law enforcement, resulting in significant reductions in youth homicides [70]. Investing in trauma-informed youth interventions, particularly in schools and community centers, can address early-life adversity, a known risk factor for future violence [39]. Expanding community-based mental health services, especially in under-resourced urban areas, can reduce both interpersonal violence and suicides, which together account for the majority of firearm deaths [40]. Efforts to improve firearm tracing and reduce illegal trafficking, as outlined by the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), are also critical [54]. Lastly, public–private funding models linking health systems, philanthropy, and government could support scalable pilot programs that address the structural roots of violence while enhancing long-term sustainability.

Evaluations of place-based violence prevention strategies have shown promising outcomes, particularly when targeting small, high-risk areas. For example, Philadelphia’s implementation of the Cure Violence public health model, evaluated using a quasi-experimental design by Roman et al. (2017), revealed that significant reductions in gun violence were achieved primarily within smaller “hot spot” areas where outreach and intervention were most concentrated. Importantly, while reductions were also observed in broader police service areas (PSAs), these effects were paralleled in matched comparison zones, suggesting that concentrated, community-based efforts may yield the clearest causal benefits. These findings underscore the value of integrating social prevention with targeted law enforcement responses. Additionally, as gun violence abates locally, such strategies can free up police resources for other investigative priorities, potentially leading to broader public safety improvements. Documenting whether these effects include consistent spillover benefits, such as fewer unsolved shootings, can strengthen the practical case for scaling such programs as part of a comprehensive public health strategy [72].