The second annual National Research Conference for the Prevention of Firearm-Related Harms(link is external and opens in a new window)—the nation’s only scientific conference of its kind—showcased the latest research findings in a field that has seen renewed funding in recent years. Over 700 people representing more than 200 institutions attended in-person and could choose from hundreds of presentations across 20 scientific disciplines. Among these were presentations by faculty and students from Columbia University Mailman School of Public Health and Teachers College.

The conference was organized by the new Research Society for the Prevention of Firearm-Related Harms(link is external and opens in a new window). Sonali Rajan, associate professor in the Department of Health Studies & Applied Educational Psychology at Teachers College and adjunct professor of Epidemiology at Columbia Mailman School of Public Health, is the inaugural president of the Society and led this year’s conference. Charles Branas, chair of Epidemiology at Columbia Mailman, serves on the new society’s board and co-led last year’s conference. Seventeen organizations, from major foundations to universities and healthcare systems,  sponsored this November’s conference, including Columbia SURGE (Scientific Union for the Reduction of Gun Violence)(link is external and opens in a new window).

Columbia researchers presented on a variety of topics, including a strategy to reduce access to adolescent means of suicide, the effects of gun violence on attention and learning, the effects of historical structural racism on community firearm violence; housing instability and firearm violence; adverse childhood experiences and violent injury; public housing and firearm violence; heatwaves and firearm violence; street construction projects and firearm violence; and the experiences of Black caregivers of violently injured men.

Ariana Gobaud, a pre-doctoral fellow in the Department of Epidemiology, received the conference’s Impact Award for her research on historical structural racism and community firearm violence in 500 US cities. She says of winning the award, “It is not only a recognition of my research but also a reflection of the collective efforts in the field of firearm violence research. I am proud to build on the important work of researchers who have been exploring the significant impact of structural racism in this area. I’m excited to continue this journey, pushing the boundaries of our understanding and developing strategies that can make a real difference in communities affected by firearm violence.”

Over three dozen faculty across seven Columbia schools and colleges came together in 2020 to form the Columbia SURGE with a vision that “more science means less violence” and to capitalize on the university’s convening power in generating new science and scientists, new resources and recognition, and transformative solutions.  As a key member of SURGE, Sonali Rajan leads the Research Society for the Prevention of Firearm-Related Harms, which was created at the inaugural National Research Conference for the Prevention of Firearm-Related Harms last year. The Society aims to promote and advance scientific research on firearm-related harm prevention across the U.S. and internationally.

Coinciding with the conference, Rajan met with the editorial board of the Washington Post, which on November 3 published an editorial titled, “Even Gun Rights Zealots Might Support These Innovative Ways to Save Lives(link is external and opens in a new window).” The editorial highlights a series of innovative solutions presented at the conference that have the potential to become policy.  It concludes, “The renewal of federal funds for firearms research is worth celebrating in itself. The answers that research provides, meanwhile, could be the starting point for meaningful action that doesn’t determine who can own a gun or where they can bring it. Policymakers shouldn’t discount these steps because they’re modest. They should take them.”

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As a part of VA’s comprehensive efforts to end Veteran suicide, VA also announced the grantees for the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, a first-of-its-kind program that provides VA funding for local suicide prevention programs, and the finalists for Mission Daybreak, a suicide prevention grand challenge.

These efforts are key aspects of VA’s 10-year National Strategy for Preventing Veteran Suicide and the Biden-Harris administration’s plan for Reducing Military and Veteran Suicide.

“There is nothing more important to VA than preventing Veteran suicide — it’s our top clinical priority,” said VA Secretary Denis McDonough. “This year’s report shows real progress, but there is still so much work to be done. One Veteran suicide is one too many, and VA will continue to work with our federal, state, local and private partners to tackle this problem and save Veterans’ lives.”  

“Suicide is one of the most serious public health issues facing our Veterans today, and VA cannot do this work alone,” said VA Under Secretary for Health Shereef Elnahal, M.D. “With the Staff Sergeant Fox Grants and Mission Daybreak, VA seeks to engage not only organizations traditionally focused on suicide prevention, but also to bring in new groups and individuals who may have fresh ideas on how we address this issue.”

Key findings from the 2022 National Veteran Suicide Prevention Annual Report include: 

• In 2019 and 2020, Veteran suicides decreased in consecutive years by 307 and 343 deaths — the biggest decrease in the suicide count and rate since 2001. 
• From 2018 to 2020, the age- and sex-adjusted suicide rate among Veterans fell by 9.7%
• Among women Veterans, the age-adjusted suicide rate fell by 14.1%, compared to 8.4% among non-Veteran women. The age-adjusted suicide rate for women Veterans in 2020 was the lowest since 2013, and the age-adjusted suicide rate for Veteran men was the lowest since 2016.  
• From 2019 to 2020, Veteran suicide rates fell across all racial groups. 
• Comparisons of trends in Veteran suicide and COVID-19 mortality over the course of 2020 and across Veteran demographic and clinical subgroups did not indicate an impact of the COVID-19 pandemic on Veteran suicide mortality.

VA also recognizes that eliminating Veteran suicide requires a sustained commitment and all-of-the-above approach that engages expertise from all sectors of society. To that end, VA announced the grantees for the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program and the finalists for Mission Daybreak.

• Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program: Today, VA announced that it will grant more than $52 million to 80 community-based organizations in 43 states, the District of Columbia, and the American Samoa. This funding will help these organizations provide or coordinate the provision of suicide prevention services for Veterans and their families. More information can be found here. 
• Mission Daybreak: Today, VA announced the finalists for Mission Daybreak —  a grand challenge aimed at developing suicide prevention solutions. Mission Daybreak awarded $250,000 to 30 finalists and $100,000 to 10 Promise Award recipients. The goal of Mission Daybreak is to transform how our nation addresses suicide by engaging Veterans, community-based organizations, health tech companies, startups and universities that are not traditionally engaged in suicide prevention but could bring cutting edge solutions to the effort. More information can be found here. 

This year, VA has announced or continued several additional efforts to end Veteran suicide, including establishing 988 (then press 1) as a way for Veterans to quickly connect with caring, qualified crisis support 24/7; proposing a new rule that would reduce or eliminate copayments for Veterans at risk of suicide; conducting an ongoing public outreach effort on firearm suicide prevention and lethal means safety; and leveraging a national Veteran suicide prevention awareness campaign, “Don’t Wait. Reach Out.” 

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Recent years have seen rapid advances in the development of long-acting effective methods to prevent and treat HIV, notably long-acting injectable antiretroviral therapy (LAI ART) and long-acting injectable preexposure prophylaxis (LAI PrEP). Yet while these formulations have huge potential, their global availability and access is inhibited by factors including lack of funding from international organizations, unequal insurance coverage, patent protections that keep costs high, and social inequities. The article by researchers at Columbia University and the University of Toronto appears in the journal Current Opinion in HIV and AIDS.

As of February 2022, LA ART administered every two months is approved in the United States, Canada, and Europe. The U.S. also approved LAI PrEP in December 2021. Both are as effective as existing daily oral pills but with a convenience that has the potential to significantly improve uptake. The World Health Organization has recommended the monthly vaginal PrEP ring, which may alleviate adherence barriers that exist for oral PrEP—and the frequency of clinic visits for LAI PrEP—but is much less effective than both. Approximately 30 long-acting ART and PrEP formulations are now in clinical trials, including monthly oral pills; vaginal and rectal gels; vaginal rings, films, and inserts; intramuscular and subcutaneous injections; implants; enemas; and micro-array patches.

“The development of long-acting ART and PrEP have provided renewed hope that ending the HIV epidemic is within reach. However, pervasive socio-structural inequities highlight the need for cautious optimism,” says study co-author Morgan Philbin, PhD, assistant professor of sociomedical sciences at Columbia University Mailman School of Public Health.

However, LA ART could exacerbate existing social inequities in care access because it is only available to virologically suppressed individuals; viral suppression is lower among minoritized populations, including by race and ethnicity, sexuality, gender, and socioeconomic status. Additionally, insurance coverage for long-acting ART and long-acting PrEP is lacking in the U.S., with many states’ AIDS Drug Assistance Programs (ADAP) not covering LAI ART; insurance coverage for LAI PrEP remains unknown. In addition, people in the Global South who participated in the research trials that demonstrated their efficacy may not have equitable access once they are approved—LAI ART is only currently approved in the U.S., Canada, and Europe.

“Tackling the social and political dimensions that limit equitable access requires political struggle, social movements, and global accountability. In order for long-acting HIV formulations to truly fulfill their promise of ‘ending the HIV epidemic’, equity in availability, access and uptake must be addressed on a global scale,” says Philbin.

Earlier research by Philbin and colleagues examined attitudes toward long-acting injectable HIV therapy among women with a history in injection, and among women more broadly. She has also uncovered geographic disparities in HIV care.   

The study’s co-author is Amaya Perez-Brumer, PhD ‘19, assistant professor at the Dalla Lana School of Public Health, University of Toronto.

The journal article was supported in part by grants from the U.S. National Institute on Drug Abuse (DA039804A) and National Institute of Mental Health (MH124552); and the Canadian Institute of Health.

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