US Report outlines roadmap to curb firearm violence by 2040

Authors' proposals include using AI and other technologies and addressing the upstream social causes of violence.

University of Washington School of Medicine/UW Medicine

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A new report proposes a range of initiatives to substantially reduce the harm caused by firearm violence in the United States over the next 15 years. 

The report, published today in the journal JAMA, proposes a range of initiatives. These include using artificial intelligence (AI) and other technologies to detect concealed weapons, and expanding programs that address poverty, social distrust and other factors behind violence in American communities. 

The report summarizes discussions among 60 experts in public health, criminology, sociology, social work, public policy and other fields. JAMA convened the two-day summit last March to chart a “roadmap that will lead to substantial reductions in firearm violence, injuries and harm in the United States by 2040.” 

“We really tried to step back and think about what innovations are needed to address the firearm problem in a new way — realizing we live in a country with a Second Amendment and somewhere around 400 million firearms in private hands,” said Dr. Frederick P. Rivara, professor of pediatrics at the University of Washington School of Medicine. He chaired the summit. 

Since 2000, more than 800,000 Americans have been killed and more than 2 million injured by firearms. Firearm homicides peaked at 21,383 in 2021. Although rates have fallen 29% since then, homicides still totaled 16,725 in 2024. Firearm suicides, which account for 2 of every 3 firearm deaths, have climbed steadily since 2000, reaching 27,310 in 2023.  

The report notes that the harms to society caused by firearms extends beyond death and physical injury. These include psychological harm to people who witness shootings, whose loved ones have been killed or injured, and others who live in fear of firearm violence in their communities. 

The report recognizes that some U.S. Supreme Court decisions have limited restrictions on firearm ownership, but notes that a number of laws regulating gun use — such as those requiring background checks, safe storage and the surrender of weapons by individuals considered at high risk for violence — still pass legal muster and have been implemented in many states. 

Promising social programs cited by the report include community violence- intervention programs, such as those that connect law enforcement and social services to help high-risk individuals obtain housing and financial assistance, job training and placement, and therapeutic support. 

AI, the report noted, can be used to enhance police enforcement and community-intervention programs by identifying high-risk individuals and locations. Such use of the technology, however, raises issues of privacy and civil liberties, which must be addressed in parallel, the report cautioned. 

Finally, the report called for action toward the root-level causes of firearm violence by changing inequitable social structures that give rise to them — an approach it calls “primordial prevention.” Such actions would include promoting “housing stability, economic opportunity, environmental improvement and equitable policies” in communities that have suffered from a long history of segregation, neglect and disinvestment, the report said. 

“The promise of primordial prevention lies in its power to shift the very conditions under which violence becomes possible and simultaneously improve health and safety. By restoring trust, redistributing power and redesigning context, these innovations can help build a future where firearm injury is not just treated, but prevented,” the report said. 

Other UW Medicine authors who contributed to the report are Drs. Ali Rowhani-Rhabar, professor of epidemiology and pediatrics, and Dimitri Christakis, professor of pediatrics. 

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Journal

JAMA

DOI

10.1001/jama.2025.18076 

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Toward a Safer World by 2040: The JAMA Summit Report on Reducing Firearm Violence and Harms

Article Publication Date

3-Nov-2025

 

When speaking out feels risky

Arizona State University, University of Michigan research study reveals the hidden dynamics of self-censorship

Arizona State University

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image: 

This figure shows how an authority adjusts its strictness, monitoring and punishment levels over time in response to a population’s behavior. The top panel shows the overall cost of these actions, while the bottom panel shows how each control measure changes.

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Credit: ASU/PNAS

In an era when social media blurs the line between public and private speech, how do people decide whether to speak their minds or stay silent?

A new study from researchers at Arizona State University and the University of Michigan, published in the Proceedings of the National Academy of Sciences, or PNAS, offers a groundbreaking look at the strategic trade-offs individuals make when facing the threat of punishment for dissent.

The work, co-authored by Professor Stephanie Forrest and Assistant Professor Joshua J. Daymude in the School of Computing and Augmented Intelligence, part of the Ira A. Fulton Schools of Engineering at ASU, and Robert Axelrod from the University of Michigan, introduces a mathematical model to explain when people choose to express dissent or self-censor.

The findings shed new light on how surveillance, punishment and boldness interact to shape societies, especially under authoritarian conditions in which expressing one’s true opinion can carry real danger.

Science behind silence

The new paper, “Strategic Analysis of Dissent and Self-Censorship,” explores how individuals and governing authorities influence one another’s behavior over time.

“Modern technologies — from facial recognition to algorithmic content moderation — have transformed the landscape of dissent,” Daymude says. “Our goal was to move beyond intuition and provide a formal way to understand when and how self-censorship emerges.”

The researchers developed a simulation in which individuals balance their desire to express dissent against the fear of punishment, while an authority dynamically adjusts its surveillance and policies to minimize both total dissent and enforcement costs.

The results reveal that self-censorship isn’t simply a product of fear. It is a rational, strategic response shaped by the interplay of boldness, surveillance and punishment severity.

When fear becomes a strategy

At the heart of the study is a model describing three distinct behaviors: compliance, self-censorship and defiance. The researchers found that when punishments are uniform, such as blanket bans or internet shutdowns, self-censorship tends to dominate. When punishments are proportional, such as escalating penalties for repeated offenses, individuals may still take small risks to express dissent.

“A population's willingness to speak out early on, and suffer the negative consequences, has an outsized effect on how long it takes an authority to suppress all dissent," Forrest says. "This is because the cost of punishing an entire population simultaneously is too high.”

In simulated societies, authorities that began with moderate policies often evolved toward stricter control, echoing historical cases such as Chairman Mao Zedong’s “Hundred Flowers Campaign,” which encouraged open critique before abruptly reversing course. The model showed that as tolerance is reduced and surveillance intensifies, dissenters self-censor progressively, leading to near-total compliance over time.

However, populations with higher “boldness,” or a measure of willingness to risk punishment, resisted longer. In these cases, authorities struggled to fully suppress dissent, even when equipped with strong surveillance and severe penalties.

Crossing disciplinary lines to decode dissent

The research reflects the interdisciplinary mission of Forrest and Daymude. While both are computer science and engineering faculty members, they also play key roles in ASU’s Biodesign Center for Biocomputing, Security and Society, directed by Forrest, a pioneer in evolutionary computation and complex systems. Together, the team brought computer science and mathematical rigor to one of humanity’s oldest political questions: What makes people speak or stay silent?

Daymude’s expertise in distributed algorithms and collective behavior complemented Forrest’s decades of work applying biological principles to computing. The collaboration with Axelrod, a renowned political scientist known for his work on cooperation and conflict, extended the project’s reach into the social sciences.

The fragile future of free expression

The implications go far beyond academic theory. From citizens in authoritarian regimes to users navigating content moderation on global social platforms, the pressures that shape public expression are everywhere. The study highlights how easily self-censorship can spread and how difficult it is to reverse once established.

“Self-censorship can start as a form of self-protection,” Daymude says. “But when people begin to silence themselves preemptively, before any punishment occurs, it becomes a powerful tool for control.”

By clarifying the strategic nature of dissent, the researchers hope their work can inform policymakers, platform designers and advocates for free expression.

“Ultimately, our findings show that preserving open dialogue depends not only on laws or technology,” Forrest says, “but on the courage of individuals and the collective willingness to keep speaking, even when it’s uncomfortable.”

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2508028122 

Method of Research

Computational simulation/modeling

Subject of Research

Not applicable

Article Title

Strategic Analysis of Dissent and Self-Censorship

Article Publication Date

7-Nov-2025

This May Be the Most Consequential Moment in US History Since the Civil War

Why Democrats must defend working people in the United States and not cave to Trump’s authoritarianism and cruel attacks on healthcare and food assistance.

Volunteers prepare food packages for the needy at a food distribution event sponsored by the Second Harvest Food Bank of Central Florida and volunteers at the Apostolic Church of Jesus on October 31, 2025 in Altamonte Springs, Florida. Supplemental Nutrition Assistance Program (SNAP) benefits are due to lapse on November 1 due to a lack of funding caused by the Federal government shutdown.

(Photo by Paul Hennessy/Anadolu via Getty Images)

Bernie Sanders
Nov 03, 2025

The Guardian


Democrats in the US Senate must stand with the working families of our country and in opposition to Donald Trump’s authoritarianism. They must not cave in to the president’s attacks on the working class during this ongoing government shutdown. If they do, the consequences will be catastrophic for our country.

This may be the most consequential moment in American history since the civil war. We have a megalomaniacal president who, consumed by his quest for more and more power, is undermining our constitution and the rule of law. Further, we have an administration that is waging war against the working class of our country and our most vulnerable people.

While Trump’s billionaire buddies become much, much richer, he is prepared to throw 15 million Americans off the healthcare they have—which could result in 50,000 unnecessary deaths each year. At a time when healthcare is already outrageously expensive, he is prepared to double premiums for more than 20 million people who rely on the Affordable Care Act. At a time when the United States has the highest rate of childhood poverty of almost any major country on earth, Trump is prepared, illegally, to withhold funding for the Supplemental Nutrition Assistance Program, or SNAP, despite a $5bn emergency fund established by Congress. That decision would threaten to push 42 million people—including 16 million children—into hunger.

And all of this is being done to provide $1tn in tax breaks to the 1%.

The choice is clear. If the Democrats stand with the American people, the American people will stand with them.

Let’s be clear: this government shutdown did not happen by accident. In the Senate, 60 votes are required to fund the federal government. Today, the Republicans have 53 members while the Democratic caucus has 47. In other words, in order to fund the government the Republican majority must negotiate with Democrats to move the budget forward. This is what has always happened—until now. Republicans, for the first time, are simply refusing to come to the table and negotiate. They are demanding that it is their way or the highway.

To make matters worse, the Republican contempt for negotiations is such that the House speaker, Mike Johnson, has given his chamber a six-week paid vacation. Unbelievably, during a government shutdown—with federal employees not getting paid, millions facing outrageous premium increases and nutrition assistance set to expire for millions more—Republicans in the House of Representatives are not in Washington, DC.

Trump is a schoolyard bully. Anyone who thinks surrendering to him now will lead to better outcomes and cooperation in the future does not understand how a power-hungry demagogue operates. This is a man who threatens to arrest and jail his political opponents, deploys the US military into Democratic cities and allows masked Immigration and Customs Enforcement agents to pick people up off the streets and throw them into vans without due process. He has sued virtually every major media outlet because he does not tolerate criticism, has extorted funds from law firms and is withholding federal funding from states that voted against him.

Day after day he shows his contempt for the constitutional role of Congress and the courts.

Given that reality, does anyone truly believe that caving in to Trump now will stop his unprecedented attacks on our democracy and working people?

Poll after poll shows that the Americans understand the need for strong opposition to Trump’s unprecedented and dangerous agenda. They understand that the Republican party is responsible for this shutdown. And, despite the Democratic party’s all-time low approval rating, independents and even a number of Republicans are now standing with the Democrats in their fight to protect the healthcare needs of the working families of our country.

What will it mean if the Democrats cave? Trump, who already holds Democrats in contempt and views them as weak and ineffectual, will utilize his victory to accelerate his movement toward authoritarianism. At a time when he already has no regard for our democratic system of checks and balances, he will be emboldened to continue decimating programs that protect elderly people, children, the sick and the poor while giving more tax breaks and other benefits to his fellow oligarchs.

If the Democrats cave now it would be a betrayal of the millions of Americans who have fought and died for democracy and our constitution. It would be a sellout of a working class that is struggling to survive in very difficult economic times. Democrats in Congress are the last remaining opposition to Trump’s quest for absolute power. To surrender now would be an historic tragedy for our country, something that history will not look kindly upon.

I understand what people across this country are going through. My Democratic colleagues and I are getting calls every day from federal employees who are angry about working without pay and Americans who are frantic about feeding their families and making ends meet. But my Democratic colleagues must also understand this: Republicans are hearing from their constituents as well. There is a reason why 15 Republican Senators are finally standing up to Trump and, along with every member of the Democratic caucus, support funding SNAP benefits.

There is a reason why 14 Republican members of the House are on record calling for the extension of tax credits for the Affordable Care Act. Understandably, Republicans do not want to go home and explain to their constituents why they voted to double or, in some cases, triple healthcare premiums. They do not want to go home and explain why they are throwing large numbers of their constituents off healthcare. They do not want to go home and explain why they are taking food off the tables of hungry families.

We are living in the most dangerous and pivotal moment in modern American history. Our children and future generations will not forget what we do now. Democrats must not turn their backs on the needs of working people and allow our already broken healthcare system to collapse even further. Democrats must not allow an authoritarian president to continue undermining our constitution and the rule of law. The choice is clear. If the Democrats stand with the American people, the American people will stand with them. If they surrender, the American people will hold them accountable.

Lancet Study Shows Over 3 Million Years of Human Life Lost in Israeli Assault on Gaza

“To speak of 3 million years of human life erased is to confront the true scale of this atrocity—generations of children, parents, and families wiped out,” said the head of a US advocacy group.


Relatives mourn over the bodies of two children killed in an Israeli strike at Nasser Hospital in Khan Younis in the southern Gaza Strip on October 29, 2025.
(Photo by Bashar Taleb/AFP via Getty Images)

Jessica Corbett
Nov 03, 2025
COMMON DREAMS

As Israeli forces continued to violate a fragile ceasefire agreement with Hamas, killing more people in the Gaza Strip on Monday, the largest Muslim civil rights group in the United States renewed calls for cutting off military aid to Israel, citing a new study in The Lancet.

“This new Lancet study offers more evidence of the catastrophic human cost of Israel’s genocidal campaign against the Palestinian people,” Council on American-Islamic Relations (CAIR) national executive director Nihad Awad said in a statement.

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The correspondence published Friday by the famed British medical journal was submitted by Colorado State University professor Sammy Zahran, an expert in health economics, and Dr. Ghassan Abu-Sittah, a British Palestinian surgeon teaching at the American University of Beirut in Lebanon.

Zahran and Abu-Sittah provided an estimate of the number of years of life lost, based on an official death toll list published by the Gaza Ministry of Health at the end of July, which included the age and sex of 60,199 Palestinians. They noted that the list is “restricted to deaths linked explicitly to actions by the Israeli military, excluding indirect deaths resulting from the ruin of infrastructure and medical facilities, restriction of food and water, and the loss of medical personnel that support life.”

The pair calculated life expectancies in the state of Palestine—Gaza and the West Bank, including East Jerusalem—by sex for all ages, using mortality and population data from the United Nations Department of Economic and Social Affairs for 2022. They estimated that a total of 3,082,363 life-years were lost in Gaza as a result of the Israeli assault since October 7, 2023.




“We find that most life-years lost are among civilians, even under the relaxed definition of a supposed combatant involving all men and boys of possible conscription age (15–44 years),” the paper states. “More than 1 million life-years involving children under the age of 15 years... have been lost.”

CAIR’s Awad said, “To speak of 3 million years of human life erased is to confront the true scale of this atrocity—generations of children, parents, and families wiped out. It is a deliberate effort to destroy a people.”

Israel faces a genocide case at the International Court of Justice over its conduct in Gaza, and the International Criminal Court last year issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Defense Minister Yoav Gallant.

“The United States and the international community must end their complicity by halting all military aid to Israel and supporting full accountability for these crimes under international law,” Awad argued.

A report published last month by the Quincy Institute for Responsible Statecraft and the Costs of War Project at Brown University found that the Biden and Trump administrations provided at least $21.7 billion in military aid to Israel since the start of the war.

Federal law prohibits the US government from providing security assistance to foreign military units credibly accused of human rights abuses. The Washington Post last week reported on a classified State Department document detailing “many hundreds” of alleged violations by Israeli forces in Gaza that are expected to take “multiple years” to review.

With President Donald Trump seeking a Nobel Peace Prize, the US helped negotiate the current ceasefire, which began on October 10, after over two years of devastating retaliation for the Hamas-led attack on southern Israel. The head of Gaza’s Government Media Office said Monday that Israeli forces have committed at least 194 violations of the agreement.

As of Sunday, the ministry’s death count was at 68,865, with at least 170,670 people wounded. Previously published research, including multiple studies in The Lancet, has concluded that the official tally is likely a significant undercount.

Longer distances to family physician has negative effect on access to health care

Canadian Medical Association Journal

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Living farther than 30 km from a family physician can negatively affect access to health care, found a new Ontario study published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250265.

Over the last 10 years, access to primary care has declined in Canada, and this decline accelerated with the COVID-19 pandemic. Even after moving, many patients reported continuing with their family physicians, despite travelling longer distances to reach them.

“Distance to health care services is an important determinant of health and can be classified as a factor of health care utilization, with increased distance a potential barrier to receiving care,” writes Dr. Archna Gupta, a scientist at Upstream Lab and a family physician at St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, with coauthors.

To understand the impact of distance between family physicians and their patients on health care usage and quality of care, researchers undertook a large study based on data as of Mar. 31, 2023. The study of almost 10 million patients in Ontario, Canada’s largest province, found that 13% of patients lived more than 30 km from their family physician. These patients were more likely to visit the emergency department for nonurgent reasons and had fewer visits with a family physician in the previous two years. They were also more likely to be male, to be under 65 years of age, to live in a low-income neighbourhood, and to be newcomers to Ontario.

“Our research shows that people use the emergency room not just because they don’t have a family doctor or can’t get an appointment. It’s also because their family doctor might be too far away to reach easily. The distance makes it harder for many Ontarians to get the care they need when they need it most,” says Dr. Archna Gupta.

Patients who lived more than 150 km from their family physician had the highest odds of an emergency department visit for nonurgent reasons and were less likely to visit their physician. As well, the farther patients lived from their primary care physician, the less likely they were to undergo preventive screening for colorectal, breast, or cervical cancer.

The authors hope this study will aid policy-makers with health care planning.

“Incorporating distance to a family physician can provide policy-makers with a more nuanced understanding of unmet primary care demand. Our findings suggest that reforms should prioritize offering primary care a minimum of 30 km from a patient’s home,” conclude the authors.

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Journal

Canadian Medical Association Journal

DOI

10.1503/cmaj.250265 

Method of Research

Observational study

Subject of Research

People

Article Title

Distance to primary care and its association with health care use and quality of care in Ontario: a cross-sectional study

Article Publication Date

3-Nov-2025