America’s Only Unregulated Product
- pschrimpf
- Sep 17
- 4 min read
Updated: Sep 30
Firearms and the Public Health Gap
Paul Schrimpf
Defective car parts trigger recalls. Children’s toys are tested for choking hazards. Even e-cigarettes face restrictions on flavors and advertising. Yet firearms, now the leading cause of death among U.S. children and teens, remain largely exempt from the consumer safety rules that govern other potentially dangerous products.
Recent editorials and studies in the Journal of the American Medical Association (JAMA) and JAMA Health Forum argue this gap is more than a political issue; it is a public health failure. The way guns are treated under U.S. law reflects a policy choice to separate them from the regulatory framework that protects consumers in other domains.
Firearms as the Leading Pediatric Killer
A 2023 JAMA Pediatrics analysis found that firearms have surpassed motor vehicle crashes as the leading cause of death for U.S. children and adolescents. In 2020 alone, more than 4,300 children and teens died from gun injuries.
Dr. Rebecca Cunningham, Vice President for Research at the University of Michigan, wrote in JAMA: “No other high-income country tolerates this level of firearm-related child mortality. If we treated this as a product safety problem, we would never accept it as the cost of doing business.”
The Regulatory Gap
Unlike cars, toys, or household appliances, guns are not subject to consumer product safety standards. The Consumer Product Safety Commission has no authority over firearms. Instead, oversight is split between agencies with narrow mandates: the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) regulates sales and licensing, while the National Institute of Justice funds research. Neither can enforce safety design standards.
As Dr. Sandro Galea, Dean at Boston University School of Public Health, wrote in JAMA Health Forum: “We treat firearms as a constitutionally protected right, not as a consumer good that can and should be regulated for safety. That distinction has enormous consequences.”
The result: no federal requirements for features like child locks, trigger pressure standards, or smart-gun technology, even though such design elements are well within reach.
The Cost to the Health System
The lack of firearm regulation also imposes major costs on the health system. A 2023 JAMA Surgery study estimated that the average initial hospitalization for a firearm injury costs over $30,000. With nearly 50,000 firearm deaths and over 80,000 injuries annually in the U.S., the financial toll is enormous — extending beyond direct medical costs to lost productivity and community trauma.
As Dr. Megan Ranney, Dean of the Yale School of Public Health, wrote in JAMA: “Every firearm injury that could have been prevented with basic safety standards translates into a family disrupted, a hospital bed occupied, and health system resources diverted.”
Lessons from Other Products
Public health experts often point to motor vehicle regulation as a model. In the 1960s and 70s, cars were killing Americans at alarming rates. Federal agencies responded with seatbelt mandates, crash testing, child car seats, and roadway safety campaigns. Death rates fell dramatically, even as car ownership soared.
As Dr. David Hemenway of Harvard’s Injury Control Research Center wrote in JAMA: “We didn’t reduce motor vehicle deaths by telling people to drive less. We regulated the product, made it safer, and held manufacturers accountable.” The contrast with firearms is stark: while cars, toys, and even food packaging must meet federal standards, guns remain outside the scope of consumer protection.
Why the Gap Persists
Why are firearms treated differently? Several JAMA commentaries point to the Protection of Lawful Commerce in Arms Act (PLCAA), passed in 2005, which shields gun manufacturers from most liability claims. This legal insulation has reduced incentives for industry-led innovation in safety features.
Congress has also long restricted federal funding for firearm research. Dr. Mark Rosenberg, former director of the CDC’s National Center for Injury Prevention, explained in JAMA: “For decades, the federal government was prevented from treating gun violence as a public health problem. That left a vacuum in both knowledge and regulation.”
A Public Health Approach
The argument advanced by many JAMA authors is not about confiscation or bans; it is about parity. Firearms should be treated like any other product with significant risk: regulated for design safety, subject to liability when defects cause harm, and monitored through robust data collection.
Potential steps include:
Mandating child-resistant features on all new firearms, similar to medication packaging.
Supporting smart-gun technology that links firearms to authorized users.
Funding injury prevention research at levels comparable to other leading causes of death.
Allowing the Consumer Product Safety Commission to regulate firearms as it does other consumer goods.
As Dr. Garen Wintemute of UC Davis wrote in a JAMA editorial: “Treating firearms as consumer products does not conflict with constitutional rights. It aligns with our responsibility to protect the public from preventable harm.”
Every product that carries risk such as cars, toys, appliances, and cigarettes, is regulated for safety. Firearms remain the glaring exception. As JAMA’s contributors emphasize, this is not an inevitability of American life, but a policy choice.
If firearms were regulated like other products, tens of thousands of lives could be saved, billions in health system costs could be avoided, and communities could be spared untold trauma. The public health case is not about ideology; it is about applying the same seriousness to guns that we already apply to every other potentially dangerous consumer product.
Acknowledgements & Citations
This report draws insights and direct quotes from:
Cunningham R. Firearms and Child Mortality in the U.S. The Journal of the American Medical Association (JAMA). 2023.
Galea S. Firearms and Consumer Product Safety. JAMA Health Forum. 2024.
Ranney M. Health System Costs of Firearm Injuries. JAMA. 2023.
Hemenway D. Lessons from Motor Vehicle Regulation. JAMA. 2022.
Rosenberg M. Federal Research Gaps in Firearm Safety. JAMA. 2021.
Wintemute G. Firearms as Consumer Products. JAMA. 2024.
Faust JS, Chen J, Bhat S, et al. Firearm Laws and Pediatric Mortality in the US. JAMA Pediatrics
Agoubi LL, Duan N, Rowhani-Rahbar A, Nehra D, Sakran JV, Rivara FP. Patterns in Location of Death From Firearm Injury in the US. JAMA Surgery