Nishi Singhal, MPH
Program Officer, Primary Care
Texas Health Institute

The Texas Primary Care Consortium (TPCC) is a multisectoral network focused on primary care, co-led by Texas Health Institute and the Texas Medical Home Initiative. TPCC’s mission is to advance equitable, comprehensive, and sustainable primary care for all Texans through a three-pronged framework: educate, activate, and transform. We educate through sharing best practices, lessons learned, and replicable tools. We activate by facilitating partnerships as a neutral convener for shared and sustainable impact. We transform through generating policy and system changes. 

TPCC engaged a group of community members and leaders with expertise in firearm injury prevention to examine Texas-specific data on firearm injuries and deaths as well as to gain a better understanding of the existing programs and services that focus on prevention of firearm injuries. Injuries and deaths due to firearms have been increasing in Texas. Firearms are now a leading cause of death among children and teens

Beyond Texas, firearm-related injuries and deaths are recognized as a public health crisis in the United States and reduction of firearm-related deaths is a Healthy People 2030 goal. To meet this goal in the United States and Texas, we must openly acknowledge the scope of the problem and promote strategies to equip health providers with appropriate guidance and resources. 

TPCC recognizes the role public health and primary care play in the promotion of safety and injury prevention. Firearm injuries and deaths are preventable and there are many steps we can take as individuals and organizations to reverse the current trends. The TPCC Firearm Safety Stakeholder Group’s objectives were to:

  • Establish and share an objective, evidence-informed, data-driven understanding of firearm injuries and deaths as a public health issue. 
  • Understand the factors that contribute to firearm injuries and deaths. 
  • Learn and share real-world examples that demonstrate the successful integration of firearm safety into clinical and community settings. 
  • Discuss and share long-term comprehensive strategies for firearm safety education and prevention. 
The group’s initial discussions led to a three-pronged framework for solutions:

Three-pronged framework

  1. Build upon the clinician’s role. Integrate discussions on firearm injury prevention as part of routine primary care. Watch TPCC’s recent webinar on Advancing Firearm Safety and Injury Prevention within clinical settings. 
  2. Build upon existing interventions and evidence. Employ multiple layers of interventions to ensure sustainable and effective change. 
  3. Normalize the conversation. Normalize the conversation around mental health, trauma, anger, and the lack of social and emotional support with all populations, especially with groups of people who historically did not receive or have access to high-quality, culturally competent, coordinated, social, emotional, and mental health support. 
Read TPCC’s recent brief, A Framework for Advancing Firearm Safety and Injury Prevention through Primary Care, to learn more about the framework for solutions and next steps. 
TPCC will continue to work with the Firearm Safety Stakeholder Group to promote firearm safety and injury prevention. To stay informed of TPCC’s firearm safety efforts, visit our website. 



1. CDC WONDER Online Database. Underlying Cause of Death. 2018-2021.
2. Patel J, Leach-Kemon K, Curry G, Naghavi M, Sridhar D. (2022). Firearm injury—a preventable public health issue. The Lancet.