From schools and malls to city streets and suburban homes, incidents involving firearms have caused injury and death across America and ignited a national conversation about how to reduce the toll. 

In fact, firearm injuries now kill more children and teens in the U.S. than anything else, even car crashes, according to University of Michigan research published this year. Other research, including studies from the U-M Institute for Firearm Injury Prevention (IFIF), has indicated that firearm incidents, including suicides, increasingly affect Americans of all ages, living in all kinds of communities. 

The toll has spurred lawmakers at the state and federal level to act, including the passage of a bipartisan law this past summer that's the first of its kind in decades.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

But policymakers aren't the only ones who can act. U-M experts say there are many things that firearm owners, and even people who do not own guns, can do to prevent tragedy in their homes and communities. 

"There's a lot that individuals can do to reduce the risk that someone they know will get hurt or die because of a firearm," said IFIP co-director Patrick Carter, M.D., an emergency physician and researcher at Michigan Medicine, U-M's academic medical center. "Responsible gun owners, and people who don't choose to own guns, can all take steps now."

1. Safe Storage: Keep firearms locked, unloaded and separate from ammunition

More than 4 million children and teens in the U.S. live in a home with a loaded, unlocked firearm. Firearm owners can take simple steps to help reduce the chance that anyone living or visiting their home will be harmed, either accidentally or on purpose. 

• If you own firearms, store them in a locked safe, case or vault, if at all possible. Keep the key so that it's accessible only to adults trained in firearm safety. 

•  Use a gun lock, which requires the firearm to first be unloaded. Keep the key for the lock separately. Many police departments and county sheriff's offices offer these locks for free; ask the one near you. 

• No matter how you store your firearms, it is safer to have them separate from ammunition and to store ammunition in a locked location. 

• After using a firearm, make sure to unload it before returning it to storage.

• If you have received a license to carry a firearm in a concealed manner, keep it unloaded to avoid accidental discharge. When you are done carrying, return the firearm, unloaded, to locked storage and keep ammunition separate.

2. Include firearm storage as part of your 'safety check' conversation before your child visits someone new 

Allergies. Pets. Sunscreen. Pools. Adult supervision. If you're a parent, and your child or teen is going to spend time at a friend's home or sleep over for the first time, you know it's common to connect with the hosting parent or guardian about these and other safety-related matters. 

It's time to add firearm safety to this conversation, experts say. That could reduce the chance of injury if children get curious about a firearm at a home they're visiting, or if the friend they're visiting wants to impress them by showing where their parent's firearms are. (Researchers have reported that many children know where firearms are hidden in their home.)

In fact, Michigan Medicine and its C.S. Mott Children's Hospital have joined a national campaign called Hospitals United, to urge parents to ask about unlocked guns at places their children might visit. The campaign's website offers helpful tips and information on how to do this.

As you go down the safety check list with the other parent, tell them your child can be really curious, and ask about whether there are firearms in their home and how they're stored. If the other parent is not willing to say, or expresses concern that you have asked about this, be ready to suggest a different location for the children to get together or sleep over.

If you're the host, volunteer information about your own firearm ownership status, and storage practices if you own firearms, to the other parent. 

If you have a teen who babysits, tell them you want them to add firearm storage to the list of safety-related things they ask about when preparing to sit for a new family. 

3. Find out how to raise firearm concerns with authorities

If you have a concern that a person with access to firearms might harm themselves or another person, even if it's a temporary concern, it's critical to speak up and seek help. 

Contact local law enforcement for an urgent situation. Or if it's a more general worry, alert the person's parent, spouse, partner, physician, therapist, teacher or principal, and talk about next steps. 

If you're concerned about someone who may be suicidal, you can contact the National Suicide & Crisis Lifeline by calling or texting 988 from any phone or using the chat feature on their website, or call their services for people who speak Spanish or need to use the TDD service because they are deaf or hard of hearing. 

Some states have extreme risk protection order laws (also known as red flag laws) which allow people to petition a court to legally restrict an individual's gun possession based on a serious credible concern about that person's behavior. More states may adopt these under the new national law. Even if your state does not have one of these laws, it's better to say something to authorities who will know what options they have.

If you are a firearm owner and you discover that a firearm has been lost or stolen, report it immediately to local law enforcement. Keep your firearms' serial numbers on file in case you have to make such a report.

4. Know when and how to remove firearms from your home 

As the risk of death and injury by firearms rises, it is vital to know when to intervene before that harm happens. 

More than half of all suicide deaths in the U.S. in 2020 were the result of firearm injuries. While suicide rates declined slightly in the past few years, they are still much higher than they were a decade ago.

If you suspect or know that your child, spouse or someone else who lives with you may be depressed or struggling, it may be time to place your firearms with a trusted friend or relative, or the police. 

Anyone who may be showing signs of frequent sadness, irritability, withdrawal from friends and family, financial distress, relationship issues and/or increased use of alcohol or drugs could be at risk of harm from a firearm. In fact, Michigan Medicine's psychiatric emergency department makes sure to ask every patient about firearm access and provides free gun locks on the spot to those who want them.

5. Talk to children and teens about firearm safety

If you are a firearm owner and you have children – or if grandchildren or other young people are regularly at your home – have conversations with them about firearm safety and treating firearms with respect, including not touching a firearm without supervision. If you have firearms, it's especially important to keep them unloaded and locked when children are around. 

Even if you aren't a firearm owner, talk to your children about the importance of avoiding firearm use except if an adult is supervising (for instance at a firing range or out hunting). Urge children to tell you or another adult if any of their friends or acquaintances are showing off or fooling around with firearms. 

Also, explain the importance of reporting someone who is posting on social media about hurting themselves or others – they should not just scroll past or think it's a joke. 

6. Be cautious of childproof firearms 

Some firearm manufacturers are introducing technology that aims to make firearms more difficult for children to operate. None of these are foolproof solutions, U-M experts say.

Even if you do purchase a firearm with such technology, properly secure it to prevent access by children or others at risk of self-injury or violence. 

7. Inquire about your school district's efforts to reduce violence and suicide risk 

In response to school-based violence and threats over the past decade, many schools have added security measures and embedded security officers at schools and other facilities. Most now conduct lockdown drills to help students and staff practice for unsafe situations, and train teachers and staff in how to respond to rumored or actual threats. 

Some school districts are sharing safe firearm storage information with families who attend their schools, and training teachers and other staff to recognize the warning signs of suicide risk and other mental health concerns. 

Even if you don't have children in school, as a voter you can find out what your local public school district is doing and urge the school board to adopt programs to prevent firearm injury and death.

In Michigan, anyone with information about a possible threat to a school, student or school staff member can use the OK2Say system to report it anonymously.

Nationally, the Say Something anonymous reporting system, the federal illegal firearms activity hotline (1-800-ATF-GUNS, or 1-800-283-4867) and the federal Reportit app are three ways to report concerns about firearm-related threats or other possible violence.  

8. Engage kids, teens and young adults in violence prevention

If you notice that a child, teen or young adult is displaying violent or erratic behaviors, or has had violent encounters with others, think about getting them involved in a violence prevention program. Researchers have been focused on how to intervene during the critical window when young people are at elevated risk for violence, but before they are in a perpetual cycle with devastating consequences. 

One example of an evidence-based intervention is SafERteens, which was designed by Michigan Medicine researchers to work with teens in emergency department settings to reduce involvement in violence. The intervention was both shown to be effective and translatable to primary care clinics. Such programs can be invaluable when trying to reduce the risk of firearm violence. 

Mental health professionals, school counselors and law enforcement agencies should know what options are available near you.

9. Don't forget that older adults have special risks for firearm injury and death, too 

Children are not the only group at heightened risk of injury and death from firearms. In fact, Carter said in a lecture to older adults earlier this year, nearly 33% of people who die from firearm injuries in the U.S. are over 50. About 84% of firearm deaths among older adults are suicides, with another 14% being homicides, including domestic violence.

Carter and colleagues did a study and found nearly one-quarter of firearm owners over age 50 regularly store their firearms loaded and unlocked, which increases risk of accidental or intentional injury. 

Suicides among older adults tend to be linked to depression or a long-term physical impairment, and dementia is also a risk factor for homicide and suicide in older adults. For these reasons, older adults and their loved ones should communicate with one another and health care providers about steps to reduce those risks.

If you have a concern about an older adult, share that concern with their doctor or other regular health care provider. They can help identify signs of increased anger, domestic violence risk, or suicidality, and intervene. Carter offers more tips specific to older adults.

Like Podcasts? Add the Michigan Medicine News Break on iTunes or anywhere you listen to podcasts.

Live your healthiest life: Get tips from top experts weekly. Subscribe to the Michigan Health blog newsletter

Headlines from the frontlines: The power of scientific discovery harnessed and delivered to your inbox every week. Subscribe to the Michigan Health Lab blog newsletter

Like Podcasts? Add the Michigan Medicine News Break on Spotify, Apple Podcasts or anywhere you listen to podcasts.