External Publication

Bullets as Pathogen–The Need for Public Health and Policy Approaches

6 Jan 2026

This article argues that bullets—not guns—should be treated as the primary agents of harm in firearm violence and addressed using public-health frameworks similar to those applied to infectious diseases, given their measurable lethality and population-level impact. Drawing on case fatality rates, ballistic science, and mass-shooting evidence, the authors show that bullet caliber, velocity, and volume of purchase are directly associated with mortality, particularly among children and adolescents. They call for bullet-specific policy interventions—including purchase limits, licensing, background checks, taxation scaled to lethality, and expanded research—to meaningfully reduce firearm injury and death in the United States.

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