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Gun violence is often treated as a narrow criminal justice problem or an episodic tragedy rather than a persistent public health crisis. In this timely and necessary book, Daniel Semenza reframes gun violence as a widespread and unevenly distributed health burden that shapes the mental, physical, and behavioral well-being of individuals and communities across the United States.

Tracing the ripple effects of gun violence exposure and trauma, Semenza documents how every shooting reverberates through families, neighborhoods, and institutions, producing lasting harms and reinforcing existing social and health inequalities. He centers the city of Camden, New Jersey, as a focal point for a wider discussion about the relationship between gun violence and public health nationwide, connecting individual experiences to broader forces such as poverty, racism, and our frayed social safety net. He articulates a three-part framework of structural, statutory, and strategic solutions, evaluating interventions and their effectiveness, tradeoffs, and roles within a broader public health approach.

Drawing on a wealth of empirical research, The Toll It Takes demonstrates that meaningful reductions in gun violence are achievable through prevention-focused, systems-based fixes that reduce exposure and promote the long-term health and safety of all Americans.