The Epidemiologists May Need To Dig Deeper To Understand The Problem Of Gun Violence.

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If we want to advance some meaningful responses to gun violence, we need to figure out the what, who and where of the problem or, as public health researchers would say, the epidemiology of gun violence. A good start in this respect is a recent publication by one of our most prolific public health gun scholars, Garen Wintemute, whose summary of gun-violence data covering 2003-2012 appears in a symposium devoted to strategies to prevent gun violence in the Annual Review of Public Health.

Wintemute introduces the problem by noting that 313,045 Americans died from firearm-related injuries, a larger number than all the troops killed in World War II.  But on a White House gun violence website, the number for gun mortality between 2001 and 2013 is given as 150,000. How come there’s such a big difference?

conference program pic               Because to the public health community, gun violence means every kind of injury caused by gunfire, whether the gun is pointed at the user or at someone else.  The fact is that a majority of gun killings are suicides, not homicides, and among certain populations, such as elderly White men in certain Western states, suicides account for virtually all gun mortalities, with homicides contributing nothing to total gun mortality at all.  This is not the time or place to engage in a discussion about the causal/responsive differences between gun suicides and gun homicides; suffice it to say that Wintemute and other public health researchers clearly acknowledge that homicide and suicide are subsets of a generic problem – access to guns – each of which needs to be understood on its own terms.

Where Wintemute’s careful and thorough analysis of CDC violent mortality data bumps up against a serious limitation (which he acknowledges) is not in terms of defining gun violence to include both homicide and suicide, but in the fact that he is forced to create an epidemiology of gun violence without being able to utilize data on non-fatal gun injuries, the incidence of which is at least twice as high each year as the number of people getting killed with guns.

Not only is the non-fatal gun injury rate twice as high as the gun mortality rate (suicide and homicide), but while the overall gun mortality rate has been fairly steady over the years covered by Wintemute’s research, the non-fatal gun injury rate has shown a remarkable annual rise, from 14.11 per 100,000 in 2001 to 19.68 in 2013, an increase of nearly 40 percent!  Part of this increase is due to innovations in trauma surgery, also to the speed at which seriously-injured victims get moved from the incident site to a trauma unit and the fact that most of the jerks who use guns probably can’t shoot very straight.  Or is this increase simply due to the fact that more guns are where they shouldn’t be?  We don’t know.

Make no mistake. The costs of gun violence cannot be understood if we don’t factor in what happens when someone is shot but not killed with a gun.  Direct medical costs of treating non-fatal gun injuries are 30-40% higher than the costs of dealing with any other serious injury; these numbers don’t include the frequent, long-term costs of post-discharge therapies, as well as the excessive loss of wages that often are the result of the physical and mental damage resulting from guns. A recent estimate of the total annual cost of all gun violence – mortality and morbidity – as being around $229 billion, may be an underestimate by far.

One other point which emerges from Wintemute’s work deserves comment here.   Of the fourteen states that rank highest in suicides and homicides, eleven are located in the South.  Some of these states, like Alabama, Louisiana and Mississippi, experience gun violence similar to Panama and South Africa, not yet Honduras, but not far behind. If we construct an epidemiology to help us figure out gun violence, the answers and strategies for some may not be sufficient for all.

If You Don’t Think There’s A Connection Between The Black Lives Matter Shooting And Donald Trump, You Haven’t Been Paying Attention.

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I’ll take the short odds that sometime in the next 24-48 hours, Donald Trump will get up at a campaign rally and tell the crowd that the kids who were shot at the Black Lives Matter encampment outside the Minneapolis police station “got what they deserved.”  I found myself at a Republican Party election rally in South Carolina on the eve of the 1976 election which was the last time that the Democratic Party was able to carry the South.  And this rally, which was headlined by none other than Strom Thurmond, could have been at another time and another place, a meeting of the Klan.  The speeches were overtly racist, the Federal Guverment was comin’ down to take away everyone’s rights, the South, according to Senator Strom, was goin’ to be ruled by a combination of the NAACP and HUD.

trump2               If you don’t think there’s a connection between the Black Lives Matter protestor who was beaten up at a Trump rally in Alabama and the attempted killing of peaceful demonstrators in Minneapolis, then you haven’t been paying attention to the news or the Trump campaign.  When you stand up in front of a cheering-jeering audience and call someone a ‘jerk’ or a ‘dope’ or a ‘crazy’ because they yell something during your speech, you’ve abandoned any degree of public civility and are now just pandering to the lowest and meanest folks in the crowd.

When Trump first started encountering hecklers during his long-winded speeches he handled them pretty well.  He never had the class of John McCain, who once bluntly told a woman who made an ugly, racist comment that she had gone over the top.  But I knew that Trump’s brief encounter with civilized behavior wouldn’t last because once he responded to a demonstrator in a proper way, he was just sounding like everyone else.  And what keeps him at the top of the polls without spending any of the billions which he claims to have but really doesn’t, is his ability to always say something that nobody else is willing to say.

So let me say something about Trump that nobody else is willing to say, at least not in a public way.  What he’s doing is debasing political rhetoric to the point that we won’t have any meaningful discussion about political or public issues at all.  He reminds me of kids in the New York neighborhood where I grew up who hung out on the corner and yelled insults at drivers whose cars whizzed by in nthe street.  If you were an African-American they yelled ‘nigger,’ if you were a Chinese-American they yelled ‘chink.’  They didn’t yell because they expected the drivers to hear them; they yelled because using an ethnic slur out loud was just fun. Some of these kids ended up in Viet Nam, others got menial jobs with ‘da city,’ one got a job in the power plant shoveling coal.  They probably still use words like ‘nigger’ and ‘chink’ but now they have to keep those words to themselves.

But they don’t have to keep quiet if they can go to a rally headlined by Trump.  And they don’t have to keep quiet when they walk up to a demonstration held by Black Lives Matter because another Black man may have been gunned down by the cops.  After all, these guys have a Constitutional right to call someone a name and they also have a Constitutional right to walk around with a gun.  Put those two rights together and you know what you get?  You get three young Black men in the hospital with gunshot wounds and the cops, in a shooting which took place right outside a police station, still looking for the guys who pulled out the guns.

It happened right outside the police station.  Think about that.


Want To Really Take On The NRA? Here’s Where It Starts.

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There’s old boy down in Virginia goes by the name Mark Carman.  Posted a video on his Facebook page and website waving around some little-ass Ruger pistol – talking one thing or ‘nuther ‘bout the 2nd Amendment. Got hisself a million hits, maybe more. Invited to the Big House up 1600 Pennsylvania way in DC.  Says that no ‘responsible’ gun owner should be afraid of universal background checks. I shoot my mouth off all the time about the 2nd Amendment and the closest I’ll ever get to the White House is to stand in front of Blair House across the street.

acrgo               What I really like about Carman, all kidding aside, is that he’s a bone-fide gun nut, same as me.  How do I know he’s a gun nut?  Because he’s from the South, which is where most gun nuts happen to be.  The truth is that guns are really a Southern thing; below Mason-Dixon gun ownership, gun use and gun violence go hand-in-hand.  So when an old boy like Carman starts saying he’s not afraid of universal background checks, like it or not he’s going to get some attention fast and quick.

I saw Mark’s video the day after it went live and today went back and viewed it again.  Then I switched over to the NRA video channel to compare his performance to the latest digital missives from Colion Noir and Dana Loesch.  The truth is that neither of them look or sound like they have any real connections to guns.  Yea, there’s Colion prancing around with an AR-15; Dana or someone whose rear end looks like Dana is pointing a pistol down range.  But the NRA videos have become too slick, too perfectly scripted, too predictable in terms of what they say. If I had a nickel for every time an NRA flack tells me that guns are the best way to protect myself from crime, I could quit work.

The video produced by Mark Carman looks like he shot it with a Droid propped up against a bookshelf on the bedroom wall.  Out of focus, lighting patchy at best, any second you think the whole gizmo is going to break down and you’ll be staring at a blank screen.  But it’s exactly the lack of pretense, the amateurish quality (believe me, Carman’s no amateur) which gives this video its power and its strength.  To use an overused word, this thing’s authentic and the message, even when Carman mumbles and drops a syllable here and there, is sharp and clear.

Because the real problem with the NRA which comes through in everything they do and say, is that the gun world is divided into ‘us’ and ‘them,’ the good guys versus the bad guys, the ones who totally agree with us and the ones who don’t.  They’ve become shrill, they’ve become strident, take a look at their videos and see if a smile ever crosses anyone’s face.  I’m sorry folks, but I lived through wars, recessions, illnesses and premature deaths.  Making me go to a licensed dealer every time I want to buy or sell a gun just isn’t that big a deal.

It’s this sense of perspective which gives Mark Carman’s video the upper hand.  Wait until near the end when he takes on the whole question of the registration of guns.  I really can’t convey how flawlessly he demolishes the ‘slippery-slope’ NRA argument when he says, “You’ve got a concealed-carry license, you’ve got a hunting license.  You think the government doesn’t know you own guns?”  Perfect. Just perfect.

And during the entire video, all eleven minutes, he’s holding onto that cheap-ass little Ruger and you know he just enjoys fiddlin’ with one of his guns. When a guy like that says that gun folks shouldn’t be afraid to support common-sense rules to keep guns out of the wrong hands, you’re hearing it about as honestly as it can be said.  And gun folks tend to be honest folks too. Which is why Mark will clean the NRA’s clock.


Sarah Palin Believes That God And Guns Go Together But She Might Look At Her Home State.

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Now that Sarah Palin has decided America is the Home of the Free and Land of the Brave because of its devotion to God and the 2nd Amendment, I thought I would do a bit of research about gun violence in her own state.  According to the Law Center to Prevent Gun Violence, Sister Sarah’s home state ranks 44th out of the 50 states in terms of the having the most lax gun laws, and is also the 4th highest gun-exporting state, with a gun-export average twice the national state average, notwithstanding that to take a gun from Alaska down to the lower 48 is really quite a trip.

Not only does Alaska impose no state requirements on gun ownership, it doesn’t even require gun dealers to be licensed by the state.  Get yourself an FFL and you’re good to go.  When I was a gun wholesaler in New York back in the 1980s, we had a customer in Fairbanks who ordered loads of Ruger hunting rifles from us all the time, but this reflected the fact that hunting was and is a major source of tourist dollars in Alaska; I doubt if many of these guns came back to the Lower 48 to be picked up as crime guns.

palin On the other hand, Alaska’s violent crime rate is remarkably high in and of itself, the rate of aggravated assault twice the rate for the country as a whole, the homicide rate also above the national rate.  But yet on the other hand, both the aggravated assault and homicide involving guns is well below the national stats, so maybe Sister Sarah’s on the right track by exhorting us in Jesus’ name to get out there and buy more guns.  Except that when it comes to gun violence there’s an elephant in the living room that I haven’t yet mentioned, and that’s the violence which occurs when someone picks up a gun and aims it at themselves.

I will shortly be reviewing a remarkable new book on guns and mental illness that blazes important paths on issues gun-related suicide, so I’m not going to get into that whole issue just yet.  But I do want to make it clear that anyone who believes that gun violence and gun suicide should be treated as autonomous and unconnected issues is just trying to find a reason why the public health risks from guns should be ignored.  You simply can’t kill yourself as quickly and efficiently any other way; and the moment you contemplate some other method to end it once and for all, you are increasing the possibility that an intervention will occur that will save your life.

And this is where the data from Alaska makes a mockery of Palin’s cynical nonsense about how God’s plan includes ownership of guns.  Because of all the 50 states, Alaska has a suicide rate and, in particular, a suicide rate among Alaskan Indians and, even more particularly, a gun-suicide rate among Alaskan Indians that’s a wonder to behold.

The Western states lead the country in suicide with an overall regional rate of 14.13 per 100,000, well above the national rate of 13.02 and far above the Northeast which comes in at 10.38.  The highest suicide state is Montana, with 23.94, but right behind it is Alaska at 23.26. But only 60% of the suicides in Montana are committed using a gun, while nearly 70% of suicide victims in Alaska pull out the ol’ firearm when they decide that enough is enough.  But here’s the real number to contemplate: Alaska’s Indian population has a suicide rate twice the state’s rate as a whole, and these unfortunate folks have no trouble getting their hands on guns.

Palin’s message is pure crap and she should be ashamed of herself for pandering to the lowest mental denominator she can find.  There’s simply no excuse for someone from a state with such horrific gun violence numbers to be promoting God and guns.

Do We Really Know How To Talk About Gun Violence When People Are Afraid?


I teach the gun safety course in my state that is required for anyone who wants a license to buy a gun.  The license also allows most gun owners to walk around with a concealed handgun, even though the state doesn’t actually mandate live fire as a requirement prior to buying a gun.  Which shouldn’t surprise, since there isn’t a single state whose training/proficiency criteria for CCW would meet what most trainers like myself would consider even minimal exposure to shooting, but that’s beside the point.

I usually teach 50-60 people each month.  But in the one week since the Paris attacks, almost that many people have signed up for the class.  The same thing happened after Sandy Hook, but I put that down to the fact that the massacre in Newtown provoked a clamor for tougher gun laws, which always creates a counter-response, i.e., more interest in guns.  But the ISIS attack was somewhat different, because this time the worst of our political fraternity, like Donald Trump, used the event to cynically and stupidly call out for more citizens to walk around with guns.

jihadBut let’s be honest about Trump and his publicity-mongering friends.  His calls for personal, armed resistance to jihadist threats wouldn’t garner the kind of support that he’s getting if there weren’t lots of folks out there who truly believe that their lives are made safer if they have access to a gun.  Even though Trump tailors his message to what the British used to refer to as “the mob,” a street-level terrorist attack in Paris can easily be conjured up to be like a street-level attack in New York.  And make no mistake about it, people are scared.

And this has always been one of the elephants in the living room for the GVP community, if only because their calls for ‘sensible’ gun regulations run up against a continuous and long-time effort by the gun industry to promote the ownership of guns based on fear.  It used to be fear of street crime, or what Dana Loesch lovingly refers to as ‘thugs.’  But now the fear is taking on a new dimension because while violent crime has always tended to be a factor of inner-city, ghetto life, violent terrorist attacks are much more targeted at the middle class: a commuter train blows up in Madrid, a luxury hotel is shot apart in Mumbai, in Paris it’s a fancy club.

Advocates for GVP have attempted to counter this linkage between fear, personal safety and gun ownership by producing solid research which shows that CCW not only doesn’t protect the average person from violence of any kind, but actually increases the risk of physical injury because of access to a gun.  The problem with this approach is not that the evidence about gun-risk can’t be found, it’s that evidence of any kind just doesn’t work very well when it is used in an argument created and sustained by emotions, particularly the emotion of fear. I have a very close friend who has 4 weeks of a Florida time-share every January but he gives up an entire week by driving rather than going down and back on a plane.  He has a fear of flying and no matter how many times I tell him that the odds of dying in a plane crash are 1/1000th the odds of smashing up his car, he’s still getting behind the wheel.

What makes it so difficult for us to protect ourselves from terrorism is its irrationality; like the President says, they’re not afraid to die.  Which is the same reason why trying to use a fact-based argument against self-protection with a gun isn’t necessarily a viable strategy in a time of generalized fear.  The GVP community needs to develop solid options for mitigating fear that reflect not just data-based research, but respond to honest emotions provoked by events which we cannot control.  If we are indeed in a War Against Terror, that’s the challenge that lies ahead.

A Holiday Safety Message From Everytown Which We Should All Read.

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I’m very lucky.  Every year when the holidays roll around I’m one of those people who will spend time with a loving, supportive family, entertain and visit friends and even attend an office party from which, if I’m careful, I can drive myself home.  But the holidays also mark a time when many of us don’t do so well; we are alone, or depressed, or drink too much during this and other times of the year.  Some of us don’t have family, don’t have friends, the Thanksgiving dinner if we’re lucky, is consumed at a shelter or in the street.

everytown logo               I’m sure you, like me, have responded to requests for donations to this or that program which will bring some cheer into other people’s lives.  Americans are generous, we like to help those in need.  I’ll pay for some dinners to be served at a halfway house, my neighbor runs Toys for Tots at our local KofC.  Which is why I was heartened to see that Everytown has just posted a Holiday Safety Message on its Be Smart campaign.  Because gun accidents, more than any other kind of safety issue, are chilling and scary events.  And if you don’t believe me, just ask the residents of Hayden, ID, who had to find the strength to get through the Holidays last year after a young and vigorous Mom was shot dead in Walmart by her two-year old son.

The Everytown holiday safety message continues a safety campaign started last year which tries to remind parents that there are ways to deal positively and properly with the risks of guns.  It’s a no-brainer to lock guns up when they’re not being used; ditto keep them unloaded around the home and, most important, always keep guns out of the hands of kids.  Children are naturally curious, they have no sense of risk or fear, they teach themselves about the world by touching everything around them and for sure this includes guns.

The gun industry has been promoting its own brand of gun safety largely through the ChildSafe program run by the NSSF.  The program distributes gun locks and safety literature and encourages parents to talk to their children about safe behavior around guns. But what this program does not do is tell parents to talk to other parents about their guns.  And this is where the rubber meets the road, so to speak, because parents who send their children to play at someone else’s home have a right to know whether that home is safe.  And like it or not, no matter what the NRA says about the benefits of gun ownership outweighing the risks, the fact is that a home with a gun inside it is a home where a gun accident could take place.

In 2013, the last year for which we have good data, 16,864 Americans were the victims of non-fatal, unintentional injuries from guns. Now listen carefully: 14,886 were males and 16,326 were over the age of 15.  In other words, when it comes to accidental shootings, what we are really talking about are boys and men playing with their own guns. Now don’t get me wrong; every life is precious and nobody should endure the heartache and pain of losing a life, particularly the very young. But gun safety, when all is said and done, is a function of the fact that we are humans which means we are careless and we forget.  The real value of Everytown’s holiday safety message is that it serves as a reminder that a memory lapse with a gun can have a terrible effect.

If there’s one thing the pro-gun community has decided is that groups like Everytown are just promoting gun safety to disguise the fact that the real goal is to confiscate all guns.  Let me break it to the pro-gun folks gently – there wouldn’t be any reason for Everytown to talk about gun safety if gun owners would all lock up their guns.




Did Jesus Carry A Gun? That’s What Sarah Palin Would Like You To Believe.

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Back in the 1980s, when the Republican Party discovered that it could build a base among Christian conservatives, the social niche issues were all about opposition to what they called ‘alternate’ life-styles; i.e., gays, feminists, pro-choice and the like.  Only a funny thing happened between Jerry Falwell and the SCOTUS decision known as Obergfell v. Hodges, namely, that all the worst excesses of secular progressivism and liberalism have, de facto or de jure, come true. Now let’s not get into an argument amongst ourselves as to whether everyone and everything really is equal in every sense of the word; when it comes to social issues that the Right can use to help sway election results, their victories have been few and far between.

palinBut in the run-up to 2016, the Right appears to have found a new issue, or at least an old issue that they are using for the first time, and the issue is guns. This doesn’t mean that Republicans ignored gun owners; various Republican Presidential wannabees always show up at the NRA convention to burnish their gun-loving credentials in front of the gun-owning crowd.  But these appearances are no different from requisite appearances that all politicians make in front of their traditional constituent groups: Democrats talk the civil rights talk before the NAACP and the UFT; Republicans greet the faithful in pilgrimages to Liberty University and the KofC.

Back in 2010 Rick Perry made headlines when he allegedly pulled a Ruger out of his jogging outfit and shot a coyote who was allegedly menacing his dog. This incident, in fact, was the beginning of the end of Perry’s political career, or at least a career that he hoped would land him in the upstairs apartment at 1600 Pennsylvania Avenue.  Put simply, the attempt to create an image of himself as a latter-day Annie Oakley got himself dismissed as a buffoon.

I wonder how Perry feels this time around when the Republican Presidential race so far has centered not on lowering taxes or cutting the cost of government, but on the degree to which each candidate supports the 2nd Amendment and who among them is walking around armed.  This nonsense started with Trump following the Virginia shooting of two television journalists, but the notion of an armed citizenry has become the de rigueur Republican response to every issue involving safety and security, particularly in the wake of the Paris attacks and concerns that the ISIS-led rebellion in Syria may be getting out of hand.

The recent attempt by the NRA to market guns as a life-style is tailor-made for helping to boost the Republican brand.  Because the polls seem to indicate that Republican support gets weaker as one goes down the age pyramid, ditto interest in guns.  When Colion Noir dresses up hip and cool and prances around the NRA video channel with his AR-15, he’s trying to promote a ‘life-style’ that will appeal to the young and non-White demographics whose support the GOP desperately needs.  When Dana Loesch tells all those soccer Moms they should be carrying guns, she’s sending a similar message to another population group that, hopefully, will vote Red instead of Blue.

Into this newly-found Republican marketing scheme jumps none other than Sister Sarah Palin, who just released a book that unites faith, freedom and guns.  It’s a collection of devotional verses that can be read every day, and Sarah chose to hype it on her Facebook page by saying that Jesus would “fight” for the 2nd Amendment because otherwise only the ‘bad guys’ would have guns.

I feel sorry for Palin; she’s reminds me of a wannabe Anita Bryant who ended up trying to prevent gay marriage and now runs some kind of online ministry which sells the usual inspirational junk. If uniting guns and religion is how the Republicans believe they’ll expand their base, it just opens the door for the faith-based GVP groups to remind their followers about turning the other cheek.


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