Do We Understand Gun Violence? Not Yet.

Yesterday a very important article appeared in the Annals of Internal Medicine that once again appears to demonstrate a strong link between homicide and suicide rates and availability of firearms.  The authors, led by Andrew Anglemyer of the University of California, San Francisco, conducted an extensive search of all relevant published and unpublished studies, compared, synthesized and correlated results and confirmed that access to firearms “is associated with risk for completed suicide and being the victim of homicide.”

This is not a new piece of news for the public health community, although it will be viewed with suspicion and distrust by groups like the NRA that view everything about guns produced by public health researchers with suspicion and distrust.  Research on links between guns and violence directed either outward or inward has been going on since the early 1990’s and the results always seem to be the same.  To quote my favorite authority on the subject of gun violence, the author Walter Mosley, “If you carry a gun, it’s bound to go off sooner or later.”

Union St., Springfield, MA

Union St., Springfield, MA

But now that we have exhaustively shown when the gun will go off, either in a homicide or a suicide, the problem still remains to figure out the why.  Because even though 30,000 gun homicides and suicides is a big number, let’s not forget that there are some 35 million homes where guns can be found, which means that somewhere around 90 million people have access to those guns, which means that roughly 89,970,000 Americans who could have used a gun to commit a homicide or a suicide chose not to do so.

What we usually do is to figure out where the people live who use guns to hurt themselves or others, and once we figure that out, then we try to identify the users themselves.  Which is easy to do in the case of suicides, because the shooter and the victim are both lying there on the floor.  It’s less easy to figure out in the case of homicides, where a police department that makes an arrest in more than one out of every two homicides is doing a pretty good job.   What we don’t seem to do is what David Hemenway calls the “individual-level studies of perpetrators;” in other words, why do certain people carry and use guns?”

The answer tends to focus on what Hemenway calls “ecological” studies which make connections between gun violence and the socio-economic factors that create environments in which high levels of gun violence occur.  And we now know that if we look at a community or a neighborhood with high rates of violence and gun homicide, we can usually also find high rates of unemployment, family dysfunction, educational underachievement and the usual list of inner-city ills.

With all due respect to this scholarship however, and I have nothing but admiration for the many dedicated researchers who have been studying this problem for, lo these many years, I also think they are ignoring one important point.  The multi-family dwelling pictured above is the location in Springfield, MA, of at least three and possibly four homicides over the last 19 months.  The area within one-quarter mile of this address contains every facility and resource that the 4,000 residents of that area ever use: school, church, hospital, community center, police station, playground, supermarket, deli and fast foods.

The city of Springfield had 25 homicides over the last 19 months and 4 of them happened here.  Springfield had a homicide rate per 100,000 of 12 – three times the national average – but this street had a homicide rate of 50 per 100,000.  And they didn’t all happen in one day.  They were spread out over 19 months and the most recent occurred last week.

I wouldn’t be surprised if what goes on in front of 435 Union Street in Springfield is what goes on in every city where high levels of gun homicides take place.   It’s not just about the demographics of the inner city, because even on bloody Union Street 3,996 of the 4,000 neighborhood residents haven’t found a reason to pull out a gun. Hemenway is correct when he calls for individual-level studies of shooters, but some way will have to be found to study them one at a time.

 

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