We Know That Guns Are A Risk. But Does Anyone Really Care?

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Two noted clinical gun researchers, ER physicians Garen Wintemute and Megan Ranney, have just published an important commentary about gun violence. The article follows from the decision of the American College of Emergency Physicians to join the seven other major medical organizations in calling for a more aggressive and comprehensive medical approach to gun violence, and the authors raise some important issues both in terms of the data on gun violence, as well as the particular challenges facing ER physicians who often face this problem on a daily basis.

The article points out that while vehicular and gun death rates were relatively stable beginning in 2000 and continuing for the next six or seven years, motor vehicle deaths then plunged again while the rate of gun mortality is beginning to creep back up. The decline in car deaths is due to a successful public health campaign, but there has been no such campaign in the case of guns. This is even more disconcerting when one realizes that the United States is, in fact, one of the least violent countries in the OECD. The percentage of American adults reporting being the victims of an assault is less than one third the number in Belgium, less than half of what is reported in Switzerland or Spain.

emt What sets America apart from these other countries is that our violence is so much more deadly, and this is due to the existence of so many guns. Only one OECD country, Israel, has a homicide rate one-third as high as ours; for the remaining OECD community our rate is ten to thirty times higher than anywhere else. The authors tie these disparities to the enormous number of guns floating around, the U.S. counts only 5% of the world’s population but more than 40% of all guns in civilian hands. I want to inject a cautionary note here, however, because our gun violence is overwhelmingly a function of the presence and use of handguns and, if anything, the U.S. probably has even a greater proportion of the world’s privately-owned pistols and revolvers, certainly this is the case when we confine our comparison to the rest of the OECD.

I mention the issue of handguns because the authors call for comprehensive background checks as the primary mechanism for reducing the possibility that guns will get into the wrong hands. But I have never understood why background check advocates always promote checks both on handguns and long guns when gun violence as a criminal behavior overwhelmingly involves handguns, and while long guns are often used in suicides, it is arguably the case that long gun suicides are usually committed by the legal owner of the gun. Given the firestorm that erupts every time an attempt is made to expand background checks, would we lose much ground by only using NICS to control the transfer of guns that cause the most harm?

My other concern is the article’s reliance on a public health approach that has worked for many other products but does not, in my view, address the central issue involved in regulating guns. I cannot think of another consumer product whose regulation was opposed by the energized, mobilized and well-financed grass-roots effort which is the case with guns. Of course car manufacturers fought seat belts, of course cigarette companies tried to deny that smoking made people sick, but when public policies were being debated you didn’t see the galleries packed by drivers or smokers demanding that the government stay off their backs.

Public opinion polls now show that, pace the valid research referenced by Wintemute and Ranney, a majority of Americans believe that a home containing guns is safer than a home which is gewehr-rein. Consider such people deluded, stupid or worse, but the NRA has done a helluva job making us feel that the benefits of gun ownership outweigh the risks. And I’m not sure the other side has a message that plays as well in Peoria or anywhere else.

Want To End Gun Violence? Stop Settling Arguments With Guns.

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As soon as the word got around last week that a middle-aged, white man shot three young Muslim-Americans in Chapel Hill, the net exploded with the usual speculation about whether it was a hate crime, an attack on the Muslim religion, a civil rights assault, and so forth and so on. While the police haven’t yet ruled out the possibility of religious or ethnic bigotry, the preliminary indication is that the gunfire erupted during a dispute over a parking a car. Three young, lovely human beings are dead because nobody could figure out how to find an empty parking space in a wide-open suburban parking zone.

Last year, a highly-decorated, retired police officer walked into a matinee showing of a movie in a suburb of Tampa and found himself sitting behind a young man who was texting messages to his daughter before the movie began. An argument over whether the younger man should continue texting erupted, one thing led to another, the retired cop pulled out a gun and that was that. At the time that these two gentlemen decided that staying put was more important than one of them moving to another location and thus avoiding any problem altogether, the theater audience filled less than 30 seats.

If you haven’t figured out the parallel between these two utterly senseless shootings, let me tell you what it is: nobody knows how to back down. In each situation a man was legally armed, no doubt walking around with a weapon to protect himself against crime. Of course the armed guys weren’t going to back down. Why should they? They had guns. As for the victims, they weren’t about to walk away either. After all, who were they to back down from a dispute in which they no doubt were in the right?

For all the talk about why the good guys need guns to protect everyone from the bad guys, the truth is that more than 90% of the 31,000 gun homicides that occur each year are the result of someone’s inability to back down. It’s what we call a lack of anger management, and if your anger gets out of control, being able to put your hands on a gun won’t result in protecting yourself against crime or against anything else, including anger directed at yourself. It will probably result in you or someone else being seriously injured or seriously dead.

violence According to the FBI, less than 15% of homicides each year occur during the commission of a serious crime; i.e., robbery, larceny, burglary or rape. On the other hand, at least 4 out of 5 homicides grow out of arguments, and these arguments involve people who know each other. And we aren’t talking about casual acquaintances – we’re talking about people who knew each other on a continuous basis and had been arguing and fighting over a period of time. The personal connection between shooter and victim in domestic disputes accounts for virtually every single killing in which the victim is a female (who are 15% of all murder victims each year) and accounts for 100% of all suicide victims who, by definition, have allowed their anger at themselves or others to get out of control.

It’s important to remember that even when we are dealing with violence as a criminal offense, more than 1 million violent crimes were reported to the police in 2013, of which only 1% involved homicides using a gun. And the fact that someone has a propensity to behave violently doesn’t ipso facto mean that they would ever express this anger by using a gun. But there is no other form of personal behavior that is as dangerous and costly as pulling a trigger at yourself or someone else. And I don’t think we will get very far just by trying to identify the most violent among us and then figuring out how to keep guns out of their hands. Wouldn’t it be much easier to just get rid of the guns?

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If The NRA Didn’t Exist, The Gun Control Crowd Would Have To Invent It

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Today I received an email from the Violence Policy Center, a DC-based advocacy group that often partners with Brady and Bloomberg to push back against the legislative and legal initiatives of the NRA. Like every organizational email I receive from both sides, the VPC wants dough. But this particular message caught my eye because of what it said about the NRA’s upcoming Indianapolis show.

The VPC is upset not just in general about the NRA’s impending celebration of gun ownership, but in particular because the show is being held this year in a city that has an alarmingly high murder rate, many of these homicides, according to the VPC, committed with guns. Here’s a quote from the email: “Wayne LaPierre, Ted Nugent, and the rest of the NRA leadership will be in Indianapolis later this month for the NRA’s annual meeting which begins on April 25. We don’t expect they will mention the fact that Indianapolis has a murder rate higher than Chicago’s and that most of those killings are committed with guns.”

I’m not exactly sure what the connection is between the crime rate in Indianapolis and the fact that the Indiana Convention Center no doubt worked like hell to land the NRA show. I also suspect that the decision to hold the show in Indianapolis was made years ago and who knows whether crime in Indianapolis has since gone up or down. But if you think for one second that anyone who’s coming to Indianapolis to visit the NRA show gives a rat’s damn about crime in Indianapolis, you’re barking up the wrong tree.

feinsteinThe crowd at the NRA show is going to look just like the NRA membership everywhere else; mostly male, White, over the age of 50 and living in rural areas or smaller towns. The NRA show is just a big gun show and these folks will do what they always do at those shows: play with the guns, eat a few treats, stand on line for a couple of hours to get Ted Nugent’s autograph, say hello to friends, then hop in their 4×4’s and drive back home. They won’t spend a second in the city of Indianapolis, and if while they’re at the show a couple of more inner-city residents are gunned down, they won’t know about it and they won’t care.

Meanwhile, the NRA will treat them to a good dose of double-talk as to why they are really there. They’ll remind the visitors that guns are the best line of defense against criminals and crime. There will be endless exhortations to fight back against a federal government that is out to grab their guns. And if they need the ultimate proof that God is on their side, they can always line up for admission to the Prayer Breakfast before entering the exhibit hall.

lapierreWant the truth? Both sides in the gun debate mobilize their followers by appealing to fear. In the case of the NRA, it’s a fear of losing your guns, a fear of the government, a fear of crime. For the Violence Policy Center and like-minded organizations, it’s a fear of guns. As long as the two sides continue to appeal to their followers on the basis of fear, there’s really no chance that we will have a reasonable and responsible discussion about how to stop the killings that occur in Indianapolis and other cities and towns.

If we ever had such a debate, maybe it would turn out that we as Americans would decide that 30,000 gun deaths every year is a small price to pay for the fun of attending the NRA show. Or maybe we would decide that the violence has to stop right now and the 2nd Amendment notwithstanding, everyone has to turn in their guns. I don’t really care which way such a debate works out; all I know is that neither pro-gun nor anti-gun advocates are interested in kicking one off.

 

What To Do About Guns? Let’s Start With The Facts

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Every time gun debate breaks out, the two sides take positions that are simply Alice in Wonderland-like in how far they are divorced from real facts. The NRA argues that the more guns are owned and carried by civilians, the safer we become. It’s errant nonsense, and the same people who believe it and who publish “research” to prove it will also tell you that they can prove that elements in the U.S. government helped bin Laden blow up Towers One and Two. Not to be outdone in terms of flights from reality, the gun control crowd insists that banning semi-automatic rifles that look like AR-15 military weapons will have a significant impact on gun violence, despite the fact that of the 11,000+ people killed each year with guns, less than 300 deaths can be blamed on rifles of all types, let alone the so-called “assault” guns with their high-capacity mags. By the way, since the overwhelming majority of shootings occur with the discharge of only one round, I have never understood the fetish that exists among the gun control advocates to ban hi-cap mags.

crime2I agree that it’s time to get serious about gun violence but the only way I know to get serious about anything is to start with the facts. And here is what we really and truly know:

  • Most (90%) people who use guns in criminal ways have a prior history of criminal behavior.
  • Most (80%) individuals who use guns to commit suicide had contact with a medical professional and expressed their feelings of mental distress within 30 days or less of when they killed themselves.
  • Most (70%+) of all gun homicides take place in inner-city, minority neighborhoods.

So there you have it or, as Jack Friday used to say, just the facts ma’am, just the facts. Yea, yea, yea, I know all about the importance of gun safety, but if every single gun in the United States were locked up every single night, the overall deaths from accidental shootings would decline by a whopping 3 percent! As for expanding background checks to be sure that guns only moved from good guys to other good guys; people who acquired a gun legally aren’t disposed to give it to a bad guy and someone who acquired a gun “off paper” isn’t about to walk into a gun shop and fill out a Form 4473.

But there are some sensible things we can do to respond to the facts stated above. The cops could stop spending so much time issuing summonses for jaywalking or rousting young teens for hanging out on street corners and instead get in the face of every known felon and ask them if they are carrying a gun. It seems to be working in New York, why shouldn’t it be adopted everywhere else? As for people with mental issues, the NRA should drop its cynical and stupid opposition to the right of physicians to inquire and report on gun ownership in instances where the patient displays a “clear and obvious” threat to himself or others. And what could be a more obvious threat than someone reporting thoughts of suicide who also happens to own a gun? Finally, the gun control folks need to drop their politically-correct attitude towards the individuals and groups who commit most of the felony gun violence and figure out what to do to keep guns out of their hands. It’s just too bad if most of these people belong to certain specific, minority groups since we are always constrained to discuss or even describe things in racial terms. But the victims of these killers come from the self-same minority populations and we certainly shouldn’t be afraid to speak up in their stead.

 

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