Do We Need CDC Funding To Understand Gun Violence?

              To paraphrase Jonathan Swift who was paraphrasing either a Greek or Persian proverb, so the mountain shook and out came a mouse. Which is the only way I can describe the Congressional hearing in DC yesterday covering gun-research funding for the CDC. The House Appropriations Committee (actually its subcommittee) heard testimony from four witnesses – Andrew Morral from RAND; Ronald Stewart from the Trauma Committee of the American College of Surgeons; Daniel Webster, who runs the gun research program at Johns Hopkins; and the hated John Lott who, on occasion, is allowed to show up at public-policy meetings to represent the ‘other side.’

               After some rather long-winded remarks by Rosa DeLauro (D-CT) who chaired the hearing and some less-winded remarks by the Ranking Member Tom Cole (R-OK) each of the panelists were given 5 minutes to make an initial statement. I listened very closely to these comments, but by end of the 15 minutes taken by Morral, Stewart and Webster, I found myself having difficulty staying awake. It wasn’t only that they didn’t really explain the connection between the lack of CDC funding and the persistence of gun violence over the past twenty years (although to Webster’s credit, I think he was about to offer such an explanation when his time expired and he was cut off) but they delivered their remarks in a manner which made them all sound somewhat bored and almost reluctant to have shown up.

              On the other hand, when John Lott delivered his opening remarks, whether or not you would agree with anything he said, at least he was animated and sounded excited about the issues that were going to be discussed. You would think that the panelists who were testifying in favor of resuming the CDC funding would have gone out of their way to make the Committee feel that this hearing marked a very important day. Frankly, I’m surprised I didn’t see Webster, Morral or Stewart stifling yawns.

              Near the end of the hearing, the mouse truly emerged from the mountain when the panelists were asked to list priorities for gun-violence research. Morral wanted more research to determine who was right and who was wrong about such hot-button issues as open carry, gun-free zones and stand your ground. That’s a biggie. Stewart knew that gun violence was caused by ‘hopelessness’ and wanted more research on how to change hopelessness into hope. A very clear agenda, I must say. Webster believed that more work needed to be done to identify ‘bad’ gun dealers although he failed to mention that most felons get their guns from sources other than retail stores.

              Lott then actually stated a fact. It was the only fact mentioned by any of the ‘experts’ on the panel. He said that 50% of all homicides occurred in 2% of American counties and were connected to the drug-selling gangs which operate in those high-violence zones. He suggested that more research was needed on ways to de-incentivize people who commit gun crimes while selling drugs – the one, specific strategy for reducing gun violence that was mentioned during the entire event.

              At one point, things actually got interesting when Andy Harris (R-MD) asked the three proponents of more research dollars whether or not they supported  a national registry of guns. Morral shlumped around in his chair and tried to beg off entirely, stating that he was just a ‘social scientist;’ Stewart said he was against it even though he heads a medical organization which has come out explicitly for just such an idea; Webster dithered a bit and then decided that he also should respond with a ‘no,’ although he has been gung-ho for comprehensive background checks which would eventually create a national list of everyone who owns a gun.

              Why do gun-control researchers and advocates like Morral, Stewart and Webster kid themselves into believing that anyone on the pro-gun side would ever think they have any interest in protecting gun ‘rights?’ If those guys are really interested in finding ‘non-partisan’ solutions to gun violence, it’s time to man up and admit that they don’t like guns. 


Gun Violence Isn’t Our Biggest Epidemic By A Long Shot.

              Every morning on my way to work I stop off at a mini-mart for coffee, maybe a doughnut, and sometimes I also fill up the car. I have no idea how many other Americans do the same thing every morning on their way to work, but it must number somewhere in the millions. Between gasoline,coffee and junk food, I probably put fifty bucks into the cash register of this mini-mart every week. Multiply fifty bucks by, let’s say 30 million commuters,that’s around $1.2 billion every week, okay? The real number is probably much higher than that.

              When I get on line to pay for my coffee, I notice that probably one out of every two customers in front of me buys at least one, five-dollar lottery ticket, one out of every three buys a pack of nine-dollar smokes, and usually two out of three buys some kind of junk food as well. And when I say ‘junk’ food, I’m talking about every ingestible product in the mini-mart with the exception of a few oranges which I have never seen anyone actually buy.

              For all the talk about healthy eating, fresh foods, low-carb diets and so forth and so on, Americans are captives of the processed food industry.  There is no other advanced country whose population consumes so much crap.  How do I know this?  Because the United States ranks at the top of the heap of all advanced countries when it comes to being fat.  The current obesity rate in the United States is nearly 40%, which is twice the rate for the OECD as a whole. The U.S. obesity rate is four times as high as Switzerland, ten(!) times as high as Japan. And since our poverty rate is somewhere around 12%, this means that most of our obese population consists of the same men and women who stand in front of me on the mini-mart line.

              Now if you follow the discussion about gun violence,you have certainly heard that our gun-violence rate is the highest in the OECD. Our friend David Hemenway has published comparisons between the U.S. gun-violence rate and other ‘advanced’ countries,finding that gun violence in the United States is 7 times higher than anywhere else. To put it in dollars and cents, we suffer from 35,000 gun deaths and rack up at least $8 billion in direct medical expenses every year.

              Let me break it to you gently, okay?  The numbers on the cost of U.S. gun violence are peanuts compared to what it costs us to walk around with so much fat. In 2008, the CDC estimated the medical costs incurred for treating conditions directly caused by obesity to be $147 billion, almost 20 times more than what we spend on injuries caused by guns.And while Gun-control Nation has recently sent out an alarm that deaths from guns in 2018 will exceed deaths which occur when we smack up our cars, deaths from obesity have been exceeding automobile deaths for years.

              Anyone who believes that gun violence is a worse ‘epidemic’than obesity either needs to have their head examined, or their waistline measured, or both. On the other hand, both obesity and gun violence share one,common thread; namely, both are caused by the ability of consumers to purchase legal products whose threats to health are barely controlled. There isn’t a single kid in the United States whose school doesn’t have a ‘healthy eating’course in the curriculum. Know how much difference this has made to obesity? No difference.  Now we have a group of dedicated, gun-violence researchers who have been given money to develop online courses on gun safety that can be used in public schools. Good luck, guys.

              Want to get rid of obesity?  Get rid of processed foods.  Want to get rid of gun violence? Get rid of – guess what?

Where Research On Gun Violence Needs To Start.

Last month our friends at the RAND Corp. unveiled a new initiative on gun violence, the National Collaboration on Gun Violence Research (NCGVR) which will soon begin allocating $20 million in research funds to promote gun-violence research.  The purpose of this effort, according to the NCGVR, is to support “rigorous research designed to broaden agreement on the facts associated with gun policy, and support development of fair and effective policies.”  RAND’s plan is to eventually grow their funding to $50 million. This ain’t chopped liver, even in my book.

              This new project grows out of a 400-page study, The Science of Gun Policy, which RAND published last year and can be downloaded here. The study identified eight major gun-violence categories (referred to in the report as ‘outcomes’), linked these outcomes to thirteen public policies that were believed to reduce violence levels in each category, and then analyzed the degree to which research conducted since 2004 supported the mitigating effects of each policy or not. The outcomes were what you would expect: homicide, suicide, unintentional injury and so forth.  The policies were the usual grab-bag of what has long served as the ‘wish list’ of gun-control advocates – comprehensive background checks, red flag laws, more intensive licensing, etc.

The researchers evaluated the ‘science’ of gun-violence research by scoring the research based on the degree to which it showed that each policy actually made a difference in the level of gun violence which the particular policy was designed to affect. The ratings ranged from inconclusive to limited to moderate to supportive, and not a single category of research received a supportive rating, not one. Two outcomes, gun suicide and gun homicide, were found to be moderately impacted by background checks and CAP laws; a spread sheet detailing the value of gun research for determining the value of every other public policy for all the other outcomes was basically blank. To put it bluntly, the RAND report found scant evidence that research conducted since 2004 has been of any real value at all. Wow.

This report no doubt reflects a decision of RAND to try and fill the gap. And while the lack of government funding for such research efforts has definitely played a significant role in restricting the degree to which the science of gun policy has remained far behind where it might otherwise be, I would like to suggest that perhaps there is another reason why the team that produced the RAND report found little, if any research that could be used to support gun-control policies from an objective, evidence-based point of view.

Every year somewhere between 1.5 and 2 million Americans attempt or succeed in inflicting serious injury on someone else. It’s called ‘aggravated assault,’ but for all kinds of reasons, we don’t have any hard data on how often it occurs. For that reason, gun-violence researchers rarely focus on gun assaults unless the victim winds up dead. Most of these deaths started as arguments, escalated to assaults, then out comes the gun.  But in most cases, actually in at least 80% or more of these events, the shooter doesn’t know how to aim the gun and the person with the bullet inside them lives.

Let’s put this into context. The context is that less than 10% of the arguments that wind up as aggravated assaults involve the use of a gun. So how come 10% use a gun and 90% don’t?  It can’t be explained by saying that there aren’t enough guns to go around. The guns are all over the place!

As long as gun-violence researchers rely on medically-based data about victims to understand gun violence, we won’t get very far. And if we don’t understand what’s going on in the head of the shooter, as opposed to the body of the victim, how can we develop public policies to reduce gun violence that will really work?

I just hope my friends at RAND will take this issues into account when deciding how to distribute their generous and much-needed research funds.


So What If The CDC Gun-Violence Numbers Are Wrong?

Our friends at The Trace dropped a real bombshell last week by exposing the fact that the gun-injury data published by the CDC may or may not be correct. And if the data which we use to understand gun violence isn’t any good, then how can we figure out what to do about the problem that kills and injures more than 125,000 Americans every year? Or maybe the real number is as high as 160,000, or maybe it’s around 90,000; according to the intrepid Trace reporting team, the CDC estimate could be off either way by as much as 30 percent.

cdc             To arrive at this shocking state of affairs, the reporters from The Trace enlisted the help of another organization whose expertise, when it comes to figuring out data, is above reproach.  I am talking about the help they received from a team that works for Nate Silver’s Five Thirty Eight website – remember how accurate they were in predicting the outcome of the Presidential election in 2016?

With all due respect to this earthshaking news about the possible lack of precision in CDC gun-violence numbers, I published not one, but two columns on exactly this problem back in June. I also was unable to get a list of the hospitals that provide the data for the injury estimates, but I did find a national map which indicates the location of each medical center whose injury numbers are gathered by the Consumer Product Safety Commission and then forwarded to the CDC.  The Trace quotes the editor of a major medical journal as stating that if the hospital sample includes sites which treat lots of gun injuries, this will influence the overall estimate in significant ways. This is nothing more than someone saying something because he’s been asked to say something; if you look at the map of participating hospital sites, you discover that, au contraire, some of them are located in places where gun violence rarely occurs.

Of course no article on anything having to do with public health gun research can be published by The Trace unless they get some quotes from some usual suspects such as major public health researchers like David Hemenway and Philip Cook. The former says he doesn’t trust the numbers, the latter was actually trying to figure out how many gun injuries end up resulting in deaths (the ‘case-fatality’ rate) which is a somewhat different issue than just trying to validate the non-fatal injury rate itself.

This report is grist for the mill of groups and organizations who are trying to re-start gun-research funding from the CDC. And I would certainly never (read: never) state or insinuate that there should be any kind of prohibition on such funding in any way. But this article raises two concerns that The Trace team does not appear to acknowledge or understand, nor are these issues found on the radar screen of their friends at 538.

With the exception of live births and deaths, both of which must be reported as accurately as possible to the U.S. Census so that we know how many people are actually living in the United States, virtually all of the data produced by the CDC on illness and health issues are estimates, and while the CDC does a much more comprehensive tracking of heart attacks than gun-shot wounds, take a look at the data on heart disease and you’ll notice that the reported numbers always are preceded by the word ‘about.’

More important the fact is that while everyone keeps barking up the tree about how we need more funding, I see little attention paid to another branch, namely, research not on the victims of gun violence, but on the perpetrators of this dread disease. If 75,000+ individuals didn’t pick up a gun every year and use the weapon to try and kill someone else, we wouldn’t experience a gun-violence rate that is many times higher than the rest of the OECD. Any chance The Trace might try to figure that one out?


Further Comment On What We Don’t Know About Gun Violence Numbers.

If I didn’t have anything better to do, I would have spent an hour this past Thursday at the Hammer Health Sciences Center, part of Columbia University’s Mailman School of Public Health, listening to a panel of experts talk about public health solutions to gun violence. The lead panelist, Professor Sonali Rajan, has published several articles on gun violence, one of which, “Firearms in K­12 Schools: What is the Responsibility of the Education Community?” notes that schools tend to be very safe environments , but “even one instance of gunfire in a school should be considered one too many.”

cdc             Is Dr. Rajan serious?  I thought the science of what happens when a bullet collides with a human body had long been settled, at least since somewhere around the 15th Century when Bartolomeo Beretta manufactured a pile of gun barrels at his little factory in Gardone in 1526.  But evidently Professor Rajan and her colleagues still believe that all kinds of gaps exist in public health research gun research; in fact, she concludes by saying, “There is an urgent need for coordinated efforts by the education community to effectively address the implications of firearms inside and surrounding K‐12 schools.”

And why is there such an ‘urgent’ need for more gun research? Because those meanies at the NRA and their sycophantic followers in Congress have blocked research money for more than twenty years. In her article, Dr. Rajan joins a long and distinguished list of scholars who have been pointing out, with good reason, that the lack of funding stymies any real effort to figure out strategies that will lead to less violence caused by guns.

Far be it from me to try and cast the boys in Fairfax as being anything other than totally opposed to gun-violence research.  But while it’s convenient to cast the NRA as the villain in this piece, the story doesn’t end there. I can’t imagine that someone doing research on any virulent disease would accept not knowing where the data came from on which the study was based. But guess what? The data on gun violence published by the CDC comes from a ‘representative sample’ of 100 U.S. hospitals who send data on all ER visits for injuries to an agency called the National Electronic Injury Surveillance System (NEISS) run by the Consumer Product Safety Commission, the outfit that DD Trump is trying to shut down.

Hey, wait a minute.  I thought that thanks to those NRA meanies, the Consumer Product Safety Commission can regulate the design of baby carriages, vacuum cleaners, lawn mowers and other lethal products, but they can’t regulate guns. But they can send data on gun injuries to the CDC.  And while the folks at NEISS declined to send me the ‘nationally representative’ list of hospitals which supply the data on gun injuries, they do publish a map showing the location of these participating hospitals, so please download it here.

Take a look at Louisiana, the Number One state for gun injuries of both the fatal and non-fatal kind.  The NEISS hospital appears to be located at least 50 miles away from New Orleans, which happens to be the state’s chief killing ground. In Virginia, the participating hospital is probably near the small town of Danville, more than 100 miles from Richmond. There’s no hospital at all in New Mexico, which is only ranked 4th-highest among all states for gun suicides involving victims under the age of 29.

This is the source for the data which scholars use for the research which then informs the GVP community about which strategies they should follow and promote?  This is the data which the GVP claims is evidence-based, as opposed to the gun-rights gang who don’t care about evidence at all? I wrote about this issue last week but I’m writing about it again because I simply cannot accept the idea that gun-violence research is flying along so blind.

I only wish that some organization with more authority than me can find a way to set this straight. We owe it to the 125,000 people shot each year by guns, even if we really don’t know what that number means.

How Many People Get Shot By Guns? Nobody Knows.

As soon as the NRA show rumbles to an end, our friends in the gun-control world can get back to business and celebrate the latest news about gun violence from the CDC.  Because the CDC has just published the numbers for how many Americans were wounded but not killed by guns in 2016, and the number is the highest it has ever been – 116,114 – an increase from the 2015 of nearly 40 percent!

cdc            The only problem with the numbers reported by the CDC is that they probably aren’t correct.  How can I say something like that?  I mean, we’re not talking about numbers from this survey outfit or that; we’re not talking about Pew, or Gallup, or even the vaunted gun researchers at Rand.  We’re talking about the U.S. Government and even more to the point, about the agencies responsible for medical research, which we all know is science- based.  This data is also instintingly used by gun-violence researchers at major academic institutions like Harvard and Johns Hopkins, so it has to be correct, right?

If by using the word ‘correct’ we are saying that the numbers on gun injuries collected and published by the CDC are accurate to the point that they withstand serious scrutiny either in terms of how the numbers are gathered or how they are used, then when I characterize these numbers as correct, I am wrong. And I’m not saying that I’m a little bit wrong. I’m saying that I am wrong to the degree that anyone who uses these numbers to support any argument about gun violence is making an argument out of whole cloth.  Which happens to be a polite way of saying that the numbers are nichtsnutzig, pas bien, non buono, zilch – whatever works, okay?

The CDC numbers on non-fatal gun injuries come from an agency known as the National Electronic Injury Surveillance System (NEISS), an outfit run by the Consumer Product Safety Commission (CPSC.) The data collected by NEISS “is based on a nationally representative probability sample of hospitals in the U.S.” Those happen to be my italics, and if you can show me a single place where these numbers are used by any gun-control organization with the caveat that they are a ‘sample’ rather than what the real numbers might be, I’ll send a hundred bucks to the charity of your choice. Don’t waste your time looking, I already did.

Hey! Wait a minute! I thought the gun industry was exempt from any consumer regulation by the CPSC or anyone else.  That happens to be true, thanks to an exemption written into the first Consumer Product Safety Act of 1972. But this law doesn’t prevent the CPSC from collecting information about consumer injuries from guns, an activity for which they use the same NEISS reporting system and then send the numbers to the CDC.  The NEISS numbers for gun injuries also come from the same ‘nationally representative’ hospitals which furnish the injury data for every other product group: toys, kitchen appliances, ATVs, amusement-park rides and just about everything else.

I don’t know about injuries from hair dryers or chain saws, but when it comes to gun injuries, the ‘nationally representative’ list of hospitals isn’t representative at all.  How do you compute a national estimate of gun violence when the hospital you use in Virginia is located in the little town of Danville, whereas Richmond is left out? How do you have any idea about gun violence in Florida without including at least one hospital from Dade County?

The CDC says that the margin for error they employ for gun injuries means that the actual number might be 30% higher or lower than the specific number they publish each year. Which means that the real 2016 gun-injury number might have been as low as 85,000 or as high as 150,000 – take a pick.

Whether they know it or not, when gun-control advocates talk about the number of gun injuries, it’s nothing but a guess. You would think that the gun-violence researchers, on whose work the gun-control movement depends, would at least try to point this out.




Do We Really Know The Numbers On Gun Violence?

When our friends at the Gun Violence Archive (GVA) first started up, they were immediately attacked by Gun-nut Nation for all sorts of misdeeds, including the usual nonsense about undercounting all those instances when red-blooded Americans use a gun to stop a crime. But I notice increasingly that mainstream media sources now routinely reference the GVA and a pat on the back from Newsweek and The Washington Post, usually means you must be doing something right.

GVA             The problem that GVA has to deal with, of course, is that they generate all their data from what we refer to as ‘open sources,’ namely media and related coverage which appears online. The good news about such coverage is that it’s easy to do a search for online content, I have been using Google Alerts with keywords like ‘shootings’ and ‘gun violence’ for years. The bad news is that these sources can’t possibly cover all relevant events that would let us know the number of people who get shot every day

What we usually rely on for gun-violence numbers is the data produced by the CDC. After all, we assume that since medicine is a scientific exercise, at least since Louis Pasteur figured out that something called a microbe spreads disease, we also assume that medical science develops its practices using evidence-based facts. And what could be more of a fact than a dead body lying in the street?

Except there’s only one little problem.  When we take a look at the data on gun violence collected and published by the CDC, particularly when we go below the summary data which tells us how many people are shot and killed in the United States every year, all of a sudden we discover that the numbers not only aren’t so exact, but don’t even add up. Now you would think that something like gun violence, which allegedly costs us more than $200 billion a year in medical costs, lost wages and other various and sundry sums, would at least provoke some degree of concern about whether we actually are using valid numbers or not. Let me break it to you gently – we’re not.

In 2015 the CDC says that 35,476 people lost their lives because a gun went off and they didn’t duck; of this number, which is routinely reported by every gun violence prevention (GVP) group, homicides accounted for 12,979, suicides amounted to 22,018, another 484 were shot either by cops or armed citizens legal defending themselves, and 282 died but nobody’s sure how those deaths actually came about.

We know that the number of gun deaths that were ostensibly justified is probably undercounted by at least half. And let’s not forget the 489 unlucky folks who accidentally killed themselves or someone else with a gun, a number which is also probably well below the annual toll. But neither of those categories, even if doubled, would change the overall gun-death number by much. Let’s face it, gun violence in America is overwhelmingly a function of intentional injuries committed by the shooter against himself or someone else.

I have spent the last week comparing gun-death homicides furnished by the CDC to the numbers found in the National Violent Death Reporting System (NVDRS) which also happens to be an agency within the CDC, but draws its data from a wider pool of sources and is considered by scholars to be more reliable when it comes to counting bodies that wind up in the morgue. When we compare numbers, however, we discover that the numbers being used by the GVP community are perhaps 20% higher than the number published by the NVDRS.

The next time someone says that you can’t trust an online, open-source aggregator like the Gun Violence Archive, you might want to reply that the numbers we get from all those medical scientists might not be any more reliable, and in terms of accuracy, might even be worse. I’m as enamored of science as anyone else, but sometimes I wonder whether the science of gun-violence research actually exists.

Does Public Health Research Explain Gun Violence?

Now that the gun-grabbing, liberal elite has decided that the way to reduce gun violence is through a ‘public health’ approach, I thought I would summarize what we know:

  • 74% of all victims of intentional fatal gun injuries committed by one person against another are men and women ages 14 – 30, of whom 40% are African-Americans who account for less than 15% of all Americans within that age group.

public healthThat is what public health research can definitively tell us about gun violence.  The research does state many other things, such as the link between gun laws and gun violence rates; such as the connection between lack of safe gun storage and gun injuries; such as gun homicides increasing when permit-to-purchase procedures are replaced by instant background checks. None of those findings, however, are definitive, and when public health scholars refer to gun violence as embracing an epidemiological approach to the problem, they are surrounding their research with an aura of scientific nomenclature which it doesn’t yet deserve.

Not to worry, I’m not turning into a pro-gun curmudgeon who all of a sudden believes that gun violence prevention (GVP) goals and objectives need to be thrown aside.  To the contrary, thanks to the Parkland kids and the overwhelming revulsion of D.D.D. Trump, his pimp attorney Cohen and the rest of the merry band, there may actually be a chance for some effective and much-needed gun-control strategies to become law of the land. All the more reason why we need to scrutinize what we know and still need to know about gun violence with a fine-tooth comb.

And here is where taking a ‘public health approach’ to gun violence can make things fuzzy rather than clear. The first time an illness appears, it may be due to nothing other than some spontaneous, physiological event. But the moment it appears in more than one person, we need to figure out how it got from Victim A to Victim B – the transmission mechanism – which often requires us to figure out the identity of the carrier, even if that individual never exhibits the symptoms of the germ himself.  It didn’t take long to figure out that AIDS was found overwhelmingly in the gay community and amongst individuals who were addicted to injected drugs. But what was the exact manner in which it spread?

We face exactly the same problem with understanding gun violence because, as opposed to most injuries (cars, falls, etc.) in the case of guns it takes two to tango; the injured party and the person whose behavior resulted in the injury aren’t one and the same. So, while public health research tells us an awful lot about the victim of this medical event, we know next to nothing about why someone else transmits this medical condition by shooting off a gun.

Our friends at the UC-Davis Violence Prevention Research Program have put up a very comprehensive resource to can be used by health-care providers who want to identify gun risk amongst their patients and counsel about same. The website contains a basic checklist of symptoms which indicate risk (violent behavior, abusive parents, substance abuse, et. al.,) behavior which has been validated by endless public health research over the past 25 years.

There’s only one little problem – these symptoms are exhibited by people who commit violence whether or not they use a gun. And less than 5% of the individuals who try to physically injure someone else each year use a gun. How come the other 95% don’t? With 300 million guns floating around, it can’t be because there’s any great difficulty getting their hands on a gun.

Until and unless we focus on the shooters and not just on the victims, I am afraid that the ‘public health approach’ to gun violence will not necessarily provide the answers we seek. And if we don’t fully understand how and why people use guns in inappropriate or illegal ways, how do we craft effective public policies to make those behaviors change?

Where Did The Term ‘Gun Violence’ Come From?

When we talk about the risk of guns, why do we use the term ‘gun violence’ and where did it come from?  In fact, this whole business started back in 1979 when the CDC decided that violence was a public health issue. Medicine had long since recognized that violent behavior was a threat to health simply because violence creates injuries, and an injury is usually a problem that brings the victim to the attention of the medical community, with more than 37 million people being treated for injuries each year in emergency rooms.

docs versus glocks              But what made violence not just a health issue but a public health issue was the awareness that certain forms of violence, in particular homicide and suicide, were consistently among the 15 leading causes of death in the United States. And in addition to overall numbers, these types of violent deaths were also concentrated in certain environments, as well as increasing dramatically in specific demographics; e.g., a 154% increase in homicide rates of 15 – 19 year-old males from 1985 to 1991. And once medicine decided that we needed to address violence the way we successfully addressed other public health threats such as polio, typhus and tuberculosis, then researchers began looking for causes which would the lead to pro-active measures to reverse and hopefully eliminate violence as a medical condition or disease.

When medicine began to focus on violence as a public health issue, it wasn’t difficult to make the connection between violence and guns, for the simple reason that roughly 60% of all homicides have been committed with guns every year since 1981. Since that date we have experienced 689,000 murders in this country, of which 460,000 have been deaths intentionally caused by guns. During that same 35-year period, England experienced somewhere less than 20,000 homicide deaths – talk about American exceptionalism!

By the way, the CDC didn’t come up with the definition of violence by pulling the veritable rabbit out of the veritable hat.  In fact, their definition comes right from the Magna Carta of medical definitions, a.k.a. the World Health Organization, which defines violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.” And this definition, copied by the CDC, also includes suicide, of which roughly half of all suicides in the U.S. are committed with guns.

Given the above, it’s clear that from a medical point of view, the gun violence prevention (GVP) community stands on pretty firm ground when they invoke the phrase ‘gun violence’ to argue about the risks and dangers represented by guns. The problem arises, however, when GVP goes beyond its own committed band of supporters and uses that kind of terminology when talking with non-advocates about the risks and dangers of guns. Because the NRA has done one heckuva job convincing not their own membership (who don’t need convincing, which is why they’re members of the NRA, duhhhh) but convincing Mr. and Ms. John Q. Public that even if guns are sometimes used in illegal or inappropriate ways, the positives of firearm ownership, in particular protection from crime, far outweigh the negatives in every respect. The idiot who represents the 27th C.D. in New York probably wouldn’t have been so quick to brag about how he’s going to ‘always’ carry a gun if public opinion polls didn’t show that a strong majority believed that having a gun makes you safe.

I’m not saying that GVP should drop the reference to ‘violence’ when they try to reach out beyond their own committed constituencies to discuss what to do about guns. What I am saying is that perhaps we need to make it clear that concerns about ‘gun violence’ aren’t based on value judgements about how people choose to live.  They are based on the same concerns that medicine has raised about violence as a health threat, an issue about which there is no disagreement at all.

Here’s An Easy Way For The NRA To Prevent Gun Accidents.

According to the CDC, in 2014 slightly less than 16,000 Americans accidentally shot themselves or someone else and survived their wound.  Back in 2009, the number was 18,610.  Which means, according to the gun industry, that guns are getting safer all the time.  And of course when it comes to accidental shootings which result in death, the number has not only been declining year after year, it’s so paltry now that the whole gun safety issue is not even worthy of concern.

nra4              After all, how can anyone get worked up over a few hundred deaths when we all know that folks walking around with guns prevent millions of serious crimes from being committed every year?  And if you doubt that figure, just take a look at the NRA’s Armed Citizen website, which shows that 38 armed Americans used their guns to protect themselves and others from criminals in the month of March alone! Now if you read the fine print you’ll discover that 8 of those armed citizens turned out to be off-duty cops who are supposed to have their guns handy even when they aren’t on the job, which gets us down to around 30 times when someone exercised their 2nd-Amendment ‘right’ to defend themselves with a gun. And a little bit of math that even I can do gets us up to a whopping 360 armed-citizen protective incidents a year. Wow! How could you even begin to doubt the value of civilian gun ownership when all we lose to gun accidents is less than five hundred folks each year?

Of course leave it to those troublemakers at Harvard’s School of Public Health to point out that official counts on fatal gun accidents may, in fact, be undercounted by at least half.  And this is because coroners are often reluctant to rule a gun death as an accident since many such events end up being reviewed in court. As one coroner told the researchers, “If one person kills another person, we usually call it homicide and let the courts decide whether there was any wrongdoing” So that’s the end of that.

In any case, there may be a chance, although I doubt it, that Gun-nut Nation will take a somewhat less benign view of gun accidents given what happened at the gun range in NRA headquarters this past week. Evidently an employee of the NRA was in the process of holstering his gun after banging a few; the gun went off, the bullet hit the guy in the ‘lower part of his body,’ he was taken to a nearby hospital at Fairfax, treated and released – no harm done.

What I found interesting in this report was that the accident evidently occurred during a training session at NRA headquarters; it wasn’t just a case of someone going down to the range on their own time to fiddle around with their gun. And the NRA training manuals repeat ad nauseum the idea that you must keep your finger off the trigger at all times unless the gun is pointed at the target that you intend to shoot.

Which brings up the whole issue of gun safety that Gun-nut Nation tries mightily to avoid, namely, that when it comes to making a mistake with a gun, there’s no oops. And the problem is that we are human, and as humans we are all careless and we will sooner or later forget. That’s the reason we mandate seat belts but we can’t put a harness around a gun.

But I have an idea for how my friends at the NRA can prevent such accidents from happening again. Why don’t they just declare NRA headquarters to be a gun-free zone? I’m not talking about the old guns in the museum – those guns are all sitting behind glass. I’m talking about the guns that folks wear in the building because, of course, there’s always a chance that a criminal might try to assault or rob you at 11250 Waples Mill Road.