Want To Do Something About Gun Violence? Take A Look At Seattle.

King County Sheriff's Office (Washington)

King County Sheriff’s Office (Washington) (Photo credit: Wikipedia)

A rather remarkable document was published this week, remarkable because it undercuts much of the current nonsense that comes from the NRA and its supporters about the link between guns and deaths or injuries suffered by children.  The report wasn’t issued by the CDC or any other federal government agency whose research has long been derided by the NRA as being useless because it’s “anti-gun.”  Rather, it’s a report issued by the Public health Department of Seattle and King County, areas not particularly known for their anti-gun or DC-elitist sentiment.

The report covers the years 1999 to 2012, during which time 68 children were killed by firearms and another 125 admitted to hospitals with gun injuries.  The sober comment that introduces the report and these numbers are: “Every one of these deaths and injuries was preventable.”  Why?  Because according to the report’s authors, more than two-thirds of all homicides involved either people who were related or people who knew each other and, in the case of suicides, more than three-quarters of the victims used guns that were owned by a member of the victim’s family.  In other words, child gun violence in King County, WA, is like child gun violence everywhere else: a personalized form of anger that has roots in social or familial relationships.

King County’s gun-owning population, according to the study, contributes to the level of gun violence simply because too many guns aren’t unloaded and/or locked away in too many homes. More than one in five gun owners stored their guns loaded and nearly one in five left them unlocked.  The result is that the risk of a completed suicide among children under the age of 18 is more than 9 times higher in such gun-owning environments, and even in homes where guns were locked away, 16% of the successful children who used a gun knew how to unlock and get their hands on the weapon they then used.

The good news in all this is that King County isn’t waiting for the Federal Government to pass another law on gun control.  In fact, the County has enrolled gun dealers all over the area in a program called LOK-IT-UP, in which consumers can purchase gun safety safety devices at discounts of ten or fifteen percent. As I mentioned in my previous post, more and more local communities are beginning to develop their own public health programs to deal with gun violence in positive and meaningful ways.  They aren’t taking guns away from law-abiding gun owners, they don’t demonize anyone for owning a gun.  They are responsible and meaningful approaches to a problem that won’t go away no matter how much we argue about 2nd Amendment rights.

As the one-year anniversary of Sandy Hook approaches, let’s hope that the program in King County becomes a national trend.

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Here He Comes Again: Tim Wheeler Continues His Crackpot Attacks On Physicians

NRA Headquarters, Fairfax Virginia USA

NRA Headquarters, Fairfax Virginia USA (Photo credit: Wikipedia)

Just when I thought we heard the last of him, Tim Wheeler’s back in town with his patented combination of half-truths, distortions and outright lies about physicians and guns.  In case you haven’t heard of him, Wheeler is the head of something called Doctors for Responsible Gun Ownership which he founded back in the 90’s to help the NRA convince Congress to cut gun research funding for the CDC.  Wheeler, who claims to be a physician, has never published a scholarly article of any kind, nor for that matter has he ever engaged in any medical or scientific research about guns or anything else. But because he can put the initials MD after his name, the NRA trots him out every time gun research appears in a medical journal.

Wheeler’s loony version of reality was in full evidence this week following the publication of an article in the journal Pediatrics, which is a favorite target for the ravings of delusionals like Wheeler who pander for the NRA.  The article, co-authored by a dozen medical specialists who work in emergency and trauma departments in the Far West, compared treatment outcomes and costs for children at emergency facilities based on the type of injury suffered that led to admission.

In addition to gunshots, the study covered cuts, blunt object injuries, falls and vehicle accidents. Not surprisingly, gun shots comprised the smallest number of all injury categories.  But gunshot injuries also resulted in the highest cost per admission, more than $28,000 per patient (the next highest, vehicle accidents, was $15,000,) and the highest incidence of in-hospital mortality.  In other words, when a kid gets hit with a bullet, he or she will require a degree of medical care that is unlike any level of care required for any other type of serious injury.

In brief, that’s what the article says.  That’s all it says. Oops, there are some recommendations which I’ll quote: “Public health, injury prevention and health policy solutions are needed to reduce gunshot in juries in children.”  I’m quoting the recommendations so that you’ll understand the irresponsibility of Wheeler who reacted to this study in an appearance on NRA’s Cam Edward’s talk show by condemning the “anti-gun hype” of this and other medical research on guns.  And just to make sure that his argument remained at the absolutely lowest intellectual level, he didn’t miss the opportunity to remind everyone that since the majority of the gunshot patients were minority males ages 15 to 19, there’s no doubt that they were gang members whose criminal behavior brought the injury on themselves.

The truth is, that with the exception of quacks like Wheeler, the NRA is afraid of physicians. They fear physicians because they know that most Americans probably trust their physician more than they trust anyone else.  They rely on their doctors, they confess their deepest fears and secrets to their doctors, and when a parent wakes up in the middle of the night and hears that child in the next room having difficulty breathing, he’s not going to grab the phone and call the NRA.  He’s going to call the doctor.

The NRA has spent the last twenty years trying to convince us that we will all be safer if we all have a gun.  Most physicians disagree.  I’m not sure that the research has yet been conducted or published that definitively proves one or the other point of view.  But I do know that the shrill and stupid comments by people like Timothy Wheeler only serve to debase the efforts of honest people to search for a reasonable point of view.

 

Do We Need More Research On Gun Violence?

 

 

coverFollowing Sandy Hook, the Obama Administration took upon itself to organize discussions that ultimately led to the publication of  a new gun research agenda.  Basically this report could be summed up as ‘new wine in old bottles,’ because it called for studies of the same issues that had been on the CDC agenda before gun research was closed down.  I have analyzed this report in my own book and it’s been subject to the usual negative commentary by the minions of the NRA.  And since no funding for any of the suggested research areas has been voted through the Congress, the report remains exactly that: another dead report.

 

But the inactivity of the CDC in this area doesn’t mean that gun violence research isn’t going on.  To the contrary, it continues to be conducted by a number of different organizations and individual researchers, to the point that there’s very little about the issue of gun violence that isn’t understood.  Most of the research has come out of the major advocacy organizations like the Violence Policy Center and the Brady Campaign. Mike Bloomberg has endowed a research program at Johns Hopkins that publishes significant work, as does David Hemenway’s Injury Control Research Center at Harvard’s School of Public Health.

 

This is hardly a comprehensive list of organizations or individuals who are conducting meaningful gun violence research.  And I apologize to the many serious researchers for whom space limitations don’t allow me cite their works.  But I did want to spend a few sentences on a particularly significant research effort being carried out for the past two decades by an emergency room physician in California, Garen Wintemute, because here we have a remarkable example of theory linked to practice by someone who deals with the net results of gun violence every day that he shows up at work.

 

Wintemute’s Violence Prevention Research Program, housed at UC/Davis, has conducted research on a wide variety of issues related to gun violence, but what makes his work so compelling is that it combines extensive analysis of data with hands-on contacts between himself and the subjects of his research: gun owners, gun-show exhibitors, gun dealers, gun manufacturers. He is the only medical or public health specialist I know who has actually verified his data by visiting gun shops, walking through and observing gun shows, walking onto gun factory floors and, it should be added, he’s been a gun owner himself.

 

Recently Wintemute and several colleagues published an article calling for physicians to become more visible advocates in the gun violence debate.  I reviewed this article in a post that I published on September 26.  At that time I was impressed by the fact that an article calling for physicians to get more involved in gun issues was published at all.  But what really stands out is the fact that physicians, despite what the NRA says, can and should play a role in decisions about guns because doctors are experts in dealing with fears about disease and death, and many people decide to own a gun because they have fears about crime.

 

This is the kind of original thinking that comes from analysis that is grounded both in data and real life.  And physicians should realize that no amount of research will convince the NRA or its supporters that medical professionals should and must play an important role in defining America’s relationship to guns.  When the trigger of a gun is pulled and someone’s in the way, it’s physicians like Garen Wintemute who have to deal with the results.  That’s enough of a reason to listen to what he has to say.

 

 

 

 

 

Too Many Guns Equals Too Much Gun Violence: Still Arguing About That One?

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What a surprise!  We are treated to yet another piece of research, this time in the American Journal of Medicine that tells us that the ownership of 250 million guns results in more gun violence.  To me, the surprise is not the conclusion of the study, but the fact that medical and public health researchers continue to indulge themselves in trying to prove something which, analytically and logically, is so obvious.

Why is it obvious?  Because the possession of a gun, by definition, creates a risk that disappears if the guns aren’t around.  Now you can go on and on about mitigation strategies – mental health, background checks, enforcement  – but to suggest that reducing something which is harmful should be based on increasing its availability is to engage in an Alice-in-Wonderland argument totally divorced from reality or common sense.

Which is exactly what the NRA has been doing for the past thirty years.  And ever since they were able to end CDC funding of gun violence gun research, they’ve flooded the public domain with pro-gun bromides that not only deny the link between gun ownership and gun violence, but even claim that more guns in private hands protects Americans from gun violence.  The “proof” that guns are a deterrent to gun violence is the assertion that gun homicides have dropped by more than 50% since the mid-90s, while gun ownership and concealed-carry licensing has doubled in the same twenty-year span.

The problem with this argument, however, is that more than 90% of the annual decline in gun homicides took place prior to 2000, while the increase in gun ownership and concealed-carry licenses largely took place after that date.  In fact, gun homicides have slowly increased since Obama took office, exactly the period when gun sales and the number of concealed-carry licenses both showed significant growth.  No matter how you analyze the data, the numbers since 2000 simply don’t support the NRA claims that more guns equals less gun violence.

Despite what readers may believe, I’m not against guns.  After all, I make my living by selling them and training people how to use them.  But I believe in informed public debate and, as Senator Moynihan used to say, “we’re entitled to our own opinions but not our own facts.”  The CDC ban doesn’t prevent anyone from using the data, it simply doesn’t allow the CDC to fund research.  In that regard physicians and medical professionals who want to contribute to the gun violence debate might take a page from the history of another physician-based organization that made a significant contribution to understanding and limiting violence of a much more dramatic type.

I’m referring to Physicians for Social Responsibility, a physician-led organization founded in 1961 that focused public consciousness about the health threats from nuclear war.  PSR first began advocating test bans, arsenal reduction and non-proliferation during the height of the Cold War and faced an opponent – the U.S. Government – whose powers to persuade the public about the necessity of an arms race was far beyond the persuasive abilities and resources of the NRA.  In 1985, largely based on its anti-nuclear work, PSR shared the Nobel Prize.

The role of physicians is to lessen harm.  This not only means treating a patient after harm occurs, it also means developing pro-active strategies to diminish harm before the unhealthy event takes place.  Physicians shouldn’t be in the slightest bit defensive about wanting to end gun violence, nor do they need to justify their commitment to healthy outcomes because the gun industry wants to keep selling guns.  It’s time for physicians to move from research to advocacy and level the playing field between themselves and the NRA. I don’t care who wins the argument, I just want an even match

It’s Time To End Gun Violence Against Kids

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For a country as wealthy as we are, the failure to do something about violent gun deaths suffered by children is really shameful. And it’s particularly shameful when we consider the disparities in between white and minority kids.  Let’s look at the numbers.

From 2005 to 2009, there was an average of 3,500 fatal deaths per year, or nearly 10 deaths every day.  About one in five of these victims was between ages 5 and 14, and the death rate for African-American children in this age bracket was three times higher than the rate for white children of the same age.

The problem with gun violence is that everyone wants it to end, but we can’t seem to get everyone on the same page.  Today Wayne LaPierre from the NRA will be interviewed on television and whatever he says, you can be sure that the anti-gun folks will find every word he utters to be wrong.  And at the end of the day, another 10 children will have been killed with guns.

So I have an idea.  For once let’s all get together around some common-sense ideas that will unite instead of divide us.  Let’s agree that if we all act responsibly around guns, they won’t get into the wrong hands.  After all, every single gun that will be used today to kill those ten children was first sold legally to someone who passed a background check.  But then the gun was lost, or it was stolen, or it wasn’t locked up or locked away.  Let’s get everyone: manufacturers, wholesalers, retailers, gun owners and non-gun owners to do the responsible thing.

If we can agree to be responsible, we can do something about this terrible violence against kids.  And if we work at it, hopefully next year there won’t be ten kids killed each day but only eight, and the next year six, or four, or none!  We’ll give everyone a little badge or a little pin for being part of the solution instead of the problem.  LaPierre and Bloomberg can be the first recipients of our annual ‘responsibility’ award.

lapierrebloom

Now just to make sure that I’ve got my facts straight, I’m going to check the data on gun deaths one more time.  It’s from the CDC.   Oops.  There’s a little problem.  The overall numbers are correct as is the disparity between white and minority deaths.  But somehow, don’t ask me how, what I thought were the alarming numbers about child gun violence turn out to be annual child deaths from – unintentional drownings!  Boy, talk about misreading the data. Man, I really blew that one.

No biggee, we’ve already got things going and we’re gaining momentum every day.  Need to change our logo a bit and re-print our mission statement. Now let’s find a nice, little backyard pool to substitute for the AR-15 and don’t forget to re-do our Facebook page.  I’m sure the same people who are upset about children being shot by guns will be just as concerned about kids who fall into pools.  And the good news is that safe swimming is just like safe shooting – it’s all about responsible ownership and doing the right thing.

Where Do All The Shooting Victims Go?

 

 

 

 

 

 

 

The Urban Institute just published an important report on the costs of gun violence.  Titled, “The Hospital Costs of Firearm Assaults,” it attempts to calculate the costs associated with hospitalizations due to shootings based on reports from hospital admitting units and emergency rooms.  Not surprisingly, the report found that more than 50% of gun-shot victims either had no insurance or were covered by public plans supported by taxpayer revenues. Since the total cost for all gunshot admissions was slightly short of $630 million, this means that Uncle Sam Taxpayer got stuck with at least half the bill.

Unfortunately, there’s only one problem with this report.  The data covers one year – 2010.  During that year, roughly 50,000 people were admitted to hospital in-patient and emergency units with gun shot wounds.  But according to the Department of Justice and the CDC, there were over 100,000 gun shootings that resulted in death or injuries in 2010.  So where did the other 50,000 go?  Maybe we can eliminate most of the 19,000 suicides that resulted from using guns because most of those folks went to the morgue.  But if that’s true, it still leaves another 30,000 men, women and children who got shot but found some other way to deal with their wounds besides going to the hospital. Maybe they went to a local clinic, or maybe there’s some over-the-counter remedy now available that takes care of the common gun shot the way that Ibuprofen takes care of the common cold.

Or maybe someone ought to get their data straight.

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Let’s Get The lead Out Of Ammo

                  The reason the NRA wins in Washington is because their opposition isn’t organized.  The opposition only comes to life when a terrible tragedy (Sandy Hook) occurs, and as soon as the posturing and pleading comes to an end, support for more gun control quickly disappears.  The NRA, on the other hand, never misses an opportunity to remind its members that the 2nd Amendment right to own guns must be constantly and continually defended.

                The problem is that people who support gun control usually don’t own guns.  But they do own something else.  What they own, and they share this ownership with gun owners by the way, is the world in which we live.  Whether we call ourselves environmentalists, preservationists, naturalists, ecologists, bird-watchers, tree-huggers, or just good, old-fashioned lovers of the outdoors, the number of people who support and enjoy the beauties and wonderment of nature dwarfs the NRA’s membership by far.

And now it appears that, for the very first time, these folks may be gearing up to challenge the NRA’s monopoly over discussions not about guns per se, but about the ways in which they are used.  I am referring  to the legislative battle in California over Assembly Bill 711 which bans all lead ammunition within the state. Previously lead ammunition was prohibited in areas inhabited by the California condor and certain other flyways; now environmentalists are attempting to extend the prohibition state-wide.

As expected, the NRA is using a combination of scare tactics (‘they’re really after your guns,’) pseudo-science (‘more animals die from road kills than from lead shot,’) and economic Armageddon (‘thousands of jobs are at stake,’) to spearhead the anti-711 crusade.  But the NRA’s campaign isn’t about what kind of ammunition will be used to shoot at game or targets per se.  It’s about who will set the terms and the tone for any discussion about guns.

The NRA has been very successful in making sure that government regulation over the gun industry, particularly the regulation of products, is minimal at best.  They know that if California bans all lead ammunition, that the regulatory virus will spread.  The country was settled East to West but new things tend to move from West to East.  Remember where half-and-half first started messing up coffee?  Remember a guy named Reagan?

The problem isn’t the lack of alternative, non-toxic materials.  The problem is the lack of communication between the two sides.  For example, we have banned lead-based paint and leaded gasoline, and nobody who wants to be taken seriously in any discussion about public health would question the Center for Disease Control’s recommendations on protecting children from exposure to lead.  Manufacturing lead ammunition creates the second highest consumption of lead, the 65 million metric tons used in 2012 ranking only behind the amount used in the manufacture of batteries.  But ammunition manufacturers have been petitioning the ATF for years without success to create realistic rules governing ammunition components that would allow non-toxic materials to be substituted for lead.

Here’s a real opportunity for the two sides to sit down, put the vitriol aside, and come up with a plan that satisfies both the public health risks of lead exposure on the one hand, and the ability of the ammo manufacturers to utilize non-toxic substances on the other.  And it wouldn’t have to involve any government regulation at all.  One of the NRA’s favorite symbols is our beloved bald eagle.  That bird lives today in great numbers because naturalists and environmentalists fought a long and difficult battle to get rid of DDT.  Why can’t we get together and do the same thing with lead?

The NRA Goes After Physicians – Again

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Last  week the Institute of Medicine published the report that grew out of the April meeting called to create a new research agenda on gun violence.  The April meeting was a response to a Presidential memorandum issued by Obama,  one of a series of Presidential directives following the massacre at Sandy Hook.  One of the NRA’s first great victories against the Federal Government was a prohibition, beginning in 1997, to use federal funds for research into gun violence because, according to the NRA, all such research would be used to justify taking away “our” guns.

Following the defunding of gun violence research, the CDC continued to define gun violence as a public health issue by listing gun injuries as a specific category in their various reporting systems, but until the publication of the IOM report, specific discussions about guns as a public health issue were ignored.  Why bother to even consider shootings as a public health problem?  After all, we’re only killing as many Americans each year with guns as we kill with cars and trucks.  And everyone knows that the feds never did anything about traffic safety, right?  Not seat belts, not airbags, not nothing, right?

Well, it actually took the NRA almost three days to react to the government’s latest attempt to destroy the 2nd Amendment but this morning they began their campaign to protect all us gun owners from the excesses of our government by sending out an email warning  that the same group of scientists who spent millions of taxpayer dollars back in the 1990s were once again planning to use their “junk science” to produce more anti-gun advocacy today.   I’ll save you the trouble of looking up the actual ‘junk science’ that was produced in the 1990s and share some of the more “controversial” findings from that research:

  • Existence of firearms in the home was linked to higher suicide rates.
  • Presence of unlocked guns in the home was linked to higher gun violence rates.
  • Gun violence was higher in the U.S. than in any other advanced country.

But if those findings aren’t bad enough, wait until you discover what the junk scientists are planning to do with our tax dollars now.  Among other things, the new research agenda includes studying safe storage strategies, private sales prohibitions and collecting information on acquisition  and use of guns; all of which represent fundamental threats to our beloved 2nd Amendment liberties which would have disappeared years ago if it weren’t for the strength and resolve of our NRA!

The NRA’s resistance to discussions about gun violence as a public health issue is irrational.  Nobody quarrels with efforts to make our highways safer because the auto industry contributes roughly $500 billion each year to the GDP.  Being generous I can make the case that the gun industry contributes about $5 billion each year.  So here we have two industries accounting for the same number of needless deaths each year and the one that contributes 1/100th as much as the other to the national economy resists every attempt at common-sense regulation and, God forbid, a lessening of the human toll.

We need to end that irrationality now.  We need to stand up and defend the work of dedicated scientists and physicians who spend their lives trying to save human beings, not finding spurious and irrational excuses to ignore their efforts. Our organization, Evolve, believes that there are many credible things that can be done to reduce gun violence without restricting in any way the access or use of guns by responsible men and women.  Let’s get together and get it done!

Here They Go Again

NRA Headquarters, Fairfax Virginia USA

NRA Headquarters, Fairfax Virginia USA (Photo credit: Wikipedia)

One of the main objectives of this blog is to be something of a one-man “truth squad” for the gun world.  There is probably no other subject in which the ability to throw around opinions that have absolutely no relationship to the facts is so widespread.  And this is primarily because of the division in the gun world between the haves and the have-nots; i.e., people who have guns and people who don’t.  And  not only don’t these two groups know what the other is talking about, but while the haves are extremely passionate about their guns, the have-nots really couldn’t care less.  So the passion of the haves often drive them to say things that, shall we say, aren’t completely true (I’m being polite) and the unconcern on the part of the have-nots often results in a lack of interest about the facts as well.  I’m going to expand on this issue – the cultural gap between the haves and the have-nots in a lengthy and detailed blog, but for the moment, here’s a brief example.

Last week the Department of Justice released its annual report on gun crime and noted that gun homicides had dropped from 18,000+ in 1993 to 11,000+ in 2011 – a decline of nearly 40%. (http://www.washingtonpost.com/blogs/right-turn/wp/2013/05/07/doj-gun-violence-down-semi-automatics-a-minor-issue/.)  The report was immediately seized on by the NRA and its right-wing minions (for example, Breitbart:http://www.breitbart.com/Big-Journalism/2013/05/07/Justice-Dept-Report-Destroys-Medias-Gun-Control-Narrative) to show that the liberal “assault” on the 2nd Amendment was misplaced because gun violence was steadily decreasing without additional gun control measures.  Even the AP repeated the “gun violence is down” mantra and let one of the NRA’s staunchest supporters, Senator John Thune (R-SD) use the report to take a shot at gun control advocates: “That’s what many of us have argued all along, is that focusing just exclusively on the guns is not the correct approach to this,” he said. http://hosted.ap.org/dynamic/stories/U/US_GUN_VIOLENCE?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT.

One little problem.  What the report actually shows is that gun homicides dropped from 18,000+ in 1993 to 10,500+ in 200 and have since then been steady and actually come back up slightly.  So there hasn’t been a steady, two-decade drop in gun homicides, which is how the NRA trumpeted the report on their website; there was a seven-year decline which, by the way, paralleled the first six years of the ban on hi-cap magazines that was part of the 1994 Clinton crime bill.  I should add, by the way, that we have never been able to figure out whether there was any connection between homicide rates and gun controls since the NRA was able to get all gun research conducted by the CDC ended in 1996.  I’m not saying there is a connection, I’m just saying we can’t find out.

My point is simply this:  It’s a real misuse of data to say that there has been a 20-year trend if, in fact, the actual trend stopped thirteen years ago but numbers have not significantly reversed since that time.  But it doesn’t matter whether it’s the NRA or one of their friendly bloggers or even the “reliable” Associated Press.  When it comes to guns, everyone gets it wrong most of the time.