What Causes Gun Violence? It’s The Guns.

              More than a quarter-century ago, two brilliant researchers, Fred Rivard and Art Kellerman, published research which definitively linked gun access to increased risk of suicide and homicide. Frankly, the entire corpus of gun-control research hasn’t really gone beyond what they said, because nothing more needs to be said. Either there’s a gun around or there isn’t, and if there is, to quote Walter Mosley,“it will go off, sooner or later.”

              This research resulted in the elimination of gun-research funds from the CDC budget, with Gun-nut Nation convincing a majority of Congress from the dumb states that this kind of research was being conducted not for science, but for partisan (read: liberal) political ends.

              Now that the House has flipped blue, Gun-control Nation and their medical, public-health allies are beating the drums for a resumption of CDC-funded research. Of course when and if such legislation comes up for a vote, you can bet the other side will argue that studies showing that guns are a risk to health are nothing more than politically-motivated research. The funny thing is, however, that public health research done since CDC funding ended is not only political in terms of topics and goals, but happens to be research that protects the ownership of guns.

              Huh? Am I saying that noted scholars like the folks at Harvard and Hopkins want to keep America awash in guns?  That’s exactly what I’m saying, and if my friends at the NRA home office in Fairfax would come back to their senses, they’ll realize that the best friend they have is a former New York City mayor whom Gun-nut Nation believes to be the devil incarnate when it comes to guns. Before you think that I’ve lost my sense, please read on.

              Here’s the policy statement from the Everytown website: “Support for the Second Amendment goes hand-in-hand with keeping guns away from criminals and other dangerous people.” As if the 2nd Amendment says anything about whether Americans have the ‘right’ to own a small, concealable handgun which holds 18 rounds of military-grade ammunition and happened to be the gun used by Seung-Hui Cho to kill 33 people on the Virginia Tech campus in 2007.

              The reason we are the only advanced country which suffers from gun violence is not because we only do background checks at the initial point of sale; it’s not because we have 350 million guns floating around; it’s not because we don’t have PTP licensing; it’s not for any of the reasons that my friends in public health research have decided requires yet another study to figure out how to reduce violence caused by guns.

              The reason is because we let the gun industry determine which guns are safe enough to be sold, while the regulators try to figure out ways to keep the most lethal consumer products imaginable out of the ‘wrong hands.’ And this naïve and foolish view, which pervades virtually every aspect of gun research, flows over into the medical community as well. Doctors are advised to show more ‘respect’ for gun culture, counseling their patients not to get rid of their guns, but to store them in a safe way. Note that the studies by Kellerman and Rivara don’t distinguish between stored and unstored guns.

              I would like to end this column on a hopeful note. I am not trying in any way to denigrate the work of my many public health friends who conduct research on gun injuries and, it goes without saying, would like to see such injuries eliminated or at least reduced. But as long as this research community continues to avoid figuring out why some people deal with their fears by buying guns, telling these folks that guns represent a ‘risk’ is to tell them nothing at all. Either we get rid of the guns that are responsible for gun violence or we don’t. And until/unless  we get rid of those kinds of guns, there will be plenty of gun violence to serve as topics for gun research.   

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Is Gun Violence A Medical Event? Not If You Agree With The NRA.

I’m not exactly sure why The Washington Post would run a big story today on the government’s continued failure to fund gun research through the CDC, considering that when it comes to health matters the new Congress has much more important things to do like getting rid of the ACA. Nevertheless, the story does make the point that gun violence is the least-researched of all major causes of death, and had it received research funding commensurate with the number of gun deaths each year, the total research dollars that might have been spent over the last decade would be $1.4 billion or more.

urban              The Post’s story is hardly the first time that the funding deficit for gun research has been mentioned and it won’t be the last. This story was prompted by a brief JAMA article in which two researchers calculated a predictive figure for gun violence research (the $1.4 billion quoted above) and compared it to research funding for other leading causes of mortality and, no surprise, the gun violence funding lagged far behind.

The number of gun deaths and the whole notion of gun violence has been attacked by Gun-nut Nation in two different ways.  First they argue that the number is wholly out of wack because two-thirds of gun mortality consists of suicides and this behavior is prompted by mental illness, it has nothing to do with guns at all.  Let’s end that one right now: the World Health Organization defines ‘violence’ as an attempt to injure yourself or someone else.  Get it? If you don’t get it, you can stop reading right now.

The other argument that gun-nut Nation uses to disparage the idea that gun violence should be studied as a medical problem is the claim that over the last several decades, coincident with the same time-period during which the Dickey Amendment prohibited gun research, in fact mortality from guns has been going down.  The total number of gun deaths today, including suicides, is roughly half what it was in 1994.  So why spend taxpayer money on researching something which seems to be solving itself?

The fact is (there’s that messy word again) that total gun deaths are about half of what they were twenty years ago, except that 95% of that decrease occurred between 1994 and 1999.  Since 2000 the annual number of gun deaths has stayed more or less the same, and if current numbers can be trusted, gun deaths have started climbing again.  Will the numbers climb back up to levels recorded in the mid-90’s?  God only hopes not, but to say that gun violence continues to go down is simply a big, fat lie.

But there’s one more aspect of gun violence which the authors of the JAMA article didn’t take into account, and they didn’t deal with it because they are physicians which means that every injury is a medical event that must be treated as a risk to health. Except that at least one-third of all fatal gun injuries, and this holds true for no other type of injury that causes death, also happen to be criminal events. And it is the criminal nature of more than 11,000 gun homicides and 65,000+ gun assaults each year which helps Gun-nut Nation support the idea that gun violence shouldn’t be the subject of medical research at all.

Because, so the theory goes, if someone picks up a gun and intends to use it to harm someone else, then that someone has made a conscious decision to commit a criminal act. And we don’t need no stinkin’ research to figure out what to do with all those gang-bangers in the ‘hood.  Just lock ‘em up, throw away the key and that’s the end of that.

Now for those of us who understand that crime is a complicated, multifactorial  phenomenon that can’t simply be reduced to a quick and easy solution, that’s fine.  But a lot of people out there would disagree.  And many of those folks own guns and support the NRA.