Do We Suffer From Gun Violence Or From Violence Itself?

If there is one argument which has carried gun violence prevention (GVP) efforts forward over the last twenty years, it is the idea that the USA is not necessarily more violent than other advanced countries, but that our violence results in a much higher mortality rate because of our access to guns.  The connection between guns and mortality rates was first noticed by Frank Zimring back in the 1970’s, it was validated by our friend David Hemenway in 2004, findings which Hemenway updated in an extensive article published last year.

 

hemenway

David Hemenway

Updating the data, Hemenway and the co-author Erin Grinshteyn concluded that, “Violent death is a serious problem in the United States.” Why? Because of our “enormous firearm problem compared with other high-income countries, with higher rates of homicide and firearm-related suicide.” And these conclusions continue to find their way into the literature, the public-policy strategies and the fundraising campaigns of every GVP organizations, all of whom shape their messaging based on gun-violence research by scholars in public health.

There’s only one little problem, however, and the problem arises from something known as the ‘substitution effect.’ What this means in plain English is that comparing outcomes from different types of violent behavior forces us to assume that if the way in which the violence was committed was the same, the outcomes would be similar as well.  For example, the latest research on guns and suicide states that access to guns increases the suicide rate. Therefore, if 1 out of 10 people who used guns to commit suicides had chosen instead to end their lives by cutting themselves or taking pills, there would have been 1,900 less suicide deaths. But what if suicidal individuals chose hanging or asphyxiation (where successful suicides run above 60%) instead of slashing themselves or swallowing medicines, the latter behaviors being much more a symptom of distress than a determined suicide attempt? Since we cannot answer such a question with any degree of certainty, how can we figure out the real effect on suicide rates if there were no access to guns? In fact, the number of non-firearm suicides in both gun-rich and gun-poor states is exactly the same.

The issue of substituting gun violence for overall violence becomes even more problematic when we consider homicides with or without the use of guns.  Grinshteyn and Hemenway find that the US gun-homicide rate is 3.6 compared to Germany, Hungary and Spain at 0.1, Australia, Austria, France and Netherlands at 0.2 (comparing to the lowest nation-states in the OECD.) But the disparity between the United States and these other countries for non-gun homicides is substantial as well.  The United States rate is 1.7, the average for the former group of OECD countries being 0.8, for the latter being 0.6.  In other words, even without using guns, Americans tend to murder each other at a rate which is two to three times higher than what occurs throughout the OECD.

Would the murder differential between the United States and other Western countries disappear if Americans couldn’t get their hands on guns? To the contrary, the differential would probably be greater precisely because of the ‘substitution effect;’ namely, Americans who tried killing other Americans would find a way to accomplish this act without using guns.

I am not trying to ignore the degree to which open access to guns, particularly handguns, creates issues of public safety and public health in the United States which do not exist in any other country within the OECD. Nor am I trying to dismiss or denigrate the efforts of the GVP community to focus public attention and promote sound public policies that would reduce every category of gun injuries, fatal or not. What concerns me are scholarly attempts to understand our elevated rates of gun violence while ignoring our elevated rate of violence with or without the use of guns. To end on a rather hackneyed note: are gun-violence researchers looking at the forest or the trees?

Advertisements

Do Strategies For Reducing Gun Violence Really Work?

One of the enduring myths in the gun world is the idea that injuries occur when guns are used either by people whose behavior indicates they shouldn’t have access to guns or by people who use guns in unsafe ways. And what these two myths have spawned over the last twenty years is an approach to reducing gun violence which I don’t believe really works.  These two gun violence prevention (GVP) strategies, which have been supported by the work of public health research, can be summarized as the ‘wrong hands’ strategy for intentional gun injuries and the ‘safe guns’ strategy for accidents caused by guns.

gun control             More than 100,000 fatal and non-fatal intentional injuries each year are caused, so it is said, by guns falling into the ‘wrong hands.’ This is certainly true for 20,000+ gun suicides, which in this case the wrong hands belong to people who are under mental stress. It is also claimed to be true for people who commit 11,000+ gun homicides, because their legal/personal/family histories contain red flags for violent behavior so they shouldn’t be able to get their hands on guns. And as for the guys who commit 65,000+ aggravated gun assaults each year, they are no different from the gun murderers, except they didn’t shoot straight. What’s the best way to keep guns out of the ‘wrong hands?’ Make it more difficult for such folks to get access to guns through more background checks and better monitoring by mental health.

When it comes to 15,000+ fatal and non-fatal unintentional injuries, the problem here is not caused by ‘wrong hands,’ but by ‘right hands’ who don’t know how to safely use their guns. So what we need to do here is teach these right-handed people how to use guns in safe ways, remind them to always lock up their guns and maybe at some time in the distant future (don’t hold your collective breaths) we will have guns which won’t be able to be used at all until the rightful owner puts on some kind of bracelet which sends a radio signal to the gun and you can fill in the rest of this dream.

I’m going to say something which I hope won’t be taken the wrong way, because when it comes to reducing violence, the fact that a particular strategy or program hasn’t worked as well as we would like it to work doesn’t mean it shouldn’t be followed at all. I’m not here to advocate throwing out the baby with the bath water; I just think that GVP needs to be more realistic as we move ahead.

The reason the ‘wrong hands’ and ‘safe gun’ strategies haven’t yet gotten us where we want to go is because they are built on assumptions and experiences involving safety measures for other consumer products which in the case of guns simply do not ring true. Want to reduce injuries from car accidents? Design a safer car, mandate seat belts, get tough on DUI, we all know the drill. Want to prevent people from cracking their heads open when they fall off a bike? Require helmets, that’s all you need to do.

Those public health success stories are all fine and well but they shouldn’t serve as templates for reducing gun violence for the simple reason that autos and bicycles were designed for the purpose of moving us from here to there. On the other hand, guns are designed to do one thing and one thing only, and that is to cause an injury when someone points a gun at themselves or someone else and the gun goes – bam!

Until and unless we figure out how to make it more difficult for anyone to pick up something as lethal as a gun, to quote the great writer Walter Mosley, ‘walk around with a gun and it will go off, sooner or later.’ And when the gun goes off, no amount of research on the causes of gun violence will keep someone from getting hurt.

Despite What Some People Believe, We Need More Gun Buybacks, Not Less.

Last week my eye caught an interesting gun article in The New York Times, and it’s not like I often read articles in the NYT that are interesting (or correct, for that matter.) But this was an article about two young men who put together a very successful gun buyback in Los Angeles that collected more than 770 weapons in a one-day program last May, and have taken more than 1,100 guns out of circulation since 2013.

confiscated             The two guys behind this initiative have put together an organization, Gun By Gun, which has been operating on the West Coast but with proper care and feeding could obviously become a national thing. The whole deal is funded through crowd-sourced donations which, according to the NYT article, have collected more than $100,000. But what I really found interesting about this effort was not the amount of money donated or the number of guns taken off the streets, but rather the fact that folks who give in their guns get a Target gift card as their reward.  I’ll come back to the significance of that fact in a bit.

But meanwhile I first have to spend a bit of time discussing the manner in which our dear public health friends have viewed the question of gun buybacks, because the truth is that the narrative they have developed about buybacks misses the basic point of such programs, which means that public health gun violence researchers simply get it wrong.

Over the years there have been a number of gun buyback programs whose results have been analyzed by some of our leading public health gun researchers, including Frederick Rivara and Garen Wintemute, along with a summary published by the National Academies in 2004. These articles basically say the same thing, namely, that gun buybacks are ineffective because people turn in old or broken guns whereas the guns which are used in felonies remain in the street. And of course it’s impossible to prove any direct connection between the number of guns which are turned in and whether or not this has any effect on crime, and if you can’t make some kind of connection or what public health loves to call ‘association’ between two sets of facts, then you can’t assume that anything has happened at all.

I would never challenge my friends in the public health community when it comes to understanding or using data about guns or gun violence and I would certainly never even hint at the idea that public health research on gun violence shouldn’t be continued and, if anything, increased in scope and size. But by casting the academic discussion about the value of gun buyback programs in terms of being able to measure results, and public health researchers simply can’t detach themselves from their never-ending commitment to measuring whatever they look at, the discussion about the importance and value of buybacks is pushed in the wrong direction and is simply never discussed or understood.

The real value of gun buybacks, the reason that such programs need to be expanded into every community which suffers from any degree of gun violence, is that when a buyback program occurs, it gets everyone in the community thinking about guns. And the thoughts have nothing to do with whether guns are a good thing to have around, the thoughts are about the importance and necessity of getting rid of guns.

Gun-nut Nation has done a very effective job of convincing lots of Americans that they would be safer if their home contained a gun. They have done such a good job that they are maybe less than 2 Senate votes away from a new law that would allow everyone to wander throughout the entire United States carrying a gun.

A buyback program is the most effective way of telling a community that guns won’t make them safer and that guns should be turned in. If my friends in the public health community have come up with a better messaging about gun violence, please share it with me.

 

Thank you Margaret Ayres.

Want To Reduce Gun Violence? Try The New Haven Approach.

When we think of gun violence, we usually think about big, urban centers like Chicago, Baltimore or St. Louis which have large, inner-city neighborhoods and, unfortunately, lots of violent crime. But it often turns out that gun violence is all too common in smaller cities, for example last week five people were gunned down in Chester, PA, a little burb of Phillly with a population of 34,000, the town leading the United States with an average of 53 gun homicides per 100,000 every year for the last fifteen years.

NNSC             Even though it’s the location of Yale University, the city of New Haven used to be right up there with places like Chester when it comes to residents getting shot.  In 2011 there were 34 homicides, which gave the city a per-100K homicide rate of 27.2, while the statewide rate that same year was 4.06.  In fact, in 2011, with three percent of the state’s total population, New Haven accounted for 25% of the people who were feloniously killed in that one year. That’s serious sh*t.

Know what the New Haven numbers looked like in 2016?  Homicides were down to 13, non-fatal shooting victims dropped from 133 to 67, and the number of gunshots that were picked up by the city’s ShotSpotter system went from 426 to 160.  To quote Mayor Toni Harp, New Haven has become a “healthier, safer city.”  That’s for sure.

If a city like New Haven, with a family media income that is 30% below the national average and with one-quarter of the residents living below the poverty line, can get it together and reduce gun violence to such a remarkable degree, we need to figure out what they are doing because it might serve as a template for other communities who would like to healthy and safe because gun violence goes away.

New Haven’s effort is based on a state initiative called Project Longevity, which brings together all the major institutional and community stakeholders to confront the perpetrators of gun violence through a combination of social service outreach, law enforcement attention and the application of both positive and negative incentives to the at-risk population on an ongoing basis.  Those individuals in the neighborhood who otherwise might commit gun violence but ask for assistance are given job, housing and education assistance; those who spurn such help and continue to commit violence are identified by the police and taken off the streets.

The New Haven project is the brainchild of David Kennedy, who ran his first police-community anti-violence program in Boston in the 1990’s and has taken this approach to cities in 31 states under the aegis of the National Network for Safe Communities (NNSC,) which operates out of John Jay College of The City University of New York. The Network’s informational guide should be required reading for everyone in the GVP community, and you can download it here. 

What runs through NNSC philosophy and practice is the idea that law enforcement is not just a tool for maintaining law and order by arresting and locking up the bad guys, it’s also a community-service organization where the cops spend as much or more time assisting and positively interacting with community residents as they spend chasing criminals. As the attitude of fear and suspicion between cops and community is replaced by an attitude of respect and trust on both sides, keeping the neighborhood safe becomes an effective basis for building a viable police-civilian partnership which drives down all crime.

Our friend Frank Zimring talks about the degree to which police shootings in the inner-city contribute to a general sense of violence that makes the presence and use of guns part and parcel of ghetto life. After all, if the cops can shoot willy-nilly at everyone, why can’t civilians do the same? But the decision by New Haven police to only use lethal force in the most extreme circumstances seems to have resulted in the decline of gun violence within the city as a whole. Could this be a template for reducing gun violence nationwide?

 

What To Talk About Gun Violence? Facts Aren’t Enough.

When all is really said and done, there’s one basic point of disagreement between Gun-sense Nation on the one hand, and Gun-nut Nation on the other. And the difference goes like this: Gun-sense Nation believes that 120,000+ or more gun deaths and gun injuries each year is a public health crisis which needs to be addressed the way we deal with all threats to public health, namely, through a combination of research, education, and enforced legislation. Gun-nut Nation, on the other hand, does not believe that guns cause any kind of threat to public health; to the contrary, legal gun ownership protects the public from threats to its welfare both from within the country and without.

area51           I think that the gun violence prevention (GVP) community needs to stop worrying about what the other side says or what the other side thinks. To be honest, I’m not sure that anyone who truly believes that the 2nd Amendment keeps us ‘free’ or protects us from an invasion by ISIS has actually thought about the issue at all. And let’s not forget that we now have a real bully in the bully pulpit who appears to share Gun-nut Nation’s point of view. Nevertheless, the folks who want to do something about gun violence still need to figure out what to do.

Or more specifically, what to say.  Because the argument between the two sides resembles a similar argument that made a brief appearance during the 2016 Republican primary campaign, when Ben Carson, a pediatric neurosurgeon, made a remarkable statement during the 2nd debate when he said there were many vaccines that aren’t really necessary, a claim that medical science has long ago decided is simply not true.

Carson was responding to a slimy attempt by Trump-o to thrill his supporters with yet another conspiracy theory, in this case the idea that childhood vaccines lead to autism, a loony and completely disproven idea that’s been floating around on the fringes of the mentally-challenged population for years. Unfortunately, what’s scientific fact to one person may be fiction to someone else, and if you don’t believe me, just spend some time perusing websites which claim that global warming is a complete and total hoax.

In essence, the GVP community faces the same issue every time they talk about gun violence as a public health problem, because they run smack up against a response from Gun-nut Nation which has nothing to do with science, or research, or facts at all.  How many peer-reviewed articles have appeared in scientific/medical journals over the last 50 years which provide substantive data showing that access to guns increases the risk of getting shot or shooting yourself with a gun?  Probably somewhere around 1,000 articles, give or take a few. How many articles have appeared in scientific/medical journals over the same time period which provide data supporting the idea that access to guns protects us from harm?  None.  That’s another way of saying ‘zero,’ in case you didn’t know.

So when it comes to figuring out whether guns are a good thing or a bad thing, or what I call the ‘social utility’ of guns, the scientific evidence goes in only one direction, the research uniformly says one thing: i.e., the social costs of free access to firearms outweighs the social benefits – period, done

There’s only one little problem.  The people who promote free access to guns, who want everyone to walk around with a gun could care less about what the scientific evidence shows.  And didn’t they just help elect a President who could also care less about the difference between fiction and fact? So Gun-sense Nation better figure out some messaging which can respond to how Gun-nut Nation feels about their guns. Because talking about gun violence by citing this or that scientific study works fine when you’re talking to someone who believes in science and facts.  But what happens when you find yourself in a discussion about gun violence with someone who believes that Martins really did land in Area 51?

 

 

 

 

If The Facts Don’t Support Gun-nut Nation, Why Bother With Facts?

Now that we have a President-elect who has made a virtue out of not even trying to distinguish between fact and fiction in debates about public policy, we will begin to see this confusion appear in public policy discussions about guns.  Actually, it’s not a confusion at all; rather, the door is now open for Gun-nut Nation to say anything they want to say about guns because as long as they say it, then it must be true. And if the other side says it, since they lost on November 8th, it’s false.

ccw           How long did it take for this new approach to appear?  Exactly one week following the election, with an article in National Review. The author, Andrew Branca, a self-described expert on self-defense, floats around the alt-right radio world and also teaches self-defense ‘law’ on a website which, of course, contains the usual disclaimer that none of the content ‘accurately communicates laws or court decisions,’ too bad these classes can’t be listed any longer on the Trump University curriculum.

The subject of the NR critique is an article which just appeared in a leading medical journal, JAMA – Internal Medicine, which finds a clear connection between the ‘Stand Your Ground’ law in Florida and an increase in homicide in the Gunshine State. The article looked at homicide rates and gun-homicide rates between 1999 and 2014, and found a significant increase in both trends after the SYG law was passed in 2005. This increase was particularly evident for age groups 20-35 and for males, which happen to be the two most common demographic categories for gun violence overall.

This is not the first study which links SYG laws to increases in gun violence and violence in general.  The Everytown research group found that after the law was passed, the justifiable homicide rate tripled, with most of the victims, not surprisingly, being young, Black men.  A detailed study based on Texas data showed that such laws did not deter crimes like assault, robbery or burglary, but did lead to an increase in murder and manslaughter. In other words, if you walk around armed and are not required to first back down when facing what you believe to be a criminal threat, you might end up shooting someone but you won’t be protecting yourself or your community from crime.

Which is exactly the opposite of what Gun-nut Nation claims is the reason for walking around with a gun. And you can be sure that you’ll hear this nonsense again and again next year when the NRA leads the charge to get a national, concealed-carry law on the Chief Executive’s desk. Which brings us back to Branca’s critique of the JAMA new study on the effects of the Florida STG laws; a critique based on a misuse of data that reaches colossal terms.

Branca states that the SYG study is ‘fatally flawed’ because it does not distinguish between murder on the one hand and homicide on the other and, in many cases, murder turns out to be a reasonable response by a victim to a violent crime.  And since the whole point of STG laws is to give a crime victim an opportunity to defend himself before or during the commission of a crime, of course the number of people killed would go up as all these gun-toting community defenders use their guns to protect themselves and everyone else.

.  In Florida, the average annual homicide rate increased from 600 to 840 after STG was passed. Meanwhile, according to the FBI, the number of justifiable homicides recorded throughout the entire United States averaged roughly 280 per year for the years covered by the JAMA report  Should we assume, therefore, that every, single act of justifiable homicide occurred only in the Gunshine State? And that’s the level of stupidity masquerading as informed opinion that we will now face when it comes to the public debate about guns.

Mike The Gun Guy’s Greatest Hits: Five Must-Read Articles On Gun Violence

From time to time I think it’s important to alert Gun-sense Nation to publications that confirm one way or another what we all know, namely, that guns are responsible for the deaths and injuries of more than 100,000 Americans every year.  And while most of us consider gun violence to be both abhorrent and inexcusable, from time to time we encounter folks who don’t share that point of view.  And I’m not talking about card-carrying members of Gun-nut Nation who are today celebrating a jury’s decision to acquit the jerks who spent a week last year eating pizza up at the Malheur National Forest Range – I’m talking about a friend, a neighbor or a co-worker- someone who might profit from a serious discussion about gun violence prevention backed up with reference to research whose findings are incontestably true.
gvp2           So what follows is Mike the Gun Guy’s ‘greatest hits,’ i.e., what I think are recent studies on different aspects of gun violence that can and should be used to bolster the gun violence prevention point of view.  Because let’s not forget that Gun-nut Nation relies on a powerful network of pro-gun promoters who never miss an opportunity to broadcast the idea that guns in the home, on campus, in front of polling places and God knows everywhere else are the only things we can rely on to keep us protected and safe.  Think I’m indulging in a bit of hyperbole?  Take a listen to Wayne-o’s latest rant. Want to have information at your fingertips that can be used to deliver a more reasonable (and rational) point of view?  Here’s the list and you can download them all right here:

—–  Center for American Progress, America Under Fire.  This study matches gun violence data with the degree to which each state experiences gun violence and demonstrates that as gun regulations increase, gun violence goes down.  Gee, what a surprise. But what got this report on my ‘greatest hits’ list was a new approach to the definition of gun violence which aggregates ten different categories of gun violence so that different patterns can be seen in different states. DOWNLOAD

—– Azrael and Miller, “Reducing Suicide Without Affecting Underlying Mental Health.” An authoritative study on the links between suicide and access to lethal means which shows that restricting access to firearms can reduce suicide rates in countries which have free access to guns (read: the USA.) DOWNLOAD

——  Webster, et. al., “Firearms on College Campuses.” This recent study is actually more than what the title suggests, because the authors go after bigger game, namely, the whole question of gun-free zones.  And what they argue and prove is that gun-free zones do not attract shooters, nor are gun-carrying civilians a deterrent to gun-violence events.  DOWNLOAD

——  Hemenway and Solnick, “The epidemiology of self-defense gun use.”  The notion that guns protect us from crime is a centerpiece of Gun-nut Nation’s continuing effort to make Americans believe that it should be normal, natural and indispensable for everyone to walk around with a gun.  This article demolishes that argument – period. DOWNLOAD

——  Lester Adelson, “The gun and the sanctity of human life.” Why would I include an article published in 1980 in a list of recently-published works on gun violence?  Because this is the best, most prescient and profoundly scholarly article ever published on gun violence and if you don’t read it, sorry, but your understanding of gun violence is sadly incomplete. DOWNLOAD

One caveat about my list.  There are many other articles and contributions which I could mention so if you happen to be a gun-violence researcher please don’t feel offended if your article doesn’t appear here.  We all need to educate ourselves on a continuing basis, and I am always willing to alert my readers to any and all research which deserves to see the brightest light of day.  And while you are reading any or all of these articles, don’t forget something you must do on or before November 8th.