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?

Advertisements

GVPedia – Good To Go!

Every once in a while, someone comes along with a really bright idea for doing something positive or useful about reducing gun violence. Not that joining an advocacy group or sending an email to your local Congressman isn’t a positive idea, but it’s not very new. On the other hand, there’s a young man sitting, of all places in Oklahoma, who has done something positive and new to reduce gun violence, which is funny given the Oklahoma is probably the most gun-rich state of all.

GVPedia             I’m talking about Devin Hughes and a new website, GVPedia, which had a soft launch last month and now is good to go. The site is basically a reference library containing publications which inform about gun violence, and to his credit, the collection of more than 700 articles includes work on both sides of the gun debate – I suspect this is the only online venue which allows a visitor to access articles written by David Hemenway and John Lott. But if you want to create a credible knowledge source about any topic, then you need to include all points of view.

The website bibliography can be searched either by topic or the usual a to z. There is also a small but growing collection of ‘white papers’ designed to give members of the gun violence prevention (GVP) community some basic information and talking-points if/when they find themselves in a public or private discussion about guns. I understand that plans are afoot to make the site more dynamic, including sponsoring gun-violence research, developing infographics that could be used for online debates – all of these activities and others being directed by Jen Pauliukonis, whose GVP creds are far beyond reproach.

So that’s the good news, and I want to congratulate Devin, his Board members and his major financial supporter (who wishes to remain anonymous but it’s not Mayor Mike) for moving this whole effort forward and getting it online. But that was the easy part, now the heavy lifting begins.

First and foremost (and I’m sure Devin and his crew have been talking about this but it needs to be said publicly nonetheless) even though GVPedia is unique to the discussion about guns, this uniqueness in and of itself doesn’t mean that the site and its associated activities will necessarily get the exposure or public presence which it deserves and needs. As much as I believe that the 1st Amendment should apply to what appears on the web, I find sometimes myself thinking that maybe getting rid of net neutrality isn’t such a bad idea. Because if nothing else, eliminating open access might (but might not) tend to curb some of the excessive digital content which continues to grow every day. I put up my first website, believe it or not, in 1995. And it was easy to build an audience because where else were the early internet surfers going to go?

I have an idea for getting GVPedia noticed, however, by a very wide audience, an idea which may or may not align with the strategies of the website’s managers, but perhaps should be taken into account.  I would run some notices on websites, blogs and Facebook pages not just favored by the GVP, but used by Gun-nut Nation to communicate amongst themselves.  For example, I belong to a bunch of private Facebook groups which promote guns; one of them is devoted to building your own AR-15 and more than 75,000 people have joined. One of the Glock private groups on Facebook enlists more than 30,000 followers – such numbers aren’t unusual on many of the better-known gun blogs.

Donald Trump started a ‘university’ so that he could peddle some drek. By opening GVPedia to researchers from both sides of the gun debate, Devin and his crew have made it very clear that the ultimate value of this effort rests on a search for truth. So why not invite everyone to join the search?

And by the way, GVPedia is a 501(c)(3). Send them a few bucks.

Do You Know How To Use A Gun To Protect Yourself From Crime?

Even though I write for Huffington Post, I have to admit that The Guardian frequently carries writing about guns and gun violence which should be read.  In fact, for several years they ran a superb open-source compilation about police use of lethal force, which my friend Frank Zimring used for a very important book on cops and shootings which also should be read.

ccw             Now The Guardian has announced a new effort, Break the Cycle, a series designed “to change the way the media covers American gun violence – and to challenge the orthodoxy that gun reform is a hopeless pursuit.” To that end, the very first story covers what The Guardian calls “ten recent victories in gun violence prevention,” most of which are of too recent vintage to determine whether these new initiatives will make a difference or not. But even if the jury is still out on whether or not such programs and laws will reduce the violence suffered from guns, at least the fear that all gun-control activity will wither and die during the Age of Trump appears to be misplaced.

I’m beginning to consider the possibility, in fact, that the defeat of Hillary, who based much of her campaign narrative on gun-control themes, may actually turn out to be a more positive event for the gun violence prevention (GVP) movement than if she had won.  Her victories in the several swing states she needed to grab the necessary 270 electoral votes would not have turned the Congress from red to blue, and facing the same hostile Congressional lineup that blocked Obama after his first two years would probably would have doomed any substantial gun legislation from moving ahead. On the other hand, one can argue that absent a Republican in the Oval Office that some of the crazy, pro-gun bills like national concealed-carry, would also never see the light of day.

But sometimes adversity becomes the incubator for new and compelling ideas, and the policy brief issued this morning by The Johns Hopkins Center for Gun Policy and Research represents just such an effort to focus our attention on work which needs to be done. The report, Concealed Carry of Firearms; Facts Versus Fiction, covers the arguments used to justify national concealed-carry (CCW) reciprocity, and then gives a balanced and evidence-based analysis of each. The text begins with a summary of CCW laws currently in force throughout the 50 states: no CCW licensing requirements in 12 states, and a CCW license must be automatically granted in 30 other states if one meets the legal requirements for simply owning a gun. In 1986 there were 9 states that did not impose any CCW requirements if one passed a background check – now that number has climbed to 42.

I wouldn’t be so adamantly opposed to national CCW were it not for the fact that what this means is the current issuance of CCW in many states without any kind of training at all will now become an accepted norm in every state. Not that jurisdictions which require a pre-licensing gun course impose anything except the most slipshod and useless qualification process, and once you demonstrate that you actually know the difference between the stock and the barrel you never have to certify your ability again.

I’m not surprised when folks tell me that a gun will make protect them from crime, even if evidence-based research indicates otherwise. After all, emotions usually trump facts, even when we think we are using valid evidence to figure something out. But the continued drumbeat by Gun-nut Nation and the NRA to make people believe that using a gun for personal defense without continuous, qualification-based and mandated (i.e., required) training is just another attempt to appeal to the lowest mental denominator when it comes to talking about guns. The organization which was founded as a training organization in 1871 should be at the forefront of an effort to tell everyone how useless this national CCW legislation will be.

              I thank the Bloomberg gun-grabbers for this fine report.

 

 

Is The Narrative on Gun Violence All It Should Be?

Our friends at Media Matters have just posted a new report on gun violence prepared and published by a California gun violence prevention (GVP) group, the Hope and Heal Fund, which looks at how the media has and hasn’t covered gun violence issues. The report, which can be downloaded here, looked at 218 newspaper articles and thousands of tweets in 2016-2017 in an attempt to develop a baseline understanding of the gun violence narrative in California, as well as making some suggestions about how the narrative might be changed.

hope-and-heal_LOGO              The researchers found that gun policies were the dominant conversation in print and social media, accounting for 40% of the total narrative, with mass shootings provoking another 15%, crime and policing covering 15% more. In other words, nearly three-quarters of the entire public discussion about gun violence in California focused on issues other than the issue which accounts for just about all gun violence, namely, the individual gun shootings – suicide, street gangs, domestic disputes – which account for nearly all intentional gun injuries both in California and everywhere else.

As to what the report calls the ‘messengers’ who were quoted on gun violence, again the data was skewed in favor of public policies because 40% of the people who had something to say about the issue were identified as politicians, whereas researchers, advocacy groups and victims each constituted 9 percent. Taken together, these three groups would constitute in broad terms the California GVP community, and what’s interesting is that as one group, the number of times they delivered a message about gun violence was more than twice as frequent as what the researchers identified as the ‘gun lobby,’ whose total participation in the public media discussion was 12 percent.

Maybe because it’s California and not Texas or some other gun-hugging state, I am nevertheless surprised that the gun-control contributions to the media coverage of gun violence is so much greater than what Gun-nut Nation was able to produce. You would think that given the fact that there have been major changes in California gun laws over the last several years, as well as highly-publicized gun ‘rights’ legal cases such as Peruta v. California, that the NRA and other pro-gun organizations would have been all over the social media world blasting about this gun issue or that. But this report tells a much different story about the relative strength of the two sides, at least in the Golden State.

Now we come to the part of the report which gives me some concern.  “Based on our findings,” says the Report’s conclusion, “we have developed the following recommendations for Hope and Heal Fund’s efforts to change the narrative on gun violence in California.” The recommendations involve: more attention to suicide, domestic violence and gangs; reminding people that much policy work remains to be done; highlight the words and deeds of community leaders; look to the public health area for more research; highlight personal stories about victims; and, “depoliticize gun violence by appealing to common values. Sidestep political opposition by crafting messages that emphasize universal values like safety, opportunity and freedom from fear.”

Sidestep political opposition? Who’s kidding whom?  The California gun-rights gang just got the Los Angeles City Council to end a ban on sale of ultra-concealable handguns (guns less than 6.75 inches long) although it’s not clear how many of the really little guns would meet compliance standards of the state law. But if anyone believes that people who are buying guns because they are afraid of crime or terrorists or whatever are going to be persuaded that there are other ways they can legally protect themselves, perhaps you could enlighten me as to what these non-gun options might be.

I’m not against any of the proposals for strengthening the gun-control narrative but I think there’s one proposal which the writers of this report appeared to have missed, namely, just get rid of the guns. Shouldn’t someone be doing some social media messaging on that?

 

What Kind Of Training Do Gun Owners Receive? None At All.

I have decided that it’s time for Mike the Gun Guy to become a little less polite (imagine – Mike the Gun Guy ‘less’ polite) and start responding to some of the things that are said on the gun violence prevention (GVP) side which I feel hold us back, rather than help us to move ahead. This decision should not be taken in any way, shape or form as a criticism or even a concern about the importance and necessity of GVP. To the contrary, as a fundamental issue with which all Americans to be engaged, in the Age of Trump GVP tops the list.

training             Last week a group of public health gun researchers published the results of a national survey which found that 4 out of 10 Americans who are legally allowed to walk around with a gun (CCW) have not received any gun training at all. And the results of this survey are not much different from similar surveys published in 1994, except that the number of CCW-holders has probably doubled, if not tripled from that earlier date.

That a majority of people who can legally walk around with a concealed weapon have received some kind of formal gun training is now validated again by the results of this survey, and the narrative will slowly but surely circulate throughout the public domain and in and around the GVP. On the other hand, the fact that four out of ten CCW-holders have not engaged in any formal gun training demonstrates the degree to which “no national standards or requirements for firearm training in the USA exist.” And this lack of consistent standard (or any standard for that matter) regarding how to use a gun is particularly concerning given the expected push by the Republicans who might not get a new healthcare law but just might vote through a national, reciprocal CCW law that their President will surely sign.

There’s only one little problem with this survey and by pro-GVP media efforts to publicize the findings hither and yon, namely, that despite what the researchers believe they were asking respondents to tell them, what in fact they were asking respondents in this survey had nothing to do with training at all. Know where the word ’training’ comes from as it applies to guns? It’s a word first used by the NRA which was actually founded as a ‘training’ organization in 1873. Not only does the NRA continue to promote themselves as America’s premier gun-training organization, but they have launched a new training effort focusing on CCW techniques called Carry Guard, which they refer to as a “first-rate, elite program” aimed (pardon the pun) at people who lead the ‘concealed-carry lifestyle’ and want to be ready for ‘real-life situations you must be prepared to face.’

This isn’t training – it’s a sham. It’s used to entice people to purchase an insurance policy which will allegedly pay all their legal fees after they shoot someone, assuming they don’t get convicted for some kind of felony committed while they were using their gun. Along with this training program, the NRA now offers its standard training programs on video, and these programs are used by most CCW-issuing authorities in states where pre-CCW training is still required. What’s the difference between NRA video training and video games like Call of Duty that you can play on your X-Box?  There is no difference.

I’m an old-fashioned guy so words have meanings, whether we like the meanings or not. I think GVP is making a profound mistake using words whose meaning has been distorted beyond all recognition by the NRA. If GVP is going to convince people that what they say about gun violence is true and what the other side says is false, then the words we use should be our words and not words that are bandied about by the NRA in order to help sell more guns.

And what I just said about GVP applies to public health researchers as well.

A Little Suggestion For Funding Gun Violence Research.

One of Gun-sense Nation’s primary concerns that will now linger in an unfinished state is the question of funding public health research into guns.  The major funding sourceCDC – was shut down in the 1990s, but while private sources stepped in to try and close the gap, much important work remains undone. And analyzing both this unfinished agenda and its implications for gun violence prevention (GVP) advocacy and policy are the subjects of a commentary by Everytown’s innovation director, Ted Alcorn, that recently appeared in a JAMA issue published online.

ph                 Before I go further into Alcorn’s discussion, I need to make my own thoughts and biases about gun-violence research clear.  As someone who holds a Ph.D. in Economic History and published several university monographs on same before getting into writing about guns, I would never, ever suggest or imply that serious research on any topic is anything other than a good thing.  But I am occasionally dismayed by what I perceive to be a desire on the part of gun-violence researchers to present themselves as being ‘neutral’ or ‘unbiased’ when it comes to the reason they study violence caused by guns.  I don’t think that a researcher should feel at all reluctant to state the obvious, which is that without guns there would be no gun violence. And if the political powers-that-be feel that 120,000 gun deaths and injuries each year are a price worth paying for a cynically-invented fiction known as 2nd-Amendment ‘rights,’ there’s no reason why any serious researcher should pay respectful homage to all that Constitutional crap. Because it’s not as if Gun-nut Nation would ever believe that any research into gun violence could be free of bias anyway since they don’t believe there’s really anything called ‘gun violence’ at all.

But let’s get back to what Ted Alcorn has to say.  He and his research group looked at 2,207 scholarly articles published between 1960 and 2014, and discovered that the number of yearly articles doubled between 1984 and 1990, then doubled again between 1990 and 1994-95, then doubled again by the early 2000’s, and then plateaued until they increased again noticeably in 2013-14.  In other words, the volume of gun research as measured by the number of published articles has not specifically increased since the mid-90’s, except for what has recently happened, no doubt due to the fallout from Sandy Hook.

More problematic than the fact that the number of scholarly resources has been essentially unchanged for the last twenty years is that the general interest in gun violence research, as measured by the number of times that scholarly articles are cited, reached a high-watermark in 1988 and then declined more than 60% through 2012.  This corresponds with the fact that the number of active gun-violence researchers also plateaued in the late 1990’s and has not increased ever since.

The problem facing gun research is not the absence of research funding per se.  It’s that the absence of research dollars tends to discourage new researchers from entering the field.  And when all is said and done, advances in science have a funny way of growing because more people not only conduct that research in a particular field, but also share their research, critique each other’s research and, most of all, conduct more research.

I think the idea that manna from heaven will ever again appear for government-sponsored gun violence research is a non-starter at best, a pipe dream at worst.  But I have an idea that I want to run up the flagpole about where to find money for this kind of research.  There’s a little foundation out there which happens to be sitting on $400 million bucks.  They refer to what they do as ‘life-changing work.’ What could be more life-changing than saving the lives of 120,000 Americans each year who are killed and injured by guns? The outfit is run by Donna Shalala who gave out plenty of gun-violence research money when she headed HHS from 1993 to 2001. Shouldn’t Gun-sense Nation give her a call?

Ending Gun Violence Means Understanding Gun Violence And Here’s A Good Start.

So now we have the second report in as many weeks that strongly points to the connection between gun violence and gun laws; i.e., less of the latter produces more of the former.  The first report came from the Center for American Progress (CAP) which found that states with fewer legal restrictions on guns have higher rates of gun violence; now we have another report issued by New York State’s Attorney General, Eric Schneiderman, which shows that states with lax gun regulations also export more crime guns to other states, hence raising gun violence rates in states which often have very strict and comprehensive controls.

gun-violence           So the bottom line is that states that do not view guns as a threat to community safety not only make their own communities less safe but also help to make communities elsewhere dangerous as well.  And if you believe that this is in any way a new discovery, let me take you back the passage of the Federal Firearms Act in 1938.  The FFA38 was actually the second gun bill passed during the presidency of Franklin Roosevelt, the first being the 1934 law that regulated sale and ownership of full-automatic weapons and sawed-off shotguns whose use became the staple of Hollywood gangster movies then and now.

The 1938 law moved the Federal government into gun regulation big-time, because it focused not on the control of these somewhat exotic and relatively unusual (and relatively expensive) machine guns, but established the regulation of standard, run-of-the-mill handguns and long guns which could be found in probably a majority of American homes. Moreover, the basic components of the 1938 law, even though much of it was revised by the Gun Control Act of 1968, created the regulatory environment which exists to the present day. To wit:

After 1938, anyone who wanted to be in the business of selling firearms, as opposed to simply collecting and transferring personal guns, had to acquire and operate the business with a federal firearms license issued by the Treasury Department.  Why the Treasury Department?  Because the license cost one buck, and anyone who paid anything to the U.S. Government paid to the U.S. Treasury.  The law also made it illegal if a felon, fugitive, or anyone ‘convicted of a crime of violence’ received a gun and, most important, required that federally-licensed gun dealers only transfer guns to individuals who were residents of the same state in which the dealer sold guns. The law was later revised to exempt long guns from the in-state purchase requirement (hence Lee Harvey Oswald was able to purchase and directly receive a rifle from a sporting-goods dealer in Chicago) but the requirement that handgun sales be limited to in-state transfers remained law from then until now.

Why has the government always required that handgun ownership be more rigorously regulated than long guns?  Because the basic purpose of federal gun regulations is to “provide support to Federal, State and local law enforcement officials in their fight against crime and violence.” So says the Gun Control Act of 1968, a law which, incidentally, was supported by the NRA.

Note that neither the 1938 gun law nor the law passed thirty years later or, for that matter, the third big law passed in 1994 attempted to regulate guns per se; all three laws were attempts to break the connection between guns, crime and violence by defining which individuals could acquire guns. But none of these laws defined gun violence for what it really is.

Gun violence is a pathogen and most pathogens spread through human contact, which is certainly the case with the pathogen caused by guns.  We still don’t know exactly how, when or why this human contact takes place, but the reports issued by CAP and New York’s AG provide a good start. They also provide valid methodological templates to be used for further research. In sum, these reports deserve to be read, discussed and their value applauded and understood.

 

 

What GVP Needs It May Finally Get: A Government-Funded Research Center Conducting Research On Guns.

I’ve said it before and no doubt I’ll say it many times again: when it comes to something new or different, it usually starts in California and moves East. Ronald Reagan?  Half and Half? Avocado and sprouts on a white meat turkey sandwich? And let’s not forget what Donald Trump would like to forget – taco shells con beans.

It’s worth thinking about this when it comes to considering a new gun bill just voted by the California State Senate, SB1235, which basically requires the same background check process required for gun purchases to be carried out for purchases of handgun ammunition.  The bill has been called the beginning of a ‘GunMegeddon’ by Breitbart and of course has got the NRA all up in arms (please no pun intended.)

         G. Wintemute, M.D.

G. Wintemute, M.D.

But what I didn’t see mentioned by the NRA legislative watchdogs, although some local Gun Nation groups are trying to rally the gun bunch against it, is another bill that came through the Senate Education Committee, SB1006, which establishes a gun violence research center somewhere within the University of California system. The center’s mission would be to conduct research, train researchers, implement ‘innovative’ violence prevention programs and receive both public monies and private funds. In other words, what we have here, for the very first time anywhere, is an attempt to establish the equivalent of Princeton’s Institute for Advanced Study, but with all the study focusing on guns.

Now I’m not saying there is any connection, but there happens to be a researcher at UC-Davis named Garen Wintemute, and this new initiative by the California state government sounds awfully like the gun research program that he funds largely from his own, private stash.  In addition to being one of the country’s principal gun researchers, Wintemute is also an ER doctor, which means unfortunately that when it comes to gun violence, he gets to unite theory with practice, so to speak, because the ER is usually the first choice for anyone who needs medical attention after being wounded by a gun.

The gun research program at UC-Davis, like the gun violence work at Harvard’s Injury Control Research Center and the Center for Gun Policy and Research at Johns Hopkins, limps along on a financial shoestring thanks to the defunding of CDC gun research in 1996.  This year a little federal research money trickled down through the Department of Justice and the usual effort to restore the CDC funding has picked up a little steam.  But don’t hold your breath folks, the NRA-compliant Republicans control Congressional purse strings, so that’s probably the end of that.

The biggest loser due to the lack of research dollars is not the absence of research per se.  Granted, there are huge gaps in what we know about the causes and results of gun violence, but the basic notion that a gun is more harmful than helpful has been driven home time and time again.  The much bigger problem, it seems to me, is that without funding, the field of gun violence research doesn’t attract scholarly attention, which means it doesn’t rank high on any institution’s list of research priorities, which means it doesn’t attract more young students and scholars looking to conduct serious research. When I was a graduate student, my own academic field – origins of early capitalism – had its own research society and held an annual conference that attracted several hundred scholars each year. Think there are more than 30 scholars engaged today in trying to figure out what to do about a problem that kills and wounds more than 100,000 people every year?  Think again.

I would love to see this gun violence research center get established, and if it comes to pass, I hope the center will hold an annual scholarly meeting to help develop and strengthen the field.  I guarantee that I’d show up for such an event and I promise to keep my mouth shut as well. Who knows?  Maybe I could learn something, too.

How Do Teens Get Guns? From Their Parents – Where Else?

This week’s JAMA article on whether and to what degree gun laws impact the carrying of guns by teenagers reflects, to me, both the great strengths and inherent weaknesses of the public health approach to research on gun violence.  This is not to say that public health research in toto should be abandoned or in any way proscribed, although the NRA would no doubt endorse a variation of the anti-lawyer joke, ‘What do we call 10,000 public health researchers buried under water? A good start,’ (there should only be 10,000 public health researchers.)

The strength of public health gun research is that it is grounded in the idea that guns are a risk to health, and if anyone doubts that rather mundane statement, frankly, what follows isn’t for you.  I have written nearly 400 commentaries on my own website and I’m done trying to convince the “other side” that guns create risk.  You don’t believe it, take another puff on your cigarette and go lay brick, okay?

gun crimes                Public health research has informed us about gun risk relative to homicide, suicide, assault and domestic violence.  It has been instrumental in linking gun violence to the absence and/or presence of regulations and laws.  It has also enabled us to better understand how the existence of a massive civilian arsenal affects criminal behavior in this country as opposed to every other industrialized country where unregulated guns do not abound. And I should add that the pro-gun response to public health is so intellectually vapid that I would be insulting gun owners to say that their interests have been supported by anything remotely smacking of serious research.  Noise ain’t research.

The weakness with public health gun research, however, is that it proves nearly impossible to validate its findings through studies that capture before-and-after changes in public policies and laws.  This is because most of the regulatory and legal responses to gun violence over the past twenty years have been changes that eased regulations and restrictions on gun ownership and gun access, rather than making it more difficult for guns to get into the ‘wrong hands.’  To the degree that public health researchers have been able to compare the results of changes in the regulatory environment that promoted safer-gun use, the examples have not been definitive or comprehensive enough to bolster a generic ‘more gun laws equals less gun violence’ argument.

The authors of this current study are aware of these limitations and, in fact, are at pains to assure the readers that their conclusions are, at best, inferential and would need further validation before definitive conclusions could be reached.  Nevertheless, certain important findings stand out, chief among them the correlation between teen-age gun access and the level of gun regulation and per-capita gun ownership in different states.

Teen access to guns is probably, in all its dimensions, the single, most important problem facing the constituencies who want to reduce gun violence.  This is not only because the age cohort 14-19 is where gun violence first becomes a significant behavioral and health issue, but kids who acquire guns in the pre-adult years tend to keep using them as they move into their adult years. If we could do a better job restricting teen access to guns, it would have a significant impact on the overall rate of gun violence.

Buried in the conclusion of this study, however, is a caveat that deserves further comment, namely, the degree to which teen gun access is clearly associated with the number of guns owned by adults.  And the level of gun ownership wouldn’t be an issue per se if it weren’t for the attempts by the NRA to reduce the minimum age for handgun purchase and promoting the idea that guns are ‘cool.’  Most Americans live in states that do not regulate whether parents give their children access to guns. If you’re a gun-owning adult, you wouldn’t let your teen-age children drink and drive, but you’ll let them play around with the guns, right?

A New Collection Of Public Health Gun Research Is A Must Read

The Journal of Preventive Medicine has just published A Special Issue on the Epidemiology and Prevention of Gun Violence, bringing together the foremost group of scholars ever assembled in one publication devoted to understanding gun violence.  If anyone wants to quibble with me over the superlatives of the previous sentence, that’s fine.  The bottom line is that if you want to know what some of the best and brightest in this field have been doing lately, this journal number is a good place to start.

It’s altogether fitting that the collection should be introduced in a guest editorial written by David Hemenway and Daniel Webster, who direct the two most important academic centers devoted to gun violence research from a public health perspective.  Hemenway and Webster can thus take a global view of gun violence research which, unfortunately, doesn’t yield very positive results.  The authors note that public health research is underfunded in medicine, injury prevention is underfunded in public health and gun research is underfunded in injury prevention – a triple whammy, if you will. Between 1991 and 2010, gun injuries were the second leading cause of injury deaths among youths ages 1-17, yet public health/medicine research accounted for less than 1% of all injury research.

conference program pic                This is a rather dismal state of affairs, and while much of the blame can be placed at the doorstep of the NRA, which pressured Congress into ending CDC-sponsored gun research after 1996, we shouldn’t discount other factors contributing to this research void as well.  Chief among the reasons that inhibit public health gun research is the fact that injuries caused by guns are almost always considered major crimes. And while someone who punches someone else has committed an assault, the impact of such an event simply cannot be compared to what happens when someone shoots someone else with a gun.  More often than not, gun violence is viewed as something more fittingly lodged within criminology rather than anything having to do with health.

Which is why I find the linkage of epidemiology to prevention in the title of this collection so exciting and perhaps signaling an important and fruitful change in the direction of gun violence research.  Because epidemiology is the study of the incidence, distribution and control of disease, and if the editors of this collection believe that gun violence is a disease which can be controlled through the application of medical knowledge and techniques, then perhaps we will see an attempt by members of the medical community to reclaim the formative position they held in this field prior to the elimination of CFC-funded gun research.

I am going to leave a discussion about each article in this collection to specific columns to be published over the next few days.  But I do want to briefly mention the editorial which introduces the volume because it’s the work primarily of three scholars from outside the United States.  And while we tend to think of gun violence in America as a particularly American problem studied only by Americans themselves, it’s good to have an international perspective on the issue, in this case submitted by three medical researchers from over our northern border at McGill.  The editorial, An elusive low-hanging fruit for public health: Gun violence prevention, notes that gun violence in America can’t be entirely separated from events throughout the world, in particular the cycle of violence unleashed by the attacks on 9-11.

This is hardly the first time that America’s obsession with guns and its toleration of excessive levels of gun violence have been tied to the continuing warfare and militarization provoked by terrorism both here and abroad.  There’s only one small problem: not true.  There was a spike in gun sales after the Twin Towers came down, but by the time it was noticed it was over.  Gun sales continued at modest levels throughout the eight years of George W. Bush, and zoomed upwards only after a certain Kenyan moved to 1600 Pennsylvania Avenue in 2009.  Want to understand the epidemiology of guns?  The U.S. Army, I’m afraid, won’t get you there.