Do We Need CDC Funding To Understand Gun Violence?

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

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

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

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

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

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

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

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Where Research On Gun Violence Needs To Start.

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

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

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

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

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

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

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

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

 

If Public Health Researchers Want To Reduce Gun Violence, They Need To Figure Out Why It Occurs.

How and why did doctors get into the argument about gun violence?  They got into it because the World Health Organization (WHO) says that violence, defined as hurting oneself or someone else, is a threat to health. And since a health threat can be measured by the number of times that someone is treated at a medical facility for something which, left untreated, could make that person feel unwell, I guess that 125,000+ such treatments each year constitutes a threat to health.

paul             But a threat to someone’s health is not the same thing as a threat to public health. The latter is usually defined as a proactive, medical response that seeks to combine scientific evidence with public policies to protect the entire community from a health threat, be that community a small village, a neighborhood within that village, a group of families within that neighborhood, or maybe the total population of an entire nation-state. In other words, first we figure out why someone gets sick, then we figure out how the illness moves from one person to another, then we figure out what we need to do to confine the illness to as small a number as possible. If people get sick because they all drink water from the same contaminated well – clean up the well. If a deadly virus is transmitted through unprotected sex, educate everyone to engage in protected sex.

Unfortunately, it turns out that many illnesses cannot be eradicated or even controlled just by figuring out how the pathogen moves through the air from Victim A to Victim B. This is because many illnesses are caused not by a virus, but by the way we behave. Drive your car at an unsafe speed and sooner or later you’ll smack into someone else. Plug a home appliance into the wall while you’re taking a bath and – zap! – you’re on the way to the morgue. In 2016, more than 230,000 Americans died because they accidentally injured themselves or someone else; another 32 million needed some degree of medical attention because they were injured but weren’t killed.

Next to those numbers, 35,000 deaths and 90,000+ non-fatal gun injuries doesn’t seem like such a big deal, except for one little difference between how and why gun injuries occur. Because if public health researchers discover that excessive speed causes automotive accidents, we lower the speed limits; if research shows that tobacco causes cancer, we can pass laws which prevent kids from starting to smoke. But how do you make someone use a gun safely when the only reason to use a gun is to inflict injury on yourself or someone else?

Now one can argue that if you injure someone else with a gun in the process of protecting yourself from that person’s attempt to injure you, then the gun has served a positive purpose and that such behavior should not only be respected but encouraged as well. But at least 100,000 gun injuries occur each year because someone consciously used a gun to hurt themselves or someone else without the slightest self-defense rationale at all.

If public health researchers want to bring the number of intentional gun injuries down, they need to figure out why only a small percentage of people who own guns use them in a violent way, and more important, why even most people who engage in violent behavior choose not to use a gun.  Last year physicians treated more than 2 million victims who were injured because someone else wanted to hurt them real bad. But less than 5% of the attackers were armed with guns, and it’s not like the other 95% couldn’t get their hands on one.

Rand Paul is totally wrong when he says that gun injuries aren’t a concern for public health. But his argument will stand until and unless researchers figure out why some people make a deliberate choice to commit an assault with a gun. If a gun is the pathogen which leads to gun violence, why don’t we have 300 million gun injuries every year?

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.

A New Study Says That Gun Control Really Works. It Does?

The GVP community is abuzz with the recent publication of a study that is being advertised as showing that more gun-control laws equals less gun violence.  At least this is the headline in a story about the study published by Vox which states that gun control “actually works.”  Except that’s not exactly what the study says.  The scholars analyzed 130 peer-reviewed articles published between 1950 and 2014, although only 58 articles were utilized to create a scale of responses to various changes in gun laws, of which 50 of the articles were published since 2001.

The article groups those 58 studies into three, broad categories: (1). studies which examine the effects of laws covering personal behavior with firearms (e.g., CCW, castle doctrine) on homicides and gun homicides; (2). studies covering changes in firearms laws that target gun access and homicides; (3). studies on the effects of changes in firearms laws that target gun access and suicide. Grouping the studies into these three categories produces results that are, to put it mildly, somewhat mixed.

conference-program-picOn the question of the relationship between arming civilians and increasing or decreasing gun violence, the jury is exactly split.  Half the articles cited found that laws which made it easier to walk around armed resulted in drops in homicides; the same number of articles found that the extension of CCW resulted in more homicidal deaths.  It should be pointed out that a majority of articles on both sides of this issue were pro and con contributions to the John Lott ‘more guns = less crime’ thesis, including, of course, the seminal publications by Lott himself.

On the issue of whether gun-control statutes play a role in diminishing gun homicides, the studies listed appear to confirm the idea that more gun laws lead to less gun violence, at least this is what the articles appear to say.  But when I looked at the article by Rosengart, which is cited no less than three times in support of the notion that more gun laws leads to less gun violence, the author in fact concludes that, “No law was associated with a statistically significant decrease in the rates of firearm homicides or total homicides.” Another article by T. B. Marvell is summarized as showing almost an 8% reduction in gun violence, but the author in fact states that, “even with many different crime measures and regression specifications, there is scant evidence that the laws have the intended effect of reducing gun homicides.”

As for the grouping of articles purporting to show a connection between more gun laws and less gun suicides, here again the articles all appear to support the idea that CAP laws, background checks, minimum purchase age and banning of small, cheap guns lead to reductions in gun suicide from 3% to as much as 45%.  But once again I find myself drawn to the text of one of those cited articles which says, “No law was associated with a statistically significant change in firearm suicide rates.”

The authors of this study admit that “challenges in ecological design and the execution of studies limit the confidence in study findings and the conclusions that can be derived from them.” Which is a polite way of saying that their conclusions should be taken with several grains of salt. But I am not surprised that the public health scholarly landscape still has major gaps when you consider that research funding has been basically non-existent since 1998.

But let’s say for the sake of argument that the funding spigot gets turned back on and all those research gaps are filled in.  And let’s further say that when the research holes are completely filled that it turns out that more gun-control laws really do result in gun violence going down.  Do you think for one second that the NRA would accept the research as valid when it comes to gun control and begin to change its tune?