What Guns To Be Safe? Get Rid Of The Guns.

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Ever since my pal Tony Scalia decided in 2008 that owning a gun is a Constitutional ‘right,’ the gun violence prevention (GVP) community has been trying to figure out a strategy that will reduce the annual gun carnage, while at the same time preserving the heritage of freedom and democracy represented by guns. So it’s become kind of a standard preamble to every gun-control argument made by every gun-control group that they ‘support’ the 2nd Amendment, as if any member of the Gun-nut Nation tribe would actually believe that someone who thinks that guns represent any kind of problem at all would ever really be in favor of the 2nd Amendment. Anyway….

kids and guns             One of the GVP strategies that tries to neatly straddle the line between being against guns and yet being for the 2nd Amendment is something called ‘safe storage,’ which means that if you do own guns, they should be kept locked or locked away at all times. Here’s the operative statement from Everytown: “Everytown’s research on unintentional child gun deaths shows that 65 percent of these shootings take place in a home or vehicle that belongs to the victim’s family, most often with guns that were legally owned but irresponsibly stored.” The Brady Campaign says that nearly 1.7 million kids live in homes with unlocked or unstored guns, and they partner with the American Public Health Association in their ASK campaign, which tells parents to make sure their kids aren’t playing in someone’s house where there are unsecured guns.

Let me make it clear that I am not suggesting or even hinting at the idea that safe storage of guns is a bad thing. Nor do I believe for a single second that someone who locks up his gun at night is now defenseless in the face of an invasion by some street ‘thug.’ But I know a bit about how guns are used and what they represent, and I’m not sure that these issues are fully understood by the GVP organizations who promote safe storage or by the public health scholars upon whose research the GVP depends.

Let’s say for the sake of argument that every single gun in America was locked or locked away every day. According to the CDC, in 2015 there were 22 unintentional gun deaths where the victim was under the age of 15. This is 4% of all unintentional gun mortality, a number which slips to 1% when we calculate all categories of gun deaths, intentional or not. The figures change somewhat but not all that much if we increase the maximum age to 19 or 21, but most states issue hunting licenses to residents beginning at age 15, so it’s pretty hard to say that older adolescents don’t understand the risks of guns.

As to whether safe-storage counseling makes any real difference in gun violence rates, the jury is still out.  An analysis in 2016 of the most comprehensive studies on the effects of safe storage showed that some programs worked, others did not. And the criteria for determining the effectiveness of these programs was comparing the use of safety devices before and after counseling occurred. In other words, we don’t have any data on whether or not rates of gun violence actually changed.
           The best and most realistic approach I know to gun safety is the Advice to Parents stated by the American Academy of Pediatrics. It goes like this: “The best way to keep your children safe from injury or death from guns is to NEVER have a gun in the home.”  As far as I’m concerned, any attempt to find some alternate, crowd-pleasing message just doesn’t work.
              I have sold more than 11,000 guns to 7,000 different people and not one of these customers bought a gun from me to take it home, lock it away and never look at it again. As Walter Mosley says, “If you walk around with a gun it will go off sooner or later.”
 

What Do Doctors Tell Their Patients What To Do With Their Guns? No Surprise – It Depends On The Doctor.

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A new study by Eitan Hersh and Matthew Goldenberg is making waves both in the medical and wider media because it appears to say what Gun-nut Nation has been saying forever about doctors and guns; namely, that doctors don’t like guns.  And since doctors don’t like guns, according to this line of non-thinking, they shouldn’t talk to their patients about guns.  And if they didn’t talk to their patients about guns, to follow this non-thinking line to its absolute conclusion, there wouldn’t be anything known as ‘gun violence,’ because everyone knows that gun violence is a figment of the CDC’s imagination anyway.

docs versus glocks           Okay, let’s get back to reality.  To gather, analyze and understand their data, the authors first created a patient ‘vignette’ which described an initial screening interview between a male or female patient and a primary care provider (PCP.)  During the interview, the patient admits to nine not-atypical health factors (tobacco and alcohol use, depression, etc.) that can cause medical problems, one of them being access to guns.  The roughly 300 physicians who participated in the study were then asked to rate how much they considered each of these health factors to represent medical risk, as well as how they would respond to each one. Their responses were then evaluated based on additional data which matched each respondent with voter registration; a process that was not mentioned to survey respondents so as to avoid the possibility that survey answers would be biased based on how respondents felt their answers might be judged.

To quote the conclusion of the study: “Our findings suggest that Republican and Democratic physicians differently assess the seriousness of patient health issues that are

politically salient. Republican physicians also differ from Democratic physicians in the treatments offered to patients who present with those health issues.” And of the nine issues that comprised the health vignettes, on which particular issue did physicians identified as Republicans versus physicians identified as Democrats differ most widely regarding degree of risk?  You got that one right – access to guns.  Grouped by political affiliation, the two groups more or less agreed on the same degree of risk when it comes to helmets, obesity, tobacco, depression, alcohol and professionally-furnished sex.  Republican-affiliated physicians rated abortion and marijuana use as their greatest concerns, Democratic-affiliated doctors viewed these two issues as having little or no concern at all.  For blue doctors on the other hand, they were most concerned about access to guns, in the case of red doctors gun ownership did not register as a concern.

So far the survey results in terms of the correlation between political affiliations and views about the health risks posed by guns holds no surprise.  After all, most gun owners are Republicans, most gun owners do not consider their guns as a risk to health, so there’s every good chance that many physicians who are affiliated as Republicans will also own guns.  Or at least may share similar views on gun access with their patients who own guns.

Ready?  Here’s the rub.  Recall that the survey not only asked participating doctors to assess the degree of risk, but also asked them to describe a treatment plan for each risk vignette.  And when it comes to firearms, both blue and red doctors would discuss gun risks, but the Democratic-affiliated physicians would counsel patients not to keep firearms, the GOP-affiliated physicians opted for ‘safe storage’ plans.

What this survey reveals is that even though physicians may differ on whether gun ownership poses a health risk, there appears to be across-the-board consensus that patients should be counseled about access to guns.  Where the partisan divide appears is not on the issue of gun-risk per se, but on the most effective strategy for mitigating that risk.  And this is a very important finding because if you listen to Gun-nut Nation, they’ll tell you that guns don’t pose any risk to health at all.  And after all, who really knows more about health – the AMA or the NRA?

Will CAP Laws And Safe Storage Keep Guns Safe? I’m Not So Sure.

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Yesterday comes the news out of Michigan that a 12-year old, mentally-impaired boy, who took a shotgun out of his grandfather’s gun safe, pulled the trigger and killed a pregnant, 28-year old woman sleeping in a different room in the same house, will now be charged with careless discharge of a firearm.  The sentence could involve fines and/or placement in a juvenile facility. According to the Law Center to Prevent Gun Violence, Michigan is one of 23 states that does not have a child access prevention law (CAP), which means that a kid who had no idea what he was doing gets charged in this death and grandpa, who owned the gun, gets off scot free.

gun safe                Every week or so the media seems to carry another story about a youngster who somehow manages to grab a gun and kill or wound someone else.  Probably the recent episode that garnered the most media attention was the shooting of Veronica Rutledge by her 2-year old son in an Idaho Wal Mart; Mom had a pistol in her handbag, turned away for a sec and – bam!  Rutledge was alleged to be a trained shooter who carried a gun for self-defense.  Some self-defense.

In 2013, the CDC estimates that 538 kids under 14 were unintentionally injured by guns and another 69 are estimated to have lost their lives because someone accidentally shot off a gun.  THE CDC also reports that 625 kids 14 years or younger died from drowning and 1,345 youngsters lost their lives in accidents involving trucks or cars. I’m not saying the deaths of 69 children for any reason should be ignored; I’m just trying to put it into perspective as regards the issue of safe guns.

Even though we don’t have exact data on how many children kill or maim themselves or others with guns, every time it happens we get the chorus about locking up or locking away the guns. The issue of gun safety needs to be understood beyond the degree to which young children are injured or killed because when we look at total unintentional firearm mortality and morbidity for all ages, the numbers dramatically change. Accidental gun deaths jump to 505; for non-fatal gun injuries the toll is 16,864. This latter figure, to quote one of my street friends, is serious sh*t.  And it would be a lot more serious were it not for skilled trauma surgeons who somehow manage to bring many shooting victims back from the dead.

The problem with relying on CAP laws and safe storage is that most unintentional shootings occur not because a little kid grabs a gun, but because the owner or one of his friends does something impulsive or dumb while the gun is being used in a lawful and legal way. In 2013, there were 2,590 unintentional gun injury victims ages 15 to 19, but nearly 2,000 of these victims were 18 years old, which meant that they were lawfully able to use a gun.  The gun accident rate for the 18-19 age group was 22.74, drops to 9.38 for ages 20-35, to 7.82 for ages 35-44 and down to 3.16 for ages 45-54.  This decrease in gun accident rates moving up the age scale is exactly what we find in rates by age bracket for accidents involving cars.

Everyone is in favor of using guns safely; the NRA talks about it all the time. What nobody wants to face, however, is the simple fact that when you have 300 million dangerous weapons floating around, a certain number are going to be used every day in stupid and senseless ways.  If CAP laws and safe storage prevented every unintentional gun injury to children, the overall deaths and injuries would drop by 3 percent.  CAP laws and gun locks are necessary, but they don’t really respond to the fact that 300 million extremely lethal weapons are owned by humans, and at some time or another every one of us will be careless or forget.

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