Studying gun violence is the only way to figure out how to stop it – but we don’t

By Sandro Galea
Boston University

It seems that not a week passes without a new report of a mass shooting in the United States.

The gun epidemic, long simmering, has in the past few weeks seemed to reach a new phase in the public discourse. The shootings in San Bernardino, California occasioned a nearly unprecedented front-page editorial in The New York Times, the country’s “paper of record,” together with comments, once again, from the president, urging congress to act on regulating firearms and firearm violence.

The top-level data on the problem are at this point familiar. There are about 32,000 gun deaths a year in the United States, approximately the same number as deaths from motor vehicle accidents. The number of firearm deaths has been stable essentially since 2000. There are another 180,000 or so people injured by firearms annually in the country. These numbers far outstrip the consequences of firearms among our peer high-income countries, with stricter gun regulations.

What ails us? Why do we continue to accept these consequences of firearms when other countries do not?

The discussions in the public space over the past several weeks have illuminated some of these challenges, including a gun culture that is fueled by historical concern with individual rights to gun ownership, and an effective pro-gun lobby that aggressively penalizes legislators who aim to introduce basic gun control regulations.

I would suggest that one more factor that has held us back on this front is the relatively limited data we have available about firearms and firearm violence.

We don’t have enough data on gun violence

For example, there exists no national registry of victims of firearm violence, comparable to the registry we have to follow victims of the September 11 2001 terrorist attacks, or to any number of other large-scale health threats. Our understanding of the consequences of gun violence is essentially limited to statistics on firearm deaths and injuries. That’s it.

While gun violence is a public health problem, it is not studied the same way other public health problems are. That is because our national health organizations, principally the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), have avoided firearm-related research for almost 20 years.

Why doesn’t the federal government fund firearms research?

The roots of this challenge go back to 1996. Spurred by a 1993 article published in the New England Journal of Medicine about gun ownership as a risk factor for homicide, the National Rife Association suggested that the agency was advocating for gun control.

Because the CDC funded the research, the NRA pushed Congress, in a 1996 omnibus bill, to state:

none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.
The CDC broadly interpreted this as a bar on firearms research, with other federal funders following suit. This has had a chilling effect on gun research.

Ironically, the author of the amendment that cast this pall on firearm research, Congressman Jay Dickey, has since recanted, noting correctly in 2012 that “We won’t know the cause of gun violence until we look for it.

We need good data to write good policy

Because of the bar on research, our understanding of the real consequences of the firearm epidemic is surface deep.

For example, while we know the number of deaths by gun and the number injured, we have no data about the psychological consequences of firearm violence, either among those injured or among their loved ones. We do not know who the corollary victims of gun violence are, or what the consequences are for this group.

We do not know the influence of common substances such as alcohol on the risk of firearm homicide or suicide. We do not know the real costs of firearm violence, including physical, mental and community harms linked to firearms. And, centrally, we do not know the most effective policy levers that we can use to limit the gun violence epidemic simply because we have not done the research to understand the policy measures that can most effectively reduce or prevent gun violence.

This is precisely the kind of public health research that groups like the CDC and NIH fund for pressing public health problems, and should fund for firearm research.

Unfortunately a shortage of data creates space for speculation, conjecture and ill-informed argument that threatens reasoned public discussion and progressive action on the issue.

Moving forward

There is hope on this issue. President Obama recently ordered the CDC to return to studying the causes of gun violence.

However, the executive action was not accompanied by the dedication of any new money to the issue, and until such funds are available, the CDC, like any other funder, would need to cut spending in some other area to sponsor this research.

An omnibus spending bill put the funding ban in place, and an omnibus spending bill could also undo it. As Congress works toward a bill to fund the government, Democrats are pushing to lift the ban on gun violence research. On December 10, House Minority Leader Nancy Pelosi said, “We must insist that we cannot have a bill leave the station that still has that ban on research in it.”

The United States has had enormous success in responding to other challenges to public health, including, for example, motor vehicle safety, through gathering data that understands the challenge and implementing structural changes to mitigate the potential harm. On the issue of firearm violence, we are not even at the first step.

Sandro Galea, Dean, School of Public Health , Boston University.

This article was originally published on The Conversation.

2 thoughts on “Studying gun violence is the only way to figure out how to stop it – but we don’t

  • Dec 16, 2015 at 6:29 pm

    Sirs, as an Oxford scholar in philosophy, please let me add support to your contention on this issue. In particular the absence of more government data on gun violence is problematic in proposing a systematic solution such that all have fiscal interest in reducing it. Here please let me present the logic on a method for reducing gun violence, based on available data, which is at best disturbing, and at worst horrifying,there being no apparent way to reverse the trend, with >50,000 gun deaths already this year.

    To create Consensus on Gun Violence

    The gun lobby is currently in conflict with its own fiscal interests if it supports gun control. Most of the arguments it uses to defend gun liberties are on 2nd amendment rights, and it is in no way my intent to challenge that. I am writing this proposal because Jefferson and Franklin, who primarily wrote most of the civil liberty issues resulting in the debate, had at least read all of Montesquieu, Rousseau, Locke, Aristotle, and Plato; but they needed to frame civil liberties for a diverse congress, mostly with less education, at best knowing Thomas Paine’s theories of ‘naïve realism,’ which held truth is known via basic common sense. So, most of the arguments about gun control are based on common-sense views of civil liberties. But opposing views easily result from common sense, simply because different people have different experience, resulting in perpetual debate over irreconcilable premises–in particular in this case, as to the meaning and extent of the 2nd Amendment, against the right of others to live freely without fear of violence. Clearly, common-sense debate cannot resolve the conflict.

    We need to step back and simply consider maximizing liberty, and therefore happiness, from first principles. We can draw on John Stuart Mill’s utilitarianism (1860 AD), which didn’t exist when the 2nd amendment was framed (in 1791 AD), but utilitarianism is now in the heart of American law. The method produces a rational solution, as follows:
    1. Some want guns and others don’t.
    2. Those who don’t want guns have to pay for expenses arising from gun violence.
    3. That results in a net loss of liberty, because: those that do want guns could buy something else, but those who don’t want guns are forced to pay for the expenses of gun violence.
    4. Therefore, to maximize civil liberty, those who want guns pay for the expenses of gun violence. Then the liberties of gun ownership are preserved, and people who don’t want guns are not forced into paying for what they don’t want.
    5. The cost of gun violence should go down, so there should be an annual registration tax or mandatory insurance for gun ownership, just like the DMV does for cars, and when gun violence goes down, the annual cost goes down.

    Annual registration or insurance also enables tracking and monitoring of guns-making guns safer, just as the DMV makes cars safer, as there could be checks like smog checks that guns are working safely. Moreover, it enables more assurance that gun owners do not illegitimately use guns due to ignorance. A survey of 500 Americans that I conducted earlier this year established a widespread belief in the right to kill merely for breaking and entering. In fact that is murder, but one in ten, at a conservative estimate, argued extensively and insisted they know better, even after presented with rational reasoning, and even after that, continue to argue they have a right to kill merely for breaking and entering, after actually being shown the law. A DMV-style test therefore should educate gun owners on the limits of freedom to kill that are granted within this nation, and to require gun owners understand what constitutes illegitimate violence, in order to own a gun.

    The current inequities in freedom are eliminated. The civil liberties debate over gun control can resolve. Gun owners will support effective legislature to prevent unwanted violence, because it will also reduce their own taxes. Even the NRA and gun sellers will seek effective gun control laws, because it will be to their direct advantage to reduce the registration cost, whereas now, supporting gun control would only be a conflict of interest for them. Guns would be safer, and their owners would know when law does permit their use to injure other people.

    The most thorough current research puts gun violence cost at $229 billion per year, or $700 per citizen annually. Some proportion of this is committed by illegal gun ownership, but the NRA has blocked government research on gun violence cost, so no more detailed information is available. But other research does show about a third of all households own guns, with an average of 8 guns per gun owner if they do. Let’s assume an average household size of two, and that half of all violence is by unregistered guns (which should be a very high estimate), and that gun registration doesn’t include any of the cost of gun violence by illegal gun owners. An average annual payment of $260/gun would totally defend the civil liberty of gun ownership. The poor state this be income scaled, and rifle owners state handgun owners should pay a larger proportion.
    Other estimates place the total number of guns in the USA at 270 million. But we must hope that to be low estimate, because on the same basis as above, then the total annual cost would be $424 per gun annually, or $3,392 annually for each household owning guns, to pay for the cost of gun violence by legal gun owners.
    That is the best that can be done with synthetic data, which has aggregated costs already. Lower numbers result from constructing direct costs upwards. Assuming 17 million guns sold per year, a one-time registration fee of $118 each would be enough to reimburse insurance companies for the cost of direct in-hospital treatments due to gun-related injuries.
    When including police and other costs, the direct expense for gun deaths alone is $14.8 billion/year. Schools are estimated to spend $5 billion/year for gun security. Taxpayers pay an additional $1.3 billion for lifetime support of gun victims. Summing scant available data places direct costs of gun violence for hospitals, police, and schools at ~$40 billion/year, or $2,352/gun sold. I am forced to repeat, better numbers are not available because the NRA blocked more research into the cost of gun violence 20 years ago. Even the senators who passed the legislature have since said its wrong, but attention which should have been focused on gun violence cost has mostly been diverted into arguments about 2nd amendment rights.
    While the above costs might seem high at first blush, assuming they are approximately correct, then there’s many other resulting cost reductions, and income from gun registration could sponsor buyback programs. It’s been established gun buybacks decrease gun injuries, so the registration fee should go down. It seems sensible to believe that many households actually do not need or want to keep 8 guns, and perhaps could sell them back for $250 each. Fro this reason, gun registration may be preferable to mandatory insurance. However, for practical reasons, it may be easier to seek mandatory insurance programs in particular districts where gun violence is particularly prevalent, as a precursor to a national requirement.
    These numbers also neither include administrative overhead, nor tax deductions for business armament and other such causes. But perhaps most importantly, there should be reductions in overall federal and state taxes as revenue shifts. Health insurance companies would also be able to seek compensation from the revenue, which would reduce health insurance costs too.

    The purpose of this proposal is upholding 2nd-amendment rights AND reducing gun violence, because gun owners, gun sellers, and the gun lobby naturally agree with those who otherwise simply desire to live freely without fear of armed attack and terrorism. An annual registration fee or mandatory insurance requirement for guns achieves this goal, and is defensible on utilitarian grounds. Reduction of the annual cost, when gun violence decreases, provides the necessary incentive such that gun lobbyists would seek sensible means to reduce gun violence. The exact amounts need to be determined with further research, and the stated numbers are merely to indicate the sheer scale of the problem. The result of this change is a defense of the 2nd amendment, because those who exercise the right are bearing responsibility for its costs.
    Those who argue against this proposal simply do not want to pay for the cost of their liberty, and in so doing, not only argue for a constitutional amendment to ban guns entirely instead, but also deny responsibility for injury and death from guns. To oppose this is to perpetuate a situation where gun violence will only increase, there being no fiscal incentive for those who profit from guns to reduce it.

  • Dec 21, 2015 at 8:50 am

    More nonsense disguised as intellectual insight.

    A study conducted about 10 years ago found that 71% of these murders committed with a firearm were by and between felons. In most cases, drugs or gang violence was the root cause. This study concluded that these deaths were the result of the “occupational hazards” of these career paths.

    These deaths were completely avoidable if the people involved stayed away from these criminal activities. I’m not shedding any tears for them. Get involved with drugs and gangs and guess what? You might die!

    The CDC continues to involve itself with people who reach their conclusions first, then research their way into that conclusion. As a taxpayer, I object to funding junk science.

    Letter two is the infantile “tax people so much they can’t afford to own a firearm.” Such baloney often takes the guise of firearms taxes and ammunition taxes. Despite claiming to be an intellectual, this writer is simply hiding his contempt for the second amendment behind his self-assured neutrality. After all, he claims, people who really want to own guns can still have them.

    His failure is to hide or ignore the fact that most crime guns are stolen or illegally possessed. So the criminals will still have their untaxed guns. Just the law abiding people will be forced to give up their guns. Crime will stay the same, just many millions more of potential victims. Criminals will be delighted.

    Whenever someone posts their intellectual credentials, it simply means they intend to hide their personal opinion behind a pseudo-intellectual facade. Their intent is to present themselves as experts, above reproach or rebuttal. Neither of these individuals is in anyway an expert in criminal behaviors.

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