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Dr. Mark Rosenberg Calls for Us to Use the Full Power of Science to Address Gun Violence Prevention

By Mark Rosenberg, MD, MPP, February 15, 2019

Our thoughts are with the Parkland community and our own community of Thousand Oaks

Let’s Bring the Full Power of Science to Gun Violence Prevention

This article originally appeared in the American Journal of Public Health.

Michael Longley, the former Ireland Professor of Poetry, wrote a poem about the war in Northern Ireland that went on for 30 years toward the end of the last century. Longley called this poem “The Troubles.” In the United States we are having our own troubles, not with 3,600 people killed—the number killed in the north Ireland troubles—but with more than 38,000 gun deaths a year. We have had more than 500,000 gun deaths in the 20 years since the federal government essentially stopped looking for a way to solve the problem. Most of these deaths could be prevented by using research to find interventions that both reduce gun violence and protect gun rights, using science to identify evidence-based solutions similar to those that saved so many lives from motor vehicle crashes, heart disease, cancer, and smallpox. But deaths continue to mount while advocates for gun control battle with those for gun rights. As in Northern Ireland, we have two sides fighting. And as in Northern Ireland, it’s not that one side is right and the other side wrong. What is wrong is not to do everything we can do to stop filling the coffins.

How did we get to this point? Scientists at the Centers for Disease Control and Prevention (CDC) had seen how research to address an epidemic of young people being killed in car crashes led to safer cars, roads, and drivers and saved more than 600,000 lives from 1960 to 2012 (1). With this example clearly in mind, these CDC scientists initiated a research program to find ways to prevent firearm injuries.

The National Rifle Association (NRA) then adopted a strategy to prevent this research. NRA leadership told their members and members of Congress that they had to choose between research on gun violence prevention and keeping their guns.

In 1996, Congress stripped the CDC of funds for research on gun violence prevention and inserted language into the CDC’s appropriations bill saying “That 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" (2). Referred to as the Dickey amendment after its author, the late Congressman Jay Dickey (R-AR), this language did not explicitly ban federally funded research on gun violence. But coupled with the deletion by Congress of the CDC’s budget for firearm violence prevention research, it resulted in a marked diminution of federal funds for researchers already committed to this field and it discouraged new researchers. Within the CDC, it cast a shadow on those doing gun research. Research continued at a low level in the field and within the CDC. After 1999, the amount of gun violence research that the CDC was funding fell by more than 90%.

If the government were to stop research on cancer, heart disease, or stroke for even one day, there would be a huge outcry. The most powerful advocates for research on these diseases have been those most affected by them. But those most heavily affected by gun violence have lacked political clout. Those most threatened by gun homicide are young Black men, who are murdered at a rate 8 to 12 times the gun homicide rate for young White men. Similarly, those at highest risk of gun suicide are persons with mental illness, a group that is highly stigmatized.

An increasing number of health professional and public health organizations have recently advocated on behalf of a public health approach to gun violence prevention and more federal funding for research on gun violence prevention. And some excellent research is being done. Articles in a special July 2018 section on gun violence research in AJPH provided encouraging evidence that important research on gun violence prevention is still being conducted, funded by foundations (3), state governments (4), and civic and academic organizations (5). But it is scant compared with what is needed.

Without knowing what works—and how effectively—and what doesn’t, Congress is deadlocked on measures to prevent gun violence. Absent a strong evidence base, what is common sense to one side is lies and propaganda to the other.

How much could the federal government spend productively for research on preventing gun violence? In the 1970s, when the US government decided to start funding research to prevent an epidemic of deaths from motor vehicle crashes, Congress appropriated $200 million a year for research on preventing these deaths. Funding has continued at that level or greater. Today in the United States there are about the same number of deaths— approximately 39,000 per year—from guns and from motor vehicle injuries (6). A recent review of research on gun violence prevention by the Rand Corporation showed that there is insufficient evidence to say definitively whether any of the interventions except for child access prevention laws are definitely effective (7). Interventions that lack definitive evidence include background checks, bans on the sale of assault weapons and high-capacity magazines, concealed-carry laws, firearm sales reporting requirements, gun-free zones, licensing and permitting requirements, lost or stolen firearm reporting requirements, minimum age requirements, prohibitions associated with mental illness, stand your- ground laws, surrender of firearms by prohibited possessors, and waiting periods.

The Rand review could provide the basis for a new federal research agenda on reducing gun violence. The goal of such an agenda should be to find interventions that would both reduce gun violence and protect gun rights.

The Dickey amendment should not be repealed because it does not prohibit the federal government from conducting research to prevent gun violence. The amendment can provide “cover” for legislators who want to support research without fear that their actions will be seen as promoting gun control. Lawmakers can use the Dickey amendment when explaining to their constituents that they favor research but do not support gun control legislation per se.

The most effective goal for research that can inform policy is to find those preventive interventions that keep guns out of the hands of those who shouldn’t have them while allowing law-abiding gun owners to keep their guns. Policies that have the potential to do this include (1) universal background checks of potential gun buyers to eliminate persons who are felons or present analogous threats to others; (2) laws that permit police to temporarily remove guns from anyone who is deemed to present an extreme risk of suicide or harm to others; (3) removing guns from convicted domestic abusers; and (4) requiring safe storage of guns to keep them out of the hands of children. Researchers should also develop a scale to measure the extent to which interventions would impinge on the rights of law-abiding gun owners.

We also need to know whether other strategies can reduce gun violence and also protect gun rights. For instance, it is not yet known whether arming teachers, hiring more armed guards, allowing more citizens to carry concealed weapons, and requiring new guns to be “smart guns” would save or take more lives.

In the newly elected Congress, advocates for both gun rights and gun control could collaborate on gun violence prevention. A bipartisan coalition working to appropriate funding for the CDC to restart its gun violence research program could end what Michael Longley called the “years of disgrace,” 20 years of our own “troubles,” years that have been so very costly for all of us.

References

  1. National Highway Traffic Safety Administration. Lives saved 1960–2012. Available here. Accessed December 3, 2018.

  2. Omnibus Consolidated Appropriations Act, 1997, Pub L No. 104-208, 110 Stat 3009-244 (September 30, 1996). Available here. Accessed January 11, 2019.

  3. Laura and John Arnold Foundation. Gun violence research. Available here. Accessed December 3, 2018.

  4. University of California Violence Research Center. Violence Prevention Research Program. Available here. Accessed December 3, 2018.

  5. Johns Hopkins Center for Gun Policy and Research. Available here. Accessed December 3, 2018

  6. Centers for Disease Control and Prevention, National Center for Health Statistics. Fast Stats homepage. Available here. Accessed December 3, 2018.

  7. Moral AR, Ramchand R, Smart R, et al. A critical synthesis of research evidence on the effects of gun policies in the United States. Available here. Accessed December 3, 2018.

Mark Rosenberg, MD, MPP Twitter

Member, Board of Directors since 2016

Mark Rosenberg, MD, MPP Twitter

Member, Board of Directors since 2016

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