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Firearm-related deaths in the U.S. reached a new peak across age groups and surpassed motor vehicle accidents as the leading cause of death among children and adolescents in 2020, according to recent data from the Centers for Disease Control and Prevention, and as noted in a May letter to the editor of the New England Journal of Medicine calling for an update to how the field understands youth mortality.
These data are subject to some qualification: the peak designation refers to number of deaths, not rate of deaths, for instance. Yet however one approaches the statistics, gun violence is undeniably a leading cause of preventable death and a grave public health issue.
Despite this, the research landscape on guns and gun violence is seriously underdeveloped. One 2017 study found that in relation to mortality rates, gun violence was the least researched cause of death and second-least funded cause of death after falls; while gun violence killed as many people as sepsis, funding for gun violence research was 0.7 percent of that for sepsis, and the relative publication volume was 4 percent, that study found. There’s still no dedicated scholarly journal or association for gun and gun violence research, either.
A dearth of available funding and data for research on guns and gun violence have contributed to this gap in knowledge. The politically charged nature of the topic and academe’s tendency to frame complex problems as within specific disciplines present additional barriers to development.
There are signs that things are changing, however. Funding for gun violence research is increasing. The number of published health sciences articles involving firearms jumped by 327 percent between 2000 and 2019, according to another study. And later this year scholars will gather for the first ever National Research Conference on Firearm Injury Prevention.
“I really see this as a time of growth where the field is starting to strengthen,” said psychologist Andrew Morral, leader of the RAND Corporation’s Gun Policy in America initiative and director of the National Collaborative on Gun Violence Research, a philanthropy that funds non-RAND researchers, including those in academe.
Of the upcoming conference, in particular, which Morral is co-chairing, he said, “It’s going to be the first time there’s been a meeting where all these people are coming together, and we’ve got all these funded projects now that we’ll be able to talk about and see what they’re learning and what they’re doing.”
Research on Ice
Why is research on guns and gun violence so far behind? Most trace the fallback to a 1993 article in NEJM by Arthur L. Kellermann and a group of colleagues that strongly and independently associated having a gun in the home with increased risk of homicide, nearly always by a family member or intimate acquaintance. The paper (and others like it) made a splash and helped establish gun violence as a major public health concern. But many gun advocates didn’t like the paper’s conclusion. The National Rifle Association, in particular, lobbied for the closure of the National Center for Injury Prevention and Control at the CDC, which funded Kellermann’s study, on the grounds that it was biased against guns.
The center survived, but NRA-friendly federal lawmakers—led by late Republican representative Jay Dickey of Arkansas—specified in a 1996 omnibus funding bill that none of the money could be used “in whole or in part, to advocate or promote gun control.” Congress also earmarked $2.6 million of the CDC budget’s—the amount spent on firearm injury research in 1996—for traumatic brain injury research.
Gun violence research went from an up-and-coming field in the early 1990s to a relative dead zone, fast, and stayed that way for decades. Some gun research was still happening, but much of it was funded by private philanthropies such as Arnold Ventures. Cassandra Crifasi, deputy director of the Center for Gun Violence Prevention and Policy and a core faculty member in the Center for Injury Research and Policy at Johns Hopkins University, estimated in 2017 that there were just 30 dedicated gun policy researchers in the country.
What’s known as the Dickey amendment is still in effect. Congress extended this language to other funding agencies, such as the National Institutes of Health, in 2011.
Dickey told NPR in 2015 that he regretted the Dickey amendment in retrospect for how it effectively stalled research on guns. “It wasn’t necessary that all research stop,” he said of his original intent. “It just couldn’t be the collection of data so that they can advocate gun control. That’s all we were talking about. But for some reason, it just stopped altogether.”
After the Sandy Hook Elementary School shooting in 2012, then president Obama directed the CDC and other agencies to conduct or sponsor gun violence prevention research. The NIH in 2013 announced plans to fund research on violence with a focus on firearms through 2017, citing Obama’s guidance. But Science reported in 2017 that the NIH had quietly let funding for program lapse. Follow-up reporting from Science based on internal NIH emails revealed that the decision had been influenced by politics.
Congress clarified in 2018 that the Dickey amendment doesn’t ban research on gun violence. But lawmakers didn’t couple that message with any funding for such work.
Jennifer Carlson, associate professor of sociology and government and public policy at the University of Arizona and the author of several books on guns and politics, told Inside Higher Ed that the Dickey amendment effectively “created a very, very strong incentive for the CDC to not fund research related to guns.” It also had a broader “chilling effect” for research on guns and gun violence, she said, even if some of that chill was based on the perception—not necessarily the reality—that the federal government doesn’t fund this research.
“I’ve never been motivated by what will give me the biggest grant—I’ve been motivated by research questions, which I think most people are,” Carlson said. “But there is definitely a sense that in terms of what’s fundable, gun research is probably not at the top of that list. Though I think that’s changing.”
The funding climate is warming. In 2020, the federal Labor, Health and Human Services, Education, and Related Agencies appropriations bill included $25 million for the CDC and NIH to research gun safety. Many grantees in academe benefited. The federal government designated the same amount for this research in 2021, and again this year.
The Missing Data
Now that funding is opening up, some scholars say they’re hoping for a similar breakthrough on data about the prevalence of guns.
Morral, of RAND, said, “There’s a lack of good data being collected by the federal government and others on gun ownership. And in the absence of that, which is critical for understanding things like the effects of gun laws, and lots of other things, we have produced estimates of gun ownership.”
RAND’s state-level estimates of household gun ownership are based on a model that draws on a variety of sources, including survey data. These estimates help researchers and the general public make educated guesses as to how many guns are in circulation. Many researchers have also used various proxies for legal firearm prevalence, such as licensing and background check data, to the extent that they are available. These researchers aren't using actual market data because this information is not tracked and reported for guns in the way that it is for so many other goods: most states don’t register legal firearm transactions. (This is to say nothing of the complicating factor that is illegal weapons sales, though researchers argue that transparency regarding legal sales would be a vast improvement from the current situation.)
Both model-based estimates and proxies are imperfect measures of how many guns there are in a certain area at a certain time, and therefore not ideal for producing the kind of evidence that gun scholars want to be able to share. A 2019 report from NORC at the University of Chicago found that the “firearms data environment is disordered and highly segmented,” and that data on “the movement of firearms from first purchase to a criminal actor [are] highly restricted by laws, regulations and real-world politics.” A related 2020 report from NORC says that “Data collection is haphazard and disorganized and it is of no surprise that our baseline understanding of the relationship between firearms and firearms injury and death are equally incomplete. A conceptual framework is an important starting point for a cohesive firearms data strategy.”
Kenneth Wilbur, professor of marketing and analytics and the Sheryl and Harvey White Chair in Management at the University of California, San Diego, co-wrote a recent study in which he tested various proxies for legal firearm prevalence and determined that invalid proxies can lead to false research conclusions. Ultimately he recommended that the Federal Bureau of Investigation publish its background check data, which are currently published monthly, by state, “at more granular levels, such as county, city, zip code, week and date.” Those few states that collect firearm acquisition data, such as California and Massachusetts, could also publish “granular counts of firearm transactions,” he said, while states, counties and cities that do not collect firearm acquisition data could begin to do so and publish them.
Firearm retailers, retail chains or retailer associations could publish aggregate sales data by place and time, the paper also recommends, and digital platforms, advocacy groups or researchers could track and report online firearm sales.
Regarding confidentiality concerns, the paper argues for “transparently safeguarding individual privacy,” and notes that there are precedents for the handling of sensitive data for research purposes.
Wilbur said recently, “I don’t want to know who bought what. I want to know the societal-level effects of what drives firearm purchases and what happens as a result of these firearm purchases.” An increase in murders in San Diego may contribute to a lack of feeling of safety that drives guns purchases, while it’s also possible that an increase in guns in the city could increase or decrease the number of murders there, for example, he said. But without detailed data by time and space, causal relationships between gun sales and effects can’t be established.
Comparing the market data for guns to those for almost anything else, Wilbur said, “Look, if I want to know how many jars of peanut butter are sold in Connecticut last month, I have that at my fingertips. If I want to get how many trucks are sold in Texas last year, it’s easy. But if a researcher wants to know how many guns were sold, that’s generally not available, and it’s almost never been. And so if we want any form of science-based evidence—not to set policy but to help to inform policy—we need to start understanding and counting how many guns go into circulation.”
Carlson said, “I open every class that I teach on guns in America at the University of Arizona with the fact that we lack basic facts about many things involving guns in the United States. I think it’s important to be up front that because of a confluence of law and data transparency and a variety of other things, we do not know how many guns are actually in circulation among private civilians in the United States. And so there are definitely gaps in what I think most people would consider basic knowledge regarding the social life of guns in the U.S.”
Following the recent mass shootings in Buffalo, N.Y., and Uvalde, Tex., some scholars have called for increased activism from the field. Mary Ellen O’Toole, director of George Mason University’s forensic science programs, in her capacity as editor in chief of the Journal of Violence and Gender, issued an immediate call to action for superior gun control legislation.
“We’ve waited long enough,” she in a statement. “This political football must stop. Our children are being killed and the laws must be changed now. We can no longer normalize these behaviors or expect our children to be the victims on the front lines. The research is clear and we must continue to stay educated, relentless, and vigilant in our quest for the future of our country.”
Ali Rowhani-Rahbar, Bartley Dobb Professor for the Study and Prevention of Violence and professor of epidemiology at the University of Washington, said it was his sense that researchers are “increasingly sharing their voices to advocate for policies and practices that, based on scientific evidence, have a good promise of saving lives and preventing firearm injuries.” This kind of activity is “valuable,” he said, and has taken different forms: providing testimonies, writing op-eds, talking with journalists and more.
At the same time, many scholars advise caution on this kind of engagement, as to avoid further politicizing the topic.
Morral, at RAND, said, “I think it’s pretty clear that this is an area where researchers have very different ideas about what their responsibilities as researchers are: I have heard people say, ‘This is why I’m a public health researcher, you know—it’s my responsibility to inform the public about ways of being safer or protecting themselves, and if I don’t, then I’m not doing my job.’ And, you know, from that perspective—which I totally get—they need to be out there advocating for what they believe is the right solution to gun violence.”
Morral continued, “And then there are other people—and I think I’m more in this camp—who feel like the most effective thing they can do is provide information that is objective and can be heard by people on all sides of this issue, to the extent that they’re open to hearing anything.”
By being “an advocate,” he also said, “my fear is that I will lose a big part of the potential audience for good science, because there will be an assumption that I’m pushing for this or that kind of policy that means that I’m biased, and how I analyze the science is biased." Morral doesn't know "that my approach persuades more people than the other approach. I don’t know that I’m doing it right. But I am very aware there is a divide in the field between these two kinds of perspectives on advocacy.”
Asked about his views on advocacy, Wilbur, of UC San Diego, said that he tends to focus on points of consensus.
“Surveys indicate that large majorities of Americans support common-sense policies, such as restricting sales of weapons with military applications and preventing criminals and mentally unstable people from purchasing weapons,” he said. “These are not controversial topics, and a lot of times the degree of actual debates over these topics seems to be exaggerated.”
From Data to Policy
According to a survey last year by the Pew Research Center and Gallup, a majority of both Democrats and Republicans support preventing those with mental illnesses from purchasing guns and subjecting private gun sales and gun show sales to background checks. Majorities in both parties also oppose allowing people to carry concealed firearms without a permit. But other proposals reveal a persistent ideological divide, according to the survey: some 80 percent of Democrats favor creating a federal database to track all gun sales and bans on both assault-style weapons and high-capacity ammunition magazines that hold more than 10 rounds, for instance. A majority of Republicans oppose both notions. Public opinion is further divided along gun-ownership lines.
What has been shown to reduce harm from guns, including violent crime, unintentional injuries and death, and suicide? RAND’s Gun Policy in America project says there’s supportive evidence that child-access prevention laws and waiting periods make a difference, moderate evidence that background checks and prohibitions associated with domestic violence work, and some limited evidence to support prohibitions associated with mental illness, licensing and permitting requirements, and minimum age requirements. There’s also some evidence that stand-your-ground laws and concealed carry laws may increase violent crime.
The bipartisan legislation that President Biden signed into law Saturday reflects some but certainly not all of what’s known about gun policies and death and injury prevention. But it does represent the federal government’s strongest action on gun violence in nearly 30 years. (The effects of the U.S. Supreme Court’s weakening of concealed carry laws last week remain to be seen.)
The Way Forward
Another challenge to the development of the field has been a siloed approach. Morral said that in his experience, “the field has been sort of divided” among public health researchers, criminologists and public policy experts, all of whom share their work within their disciplines at annual meetings. He said that the upcoming conference he’s organizing is intended to “mix” these researchers and efforts for the first time.
Team-based approaches to gun and gun violence research are promising. The University of Michigan, a leader among universities in securing federal research funding to study firearm injury prevention, in 2019 announced a Firearm Injury Prevention Research Initiative connecting researchers in public health, medicine, social sciences, engineering, public policy and the arts while respecting the Second Amendment, for instance. The university launched the Institute for Firearm Injury Prevention last year. California’s state Legislature also established a $5 million center for gun violence research at the University of California, Davis, in 2016. A few other states followed suit.
Carlson, at the University of Arizona, said that gun research hasn’t just suffered from a siloed approach but also from limited framing, meaning a focus on gun violence to the exclusion of other questions about guns in this country. This is partly because sociologists historically have not engaged in gun culture research, she continued. But if gun researchers want to understand why and how the U.S. arrived at this point, they need to consider sociologists’ methods and perspectives, as well.
“My point isn’t that we shouldn’t be talking about firearms violence, but rather that that is one element—a core element—but one element of how firearms are significant sociologically in this country,” Carlson said. “If you want to understand gun violence and ameliorate gun violence, you have to engage the question of not just what gun policies should we have, but also why we have the gun policies that we do have. And that latter question cannot be addressed solely by focusing exclusively on gun violence itself.”
She added, “It’s our duty as scholars to create expansive spaces to think through the many ways that not only gun violence, but guns themselves matter and are impactful within American society. I’m not arguing against any approach. I am arguing that we need to create spaces to not only have multiple approaches and multiple ways of engaging this issue, and also that we talk across those approaches and those disciplinary perspectives.”
Rowhani-Rahbar, the epidemiologist, agreed that paying close attention to the “cultural aspects of gun ownership and firearm-related behavior are very important if we want to be effective as credible messengers.” He and colleagues have received a $1.5 million grant from the CDC to study the culture and patterns of handgun-carrying rural adolescents.
As the field continues to grow, Rowhani-Rahbar said, “my hope is that the new generation of scholars will have the resources and training needed to sustain rigorous levels of research while working with communities most affected by firearm injury and violence to disseminate the findings and translate them into action.”