The most recent massacre in San Bernardino and other horrific acts of violence encountered in the U.S. and abroad spur the polarizing debate around gun ownership and its easy access. There would be little debate if the number of firearms-related deaths was small, but that is not the case. Firearms contribute to over 30,000 deaths by homicides and suicides annually. This does not include the more than 70,000 nonfatal injuries. The per capita rate of gun injuries and deaths in the U.S. far exceeds all European countries and Japan combined.
While research on adverse health effects is required for most consumer goods, from toys to cosmetics, none exists for guns.
To illustrate the positive effects of research, we can examine the advancements made in motor-vehicle safety. In 2013, motor vehicles contributed to 33,804 deaths, about the same number as guns (33,646). In contrast to gun-related deaths, this is the lowest deaths per capita ever and half that of 1975, according to the Insurance Institute for Highway Safety. This improvement was possible because of the tremendous resources that went into collecting data on vehicles, the people who drive them, and the roads.
The National Highway Transportation Safety Administration 2015 budget for safety research and development is $122 million. This does not include the research funding imbedded in its budget for vehicle safety ($152 million) and Highway Traffic Safety Grants to states ($577 million). It also does not include the vast amounts of resources auto manufacturers invest in safety. Resources for data and research enable NHTSA to know that 50 percent of people killed in crashes are unbelted; 30 percent of highway fatalities involve an impaired driver; and 90 percent of crashes involve an element of human error. The research leads to innovations like airbags, high-strength occupant cages and crumple zones; laws and regulations such as drunk-driving laws, seat-belt and cell-phone use laws; and environmental improvements like better street lighting, safer guardrails, and improved signage.
Even a fraction of the resources that go into motor-vehicle safety would help determine how to decrease gun injuries and fatalities. We can research and evaluate how to avoid accidental discharges. We can have accurate data on the consequences of having a gun while intoxicated. We can study whether guns in the home, work, and schools actually lead to decreased violent incidents. I do not posit these research questions facetiously. In medicine, we have excitedly implemented a number of “promising” treatment modalities only to learn that they actually harmed or even killed patients. The NHTSA also recognizes this, and the agency states, “Many emerging vehicle technologies present enormous life-saving potential, but we must ensure that they don’t pose unintended safety consequences.” Only through data collection and rigorous research can we know this.
Research can help us focus and prioritize where to intervene. The media likes to use the phrase “random acts of violence” when describing gun violence, but the data already show that there are patterns to where gun violence occurs, who pulls the trigger, and who is hit by the bullets. Criminal-justice data clearly show that poor urban neighborhoods are disproportionately impacted, but insufficient data leads to broad generalizations, misguided policies, and ineffective programs. Worse yet, it can result in resignation from the public and hopelessness from the community.
Harmful generalizations also impact those who suffer from mental illness. The mass shootings in Newtown, Aurora, and other places have put scarlet letters on the chest of millions who will never commit such acts. A study published by the American Psychological Association found that only a small percentage of crimes can be attributed to mental illness, and there were no predictable patterns linking criminal behavior and mental illness. As a primary care provider, I worry less about my patients becoming perpetrators of crime than that they will simultaneously become the perpetrator and victim through suicide. In 2013, Centers for Disease Control and Prevention data show that of the 41,149 suicides, firearms accounted for over half (21,175).
One dramatic case occurred when I spent a month at an Indian Health Service hospital in northwest Alaska. A 15-year-old boy had committed suicide by shooting himself in the abdomen with a shotgun. Horrified by his death as well as the location of the wound, I asked the nurse if this was common. She stated that suicide among Native youth, and the manner by which this case happened, was typical. The Aspen Institute confirms that observation, stating, “Native teens experience the highest rate of suicide of any population group in the United States.”
Victims, perpetrators, poverty, geography, race, and mental illness are a few of the variables that make the gun debate so complex. Whatever one’s views about the Second Amendment, we can agree that we need to save lives and prevent injuries. Research using rigorous scientific methods can tease out what makes a difference for what we care about most: health.
In April, eight health professional organizations and the American Bar Association advocated for research to reduce firearm-related injuries. Hours before the San Bernardino massacre, 2,000 signatures from physicians were delivered to Congress to lift funding restrictions for gun-violence research.
Seiji Hayashi is a family physician and executive vice president for transformation and innovation at Unity Health Care, Inc.
Say It columns are works of opinion that reflect the writer's viewpoint as supported by evidence. They do not represent the opinions of Next America, its parent company or affiliates.
This article is part of our Next America: Criminal Justice project, which is supported by a grant from the John D. and Catherine T. MacArthur Foundation.
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