Anthony Komaroff, M.D.

Focusing on gun violence could pave the way to fewer firearm-related deaths

The gun control proposals that President Barack Obama unveiled yesterday highlight the intensely personal nature of this issue. The President promised to “put everything I’ve got” into pursuing gun control. It’s equally personal for gun control opponents, who see these efforts as moves against their right to bear arms.

What’s the problem, and is gun control the solution? The problem is acts of violence, using guns.  What do we know from public health studies about how big the problem is, and what works to reduce gun violence?

In 2011, the last year for which we have complete statistics, 32,163 American men, women, and children were killed by firearms. That’s almost exactly the number killed in automobile accidents.  It’s nearly seven times the number of U.S. combat deaths in Iraq and Afghanistan since the start of those conflicts, more than 10 years ago. It’s half as many as have died from diabetes, a disease that affects nearly 30 million Americans.  In other words, it’s  a staggering loss of life.

Now, only about a third of deaths from guns are homicides, such as happened in Newtown, Connecticut. Some are accidents, and others are suicides. But deaths by accident or suicide are also tragedies.

One way to sidestep the contentious debate over gun control would be to focus more effort on preventing gun violence. In a compelling article, three of my colleagues at Harvard make the case for approaching gun violence as we have tackled other serious public health issues. Writing in JAMA, Drs. Dariush Mozaffarian, David Hemenway, and David Ludwig summarize lessons learned from successful efforts at reducing deaths from smoking, motor vehicle accidents, and poisoning and suggest ways to apply similar approaches to stemming gun violence.

Take motor vehicle deaths. Cars and trucks are useful devices that are generally driven safely and responsibly but that can be misused, often with deadly consequences. The authors note that without banning the automobile, efforts such as implementing safety standards, making cars safer to drive, and improving roadways have reduced death rates per mile driven by 90%. A similar concerted approach could work for reducing firearm-related deaths.

“Gun violence arises from sociocultural, educational, behavioral, and product safety issues that transcend gun ownership alone,” write Mozaffarian, Hemenway, and Ludwig. “Addressing this crisis will require a comprehensive, multidimensional strategy.”

I’m a physician scientist. I believe the way we solve problems is by studying different approaches to them. That’s how we learned how to cure most cases of acute lymphoblastic leukemia in kids, and most cases of pneumonia in adults. That’s one important part of the reason that the average U.S. citizen lived just about 50 years in 1900, and nearly 80 years in the year 2000. Research has resulted in these breakthroughs. Research has saved millions from premature death.

Gun violence is no different: it’s a serious problem, and it requires research. That’s why a second Viewpoint article in JAMA, by Drs. Arthur Kellerman and Frederick Rivara, is so disturbing. In 1996, Congress severely curtailed research into gun-related violence by de-funding the CDC’s research on firearm injury research. Congress stipulated that no funds made available to the CDC for injury prevention and control could be used to advocate for or promote gun control. In other words, the same Congress that has funded most health research more generously than the governments of any other nation has specifically prohibited learning more about a problem that has killed about 400,000 U.S. citizens since 2000. Does that make sense?

Exactly what was or was not permitted under the Congressional mandate was unclear. “But no federal employee was willing to risk his or her career or the agency’s funding to find out,” write Kellerman and Rivara. “Extramural support for firearm injury prevention research quickly dried up. Even today, 17 years after this legislative action, the CDC’s website lacks specific links to information about preventing firearm-related violence.”

One of President Obama’s new proposals lifts the ban on gun violence research by the CDC.

I applaud the authors of these two papers and others who are trying to reframe the gun control debate. (Watch a forum on the topic from the Harvard School of Public Health.) By talking about it as a public health issue, and treating it that way, we may be able to save thousands of lives that are now needlessly lost each year.

Related Information: Harvard Health Letter

Comments:

  1. Jack County

    Thank you for this thoughtful post. I mostly avoid information and discussion of guns, especially lately. But it’s an important topic, and you are contributing to what I hope will be good decisions that make us all safer

  2. DS

    Many recent studies, including one by the Harvard law department, show that there is either no correlation or a NEGATIVE correlation between gun ownership and murder rates. Where law-abiding citizens are allowed to defend themselves, murder and violent crimes go down, not up. Where this right is restricted, the rates go up. Within this country, the areas where concealed carry is allowed have lower crime rates than areas with heavily restricted or non-existent concealed carry laws.

    See
    http://www.law.harvard.edu/students/orgs/jlpp/Vol30_No2_KatesMauseronline.pdf
    and
    http://theacru.org/acru/harvard_study_gun_control_is_counterproductive/

    Also see http://www.foxnews.com/opinion/2011/09/30/media-silence-is-deafening-about-important-gun-news/

    This has more to do with the right to life and the right to defend that life than just the object with which life is defended. For example, how is a 90-year-old grandmother going to stop a 30-year-old man with a crowbar or knife who decides to break in her home?

  3. Norm

    I subscribe to the Harvard Health Letter for advice on health. It’s bad enough thay they use my subscription money to promote their political opinion, but now they want to use my tax money for the same purpose. Of course they make it sound as if they are just promoting research into “what works”. They must be getting BS lessons from Obama.

    • Lucy M

      Norm, I agree with you. I subscribed for medical information. I do not play around with guns, but my husband legally has some for sport. Why are they preaching to the choir when it is the inner city youth who need to be rounded up and have their guns confiscated.

  4. ipsol cisco

    Here you are wright about Focusing on gun violence could pave the way to fewer firearm-related deaths i live in India here its not a problem.

  5. Waulter Austin

    Very nice post and really thoughtful post. I would like to escape from gun, the word gun hurt my heart because I would not like to hurt others. But I also think some times it gives us much importance. But your post is much important in our livelihood.
    thanks

  6. Tracy

    Google Kennesaw, Georgia’s gun laws. When the residents were required to possess a firearm and ammunition in each household or be fined, the crime rate went down 80+% (can’t remember exact number). When law abiding citizens are allowed to protect themselves from thugs, those who would attack them were less likely to be willing to confront someone they knew was armed. Do we need automatic weapons? No. Obama is right in restricting those weapons meant purely to kill as many people as quickly as possible, meant for the military. We do not need those to protect our homes, or to hunt. We also want to try to ensure that those that are licensed to carry a gun are not felons or mentally unstable and thus more likely to commit crimes.

    • Lucy M

      I agree Tracy, we do not need anything more than rifles or pistols, but what we do need are strong mental health laws that protect the innocent rather than a mentally unhealthy person who could be violent. We have guns for protecting famous people, on our police, in the military, so I do not like saying that a normal, law-abiding person cannot have one.

  7. Stephen Ryan

    You can pick, choose, and twist statistics to prove what you want. Of course, homicide by firearms is greater in this country than in Britain, which has very strict gun laws, but it was always thus, even before Britain passed the anti-gun laws. Britain’s fairly recent stringent gun-laws changed nothing. In fact, the instances of homicide by fire-arms has decreased slightly in this country compared to Britain since Britain passed its stringent gun-laws.
    Britain and Australia do not have the gang violence that America has, which distorts the statistics.
    Australia’s death by fire-arms has increased slightly since the recent passage of stricter gun-laws relative to neighboring New Zealand which did not pass any such laws.
    You can go on forever throwing statistics back and forth.
    The United States is unique, with its traditions, social conditions, and culture peculiar to itself. But it is gratifying to see that there are so many right-to-life advocates horrified by the deaths of children. Who knew.

  8. Louise

    Viewing gun related violence as a public health issue is certainly valid, and it highlights deficiencies in the systems that aim to help people, well done. But the murder rate in the US is roughly four times that of countries like Australia, New Zealand and Britain. For interest, following the 1996 Australian gun law reforms banned the sale, importation and possession of all automatic and semi-automatic rifles and shotguns, these measures were prompted by the Port Arthur massacre. Firearm homicides in Australia dropped 59 per cent between 1995 and 2006 and there was no offsetting increase in non-firearm-related murders.

  9. Rob Potter

    Thank you for this thoughtful post. I mostly avoid information and discussion of guns, especially lately. But it’s an important topic, and you are contributing to what I hope will be good decisions that make us all safer.

  10. Harry

    I live in Canada where this is not a problem!! You want the right to “bear arms” god gave you 2 use them!!!!!

    • Mike Taylor

      I’m with you Harry. That 2nd amendment business is so very outdated, yet the American public seem to feel they need to embrace that colonial way of thinking even though 300 years have passed them by.

  11. Ken

    How about focusing on mental health issues related to the recent shootings? And alcohol’s involvement with shootings? Not saying something should not be done. Yet please look at all the circumstances involved and not just focus on one.

    Besides that an unarmed population can do very little about a corrupt government.

  12. Sidney Schofield

    32,163 deaths by guns, and from and Institute of Medicine report on accidental deaths attributed to Doctors 98,000.
    Just from these numbers alone three times as many people are killed by Dr’s then are by gun violence. Shouldn’t they then be looking into how they can keep from killing people first?

    • Ron

      You are soooooooooooooooooooooo right doctors kill more kids then guns do wake up america

    • Griz

      Doctors and the abortions that you preform kill more of our babies then nutty people do police your profession be for you comment about our guns

    • Robert Flood

      In listening to the nonsensical rhetoric regarding gun control in this country, it is become clear to me that no matter how much outrage we express over the violence against children in this country, the Second Amendment to the US Constitution will continue to impede the drafting of reasonable laws addressing this national crisis.

      Thus, I believe the only way to allow for reasonable progress in protecting the welfare of children is to draft and ratify the following Children’s Rights Amendment (CRA) to the United States Constitution.

      Section 1. As a member of the United Nations, the United States of America, and all its peoples, fully endorse and support the following statement of the United Nations Convention on the Rights of the Child: all children everywhere have the same rights, no matter where they live or what they believe.

      Section 2: Every child born to this world has the right to life, survival and development; the child’s view should be taken into account in all decisions affecting his/her life.

      Section 3. The best interest of the child born to this world will take primary consideration and will supersede all existing laws and amendments that otherwise could endanger the safety and welfare of children.

      Section 4: All Children born to this world have the rights guaranteed by this amendment, without discrimination of any kind.

      Section 5: The Congress shall have the power to enforce, by appropriate legislation, the provisions of this article.

      Section 6: This amendment shall take effect immediately upon ratification.

      Section 3 is the key to this concept: only after we, as advocates for children, can pass a law that supersedes the Second Amendment will meaningful legislation be passed in this country.

      This fight must have a beginning, so please work to ratify this proposed Children’s Rights Amendment to the US Constitution.

      Thank you for considering,

      Robert Flood, MD
      Associate Professor of Pediatrics,
      Saint Louis University
      St. Louis, MO

      • Lucy M

        Oh dear. How lovely is your idea, but you completely overlook the inner city youth and the criminal. Do you seriously think they are going to give up guns? Do you really think they care about children or anyone? Do you really think the police can find all the guns owned illegally? Do you think Swiss people will give up their guns, which they are required to own? Please concentrate on the good you do by being a pediatrician.