Gun Violence: A Public Health Problem

The following article appeared April 6, 2018, in The Hill.

Debates about combating gun violence are raging at every level of government. Questions around age limits, more comprehensive background checks and banning of certain weapons are all top of mind.

The only problem? Policymakers are restricted in their ability to make fully informed, data-backed decisions about who should have access to firearms, when and how they should access them, and how gun-related tragedies can be prevented.

Here’s what we do know — gun violence is a public health crisis. Every day, nearly 100 people are killed in the United States with guns, largely by suicide, domestic disputes and community violence. Guns are more lethal than most other weapons and are often used impulsively, meaning that individuals in crisis are likely to succeed on their first attempt to harm themselves or others. For this reason, a public health approach must include restricting access to firearms.

Gun violence costs our economy billions of dollars each year, and takes a dramatic and long-term toll on families across America.

But, due to federal restrictions, there aren’t many more national statistics or trends we can examine.

In 1996, Congress enacted the Dickey Amendment, which restricted funds for injury prevention and firearms control at the federal Centers for Disease Control and Prevention from being used to advocate or promote gun control. This move has had a chilling effect, halting vital prevention research at the CDC for more than 20 years.

To make matters worse, the Bureau of Alcohol, Tobacco, Firearms and Explosives is prohibited from releasing information about its firearms database to the CDC and the National Institutes of Health.

In stark contrast to the limited data on gun violence is the wealth of data available on motor vehicle deaths. The federal government’s Fatality Analysis Reporting System records more than 100 variables related to vehicular deaths, including the type of car, weather conditions, speed, seatbelt use, age, sex, seating position and drug use of every single occupant. Those numbers then serve as the basis of car safety standards nationwide.

Even though the number of gun-involved deaths is just shy of those caused by motor vehicle crashes on an annual basis, there is no comparable system for firearms. But, as city leaders, state legislators and federal officials consider how we address this growing public health crisis, the need for this data has never been more pressing. Behavioral health scientists need this information, too, as they develop evidence-based interventions.

For instance, when policymakers consider age restrictions for purchasing firearms, it would be important to know the distribution of gun purchasers — and, specifically perpetrators of gun violence — by age and where they obtained guns. We also need data to better evaluate the impact of certain measures, such as comprehensive background checks and protective orders, on the incidence of school and other mass shootings.

Yet, we have no way of knowing how many U.S. households even own a gun.

Solving this crisis requires innovation, which is evident in cities across the nation that are using data to tackle prevention from a public health perspective. But these programs need steady, dependable funding to become embedded in the culture and ultimately to be effective.

When New Orleans Mayor Mitch Landrieu started NOLA FOR LIFE in 2012, it was touted as a murder-reduction effort. What is unique about the program is its approach — targeting not only crime reduction, but risk factors, such as involvement with gangs, truancy and diminished economic opportunity. The program focuses on five factors that together can make a real difference: violence reduction; prevention, including recreation, mentoring, restorative justice and school-based responses to trauma; promoting jobs and opportunity; rebuilding neighborhoods physically and altering community norms; and strengthening the local police department.

Efforts to prevent firearm injuries and deaths warrant dedicated funding and federal and state support, just as it is for other public health crises, such as cigarette smoking, HIV/AIDS and the opioid epidemic. And, most important, these efforts require data collection and data sharing among federal, state and local agencies.

To be truly successfully in addressing gun violence as a public health crisis, everyone in the community must work together — law enforcement, public officials, schools, behavioral health experts and communities of faith.

As cities and local communities have demonstrated, gun violence can be prevented. But we need research, sustained investments in prevention and the commitment to make it happen on a national scale.

Evans is CEO of the American Psychological Association. Anthony is CEO of the National League of Cities.