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Removing Barriers and Reinvesting in Public Health Research on Gun Violence

Doctors for America presents a petition at a press conference on December 2, 2015, in Washington, D.C.

Endnotes and citations are available in the PDF and Scribd versions.

Bottom Line: With more than 33,000 gun deaths and more than 84,000 nonfatal shootings occurring in the United States each year, the U.S. Congress must act to remove the restriction that limits the ability of the Centers for Disease Control and Prevention, or the CDC, and the National Institutes of Health, or NIH, to conduct research on gun violence and appropriate sufficient funding for this life-saving research.

Gun violence in the United States is an urgent public health crisis.

  • A person is killed with a gun every 15 minutes in the United States.
  • During 2014 alone, there were 10,945 gun homicides in the United States. That is more than double the number of U.S. soldiers who were killed in combat during the wars in Iraq and Afghanistan combined.
  • The gun murder rate in the United States is more than 25 times higher than the average gun murder rate of other developed countries.
  • Nearly two-thirds of gun fatalities annually are the result of suicide.
  • The approximate cost of gun violence in the United States is $229 billion per year.

A restrictive policy rider enacted by gun lobby allies in Congress has prevented adequate public health research on gun violence for the past two decades.

  • In 1996, allies of the gun lobby added a rider to the CDC budget that prevented the agency from spending any funds to “advocate or promote gun control.” That year, Congress also reduced the funding appropriated to the CDC by $2.6 million—the exact amount that the CDC spent on gun violence research the previous year.
  • A similar rider was added to the NIH budget in 2011.
  • These riders—while not outright bans on research relating to gun violence—have had a substantial chilling effect on such research.
    • Average annual funding for the CDC’s research on firearm injury prevention between 2009 and 2012 was 96 percent lower than the average annual funding between 1993 and 1996.
    • This has created a substantial information vacuum about the causes and consequences of gun violence in the United States.

The original author of this restriction—former Rep. Jay Dickey (R-AR)—has rescinded his support for the provision and has urged Congress to resume public health research on gun violence.

  • “Research could have been continued on gun violence without infringing on the rights of gun owners, in the same fashion that the highway industry continued its research without eliminating the automobile… it is my position that somehow or someway we should slowly but methodically fund such research until a solution is reached. Doing nothing is no longer an acceptable solution.”

Public health research is a key component of developing an effective approach to reducing injury deaths.

  • Public health research has been a key component of a comprehensive approach to reducing motor vehicle accident deaths in the United States. The U.S. Department of Transportation’s National Highway Traffic Safety Administration spent $830 million in 2015 alone on safety research and grants.
  • This type of research has helped inform a number of responses aimed at reducing car accident fatalities, including new legislation to change driver and passenger behavior; improvements in safety standards for cars and highways; and improvements in technology.
  • These changes led to a dramatic 28 percent reduction in the rate of annual car accident deaths between 1999 and 2014, from 14.68 deaths to 10.58 deaths per 100,000 people.
    • This stands in stark contrast to overall gun-related deaths, which slightly increased 2 percent during the same time period.
  • The National Highway Traffic Safety Administration estimated that nearly 329,000 lives were saved by vehicle safety technologies between 1960 and 2002.
  • This public health research into car accident fatalities remains ongoing at the CDC. In 2012, the CDC found that driver distraction was a factor in more than 3,000 vehicle-related deaths and 420,000 vehicle-related injuries. As a response, 44 states and the District of Columbia enacted laws banning all drivers from texting, and four additional states prohibited texting for new or young drivers. These laws are already proving to be effective: A 2014 study found that enforced texting laws were associated with a reduction in vehicle-related deaths among younger individuals.

Public health experts have identified a number of urgent research questions about gun violence that currently have insufficient answers:

  • What are the risk factors for gun violence? What factors decrease that risk?
  • What are the most effective interventions to prevent gun violence in impacted communities?
  • How many people in the United States are victims of nonfatal gunshot wounds annually?
  • How effectively are gun laws being enforced at the local, state, and federal levels?
  • Are there design features of guns that can be changed to make guns safer?
  • How effective are gun-safety training programs?
  • How do guns move into illegal, underground gun markets?
  • What are the most successful intervention strategies to prevent gun-related suicides?
  • What is the true extent of gun ownership in the United States, and what percentage of U.S. households own guns?
  • How do people who use guns in the commission of crimes obtain those guns? Is it through theft, social networks, straw purchases, corrupt dealers, or other means?
  • What is the specific impact of state-level gun laws on the movement of guns across state lines?