As we collectively mourn the victims of the latest school shooting at Apalachee High School, it’s obvious that our tax dollars aren’t protecting us. Between 2008 and 2017, sepsis and firearm violence killed the same number of people, yet gun violence received less than 1% of the federal research budget allocated for sepsis. Due to a 1996 budgetary provision that restricts tax-funded research on the effects of guns, the average child who dies from firearm-related injury receives a mere $597 in federal research funding. This historical underfunding has contributed to a grim statistic: firearm violence is now the leading cause of death for youth under 19 in America.
Recently, the Surgeon General published an advisory framing firearm violence as a public health crisis. If there is enough tragedy to develop an evidence base that informs life-saving policies, why can’t Congress adequately fund firearm research?
At the heart of this issue lies the Dickey Amendment, a 1996 budgetary provision that has severely limited the Department of Health’s ability to research gun violence and develop effective policy solutions for over two decades. In 1993, the Centers for Disease Control and Prevention (CDC) funded a study that found having guns at home increased the risk of adverse outcomes like homicide. In response to unflattering press coverage, the National Rifle Association (NRA) attempted to completely dismantle the CDC’s Injury Center. Although their initial plan failed, the NRA successfully introduced restrictions on gun violence research through an appropriations bill introduced by Jay Dickey, an Arkansas Representative. The amendment prohibits the CDC from using funds to “advocate or promote gun control.”
Congress redirected the CDC’s $2.6 million firearm injury research budget to fund traumatic brain injuries. Funding for firearm injury studies became virtually “nonexistent.” In 2011, The Dickey Amendment was extended to include the National Institutes of Health (NIH) after they published a study about the relationship between gun possession and assaults.
Daniel Webster, ScD, MPH, a professor of American Health at Johns Hopkins Bloomberg School of Public Health, has witnessed the chilling effect of the Dickey Amendment firsthand.
“Public health nurses didn’t feel safe doing public health work in communities with high levels of divestment because people were shot so frequently,” recounted Webster. “It was hard to imagine how we could achieve reasonable public health and safety without addressing gun violence.” Despite never advocating for gun control, researchers found themselves walking on eggshells, afraid to jeopardize funding for entire centers focused on injury and violence prevention.
“They were trying to change behaviors and mediate conflicts nonviolently,” explained Webster. “The research didn’t focus on the role of guns, it asked if these programs were effective in reducing the number of people being shot.” Over the years, Webster’s attempts to discuss the role of guns have made CDC staffers uncomfortable. Nobody wants to jeopardize funding for an entire center focused on injury and violence.
“As this was going down in the 90s, I was publishing an article about youth-focused gun resurgence in the Journal of the American Medical Association (JAMA). Typically journals require disclosures about research funding sources. We had a long conference call with JAMA and the CDC because the CDC didn’t want us to acknowledge that they funded the study. Normally, that’s precisely what they want so they can go to Congress and request additional funding.”
To avoid raising red flags in Congress, Webster says the CDC scrutinized discussion sections that described policy implications of gun violence. “They didn’t want to fund any study where the discussion section suggested more lives would be saved if you had policy x.”
While researchers tiptoed around the NRA-sponsored budgetary provision, school shootings increased. The Columbine High School massacre in 1999, the Sandy Hook Elementary School shooting in 2012, and the Marjory Stoneman Douglas High School shooting in 2018 all failed to prompt significant legislative change. It wasn’t until 2022, in the wake of mass shootings in Buffalo, New York and Uvalde, Texas, that the Bipartisan Safer Communities Act (BSCA) was finally adopted.
Although the BSCA does not fund gun violence research, its impact and implementation will likely inspire a new generation of studies. The BSCA was the first federal gun safety law passed in nearly 30 years. Understanding how stakeholders are implementing its various provisions and measuring its impact on gun violence and other outcomes is key to improving public safety.
Gun violence is a multifaceted issue encompassing gun suicides, gun homicides, shootings by police and unintentional shootings. Gun homicides include mass shootings and domestic violence. The vast majority of gun homicides are connected to community violence which tends to be concentrated in larger cities and towns. Many people that die from gun suicide are under the influence of alcohol at the time of their death or have had alcohol use problems in the days or months preceding their death. The same principle applies to homicide. Each category presents unique challenges and requires targeted research. Kelly Drane, the Research Director at Giffords Law Center, works with legislators to compose and justify data-driven policies that protect people from gun violence, and emphasizes the gaps in our current understanding.
“A lot of times, the research we want doesn’t exist,” explained Drane. “We have some research, it helps us do our job, but there is a hindrance to really making progress on this issue because there are a lot of decisions and choices being made that haven’t been fully fleshed out in the research.”
Most gun violence researchers rely on administrative records from police and health entities because funding doesn’t support primary data collection. That’s like studying the opioid epidemic without collecting direct data from users or people in their social networks. If all we had to analyze the opioid crisis was hospital records and death certificates, our ability to formulate effective countermeasures would be greatly constrained. This approach fails to capture crucial information about how guns are used and how people’s experiences with guns change under different policy environments and circumstances.
There’s a growing body of research that identifies substance abuse as a risk factor for gun violence, but as Drane explains, “We need to know what kind of risk factor it is and how we can generate the policy answer to this question.” The complexity of gun violence research extends beyond individual factors. “We need to understand how different kinds of gun violence intertwine, what policies target multiple pieces of this epidemic at once and which policies are targeted to one piece at a time,” Drane adds.
Current research faces significant limitations. Most gun violence studies are not funded to investigate critical areas such as the underground market or extremism. Researchers lack specific data on how often people are being threatened with firearms, a common factor in hate crimes. Even data on police shootings presents challenges, as Drane points out: “A shooting by an on-duty police officer of a civilian that they are tasked with protecting deserves to be in a different category than a neighbor that shoots another neighbor.” Yet, official data sources often fail to make this crucial distinction.
These gaps in data and research have real-world consequences. For instance, media outlets like The Guardian and The Washington Post, relying on their own data collection efforts, report nearly twice as many police shootings as the CDC. “A consequence of not having federal funding to collect data is that systemic gaps and issues persist,” Drane explains.
Hundreds of gun violence studies are published every year with support from the private sector, filling some of the gaps left by limited federal funding. This research has yielded crucial insights: for instance, available evidence strongly suggests that preventing domestic violence offenders from obtaining firearms is life-saving for women and children. United States v. Rahimi challenged the constitutionality of gun restrictions for domestic violence offenders based on a previous ruling that gun laws should be based on tradition. However, domestic violence was not a crime until recently.
In June 2024, the Supreme Court, in an 8-1 decision, upheld a federal law that cites domestic violence as prohibiting criteria for gun ownership. Drane acknowledges the role of research in preventing a detrimental threat to women’s safety.
Despite a $25 million earmark for gun violence research at the CDC and NIH, gun lobbyists continue to oppose such efforts. By funneling copious amounts of money to candidates, gun lobbyists have created a mismatch between what the public wants and what politicians are willing to do.
Former White House Secretary, Jim Brady, led The Brady Center after being paralyzed in 1981 by a bullet meant for Ronald Reagan. Brady’s current Director of Federal Policy, Mark Collins, has seen it all. He remembers the swift political upheaval of former Representative Chris Jacobs in retaliation for his support of an Assault Weapons Ban following a mass shooting in his district. Beyond ousting politicians, Collins has witnessed the only agency with jurisdiction over the gun industry, the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), repeatedly undermined by gun lobbyists.
“For nearly two decades, if anyone at ATF stepped out of line as far as the industry was concerned, the gun lobby would call their friends in Congress and have ATF’s budget stripped again,” explained Collins. If they enforced the law as they were supposed to, they would get less money and additional congressional appropriations riders, making it harder for them to do their job.”
To adequately fund gun research and implement life-saving policies, we need to radically restructure the role of money in politics.
“Unfortunately it does seem like congress is unwilling to act on a bipartisan basis to advance bills unless something terrible has happened,” says Collins. “As a survivor myself and as a parent, it takes a lot to get through certain days. The reason that things move forward is because Brady and organizations like it have done the groundwork to make sure that lawmakers are as educated as they can be on policy.”
The Dickey Amendment was implemented to make it harder to advance protective policies on gun violence prevention while allowing the weapons industry to control the national narrative about firearms. However, purchased politicians, inequitable electoral procedures and a tendency to individualize social problems through criminalization and divestment made gun violence the leading cause of death among youth in America.
“Recent studies show that someone who witnessed violence or was shot is twice as likely to commit violence over the next couple of years,” explained Collins. Although solutions exist, a 23 year research gap makes it harder to address gun violence effectively. We need to answer any and all questions that are relevant to public health policy and practice – not just ones that are politically convenient. Funding should be structured in an open and flexible way to give researchers the opportunity to study different strategies. We should consider every relevant approach to address one of the biggest public health problems that we face.
Just as we’ve made driving safer through evidence-based policies, we can develop strategies to reduce gun violence without eliminating access to firearms. Car accidents wouldn’t happen if people didn’t drive, but no researcher is suggesting that we eliminate cars. Driving is significantly safer because there are policies around who can drive based on age, a driving test and rules about driving under the influence. All of those protective measures have not eliminated access to motor vehicles. Similarly, firearms are a part of our society, and there are things we can do to make their presence safer.
It’s time to allow public health workers to research gun violence as they would research any other public health issue.
Christine Forbes is an award-winning multimedia journalist based in New York City covering style, health, culture, and education.
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Publish date : 2024-09-17 10:27:00
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