JAMA Authors Lament Suspension of Gun Violence Research
The authors of an online JAMA article, Arthur L. Kellermann, M.D., MPH, and Frederick P. Rivara, M.D., MPH, argue we'd know more about how to prevent mass shootings and firearm fatalities in general if CDC and other federal agencies still studied why they happen.
A paper published online Dec. 21 by JAMA contends the people now debating new gun controls would know more about effective solutions if CDC and other federal agencies still studied why mass shootings and firearm fatalities in general happen. Citing the Newtown, Conn., school shootings and recent mass shootings at a shopping mall in Oregon, a movie theater in Colorado, a Sikh temple in Wisconsin, and a business in Minnesota, co-authors Arthur L. Kellermann, M.D., MPH, of RAND (Washington, D.C.) and Frederick P. Rivara, M.D., MPH, of the Department of Pediatrics, Child Health Institute, University of Washington, and Seattle Children's Hospital (Seattle), and editor of Archives of Pediatrics & Adolescent Medicine, ask what the nation can do "to prevent more such acts from happening, or at least limit their severity? More broadly, what can be done to reduce the number of US residents who die each year from firearms, currently more than 31,000 annually?"
"The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997," they write. "But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC's budget — precisely the amount the agency had spent on firearm injury research the previous year. Funding was restored in joint conference committee, but the money was earmarked for traumatic brain injury. The effect was sharply reduced support for firearm injury research. To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: 'none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.'
"Precisely what was or was not permitted under the clause was unclear. But no federal employee was willing to risk his or her career or the agency's funding to find out. 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. When other agencies funded high-quality research, similar action was taken. In 2009, Branas, et al. published the results of a case-control study that examined whether carrying a gun increases or decreases the risk of firearm assault. In contrast to earlier research, this particular study was funded by the National Institute on Alcohol Abuse and Alcoholism. Two years later, Congress extended the restrictive language it had previously applied to the CDC to all Department of Health and Human Services agencies, including the National Institutes of Health."
They cite other examples, including:
- A 1997 study utilizing firearm registration files in Washington state could not be done today because those files are no longer accessible.
- Florida officials last year enacted a new law that could take away the licenses of health care practitioners if they discuss with patients or record information about firearm safety that a medical board later determines was not "relevant" or was "unnecessarily harassing." Similar bills have been proposed in seven other states, the authors report.
- The 2011 National Defense Authorization Act prevents military commanders and non-commissioned officers from talking with service members about their private weapons, even in cases where a leader believes the service member may be suicidal.
"Injury prevention research can have real and lasting effects. Over the last 20 years, the number of Americans dying in motor vehicle crashes has decreased by 31%. Deaths from fires and drowning have been reduced even more, by 38% and 52%, respectively. This progress was achieved without banning automobiles, swimming pools, or matches. Instead, it came from translating research findings into effective interventions," they write. "Given the chance, could researchers achieve similar progress with firearm violence? It will not be possible to find out unless Congress rescinds its moratorium on firearm injury prevention research. Since Congress took this action in 1997, at least 427,000 people have died of gunshot wounds in the United States, including more than 165,000 who were victims of homicide. To put these numbers in context, during the same time period, 4,586 Americans lost their lives in combat in Iraq and Afghanistan."
The article is available at http://jama.jamanetwork.com/article.aspx?articleID=1487470&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=JAMA%3AOnlineFirst12%2F21%2F2012