Shooting in the Dark

We don’t know much about gun violence in America. We don’t know how many firearms are in the United States. We don’t know who owns them. We don’t know why gun violence has been on the decline for the past two decades. We don’t know how many people are the victims of nonfatal gunshot wounds. We don’t know how many guns are purchased over the Internet or at gun shows. And, most important for our country’s constant tug-of-war over the Second Amendment, we don’t know whether stringent gun policies work or whether it’s the more guns, the better. At a time when no topic seems too inane for scholarly inspection, it’s hard to come up with another aspect of American life about which we know so little.

For the past 17 years, the federal government, the crucial quotient in advancing scientific inquiry in fields from public health to space exploration to stem cells, has been terrified to fund gun research. The successful campaigns of the National Rifle Association, combined with just one sentence in a 1996 appropriations bill, have left our understanding of gun violence outdated and perforated.

After the litany of mass shootings in 2012, a spree that reached a new height of senselessness with the deaths of 20 students at Sandy Hook Elementary in Newtown, Connecticut, the government looked ready to support research on firearms once again. President Barack Obama announced 23 executive actions on January 16, 2013. One of those actions directed the Centers for Disease Control and Prevention (CDC) to find answers to our many questions about gun violence. “We don’t benefit from ignorance,” the president said. “We don’t benefit from not knowing the science of this epidemic of violence.” 

A series of executive actions alone, however, can’t erase 17 years of ignorance. 

 

One of the few statistics we do know is that annual firearm homicides in the United States peaked at 18,253 in 1993. Two years later, 27 percent of Americans said that crime and violence were the most pressing issues facing the country. Not coincidentally, the early 1990s were also “the golden days of gun-violence prevention research,” according to Stephen Teret, the founding director of the Johns Hopkins Center for Gun Policy and Research.

Congress appropriated funds for the National Center for Injury Prevention and Control—under the auspices of the CDC—to undertake gun-violence research. The promise of grants encouraged academics to enter this new field. Centers studying guns and their effect on society sprang up; the Injury Control Research Center at Harvard, the Violence Prevention Research Program at the University of California, Davis, and the Injury Research Center at the Medical College of Wisconsin were among the first. Scrupulously agnostic on whether the Second Amendment allowed restrictions on gun ownership, the centers tackled the issue as a public-health problem. If American citizens were going to have guns, the researchers wanted to make owning them as safe as possible.

In the 1970s and 1980s, firearm violence was a problem best solved by criminologists, law enforcement, and tough punishments. When gun deaths kept rising, though, academics lifted a model that had proved successful in reducing motor-vehicle fatalities and tobacco use. “The public-health approach was getting a lot of traction,” says David Hemenway, director of the Harvard Injury Control Research Center. “Name any topic, and people were like, let’s try the public-health approach!” 

When car accidents reached epidemic levels in the mid-20th century, government poured funding into figuring out why and how they could be prevented. Public-health researchers recommended mandatory seat belts, better-designed roads, and safer cars. Public-awareness campaigns imparting the dangers of drunk driving became a familiar sight in the nation’s schools. Automobile deaths dropped. In a similar fashion, the government advertised the dangers of smoking and passed laws limiting the places where people could use tobacco. Cigarette usage dropped. Firearm researchers wanted to duplicate this success, but almost immediately they ran into an obstacle: Unlike driving and smoking, gun ownership was granted protection by the Constitution.

The National Rifle Association saw all the new research as a front for anti-gun legislation—and worse, the government was sponsoring most of it. “The problem that I see with what the CDC is doing is that they are not doing medicine—they’re doing politics,” said the NRA’s executive vice president, Wayne LaPierre. “And they shouldn’t be doing politics.”

As Exhibit A, the NRA pointed to a study by Arthur Kellermann, the founding director of the Center for Injury Control at the Rollins School of Public Health at Emory University. Kellermann’s research, which the CDC funded, concluded that people who lived in a house with a gun were much more likely to be victims of firearm violence. The study generated an enormous amount of controversy, with pro-gun groups questioning Kellermann’s methodology and he, in turn, accusing them of their own bias.

Three years later, Representative Jay Dickey of Arkansas, a Republican, sponsored an amendment to the 1997 budget that cut $2.6 million from the CDC—the exact amount the center spent on gun-violence research the previous year. (This wasn’t the first time Dickey had gone after science budgets. He had inserted an appropriations rider into the 1995 budget that eliminated government funds for stem-cell research, a prohibition that remained until 2009.) The key sentence in Dickey’s amendment was this: “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.” That clause has been reauthorized in every Health and Human Services appropriations bill since.

Although the amendment did not ban federal gun-violence research, the threat was implicit, and the effect was immediate. “CDC, our most important funder, stopped the funding,” Hemenway says. “They were afraid to say the word ‘firearm’ for 17 years.”

Teret remembers a call he received from someone at the CDC after he gave a lecture on gun-violence prevention. “He phoned to tell me, ‘I think it’s best if you don’t give those lectures anymore. Don’t talk about gun-violence prevention.’ When I’m giving a lecture, I’m not doing that on the CDC’s dime. The person called again: ‘I don’t want you to give these lectures.’” Teret says he threatened to sue the CDC for violating his First Amendment rights. The CDC left him alone after that, he says, but continued to “overreact.” 

In those rare times when researchers secured federal funding for a firearm study, the CDC would send the results to the NRA before publication, according to Hemenway. (The CDC declined to comment on Hemenway’s and Teret’s allegations.)

By 2012, the CDC was spending $100,000 annually on gun-violence prevention. As funding from the federal government dried up, so did that of most foundations. Those that remained, most prominently the Chicago--based Joyce Foundation, were asked to keep dozens of programs and researchers afloat with limited budgets. Many gun-violence academics drifted to other public-health areas, worried that their grants would disappear. “The stalwarts who stayed in the field,” Teret says, “you can almost count on one hand.” 

In 2003, Representative Todd Tiahrt of Kansas, a Republican, introduced an amendment to the bill funding the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) that made it nearly impossible for researchers and law enforcement to access the agency’s data on gun markets. The most baffling part of the amendment, which remains law, was a prohibition on computerizing the ATF’s data. The reason Tiahrt gave for keeping the agency in the dark ages? The need to protect the privacy of gun owners.

A 2004 study from the National Research Council summed up the effect of all the cuts and restrictions. “The committee does not wish to paint an overly pessimistic picture of this research area … [but] in key data areas—the availability of firearms, the use of firearms, and the role of firearms in injuries and death—critical information is absent.”

When the Affordable Care Act was passed in March 2010, it included a provision that made it difficult for doctors to collect information about gun ownership and usage from patients. In 2011, Representative Denny Rehberg of Montana, a Republican, added an appropriations rider to the National Institutes of Health (NIH) budget, which mirrored the language Dickey used to inhibit the CDC. To the remaining researchers in the field, the rider was superfluous: From 1973 to 2012, the NIH had awarded only three grants for firearm-violence studies.

Without research, it has been impossible to evaluate existing firearm legislation or justify new bills. Recently, Governor Jerry Brown of California, a Democrat, vetoed seven bills regulating guns because no evidence existed that validated their effectiveness. “We don’t know what works, and legislators and lawmakers don’t know what to propose,” says Mark Rosenberg, who was the director of the National Center for Injury Prevention and Control from 1994 to 1999. “You can’t blame people for being reticent to propose a policy if there’s no evidence that it will work. The assault-weapon ban, for example—we don’t know that it will work, because it hasn’t been evaluated. Universal background checks—we don’t know if they work, because they haven’t really been evaluated. We are really suffering because we don’t have this information.”

Even Dickey, who’s now retired from Congress, thinks more research is prudent. After the mass shooting in Aurora, Colorado, in July 2012, he co-wrote an op-ed in The Washington Post with Rosenberg that called for federal funding: “We were on opposite sides of the heated battle 16 years ago, but we are in strong agreement now that scientific research should be conducted into preventing firearm injuries and that ways to prevent firearm deaths can be found without encroaching on the rights of legitimate gun owners.”

In June 2013, the National Institute of Medicine (IOM) and the National Research Council released a report listing the most pressing needs for gun research. In September, IOM’s annual meeting revolved around the science of violence “with an emphasis on firearms.” The National Institutes of Health has announced that it is issuing three grants for violence--prevention studies with a focus on guns. The National Institute of Justice has given grants for six projects. The Senate’s proposed 2014 budget for the CDC included $10 million for firearm-violence research. A May 2013 survey from the Pew Research Center showed that 66 percent of Americans think there should be a federal database that tracks gun sales.

However, the main deterrent to researching gun-violence prevention still remains. The president may have authorized the CDC to restart research on firearms, but the 2014 budget that included funding for this task was never put to a vote. Not only is there little money but there are hardly any new researchers to accept the mostly nonexistent funding either. At the Institute of Medicine conference in October, a professor relayed a story about a student who came looking for advice on an NIH proposal about gun research she was writing. Her mentor told her that “getting involved in this discipline was a career killer and that she should have nothing to do with it.”

Then there’s the National Rifle Association. “I do not think the NRA has become more kitten-like in its opinion of gun researchers,” Teret says. “I wouldn’t be surprised if the attacks returned when the research resumes.” Unlike gun researchers, the NRA is not having any difficulty raising money. After Newtown and President Obama’s call for greater gun control, the organization raised record sums. 

When the new federal grants are matched with scholars, the studies will take years to complete. After the findings are released, there’s no certainty that they’ll lead to good policy. Despite all this, researchers are more hopeful than they’ve been in a long time. “I tend to be optimistic,” Teret says, “but I’d like to see proof of resuscitated work.” 

Given the still-limited funding, researchers say the first priority is examining the effect of gun regulation that has remained on the books. States that place restrictions on ownership tend to have fewer gun murders and suicides, but researchers have not determined whether it’s correlation or causation. If, however, widespread ownership is the simplest means to curb firearm violence for good, well, we need definitive proof for that too. The gun industry has changed in myriad ways since the mid-1990s. The Internet is now an easy way to purchase a gun for those who don’t want to leave a paper trail, but the number of firearms being bought online is a mystery.

One of the few successes during the slow years of gun-violence research was the CDC’s National Violent Death Reporting System, which the agency describes as a database “that pools information about the ‘who, when, where, and how’ from data on violent deaths to provide insights on ‘why’ they occur.” The system started operating in six states in 2002, with a mixture of private and public money, and expanded to 18 states by 2006. It’s been stalled since because of a lack of funding, but the information collected so far has been exceptionally useful. The Veterans Administration, for example, is mining the database to uncover which soldiers returning from Iraq and Afghanistan are most at risk for suicide. The initial Senate budget for 2014 appropriated $18.5 million to bring the reporting system to other states, but it has since been excised.

“The situation we’re in is kind of like chemotherapy,” Rosenberg says. “I had a friend who had a horrible tumor. If all you want to do is get rid of the tumor, there are very good drugs. We know how to do that. The problem is that these drugs are very toxic, and they would kill his kidneys and his liver and his heart as well as the tumor. So you have two objectives, one is to stop the tumor—like firearm injuries and death—and the other is to protect the patient’s vital organs. So the other goal is to protect the rights of gun owners. To find the right drug that does both of them is hard. You need to do research—there’s no other way to find it.”

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