What’s Missing from the “Gun Control Debate”? Respecting the Science

(from ibtimes.co.uk)

(from ibtimes.co.uk)

[Ed: This first appeared February 26 on American Greatness as “Gun Grabbers Deny the Science”, slightly expanded here.]

Mark Rosenberg, MD, MPP, former assistant surgeon general and founder of the National Center for Injury Prevention and Control at the Centers for Disease Control, claimed in Politico this week that there is still too little useful research into how to reduce “gun violence” in the U.S. This is the same Dr. Rosenberg who in his official capacity in1994 said that firearms should be seen as “dirty, deadly—and banned.” (For the whole story about the CDC’s anti-gun activism then, see discussions by Timothy Wheeler, MD and Don Kates et al.)

Rosenberg claims that “Research efforts had slowly but steadily ground to a halt following the passage of the [1996] Dickey amendment.” That’s always been false. The CDC, the National Institutes of Health and other federal agencies have been free to fund research so long as it does not propagandize for gun control, which the CDC pointedly did during the 1980s and early 1990s.

Academics always want greater federal funding of their specialty, but the number of published studies on gun violence has significantly increased since 1996. Only their proportion of all medical research has decreased, which is perfectly reasonable as medical science expands. Even Dr. Rosenberg points out that there are many “. . . public health programs that are viewed as more central and critical to CDC’s mission—fighting infectious diseases like Ebola or influenza and chronic diseases like heart disease, hypertension, diabetes and stroke.”

Dr. Rosenberg says that gun control advocates can seem “so single-mindedly focused on safety that they would happily take all firearms out of civilian hands . . . [while] those who favor gun rights . . . have been conditioned by the NRA leadership to have zero tolerance for any discussion whatsoever about preventing gun violence.” Nonsense! Many gun control advocates would indeed happily deny Americans their right to keep and bear popular, historically legal arms of their choice.

“Gun safety” comprises the knowledge and skills to handle guns responsibly, and has nothing to do with the gun control restrictions constantly mooted. It is a distortion of reality to accuse gun owners of being “conditioned” by the National Rifle Association or any other pro-gun group. They are successful because they reflect the values of millions of Americans, which includes accomplishing background checks on nearly 90% of all firearm purchases. Reducing firearm deaths and injuries is important to everyone, and accusing pro-gun organizations and owners of refusing to talk about it is insulting.

What “gun contr . .”—excuse me, “gun safety” [sic] advocates believe would mainly further limit the civil rights of the vast body of over 150 million safe, responsible, law-abiding American gun owners.

The flaw in the public health claim about the need for more research into gun violence is holding that solving it requires “the same kind of scientific research that showed us how to save millions of lives from cancer, heart disease and high blood pressure. . . [to] save half a million lives from road traffic crashes, without banning cars. . . [and] that proved that second-hand smoke harms people.” And to compare “gun violence” to the thalidomide tragedy of the 1960’s is just noxious. We’ve addressed these irrelevancies many times at Doctors for Responsible Gun Ownership, in great detail here.

Guns are inanimate objects controlled by people. With any knowledge at all, they can be dealt with safely despite certain intrinsic risks like misfires. It’s entirely about where they are pointed and, literally, how they are handled. They cause no contagion (perhaps psychological), no pathological spread (just illegal acquisition like straw purchases and theft), and no societal threat (except by criminal use). None of this compares to the issues addressed by true public health science, when people living normal lives are unknowingly, even helplessly subject to illnesses and other risks of pathogens, lack of sanitation and accidental injuries in the workplace and at home. This is why gun detection is important, if everyone is aware of the firearms that are present, it’ll be easier to use this data to make better decisions about the safety precautions required to prevent more accidental deaths.

Deaths (currently something more than 30,000 annually) and injuries (70 – 100,000 annually) by firearms have been in general decline for 4 decades, even while the stock of civilian owned guns in the United States has increased (up nearly 50% from 1993 to 2013). During that time, our population has increased by about 20%, while the gun homicide rate has fallen by nearly 50%. By any standard, that is a remarkably, happy reduction of mortality that unquestionably confirms that the number of firearms in circulation does not increase harm, and may well be a factor in reducing it.

Criminologists address homicide and violent crime, mental health researchers seek to understand how to reduce suicide, and safety education by firearm experts on gun handling and storage options (no one size fits all here) continue to reduce accidents. Sociologists and economists are good at teasing apart societal fundamentals that foster violence as a way of life for poor urban youth, drug gangs, and criminal enterprises—central problems in “gun violence”. Without our socioeconomically disadvantaged urban crime centers, the United States is one of the safest countries in the world. These are the areas of expertise that can promote further harm reduction. There is simply no useful role for the epidemiological “public health approach”, except perhaps to identify the locales and patterns that elevate the risk of criminal shootings.

Is it true that, as Rosenberg says, “. . . we don’t know whether arming all teachers in a school will save lives or take more lives. We don’t know whether making it easier for people to carry concealed weapons will save lives or result in more deaths. And we don’t know whether banning the sale of semi-automatic rifles will prevent mass shootings or lead to more gun deaths because there will be fewer good guys with a gun to stop the bad guys with guns.”?

No, not at all.

We know that trained, armed school staff has resulted in no harm where it has been established in recent years, and that mass shooters of every variety always target places that are theoretically “gun-free”. We know from studies of permitted concealed carriers that they are far more law-abiding (i.e., safer) than the general public or even law officers. We know that good guys with guns intervening do prevent or minimize casualties because attackers don’t like return fire (e.g., the Klackamas mall attack, the Colorado Springs and the Sutherland Springs, Texas church assaults). We know that banning semi-automatic rifles doesn’t help from the 1994-2004 “assault rifle” ban. These weapons have always been statistically insignificant, being used less than 2% of all shootings while mass shootings themselves are responsible for only about 1% of all firearm-related deaths.

A core component of any public policy analysis is balancing risks with benefits. Academic health researchers roundly ignore the fact that firearms are used every day by Americans protecting themselves, their property and others when facing assault with deadly weapons. The National Research Council reported in 2004 that this happens anywhere from 500,000 to 3 million times each year. That’s enormous benefit, with many lives saved and injuries prevented, to set against the tens of thousands of deaths and scores of thousands of injuries documented (a significant number of which are justified by being defensive). If only a fraction of these defensive gun uses prevent deaths and injuries to innocents, that more than balances the losses that occur from other causes.

If researchers care about true public health crises, I’d urge them to focus on much more damaging problems that are more amenable to public health solutions. These include the escalating opioid epidemic, which used to kill a fraction of those who die by gunshot. More than 64,000 people died of opiate overdoses in 2016. Or address the little noted epidemic of iatrogenic deaths (i.e., caused by health care professionals). Estimates of this tragically run to approximately 400,000 deaths per year, with 10-20 times as much serious harm.

Interestingly, after criticizing the Dickey Amendment 2 years ago with its framer, Jay Dickey, Rosenberg seems to have had a change of heart, saying “that the Dickey amendment should be preserved, to assure those on the gun-rights side of the debate that none of the funds they send to CDC will be used to lobby for gun control legislation and that these funds will be used only to support scientific research.” It will be a hard sell for a long-time gun restrictionist like Dr. Rosenberg to convince Americans who’ve felt condescended to and criticized by his ilk to buy this.

My advice to Dr. Rosenberg and anyone who wants to grow their careers in public health at the expense of Americans who stand by their natural right of self-defense and our Second Amendment’s guardianship of the consequent right to keep and bear arms is this: Heed the science as it already exists. We have a great deal of work to do to decrease violence and preventable causes of deaths in our country without questioning whether the wheel is round.

The truth is already out there. Let’s use it.

 

Robert B Young, MD

— DRGO Editor Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association.

All DRGO articles by Robert B. Young, MD.