Opinion

Calls for gun death research funding are misguided

If we are going to advocate for restricting access to items for health reasons, let’s start with those that cause more deaths and aren’t as legally protected.

Editor’s note: This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

Recently, the Student Osteopathic Medical Association announced that it was joining with the Giffords organization to lobby for gun death research funding. The announcement compared gun deaths to “threats like car accidents, smoking, and sudden infant death syndrome,” along with an accusation that policymakers are “prioritizing firearms over patients.”

This indicated to me that these groups were unaware of actual health comparisons, legal concerns, and current data concerning gun deaths, firearm ownership, and murder rates in our nation. As osteopathic medical students, we are trained to look at situations as a whole—considering multiple factors, rather than making reflexive decisions.

Guns vs. cigarettes, alcohol

Preventable causes of death include cigarette smoking (480,000 deaths annually), alcohol use (88,000), accidental poisoning (58,335), and motor vehicle traffic (40,327), and these are far more epidemic compared to gun deaths (39,773), particularly gun homicides (14,415).

It is hypocritical to call for research and political intervention on firearms when we have not yet conquered these other issues. In fact, banning cigarettes would, applying the same theory of gun control, save 12 times as many lives.

Tyler Watson, OMS II

Extending this same reasoning to alcohol and automobiles, banning these items would save three times as many lives as banning firearms. Although “car control” may not be as popular as gun control, it would arguably save more lives.

The legal factor

With gun control, there’s also the legal factor to consider. The Second Amendment states: “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”

Further, the Supreme Court has held that “private citizens have the right under the Second Amendment to possess an ordinary type of weapon and use it for lawful, historically established situations such as self-defense in a home, even when there is no relationship to a local militia.”

The government has an obligation to protect Americans’ rights to own and use firearms. No such right or obligation exists for cigarettes, alcohol, or automobiles. If we are going to advocate for restricting access to or banning items in the name of public health, let’s start with items that cause more deaths and that aren’t as legally protected.

Federal dollars unnecessary

The campaign to bring in federal dollars isn’t entirely necessary either. The Giffords Law Center has done research without federal finding. It has established a rating criteria where each state gets a scorecard based on that state’s gun laws—A for tight gun regulations, F for few gun laws, and ranked each of the 50 states by the strength of their gun laws.

However, this rhetoric fails to address a basic premise: access to guns will necessarily increase gun death rates, but murder and overall death rates are more important factors to consider than simply gun death rates.

Urban areas have higher access to subways, leading to higher subway deaths—that doesn’t mean there is a subway problem, and focusing on “subway deaths” would neglect the fact that rural areas have higher mortality rates than urban areas. Similarly, focusing on “gun deaths” ignores the more basic issues of murder and death rates.

To look at the data, I compared the Giffords Law Center’s state scorecards and ranks to each state’s gun death rates and then compared Giffords’ state grades to factors that the organization cites in its campaign: suicide, murder, gun ownership (measured by NICS federal gun background checks), and death rates.

The only factor that correlated strongly was suicide (-0.7 Pearson coefficient); murder, gun ownership, and death rates were weakly correlated (ranging 0.15 to -0.22). To investigate further, I compared gun ownership to each of those rates, and found weak correlations to murder (0.07), gun deaths (0.23), suicide (0.14), and death (-0.05). This seems to indicate that states with higher gun ownership rates have little correlation, positive or negative, to any of these undesired effects.

Further searching showed some abnormalities that might be of interest: several states with “F” ratings actually have lower-than-average gun death and murder rates. These states also have a murder rate lower than the national average.

If it is evidence from research we need, we should start with the evidence from research we already have.

Related reading:

Citing shooting risks, physician calls for policies to disarm patients with dementia

Kicking the habit: Free resources to help your patients quit smoking

24 comments

  1. Well thought out opinion by Mr. Watson. Two points that I would like to make for discussion

    1) The second amendment was created when there was general lawlessness in the country along with multiple problems, the British, local native Indians, gangs of bandits, people moving out west without any “police protection” etc.

    2) The weapons available at that time were single fire and short range weapons, which were meant to protect the individual rather than assault. Is there a need for semi-automatic weapons and armor piercing bullets, in the hands of general public?

    1. Neil,
      I agree with some of your perspective but your interpretation of the intent of the founders in creating the second amendment is inaccurate. You have followed the path that many have in assuming that it was written for individual protection alone. Contemplate these words,”…necessary to the security of a free State,…”. The founders knew that the only way they had achieved freedom was by opposing a powerful government force with their own arms. Second amendment is primarily to afford the people some means of opposing tyranny. History affords many examples of tyrants and other oppressive regimes that begin their rise to power by disarming the citizenry. Yes, a personal firearm does afford one a means of self-protection. But above all, the people have the right to firearms in order to maintain freedom. As for the semi-automatic question, keep in mind that the British had the same or better weapons than the Americans did. For the second amendment to be effective, the citizens have the right to possess weapons similar to those which they might face. The Americans had no standing army nor significant Navy when the revolutionary war began. But they did have their own weapons. From that small beginning, they were able to free themselves from tyranny.

    2. I mean this as a discussion point not to disrespect Mr. Mandava:
      1) “general lawlessness” is not accurate. I would recommend some comparative historical research on that. Guns to defend against the “British” which was the oppressive government is making the strongest point of the supporters of the Second Amendment. Native Indians, bandits, and people without “police protection” are all describing needs for self defense which are again the second strongest point of the supporters of the Second Amendment.
      2) Semi-automatic is a single fire weapon. All physicians should understand at least the basic terminology. Only an oppressive government would not want the citizens to have equal fire power to defend their property. Again making the supportive argument.

      We as osteopathic physicians will be able to help in this discussion only when we are able to see this beyond the one dimensional argument: Guns kill people. What are the socio-ecomonic ( native americans attacking, gang kilings) and health/psychological variables (Bullying at school as the outcast or weirdo or family tragedies in the background) in the reasoning behind shootings. That is the heart of the matter. But too politically charged. “Do you feel safe at home?” is not a question about the second amendment – it is about another who may do harm to our patient in any way. Treat the patients ( both perpetrator and victims) not the mechanical devices used. Then we will understand the issue of people harming people.

  2. Bravo, about time a courageous individual speaks out! Well said. Mental health is the real crisis in this country. Now prepare for the push back from your progressive peers!

  3. I am encouraged to see that there are students and future physicians that have not succumb to group think and non fact based ideology. Excellent article using facts, drawing a rational conclusion.

  4. Gun deaths are 5th on the list. Moreover fatality is from acute exposure not chronic exposure. The deaths most often strike people in the prime of their life. Hence the impact of a gun death often carries a higher burden of grief and financial impact for the survivors than say smoking related deaths later in life. Futhermore, mass shootings have a high terror impact upon communities. Also, the preventable deaths from smoking, alcohol, motor vehicle accidents, etc. are being researched. So the argument to not spend money on gun deaths is daft and tone deaf. Lastly, is this young man aware of the article recently published in JAMA in May 2018 that found that strong state firearm laws were associated with lower suicide and homiced rates?

    1. I agree with you. The initial argument that it’s “hypocritical” (which is a misuse of the word by its definition) to look into gun deaths when we haven’t conquered other causes of death is ridiculous on its face. Should we not research cancer because we haven’t conquered the flu? And I always have to shake my head when people make those comparisons to show causes of death that are more prevalent than firearm-related deaths. You’re not talking about deaths related to shark bites or blizzards; the company you’re making comparisons against is really not favorable, and the numbers are a big deal.

      It also doesn’t help the argument that we actively work to eliminate and reduce the other causes of death that were listed. Anyone tried asking patients who admit to gun ownership the usual safety questions? I tend to get an answer, but not before there’s a snide remark about how “it’s none of your business” and/or “the government wants to know everything.” Articles like Student Doctor Watson’s, with the defensive tone and emphasis purely on the 2nd Amendment, seem to me to encourage an attitude like that. The notion of safety is tossed.

      There’s nothing courageous about burying your head in the sand when it comes to gun deaths and claiming that it’s about freedom. If you want to have firearms freely circulating around society, try to find a solution to make it happen while reducing the number of deaths. You are wasting your intellect and good intent by digging in your heels.

  5. You are against research funding?

    If your suggestion is tit for tat then yes, we absolutely need tighter control on alcohol use… then let’s tax the hell out of it. I get tired of treating the same alcoholic over and over for consumption of $5 gallons of vodka.
    If your suggestion is too many people die of traffic deaths, ok let’s create safer traffic laws, safer automobiles, prosecute drunk divers (hmmm seems to point to my first point).

    But more to the point, I really don’t need research to suggest guns lead to violent deaths by suicide or homicide… I need simply to go to work. It makes quite the impression when a 12 year old accidentally kills his brother, or when a grandfather violently shoots himself in the head from the shame of a DUI (yep back there again).
    We are a violent and angry society full of impulsive behavior. That may never change, but it is easier to put the pieces back together when the tools of destruction are a bit more forgiving.

  6. Not to mention of the fact that the vast majority of gun deaths are not from the hands of registered gun owners, but those who are illegally in possession of the firearm. Outlawing guns will only allow the bad guys who will still have them unfair advantage. Mental illness is at the root of most of the mass shootings. The evidence is very clear. Fake news will never give you the truth.

  7. It is refreshing to see an article published that begins to simply illustrate the misinformation that political hacks use to restrict our rights given to us, “THE PEOPLE” by the Constitution. Accurate, factual research, NOT shaded by bias, to find the root cause of gun violence would show the misplaced notion of the inanimate object (gun, automobile, knife, etc.) by itself causing mayhem, there is a human component to the damage caused by those inanimate objects. Start to focus on that as a starting point and I believe that an decrease in gun related violence could be achieved.

  8. This has nothing to do with the second amendment on gun ownership, this is about the research into whether people are safe/safer with guns in their homes. The Dickey amendment has essentially stopped all research on this subject and we as physicians should know about this amendment and what it means. Why are you so afraid of the research that these students want, or do you already know the answer to what they will find? Of course, we need RESEARCH into gun ownership, to trivialize 45,000 lives is awfully pretentious. We also should advocate for the immediate repeal of the Dickey amendment, the author of which has stated such.

    https://en.wikipedia.org/wiki/Dickey_Amendment

    1. Lawrence,
      You seem to be suffering from misinformation about the Dickey Amendment. It doesn’t prevent research into gun violence, in fact there are several government funded studies to that effect. What it does do, is prevents the CDC from advocating, or promoting gun control.

      1. Misinformation or not, is there a good reason for the CDC to refrain from advocating for or promoting gun control? (Influence by the NRA does not count as a good reason.)

  9. No president or legislative body has called for a “ban on guns”, so I wouldn’t make that analogy to banning cigarettes, alcohol, etc. But the analogy to “car control” is a good one. We have car control now. It’s a written test, and a driving test. We don’t allow blind drivers or those with uncontrolled seizures to drive. Just some simple common sense measures to keep cars out of the wrong hands. The proposals out of Washington, and many states, have merely been to do more extensive background checks, especially mental health (as was alluded to in the comments as a significant issue in our country), before allowing one to legally purchase a firearm. This doesn’t violate the intent of the 2nd amendment right. Background checks are easy to implement and are actually in the works as we speak. Perhaps it will be a little harder for psychopaths and other mentally impaired citizens to obtain a weapon for purposes other than self-protection or overthrowing our tyrannical government.

    1. Dr. Lewis,
      I would like to respectfully respond and clear up the misinformation for the benefit of all readers:
      – You are right, background checks were ruled as not violating the Second Amendment. Federal Background checks are already in place on any firearm bought from a dealer
      – The background check denies people with felonies, fugitives, mentally ill, controlled substance abusers, and convicted domestic violence offenders
      – The Gun Show loophole you hear in the news is not a loophole. Not the place to elaborate, but happy to.
      – Most intentional shootings were done by people who broke the law to acquire the weapon. Either stealing from family, gangs, etc.
      – The overwhelming majority of people who bought firearms legally and went on to commit mass murder, were supposed to have been denied, but because of paperwork slip ups in government on reporting their records, they fell through the cracks.
      – The current administration has actually
      signed legislation to address this.
      – Proposals in Washington seek to create “Universal” background checks which mean all guns will have to be put on a list in order for the “universal” part to work. The list part is troublesome.
      – We have many laws on the books on transferring firearms, the specific features/composition of the firearm (automatic weapons are extremely hard to legally possess), and every state has a law in place by which unstable people can be involuntarily committed and evaluated. Would look forward to hear your perspective.

  10. Excellent article Tyler! Anti-gun bias is an article of faith for many. Often, one must express agreement with this “group think” or be thought of as a “gun kook” and ignored as out of the mainstream. I refer you to Dr. John Lott’s book, “More Guns,, Less Crime” for an authoritative and scholarly study on this issue. After a lengthy discussion of this issue with an acquaintance, I offered to buy him one of Dr. Lott’s books. My offer fell on deaf ears. “No need for any such books”, was his response. His mind was made up!

  11. Fellow medical student here, would like to commend the author for a well-thought out article.
    I personally am not against researching gun injuries/deaths, as long as it is done without bias. Many Second Ammendment supporters have a long memory and a bad taste in their mouth from when some in CDC proposed that guns needed to be presented as a social ill like smoking. Link: (https://www.washingtonpost.com/archive/opinions/1994/10/19/sick-people-with-guns/6c7f2bd2-fa57-4d69-b927-5ceb4fa43cf4/?noredirect=on&utm_term=.daa75ee578e2).
    Just to respectfully respond to my peers:
    Dr. Wagner, I also don’t think it should take research to tell us that guns should be locked up and people should be taught firearm safety rules. The NRA and NSSF have been educating new gun owners on this stuff for years, and gun injuries have gone down in fact. I agree that when it happens, it is tragic and often preventable. At the same time, please don’t confuse this as a reason to “get rid of the guns”.

    Neil:
    Semi Automatic firearms have been in common use for well over 100 years. Well over 75% of firearm models in use by everyday people are semi-automatic. As medical professionals we believe in human rights. The Second Ammendment is a human right given to well-behaved, law abiding people (criminals and crazies excluded) to choose their means of personal defense, be it an AR, 9mm pistol, or a 150 year old Mauser. Armor piercing rounds are not available on the legal market.

    Happy to continue to enage.

  12. Research on gun violence is not calling for a ban on guns. The article conflates gun control with banning of firearms.
    “It is hypocritical to call for research and political intervention on firearms when we have not yet conquered these other issues. In fact, banning cigarettes would, applying the same theory of gun control, save 12 times as many lives…Extending this same reasoning to alcohol and automobiles, banning these items would save three times as many lives as banning firearms. Although “car control” may not be as popular as gun control, it would arguably save more lives.”
    Research into gun violence is not a ban on firearms. One of the issues ignored in this article is the killing power of high velocity rounds which kill rather than wound with far greater efficiency It is a mystery to me that such weapons are available to the general public when their use is for military purposes.
    Finally, what is wrong with doing research?

  13. I read from this that the author is oblivious to the fact that public health problems such as cigarrette smoking, ETOH abuse, accidental poisoning, and MVC, have been studied, that there are regulations to decrease mortality from these causes, and these interventions have been EFFECTIVE. I find it very hypocritical that the author ridicules the calls for gun violence research because “we have not yet conquered these other issues”. Why do we have to wait until no one dies from smoking while we show no concern for those who will continue to die at the end of a gun barrel? The author also equates gun regulation with banning guns, which is NOT what the medical community is advocating for; we are advocating for well funded research to develop evidence-based policies. He said in regard to motor vehicles and ETOH that “banning these items saves three times as many lives as banning firearms”. What he doesn’t conveniently mention is that motor vehicles are regulated, ETOH and cigarrettes are heavily taxed, and there are plenty of awareness campaigns about alcohol and tobacco abuse. It seems for some people guns are more important than the more than 30K lives lost every year to firearms. Our country stands out among first world nations for its absurdly high firearm mortality rate. Physicians should put facts before ideology for the sake of their patients, and develop the empathy for the victims of gun violence, their families, and the impact gun violence has in our communities.

  14. I don’t understand the relationship that the author draws between researching gun violence being equivalent to banning guns. He suggests banning cigarettes as a solution to all the negative health effects we have learned from all the research that has been done regarding smoking. Yet, cigarettes are not illegal. What all the research has allowed providers to do is provide education and counseling to our patients to help keep them safe and healthy the best we can. My interpretation of the push for further gun violence research is to do just that: learn more about something that potentially endangers our patients. If anything is true, it is that there is always more to learn, and medicine is ever changing because of that. It seems that this author is suggesting that gun violence is a topic that has nothing to teach us. Anyone in the medical community that doesn’t support federal funding for increased research of an issue that has been established as a public health/safety issue and is severely understudied ought to reevaluate what practicing medicine is about.

  15. The purpose of comparing firearm violence relative to other causes of mortality and presenting these statistics is to establish that firearm violence is a legitimate source of mortality in the United States, worthy of notice. This is not to say that other issues such as motor vehicle accidents, alcohol usage, etc. are not also public health concerns. As physicians and scientists, we know first hand that meaningful solutions can not exist evidence. Although Gifford’s organization is a positive example of research on this topic, one entity is not sufficient. Multiple entities researching a similar topic helps build a wider breadth of knowledge, can accelerate the scientific process, provide multiple perspectives on a given topic and may allow reproducibility of results. Often, it is wrongfully assumed that calling for research on firearm violence is a condemnation of firearms, firearm owners, and the constitutional right to defend oneself. Allowing federal entities to conduct more research on firearm violence will help inform us as to whether or not stricter gun laws work in the first place.

  16. Research may reveal that stricter gun laws actually leads to more firearm violence, or it may not. Therein lies the point, we need more data and research in order to advocate for the correct policies regarding firearm violence to protect public health. Once that research is available, we can support evidence-based, and constitutionally appropriate, measures to reduce gun violence.

  17. Thank you to The DO for publishing this opinion piece:
    Calls for gun death research funding are misguided, Tyler Watson, OMS II.
    It is good to know that there is still enough sense on the editorial board to allow the publication of dissent.
    And thank you to all for such a vigorous discussion.
    I have been a professional student all my life. The fact that I am a physician-for over thirty years-makes me one. In my experience (both personal and professional) I have found that it is not the user but the “abuser” that causes the most harm.
    Many of my patients, friends and family-and fellow physicians-have owned cars, alcohol, cigarettes, AND guns…and ropes, knives, shovels, plastic bags, duct tape, bricks, baseball bats, bowling balls, cinder blocks…and none of them have ever caused harm to themselves or anybody else.
    I suspect that if we all did our academic due diligence one could argue that doctors too have caused as much harm as any of the listed causes above:
    1. Medical errors “third-leading” cause of death in America- CNBC.com; Feb 22, 2018 (Johns Hopkins study claims…)
    2. The DO, October 30, 2017: Medical mistakes happen. Here’s what helps; Ashley Altus
    3. ABC News, September 19, 2018: Prominent doctor allegedly drugged, raped women; officials fear ‘many’ more victims; Meghan Keneally
    4. CNN.com, November 20, 2018: Female genital mutilation case, Laura Ly, CNN

    Let’s all shake hands instead of shaking fingers. Politics is cancerous and has no business in medicine.

  18. Tyler, Excellent Well thought out Opinion write up. I agree completely.
    I took the liberty of forwarding the link to Drs for Responsible Gun Owners. An organization I recommend you consider joining.
    In response to some or your other commenters. We (some parts of Society) mistreat lawful gun owners who are exercising a constitutionally protected right.
    Alcohol use is a good similar thing to think about. Banning it has failed. Regulating it has maybe lowered some morbidity and mortality. If we really could eliminate it (and tobacco)we might only need half of the medical establishment.
    Perhaps there should be a breathalyzer ignition interlock on each car to possibly decrease drunk driving. Back ground checks to purchase alcohol. (If you have been convicted of drunk driving should you be able to but alcohol? Felony if you share alcohol with some one who has been convicted. Etc)
    . We could go on and on with ways to make us safer by violating the privacy and rights of law abiding citizens.
    How much control will we put up with?

    The CDC has conducted research on the use of firearms for self defense.
    It needed to be pried out of them
    So research is good, but if we pay for it it needs to be done honestly with the results published.
    [ In 1996, 1997, and 1998, the Centers for Disease Control and Prevention (CDC)
    conducted large-scale surveys asking about defensive gun use (DGU) in four to seven states. They did not publish the results because it did not fit . ]
    Ran out of space.

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