Police barrier on the scene of a shooting in Royal Oak, Michigan, in May 2018.
Opinion

Gun violence in the US is an epidemic, and federal funding to research it is necessary

Despite firearms being related to high mortality rates, the data on the topic lags far behind that for other leading causes of death.

Editor’s note: This is an opinion piece; the views expressed are the authors’ own and do not necessarily represent the views of The DO or the AOA. This article is a response to a recent op-ed that questioned SOMA’s advocacy decisions.

In March 2018, the SOMA House of Delegates adopted policy concerning the current gun violence epidemic.

As a part of this policy, SOMA called on the AOA to join other physician organizations in the call for Congressional legislation to label gun violence as a national public health epidemic and fund appropriate research at the CDC as part of the federal budget. SOMA’s efforts were successful; the AOA adopted the policy in July 2018.

SOMA’s advocacy to address gun violence continued in 2018. The Giffords Law Center to Prevent Gun Violence is a national public interest law center that promotes and supports measures to reduce gun violence in the United States. In December, SOMA joined an alliance supporting their goal of securing CDC funding to research this crisis.

‘A leading cause of premature death’

Gun violence is a leading cause of premature death in the United States. According to the CDC, firearms are used in between 74 percent and 87 percent of homicides, depending on age, and are used in between 42 percent and 50 percent of suicides.

Furthermore, suicide attempts by firearm have an 82 percent chance of resulting in death, representing the most lethal mode of suicide, based on historical emergency department data.

According to the same CDC report above, from 2015 to 2016 there were 27,394 firearm homicides and 44,955 firearm suicides.

That is a total of 72,349 deaths in a one-year span, which represents approximately 198 deaths a day, or 8 deaths every hour. For comparison, according to the National Vital Statistics Report for 2016, diabetes was the nation’s seventh leading cause of death in 2016 and responsible for roughly 80,000 deaths. The nation’s eighth leading cause of death was influenza/pneumonia and responsible for approximately 52,000 deaths.

Most conservative estimates find that firearm violence can be attributed to at minimum 30,000 deaths annually, and as high as 70,000+, according to the CDC. Even with the lower estimate, we find that firearm violence is still a significant cause of mortality in the United States. For comparison, 33,235 deaths were attributed to essential hypertension and hypertensive renal disease in 2016; it was the nation’s No. 13 leading cause of death for the year.

Lack of research

Despite firearms being related to such high mortality rates, the data on the topic lags far behind that for other leading causes of death. In 2017, using CDC statistics from 2004-14, JAMA found that “gun violence was the least researched cause of death and the second least funded cause of death” in relation to mortality rates.

This lack of research stems from the fact that the CDC and federal entities were for years deterred from freely researching firearm violence due to unforeseen consequences of the Dickey Amendment and now lack sufficient funds to do so.

Data-driven solutions

Funding federal entities to conduct more research on firearm violence will demonstrate which gun violence reduction measures may be most effective.

A report by the RAND Corporation attempted to examine the outcomes of 13 classes of gun policies, such as background checks and concealed-carry laws, on eight categories of gun use outcomes.

The report found that no significant studies had been conducted on the effects of firearm sales reporting requirements, gun-free zones and lost/stolen firearm reporting requirements on gun use outcomes. Also, the report found that no significant studies had been conducted on the impacts of gun policies on officer-involved shootings.

The Giffords coalition stands for evidence-based, data-driven solutions to address gun violence, and we believe that such collaborative efforts are critical to producing high-quality, actionable research that will improve the health and wellbeing of our patients.

SOMA will continue to support efforts to fund gun violence research, and once strong evidence is available, will support data-driven, constitutionally appropriate measures to reduce this public health crisis.

This article was written by Wessley Square, OMS III, SOMA Political Affairs Director, Harris Ahmed, MPH, OMS III, SOMA Parliamentarian, Tyler King, OMS III, SOMA Region IV Trustee, John Rajala, MS, OMS III, SOMA Treasurer, and Kate de Klerk, OMS IV, SOMA President.

Related reading:

Calls for gun death research funding are misguided

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

12 comments

  1. Thank you for this. I was just literally incredulous at the opinion piece Tyler Watson wrote. I wrote a comment in protest on the fly, and wanted to write something more reasoned later. Then I read all the other comments, and was even more flabbergasted. Since when do we not want to study something with this many casualties and such a high dread factor. The solutions are of course debatable, but the question as to whether it is a problem and whether we should spend money coming up with preventive solutions in my mind is a no brainer.

    1. I liked what Tyler Watson wrote. SOMA should stick to student issues; the profession as a whole needs to stay in its lane and not stray into media-generated political controversies. The right to own guns is enshrined in the US Constitution. Why? Because sooner or later people that cannot agree on how to live together will want to live apart; when that happens, violence prevails. Every one has the right to defend themselves and their loved ones under such conditions.

      1. Dear Anonymous, this is every citizens lane, but particularly the lane of medical professionals. I spent 24 years serving my country, defending the US Constitution with multiple combat deployments under my belt. Here is what I know. We also have a right to life, and when that right is infringed upon there are limits to Constitutional protections. Furthermore, the right to own guns is in the context of a well regulated militia. This also underscores that there are limits to this right.

        I don’t know many people that are advocating gun ownership across the board. However, it is worthwhile to see what we can do to limit firearm related deaths, since there are about 30,000 homicides and about 40,000 suicide deaths related to firearm use per year. That’s what you call an actual crisis, not a media generated crisis. To provide context, opioid related deaths are about 70,000 per year and 88,000 alcohol related deaths per year.

        Do not attempt to silence SOMA’s freedom of speech, and don’t attempt to silence mine, just because you don’t want to hear it. When one attempts to shove someone into “their lane” and tell them that they should take their protest and/or advocacy to another venue, they are behaving like an oppressor, stifling the very freedoms they profess to support. I will not be silenced. My job is to prevent untimely death and promote quality of life.

  2. Both the CDC and the FBI have studied various aspects of firearms. While there may be less “studies” on the topic there are detailed statistics kept every year.

    The number of guns has increased but the number of gun related deaths and crimes has decreased over time (see first link). It has also been found by the CDC that defensive use of firearms is used anywhere from 2.2-2.5 million times a year (even if not discharged but as a deterrent/brandishing). Firearm deaths are around 33K, suicides consisting 21k. Medical errors kill 250k. Perspective.

    There are no federal guidelines for what is considered a “mass shooting.” This leads to various outlets claiming anywhere from hundreds a year to just a handful. Mother Jones keeps pretty good data on this and mass shootings are in the decline.

    Death decline w/time
    http://media.graytvinc.com/images/810*493/Private+Ownership+v+Gun+Homicide+Rate.jpg

    US gun violence
    https://en.wikipedia.org/wiki/Gun_violence_in_the_United_States

    Defensive use of firearms
    https://en.wikipedia.org/wiki/Defensive_gun_use

    Murder by weapon Type
    https://ucr.fbi.gov/crime-in-the-u.s/2014/crime-in-the-u.s.-2014/tables/expanded-homicide-data/expanded_homicide_data_table_8_murder_victims_by_weapon_2010-2014.xls

    By crime class
    https://ucr.fbi.gov/crime-in-the-u.s/2017/crime-in-the-u.s.-2017/tables/expanded-homicide-data-table-11.xls

    By demographic
    https://ucr.fbi.gov/crime-in-the-u.s/2016/crime-in-the-u.s.-2016/tables/expanded-homicide-data-table-2.x

  3. Thank you for writing this! I am glad that SOMA has adopted a policy to support more research into gun violence.

    Sadly, today is the one year anniversary of the Stoneman Douglas High School shooting. This is a good article written by Dr. Heather Sher that shows there is a big difference between owning a handgun for self-defense and a military-grade assault rifle.

    https://www.theatlantic.com/amp/article/553937/

  4. First I am curious where the 72,000 gun deaths figure arose. According to the CDC there were 38,658 firearms related deaths in 2016. No where near the stated number. 70,000 plus deaths in 2017 were due to opioid overdoses and many of those directly related to physicians and yet the anguish can’t be discerned due to the outrage over 11,000 gun homicides many of those in poor inner city areas like Chicago. The outcry to study poverty, lack of economic opportunity, education and other drivers of crime seems pretty dim. Suicides made up 45,000 deaths in 2016 and half of those involved firearms.
    And yet are rate of 13 or so per 100K pales to total numbers in Russia, South Korea, Japan where firearm related suicides are rare. So physicians don’t feel ineffectual in their ability to prevent 22,000 suicides as long as they claim the other 22K are the fault of guns?
    The conversation needs to start with accurate data and not hyperbole with which to whip the denizens into a frenzy. As a profession we need to do better.

    1. The number in question is from a report that is available by hyperlink in the text. As to the other concerns, I would say we can and need to study multiple things just as we have always done. Firearms are a factor but not sole factor in many deaths, we should do what we can to understand the role they play in those deaths.

  5. SOMA should stick with student related issues and not hot CNN generated sound bites.

    Last I check I have a god-given right to defend myself and my family. The Constitution of this great country allows me to do this. If you hate it and America, you more then welcomed to move.

    1. This is not your country. This is our country. It is incredibly audacious and condescending to suggest that your fellow Americans should move somewhere else, because they are advocating more research to prevent unnecessary deaths. How about a thank you.

      Also, there are limits to Constitutional rights. Like when they infringe upon “the right to life.” Furthermore, all I see that SOMA is saying is that it is our duty to study this, because the deaths are untimely and significant. To prevent this is one of the tenets of the profession.

      Perhaps if you don’t want to be a team player, and do what you can to prevent untimely deaths of your fellow Americans, you may not be as patriotic as you thought. Perhaps you should look for other living arrangements?

      1. Let’s teach 4 rules of gun handling which will decrease accidents. As someone who is both in the medical profession and an ardent supporter of the Second Amendment, I don’t mind CDC research being conducted on accidental/intentional shootings committed by people with guns. As long as it is done without bias! When I see SOMA partnering with Giffords, I can tell that they are already biasing themselves pre-research on guns. Giffords has already proposed policy changes that are problematic to millions of law abiding gun owners. At the very least they want the gov’t to register nearly all models of existing semi-auto firearms and ban their manufacturing. Concealed carry would be highly restricted and given out at the discretion of government officials. Acting as if they are just waiting for data to dictate policy is disingenuous. I would rather SOMA directly lobby congress for CDC funding instead of joining forces with groups that have declared a dedicated platform of gun control even before any research has taken place. So please excuse 2A supporting doctors for shaking their head at the mention of research; we all know the true legislative intentions even if SOMA is not revealing it. And yes, some of the 2-A supporters here can be abrasive; that’s what happens when society insinuates to a gun owner that has behaved their entire life, that they are encroaching on people’s right to life just because they are one of millions of normal people who happen to have an AR15 in the safe

    2. You are grossly mistaken if you believe we oppose the constitution, second amendment or lawful gun ownership. This is about research, not about gun control. Research may show strict gun control leads to more firearm violence or has no effect, or it may not. That is the point. We would like to explore what works and what doesn’t, with the intention being to protect public health.

      1. (Came back to see if any more comments were posted).

        Harris,
        You sound like you are approaching the issue from pure intentions. I want to believe you, and I applaud you for your refreshing open-mindedness to go where the data points to, but when SOMA pairs up with Giffords, it seems like they are endorsing the legislative proposals being heavily pushed by Giffords and other organizations such as the AMA even before any research has been conducted!

        If SOMA is approaching this from a purely scientific mindset, open to change as you say, without any of the political baggage I listed in my earlier comment (such as disparaging/penalizing the millions of law abiding gun owners among us for the actions of a few deranged losers, demanding registration lists/firearm bans/expansion of Gun Free Zones), then have them and any other medical organizations in the alliance adopt your perspective. They should publicly distance themselves from any agenda driven groups and legislative policies, pending research results. The medical community as a whole will emerge stronger and more respected from this.

        (Of course, I’m not saying that we can’t emphasize safety like keeping guns secured and handling them properly – we don’t need Pro-gun restrictive groups to advocate for this to be studied. Gun owners have no problem with this and the NRA has been teaching this for generations).

        Happy to continue a discussion.
        Thanks for your time and hoping you can share this message with SOMA’s board.

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