We know frighteningly little about gun violence.
In the aftermath of the recent Orlando massacre, Vox’s Brad Plumer asked some of America’s top gun researchers to list the biggest unknowns in their field. Many of them were shockingly basic, like, "How are guns actually used?"
The general lack of data on the issue is by design. In 1996, Congress issued an amendment barring the CDC from allocating any funds to projects that could be used to "advocate or promote gun control." The legislation didn’t amount to an outright ban, as the former congress member who initially championed it now argues, but it was enough to bring the majority of gun violence research in America to a screeching halt. Two decades and one executive order from President Barack Obama later, we remain in pretty much the same situation.
Throughout this funding drought, Dr. Garen Wintemute, a professor of emergency medicine who runs the Violence Prevention Research Program at the University of California, Davis, has been one of the very few researchers committed to full-time firearm violence research. In the absence of federal dollars, he has donated over $1 million of his own money to keep his research afloat.
I wanted to know just what the CDC "ban" meant for violence prevention in America, and what we lose when we fail to think about gun violence as a public health problem, so I gave Dr. Wintemute a call.
(Our conversation has been edited for brevity and clarity, and to make my questions a little more coherent.)
Caleb Lewis: Tell me a little about the importance of studying gun violence from a public health perspective. Just how damaging have two decades of little to no research on this front been for us?
Garen Wintemute: I often pose a rhetorical question asked by a former head of the CDC, "If violence isn’t a health problem, then why are all these people dying from it?"
It really is just that simple. Violence is more than a public health problem, it’s a health problem, it’s a social problem, it’s an economic problem, it’s a manifestation of widespread structural injustice.
The specific value of studying gun violence using public health methods is that those methods do for violence what they’ve done for cancer and heart disease and motor vehicle injury — other important health problems that have social connections. Those studies have helped us understand the problem, they’ve helped us understand risk factors, how to implement interventions, and to see if those interventions actually work.
CL: The automobile analogy comes up quite often. Could you elaborate on it? How has automobile research made driving more safe, and how does that story reflect what could happen with gun violence?
GW: There was an epidemic in the late 1950s and early 1960s with rates of motor vehicle death going right through the roof. So we did what this country does best, we committed resources, we put smart people on the case to figure out what was driving the epidemic and how its course might be changed. Congress was waiting to put the recommendations that came out of the science into action. In the space of a few years, we took rates that were increasing rapidly and completely stopped the trend. Overall, they’ve been declining ever since. The approach to motor vehicle trauma is seen as one of the great health and medical successes of the 20th century.
By contrast, with firearm violence, when we were faced with rapidly rising rates in the late '80s and early '90s, we started a mobilization — but in the mid 1990s we shut that mobilization down. The result of these two different approaches being that today, for all intents and purposes, there are as many deaths from gun violence as there are from motor vehicle crashes.
CL: The difference you laid out here is a result of the congressional "ban" on gun violence research. But why is federal funding so important? Why can’t private foundations or universities just fill the gap?
GW: Let’s broaden that question. Why don’t we stop federal funding for research on cancer or heart disease or motor vehicle trauma or climate change?
The point of federal research across all these problems is, one, that the federal government can bring resources to bear in ways that no coalition of foundations or universities can, and two, that all of the problems that I mentioned seriously affect the public health, the future of our country. In other areas, the government has taken its moral responsibility to protect the health and safety of its citizens very seriously. Firearm violence is a unique case. We have consciously and deliberately and repeatedly turned our back on the problem. Mass shootings are just one of the consequences.
CL: A common justification for the ban was that federal dollars were being used to fund "advocacy research," or research that was designed to yield results that could then be used by gun control champions. In your experience, is there any truth in that claim?
GW: The studies were absolutely not designed to produce a particular answer. I know this firsthand. We didn’t know what the answers were going to be, we are scientists who are driven by curiosity and a hope to improve the human condition. We weren’t doing advocacy; we were doing research.
There was one case that isn’t widely discussed. One of the CDC-funded injury centers back then took advocacy positions in a newsletter. The findings of the research, as it turned out, were such that people who were interested in reshaping policy found their interests supported by some of the findings. That was not the intention of the research, that’s just how it worked out.
CL: But using that argument, an entire field of research was immobilized?
GW: Imagine if the tobacco industry had been able to choke off research on the connection between smoking and cancer, or if the motor vehicle industry had been able to shut down research on the causes and consequences of motor vehicle trauma. It was brilliant. 20 years later, we’re still in the same position.
CL: You’ve personally spent a large sum of your own money to fund research. Could you tell me about that decision?
GW: I fund research on firearm violence and its prevention. I provide funding for two reasons. The first is because I can, and the second is because it’s a huge problem that directly affects hundreds of thousands of people every year. It indirectly affects every man, woman, and child in the United States. It’s a huge problem, very few people are working on it, there isn’t enough funding, and I’m in a position to help.
CL: Have you ever personally published research that has made gun control advocates uncomfortable?
GW: Sure, I make them uncomfortable all the time. Recently, at a time when there was interest in "closing the gun show loophole" [the legislative exception that doesn’t require gun show sellers to run background checks] we released a report saying that would have very little effect on violence. Knowing what the impact of that would be on the policy effort, I convened a conference call that included a lot of representatives from "gun control organizations" and told them what we were going to be publishing. They were furious. But that doesn’t really matter. I am not driven by a policy agenda. My interest is in preventing violence, and I do believe that having evidence on hand when one is contemplating efforts to address a health problem makes good sense.
CL: What are some of the gun violence questions that are most interesting to you?
GW: Speaking broadly, we need to know more about risk factors for involvement in gun violence. We need to know a great deal more about the consequences, we need to know more about the effects of interventions.
For example, across the country, rates of gun violence, including suicides and homicides, have not budged an inch in 15 years. During that same period the rate of fatal gun violence here in California has gone down by more than 20 percent. And we don’t know why.
My guess is that several different things are involved, but I would love to find them out so we could encourage those favorable factors both in California and throughout the country.
CL: Earlier you said that violence isn’t just a public health issue, but a health issue in its own right. What are some ways that violence impacts Americans’ health that we don’t often consider?
GW: People who have gunshot wounds are on balance the most serious injuries that hospitals are likely to see. They require a lot of resources to take care of and rehabilitate. Those resources are then not available for anyone else. This argument could be made about a lot of different conditions, but one of the ways that people have a stake in gun violence that they often don’t think about is if the trauma team is taking care of a young man who has been shot, they’re not available to take care of the middle-age woman who’s been in a car wreck. Now, of course, we try to divide forces and bring in more people, but the fundamental point is valid.