03/23/2018

Shaping The Future Of Gun Research

17:28 minutes

black handgun in plastic Secure Storage Case
Credit: Shutterstock

Guns kill more people in the United States than alcohol—from homicides and suicides, to mass shootings like the one that left dead 17 high school students in Parkland, Florida last month. But public health researchers will tell you that studying alcohol-related deaths is much easier. Gun research is so fraught politically that the Centers for Disease Control and Prevention doesn’t fund it (though the National Institutes of Health did for three years during the Obama presidency), and a pair of Congressional amendments continue to throw red tape on funding and access to certain kinds of data.

Researchers who do want to study guns find support from their universities, private foundations, and sometimes state government. In 2017, the state of California established the first state-level research center for gun violence. New Jersey and New York are considering following suit. Does this mean the future of gun research lies with the states?

[What we do (and mostly don’t) know about guns.]

Not quite, says Dr. Garen Wintemute, a firearms researcher who is now directing the University of California’s new center for firearm violence research. He explains why state-level support still leaves holes financially and in the available data. And as legislative solutions—like background checks and banning bump stocks or assault rifles—continue to be pushed forward, Catherine Barber, a researcher at Harvard’s T.H. Chan School of Public Health, describes an ongoing project that works with gun owners to reduce the biggest cause of firearm-related death: suicide.


Interview Highlights

On gun violence as a public health issue.

Garen Wintemute: Fundamentally, firearm violence is a health problem. It can be studied as any other health problem is. And for other health problems, we recognize that understanding the nature of the problem and how to intervene lies at the foundation of effective treatment and prevention efforts. We do that for motor vehicle injuries, opioid overdoses, we do it for heart disease and cancer. We need to do it for firearm violence.

On gun violence among different populations.

Catherine Barber: About 60 percent of firearm deaths are suicides. That statistic in some regards conceals more than it reveals, because there’s a tale of two very different populations in the United States. Among white Americans, 83 percent of suicide firearm deaths are suicides. Among black Americans, 84 percent of firearm deaths are homicides. So it becomes very important to look at the specific local circumstances at the local data to see what can be done in the white community around suicide and particularly in certain black communities around homicide, and to be to be detailed in those investigations, and particularly on this suicide issue, to involve gun owners in that conversation.  

On a culture shift around suicide and guns.

Catherine Barber: Thirty years ago, nobody had heard about designated drivers or “friends don’t let friends drive drunk.” There’s a huge need for a cultural shift that takes that same approach to guns and suicide. If a friend or family member is really struggling with a depression or a drug problem and especially if some other crisis is overlaid on that like a horrible divorce, that’s the time to say, “Hey, I’d feel a lot safer if I could hold onto your guns for you.” Or if that’s not legal in your state, “What do you think about putting your guns in storage? Just for now until until the worst of this blows over.” It’s a nice “bro” way of showing you care. And it also substantially improves their safety.

On current research into guns.

Garen Wintemute: We we know that identifying and prohibiting firearm purchases by people who are at high risk—and federal law and state statutes have varying definitions for who should not be allowed to purchase a firearm—we know that those sorts of restrictions work. We did a prospective controlled study here in California of a policy that prohibits people who’ve been convicted of violent misdemeanor crimes from buying guns. It’s a myth that people who’ve been convicted of violent crimes can’t legally buy guns. California changed its policy and we found that that change in policy reduced risk of future violence among the people who were affected by 25 to 30 percent which is which is a big effect.

On whether states can pool their data without federal involvement.

Garen Wintemute: No, not a chance. The data collected at individual state levels differ quite a bit, so pooling would not be an effective approach. But there’s a larger point to make here: There is a level of research that at least traditionally has only been feasible with federal support. I’m talking about the large projects that sometimes address the most important questions questions that can’t be addressed on a small scale projects that might cost several million dollars to complete without that level of support. Those questions simply will not be answered and I don’t think it’s realistic to expect individual states to pony up that kind of money.

On what research still has to be done.

Garen Wintemute: The question is this: Among people who legally purchase firearms, are those who at the time of purchase have a documented history of alcohol abuse at greater risk down the road for violent crime? Preliminary data suggest that they are, and that would comport entirely with what we know about alcohol and violence. But in order to answer the question definitively, the study has to be large enough—it has to involve tens of thousands of people who are followed over time to see, based on their prior criminal record and other characteristics, what their risk for outcome events is.

Catherine Barber: What’s been so fascinating for the kind of work that we’ve been doing in New Hampshire with the New Hampshire Firearm Safety Coalition and in Utah with a similar group, is bringing gun owners and people who care a lot about gun rights into the process of developing the research questions and thinking through the data. It’s fascinating to learn to respect one another’s opinions and to really challenge the kind of blinders that we all have.

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Segment Guests

Catherine Barber

Catherine Barber is Director of the Means Matter Campaign and a researcher in theHarvard T.H. Chan School of Public Health Injury Control Research Center in Boston, Massachusetts.

Garen Wintemute

Garen Wintemute is the Susan P. Baker and Stephen P. Teret Chair in Violence Prevention, a professor of  emergency medicine, and the Director of the Violence Prevention Research Program at the UC Davis School of Medicine in Sacramento, California.

Segment Transcript

IRA FLATOW: This is Science Friday. I’m Ira Flatow. It’s been over a month since a shooter gunned down 17 people at Marjorie Stoneman Douglas High School in Parkland, Florida. And since then, survivors have done their best to reinvigorate the national conversation about preventing gun violence of all kinds.

They’re calling for assault weapon bans, closing background check loopholes, and beyond. They and their supporters are rallying in Washington this weekend in the March for Our Lives to make these demands heard. But if you’re a public health researcher, and you want to study gun violence– where it comes from, what interventions might actually work, good luck getting funding.

A 20-year-old congressional act, the Dickey Amendment, says, of the funding given to the Centers for Disease Control and Prevention, none may be, quote, “used to advocate or promote gun control.” You can imagine how that political language has chilled firearms research.

Well, fast forward to this week, congressional Republicans this week are adding a clarification that the amendment does not actually prevent research. That clarification says, on the other hand, a different amendment still limits access to the FBI’s database of firearm purchases. Now wouldn’t that data be useful.

That doesn’t mean no one’s doing the research. Researchers with university funding, private foundations, even the Justice Department, they are turning out papers. And the states themselves are trying to bridge the gap. Last year, California established its own center for gun violence research with the University of California. New Jersey is considering a similar project at Rutgers, and even New York state might follow suit.

So what’s next for firearms research? What have we learned about stemming the death toll, and where are there still gaps? Let me introduce my guest, Garrett Wintermute is director of the University of California Firearms Violence Research Center, professor of Emergency Medicine at UC Davis. Welcome to Science Friday.

GARRETT WINTERMUTE: Thanks for having me.

IRA FLATOW: You’re welcome. Catherine Barber, researcher at Harvard’s TH Chan School of Public Health, director of the Means Matters Program for Suicide Prevention. Thank you, welcome to Science Friday.

CATHERINE BARBER: Thank you very much. Glad to be here.

IRA FLATOW: Garrett, I just said that there are plenty of researchers turning out papers. But what do people mean when they say gun violence research is hard to do?

GARRETT WINTERMUTE: Well, first off there are way shy of “plenty” of researchers. The small size of the labor force is one of the larger problems we’re dealing with. Fundamentally, firearm violence is a health problem. And to quote a prior director of CDC, if it weren’t a health problem, why would all these people be dying from it?

The point here being that it can be studied as any other health problem is, and for other health problems, we recognize that understanding the nature of the problem and how to intervene lies at the foundation of effective treatment and prevention efforts. We do that for motor vehicle injuries, opioid overdoses. We do it for heart disease and cancer. We need to do it for firearm violence.

IRA FLATOW: Now, the Dickey amendment, and I’ll quote from the amendment. It says, “no money can be used to advocate or promote gun control.” But this doesn’t talk about, I would think, in the pure state, doing research about guns doesn’t actually have to lead to gun control. It’s just understanding how it’s all working.

GARRETT WINTERMUTE: So that’s exactly right. And I’ll also say that some of the work that we do makes gun control people quite angry because we follow the data. But to the Dickey Amendment, people in the field have understood since the ’90s that, at least in the language, there never was, there is not today, a ban on research.

So fast forwarding to the events of the last 24 hours, all that has happened, as you pointed out in your set up for this segment is a clarification of that. Nothing new has happened. So the research community doesn’t see a significant change in the events of the last 24 hours. If there were funding, if there were even encouragement, that would be something else again.

IRA FLATOW: So you are saying, as you mentioned before, that it would be helpful to research guns in the same way we research public health problems, like drug overdoses or car crashes because so many people die.

IRA FLATOW: Yes, exactly. Now Catherine, one of the areas of gun research that’s still happening despite the obstacles is your project Means Matter. What we know that Two-thirds of gun related fatalities are from suicide. That’s more than 20,000 people every year. Tell us what you’re learning about preventing those.

CATHERINE BARBER: Well, it is true that about 60% of firearm deaths are suicides. That statistic, in some regards, conceals more than it reveals because there’s a tale of two very different populations in the United States.

Among white people, among white Americans, 83% of firearm deaths are suicides. Among black Americans, 84% of firearm deaths are homicides. And so it becomes very important to look at the specific local circumstances, at the local data, to see what can be done in the white community around suicide, and particularly in certain black communities around homicide, and to be detailed in those investigations, and to involve, particularly on a suicide issue, to involve gun owners in that conversation.

IRA FLATOW: So what does your project, Means Matter, do to help what you’re looking for?

CATHERINE BARBER: Well, 10 years ago the suicide prevention movement wasn’t talking about guns, and gun owner groups weren’t talking about suicide. It simply wasn’t on thir radar. For the suicide prevention groups, they were well aware that gun access was a risk factor for suicide, but they felt it was too controversial to talk about guns because they had a very narrow perception that talking about guns meant taking a stand on gun control. When instead, there’s tremendous scope for common ground, for non-legislative solutions to the issue of firearm access and suicide.

IRA FLATOW: So what strikes me about this project is that nothing you’re talking about requires any actual legal change in the regulation of guns, just a cultural shift.

CATHERINE BARBER: There is a huge need for a cultural shift in the same sense that, 30 years ago, nobody had heard about designated driver, or friends don’t let friends drive drunk– that’s taking that same approach to guns and suicide so that, if a friend or family member is really struggling with a depression or a drug problem, and especially if some other crisis is overlayed on that, like a horrible divorce, or third drunk driving arrest, or something– that’s the time to say, hey, I’d feel a lot safer if I could hold on to your guns for you, or, if that’s not legal in your state, what do you think about putting your guns in storage, just for now, until the worst of this blows over? It’s a nice, bro way of showing you care. And it also substantially improves their safety.

IRA FLATOW: Well, that brings me to that question. Do you know that it actually works? Does it substantially improve their safety?

CATHERINE BARBER: Well, the way that we got to this was by looking at that– there are over, about 16 case control studies in the United States looking at risk factors for suicide and looking at whether gun access is a risk factor. And in fact, it is.

And we looked at data to figure out, well, is that because of the nature of the person, the community, or the gun itself? And so I asked Ron Kessler to add to the National Comorbidity survey a question about gun ownership. And it’s a survey that screens for mental health problems.

We saw that gun owners were no more likely to be suicidal or to have a mental health problem. So what it is is that, in the event that they become suicidal. They’re just more likely to die in a suicide attempt.

So it seemed like, well, that means we need to get word to gun owners and their families. And do you send– into the gay and lesbian community to do to do suicide prevention group work, would you send an anti-gay group? Probably not.

So who are the right messengers for this message for the gun owning community? Well, probably you’re going to trust the messenger when it’s a firearm instructor, when it’s a gun shop owner, when it’s a lecture at the spaghetti dinner at the sportsman club.

IRA FLATOW: Very interesting. Garrett, what are some of the other research projects that are turning out interesting results give us an idea?

GARRETT WINTERMUTE: Sure. I’ll mention, as a bridge, an intervention that’s called the Gun Violence Restraining Order, which is actually quite similar to what Cathy has been describing. In a situation where risk is high and imminent, and firearms are involved, there are currently five states– we, in California, are one of them– that allow– as with domestic violence– allow members of the family or law enforcement to go to a judge and make the case that the firearms are to be taken out of the situation.

We are evaluating the program in California. I don’t have aggregate data. But, at the anecdotal level, I’m aware that this process has been effective. There has been a rigorous quantitative evaluation done in Connecticut, which also shows that there’s been good effect.

On your broader question, we know that identifying and prohibiting firearm purchases by people who are at high risk– and federal law and state statutes have varying definitions for who should not be allowed to purchase a firearm– we know that those sorts of restrictions work. We actually did a prospective controlled study here in California of a policy that prohibits people who’ve been convicted of violent misdemeanor crimes from buying guns.

It’s a myth that people who have been convicted of violent crimes can’t legally buy guns. In most of the country, they can buy as many guns as they want, as long as those crimes aren’t felonies. California changed its policy, and we found that that change in policy reduced risk of future violence among the people who were affected by 25% to 30%, which is a big effect.

IRA FLATOW: So if the state of California is having its own fling at gun research now– and I mean that derogatorially– if enough states step up in the same way, you know, because that’s what states seem to be doing now in many different aspects of social caring, can they make up for a lack of the federal involvement? Can you all pool your data without having a centralized federal agency doing it.

GARRETT WINTERMUTE: No, not a chance. The data collected at individual state levels differ quite a bit. So pooling would not be an effective approach. But there’s a larger point to make here.

There is a level of research that, at least traditionally, has only been feasible with federal support, whether it comes from CDC, or from NIH, which also, for a few years, was funding research in this field but has since essentially stopped, or from NIJ.

I’m talking about the large projects that sometimes address the most important questions, questions that can’t be addressed on a small scale. Projects that might cost several million to complete. Without that level of support, those questions simply will not be answered. And I don’t think it’s realistic to expect individual states to pony up that kind of money.

IRA FLATOW: Tell me about the questions that need to be answered, that are not being answered.

GARRETT WINTERMUTE: Sure, so I will give you, as an example, one that is being answered– we’re answering it– that couldn’t be answered on a small scale. The question is this– among people who legally purchase firearms, are those who, at the time of purchase, have a documented history of alcohol abuse– repeated DUI conditions, et cetera– at greater risk down the road for violent crime?

Preliminary data suggests that they are, and that would comport entirely with what we know about alcohol and violence. But in order to answer the question definitively, the study has to be large enough, it has to involve tens of thousands of people who are followed over time to see, based on their prior criminal record and other characteristics, what their risk for outcome events is. And we are doing that study here in California– with support from NIH.

IRA FLATOW: And Catherine, does gun suicide have any connection with domestic violence shootings, or mass shootings?

CATHERINE BARBER: Well, certainly there’s a great deal of overlap when it comes to the issue of murder suicide. When a man kills his current or former intimate partner, in over half of those cases, he also kills himself. Even though murder suicide is a very rare event when it comes to intimate partner violence perpetrated by a male, it becomes more the norm than not.

So voluntary steps among family members and friends to look out for their loved ones when they’re going through a difficult crisis that may lead to either suicide or homicide, to say, hey, you would be safer with the guns out of the house for now.

IRA FLATOW: This is Science Friday from PRI, Public Radio International. It’s like you say friends don’t let friends drunk drive drunk. Take the keys away, drive somebody home. You’re saying you need– you need the same kind of friendship going on and when you’re talking about guns.

Yeah, and terms of the research, what is so fascinating for the kind of work that I’ve been doing in New Hampshire, with the New Hampshire Firearms Safety Coalition, and in Utah with a similar group, is bringing gun owners and people who care a lot about gun rights into the process of developing the research questions and thinking through the data.

It’s fascinating to learn to respect one another’s opinions, and to really challenge one another’s– the kind of blinders that we all have.

IRA FLATOW: I only have a couple of minutes left. I want to get two more questions. What kind of data do you need? Garrett, and also Catherine– what data is missing. Garrett you gave me one answer. Catherine, what data do you need?

CATHERINE BARBER: Data at the state and sub-state level on gun ownership, and gun storage, and on perceptions of risk. We need data on how guns, very specifically, are moving from the legitimate to illegitimate markets, and how they are moving from legitimate use to illegitimate use.

IRA FLATOW: Do you think anything is going to change, Garrett?

GARRETT WINTERMUTE: Yes. I think very concretely and in a short period of time, we are likely to see gun violence restraining order statutes adopted at the state level. The available data suggests that they work. Had such a policy been in place in Florida and used, it might well have prevented the Parkland shooting, and that’s a matter of general knowledge now.

Florida has since adopted a gun violence restraining order statute. The National Rifle Association has come out in favor of them, and I suspect we will see that movement pretty quickly.

IRA FLATOW: OK. That’s all the time we have. Next week, our story is going to continue with efforts at tackling urban gun homicides and new research on how social networks and social media might help us predict, and even intervene, before violence happens. Garrett Wintermute, director of University of California Firearms Violence Research Center at UC Davis, Catherine Barber at Harvard’s TH Chan School of Public Health, director of the Means Matters Program for Suicide Prevention. Thank you both for taking the time to be with us today.

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