Opinion: Questions and insights to guide public health research on gun violence


Editor’s note: From the April 2021 Annual Review of Public Health report, “Considerations for Developing an Agenda for Gun Violence Prevention Research,” by Dr. Mark Rosenberg (with help, he says, from many experts.)

From the executive summary

The goal of this research agenda should be to find ways for the United States to reduce injury, death, and suffering while protecting the right of law-abiding citizens to own firearms.

This way of approaching what we need to learn will also help us know what we do not know. There is a lot we do know and a lot we do not know, especially with respect to determining which interventions, programs, and policies will both prevent gun injury and protect gun rights.

The public health approach to gun violence prevention is based on science, focused on prevention and collaborative by necessity. Collaboration between public health and public safety is very important.

The question we are asking is not whether gun violence is a problem primarily for the public health or criminal justice sector, but how these two sectors can work together — and with other sectors — to maximize public safety and well-being while fully respecting citizen rights. Equity must become another important variable: We must keep focused on the impact of our interventions on racial disparities as we examine the effectiveness of these policies.

The science is organized around four questions, which are used to structure this research agenda.

A.) What is the problem?

How many people get shot, who are they, where does it happen? What kind of gun was used and how was it obtained? What is the relationship between the shooter and the victim? What other types of damage are incurred and are the shootings increasing or decreasing?

B.) What are the causes?

What is the role of alcohol and drugs? What is the role of gangs, poverty and systemic racism? What is the role of mental illness, robbery and domestic violence? What is the role of private gun ownership (both positive and negative) and easy access to guns? What are the factors that protect us, such as stable families and safe environments?

C.) What works?

Which practices, interventions, policies and laws work best to prevent these deaths and injuries?

What kind of evidence of effectiveness do we have for policies such as background checks, bans on the sale of high-capacity firearm magazines, child-access prevention laws, concealed-carry laws, firearm sales reporting requirements, gun-free zones, licensing and permitting requirements, lost or stolen firearm reporting requirements, minimum age requirements, prohibitions associated with mental illness, stand-your-ground laws, surrender of firearms by prohibited possessors (including extreme risk protective orders or “red-flag laws”), or waiting periods?

What does the evidence show about the effectiveness of voluntary gun safety practices such as using trigger locks, firearm training, self-enrollment in the federal National Instant Check System (NICS) (a pre-commitment against suicide) and the preventive use of firearms for personal protection and to deter crime?

D.) How do you do it?

How do you implement the findings and translate them into policies, legislation and practices that can be scaled up?

How can researchers better communicate their findings to the public in a way that will change beliefs and culture around guns in a safer and healthier direction, when private gun ownership in the United States is “highly prevalent, culturally entrenched, and constitutionally protected”? How can scientific findings be effectively communicated and applied when increasingly large parts of the population are science skeptics and deniers?

Other selected details from the report

What works to prevent gun violence and protect gun rights?

To answer the question of what works, one must find interventions that simultaneously satisfy two objectives: reducing gun violence and protecting the rights of law-abiding gun owners.

These are not mutually exclusive objectives. Through gun violence prevention research, we can find interventions that will achieve both objectives: protect gun rights and reduce gun violence.

Strategies that work by meeting both objectives might, for example, aim to keep guns out of the hands of those who should not have them while allowing law-abiding gun owners to keep their guns. These strategies should be carefully crafted using behavioral risk factors and targeted to individuals at high risk for gun homicides or gun suicides while fully respecting constitutional law and policies.

Once we find these strategies, research will be needed to prove that these interventions work to both reduce gun violence and protect gun rights. A third objective of this research should also be to find interventions that will reduce racial disparities in terms of the burdens of gun violence and in the ways that laws are applied.

Some of the answers to these questions will come from the analysis of existing data sets, others may require new data collection efforts and some may require large-scale controlled trials that cover multiple jurisdictions over a sustained period of time.

Federal and state governments may have a unique role to play in helping to design and implement such studies, especially when they will require the collaboration of different departments (such as police, public health, housing and urban development, education, health care, and mental health). Examples of possible ways to achieve both objectives include universal background checks, eliminating loopholes and tracking results; access restrictions for domestic violence offenders; red flag laws; and safe storage (of guns).

How do we measure the extent to which an intervention or policy impacts the rights of law-abiding gun owners?

Research is required to develop a way to measure the impact of different interventions on the rights of law-abiding gun owners. Just as environmental impact measures help us protect the environment, this research will help us protect and measure gun rights. What gets measured gets done.

What are the benefits and costs of gun ownership?

What are the benefits and costs of gun policies for law-abiding gun owners, individuals who do not own guns, and other stakeholders (e.g., police, school personnel)? Does having more law-abiding citizens carry weapons deter crime and reduce gun violence? Are firearm safety programs that include improved safety practices for firearm owners effective?