In the wake of last week's tragic school shooting in Connecticut, three Journal of the American Medical Association publications are running editorials today about gun safety. All three are free online and worth reading. Archives of Internal Medicine's piece advocates for tighter restrictions on the sale of guns and ammunition, while the editorial in Archives of Pediatric & Adolescent Medicine describes the legal battle in Florida to defeat a law that would muzzle pediatricians' first-amendment right to talk with their patients' parents about gun safety in the home.
The piece that I found most powerful, however, was JAMA's Silencing the Science on Gun Research, in which the authors describe how Congress has systematically stripped all Department of Health and Human Services agencies of the ability to fund research into the epidemiology of gun injuries:
In 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC's budget—precisely the amount the agency had spent on firearm injury research the previous year. Funding was restored in joint conference committee, but the money was earmarked for traumatic brain injury. The effect was sharply reduced support for firearm injury research.
To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”
Congress later expanded this restrictive language to all DHHS agencies, including the National Institutes of Health, the authors explain. They conclude:
Health researchers are ethically bound to conduct, analyze, and report studies as objectively as possible and communicate the findings in a transparent manner. Policy makers, health care practitioners, and the public have the final decision regarding whether they will accept, much less act on, those data. Criticizing research is fair game; suppressing research by targeting its sources of funding is not.
...Injury prevention research can have real and lasting effects. Over the last 20 years, the number of Americans dying in motor vehicle crashes has decreased by 31%. Deaths from fires and drowning have been reduced even more, by 38% and 52%, respectively. This progress was achieved without banning automobiles, swimming pools, or matches. Instead, it came from translating research findings into effective interventions.
Given the chance, could researchers achieve similar progress with firearm violence? It will not be possible to find out unless Congress rescinds its moratorium on firearm injury prevention research. Since Congress took this action in 1997, at least 427 000 people have died of gunshot wounds in the United States, including more than 165 000 who were victims of homicide. To put these numbers in context, during the same time period, 4586 Americans lost their lives in combat in Iraq and Afghanistan.
The United States has long relied on public health science to improve the safety, health, and lives of its citizens. Perhaps the same straightforward, problem-solving approach that worked well in other circumstances can help the nation meet the challenge of firearm violence. Otherwise, the heartache that the nation and perhaps the world is feeling over the senseless gun violence in Newtown will likely be repeated, again and again.
