This Medical News article is an interview with US Surgeon General Vivek Murthy, MD, MBA, and JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, about a new advisory that declares gun violence a public health crisis.
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New US Surgeon General Advisory on Gun Violence
Deaths from firearms have soared in the US over the past few decades. Now, guns are the leading cause of death of children. In addition, the majority of adults report they’ve experienced gun violence, including being threatened by a firearm or witnessing someone getting shot.
Investigating the Link Between Gun Possession and Gun Assault
Among a long list of issues facing the American public, guns are third only to gay marriage and abortion in terms of people who report that they are ‘‘not willing to listen to the other side.’’
In concert with this cultural rift, scholarly discussion over guns has been similarly contentious. Although scholars and the public agree that the roughly 100000 shootings each year in the United States are a clear threat to health, uncertainty remains as to whether civilians armed with guns are, on average, protecting or endangering themselves from such shootings. Several case–control studies have explored the relationship between homicide and having a gun in the home, purchasing a gun, or owning a gun. These prior studies were not designed to determine the risk or protection that possession of a gun might create for an individual at the time of a shooting and have only considered fatal outcomes. This led a recent National Research Council committee to conclude that, although the observed associations in these case–control studies may be of interest, they do little to reveal the impact of guns on homicide or the utility of guns for self-defense. However, the recent National Research Council committee also concluded that additional individual-level studies of the association between gun ownership and violence were the
most important priority for the future. With this in mind, we conducted a population-based
case–control study in Philadelphia, Pennsylvania, to investigate the relationship between being
injured with a gun in an assault and an individual’s possession of a gun at the time. We included
both fatal and nonfatal outcomes and accounted for a variety of individual and situational confounders also measured at the time of assault.
Can Mass Shootings be Stopped?
The mass shooting at Columbine High School in Littleton, Colorado, happened nearly two decades ago, yet it remains etched in the national consciousness. Columbine spurred a national debate — from personal safety to the security of schools, workplaces, and other locations and to broader considerations of guns and mental illness. To this day, communities still are grappling to find solutions to the complex and multifaceted nature of mass shootings.
Assault Weapons, Mass Shootings, and Options for Lawmakers
What Are the Most Effective Policies in Reducing Gun Homicides?
The public mass shootings in Newtown, Charleston, Orlando, Las Vegas, Sutherland Springs, Pittsburgh, and, especially, Parkland have brought the issue of firearm violence to the forefront. These tragedies have sparked a national debate about federal and state policies to reduce firearm violence. State policymakers are grappling to identify solutions by considering multiple legislative proposals, from red flag laws to universal background checks to bans on assault weapons to stricter regulation of semiautomatic weapons. Some states are considering laws that make it easier to carry and use firearms in public. Still others are debating laws aimed at eradicating gun culture, by — for example — banning all gun-related activities (such as shooting clubs or trainings) at public high schools. With a myriad of often conflicting ideas and proposals, where does a state policymaker begin?
This policy brief will help state policymakers navigate the scientific evidence regarding the impact of state firearm laws on gun-related homicide. Taking advantage of new data resulting from a research project at the Boston University School of Public Health and with funding from the Robert Wood Johnson Foundation’s Evidence for Action Program,[1] we developed a comprehensive database of state firearm laws spanning the period 1991-2016. We then examined the impact of a range of state firearm laws on total, firearm-related, and nonfirearm-related homicide rates at the state level during this time period. The State Firearm Laws Database is publicly available at www.statefirearmlaws.org.
Our analysis found three priority pieces of legislation that would have the greatest impact in reducing overall firearm homicide rates:
Universal background checks.
+ Prohibition of gun possession by people with a history of any violent misdemeanor, threatened violence, serious alcohol-related crime, or subject to a domestic violence restraining order. This must be accompanied by: (1) a requirement that firearms already in their possession be surrendered; (2) a procedure for confiscating guns if they are not relinquished voluntarily; and (3) procedures for confiscating guns in situations where a person becomes prohibited from owning firearms after having passed an earlier background check.
+ Laws that give discretion to law enforcement officials (“may issue” laws) in denying concealed carry permits to those who are at high risk for violence, especially those who have a criminal history of violence.
The purpose of this research was not simply to identify a list of laws that “work” and laws that “do not work.” The advantage of this research is that it allowed us to compare the impact of multiple laws at the same time, enabling us to obtain a sense of what laws appear to be most strongly associated with lower rates of firearm homicide. Ultimately, our goal was to identify the types of laws that appear to have the greatest impact and which should therefore be a priority for policymakers.
Deconstructing Mass Shootings: Exploring Opportunities for Intervention
When it comes to mass shootings, the United States is tragically in a class of its own. There are more mass public shootings in the US than in any other country in the world (Lankford, 2016). By some estimates the United States has experienced 318 mass public shootings between 1966 and 2017 (Capellan, Johnson, Porter, & Martin, 2019). These attacks resulted in 1,167 dead and 1,777 injured victims. Unfortunately, mass public shootings show no signs of slowing down. Most research indicates that the rate of mass public shootings has been accelerating over time. For example, Joel Capellan finds that in the 1970s a mass shooting occurred, on average, every 608 days. By the current decade, a mass public shooting occurred, on average, every 20 days. Due to their reoccurring and devastating nature, mass public shootings are starting to be considered a major public health hazard.
Research on mass public shootings has focused almost exclusively on either the characteristics of offenders or the causes leading to these massacres. Although this research is invaluable to our theoretical understanding of the sociological and psychological factors that lead to mass public shootings, it has yet to provide an actionable understanding of how to prevent or mitigate the lethality of these massacres. In this policy report, we argue that prevention requires us to refocus our attention from why to how mass public shootings happen. To this end, we deconstruct mass public shootings into a series of stages and decisions and explore various opportunities for intervention. We analyze the motivations, preparatory behaviors, execution, and conclusion of 318 mass public shootings in the United States between 1966 and 2017. Furthermore, we offer some potential policy solutions to exploit these opportunities for intervention.
Unfinished Business: Gun Violence on the Policy Agenda
Gun violence mortality is 27 percent higher than a decade ago, and, due to a lack of federal action, states have taken the reins in combating this crisis through significant policymaking. However, there is not much research on the progress or process of enacting important laws on gun violence, including identifying the types of bills introduced, how they proceed through the legislative system to enactment, and how year-to-year changes in political leadership affect that process. To better understand recent state policymaking in New York, the Rockefeller Institute of Government’s researchers analyzed the 161 firearm-related bills introduced by the governor, Senate, and Assembly in New York between 2018 and 2019 to identify trends in legislative interest and activity.
Ghost Guns: A Haunting New Reality
On April 7, 2021, President Biden announced multiple executive actions on gun violence with several specifically targeted at addressing the nation’s ghost gun problem. But what exactly are ghost guns, what challenges do they pose, and how would these actions help find a solution?
Ghost guns are homemade firearms that cannot be traced by law enforcement. They are an emerging problem across the United States, being used in crimes and recovered by law enforcement at a rate that continues to climb with each passing year. In 2020, law enforcement in New York State recovered 220 ghost guns compared to 72 in 2019 and only 38 in 2018, a 479 percent increase statewide over the three-year period, according to data from the New York State Intelligence Center. Similarly, the Baltimore Police Department reported a 400 percent increase in ghost gun recoveries from 2019 to 2020. In Washington, DC, the number of ghost gun recoveries jumped from just three in 2017 to 282 in 2020.
While these numbers may represent a relatively low percentage of total gun recoveries, ghost guns pose a unique and rapidly growing challenge. Law enforcement agencies are unable to trace and therefore prohibit the flow of ghost guns. While the federal government considers regulations, state and local lawmakers are exploring and enacting laws and policies designed to monitor and prevent ghost guns from falling into the hands of people who are prohibited from purchasing or possessing firearms.
Can Mass Shootings be Stopped?
The first five months of 2021 saw high-profile public mass shootings in cities across the United States of America, like Atlanta, Georgia (March 16, 8 dead), Boulder, Colorado (March 22, 10 dead), Indianapolis, Indiana (April 15, 8 dead), and San Jose, California (May 26, 9 dead). Following a year where such events rarely made headlines as the nation found itself in the throes of the coronavirus pandemic, these incidents revived the public discourse about mass shootings in America, as well as how to prevent and respond to such tragedies. This dialogue raised an important question: As society returns to normal after the COVID-19 pandemic, what does the future of mass shootings look like?
To answer this, it is important to understand the trends associated with the phenomenon of mass shootings. The first issuance of this policy brief in 2018 examined 51 years (1966-2016) of mass shootings data based on a comprehensive database from researchers Jaclyn Schildkraut and H. Jaymi Elsass. As described below, the researchers developed their own definition that became the foundation of this analysis given deficiencies with existing classifications and data sources.
This updated brief provides analyses including an additional four new years of data since the original 2018 policy brief to identify changes in trends and broader considerations for policymakers, particularly given the COVID-19 pandemic’s impact and lessons learned from specific shootings within this period. Specifically, this brief presents and analyzes a total of 55 years of mass shooting data from 1966 to 2020, including frequency, injury and fatality, location type, weapon usage, and perpetrator demographics. The appendix contains information on only the most recent four years of data from 2017 to 2020.
Although all episodes of firearm violence are cause for concern, public mass shootings differ from other incidents in key ways. For instance, unlike family murders and a considerable portion of gang violence that may be targeted, public mass shootings are random in nature. They also typically involve considerable planning, rather than other incidents that are more spontaneous in nature, which can provide important opportunities to deescalate the situation before it culminates in the mass shooting. Similarly, the location selection—large, often open public spaces—presents significant challenges for both preventative security measures and responses from law enforcement to active shooter incidents. As such, better understanding this phenomenon in its unique context is necessary to distinguish strategies needed to prevent and respond to public mass shootings. Promoting a deeper understanding of mass shootings can also provide policymakers with important insights upon which to craft more effective prevention and response efforts.