WASHINGTON — Dr. Bindi J. Naik-Mathuria, a pediatric trauma surgeon at Texas Children’s Hospital who grew tired of seeing toddlers die of gunshot wounds, has a $684,000 federal grant to track every gun-related death and injury in Houston. The goal: identify and address “hot spots” the way public health researchers track and contain the coronavirus.
Dr. Garen J. Wintemute, an emergency room doctor and longtime firearm violence researcher in California, is supervising scientific research on whether community interventions in Detroit and Cleveland — including the greening of vacant spaces and the work of so-called violence interrupters like former gang members — can drive down gun-related deaths and injuries.
And Andrew R. Morral, a behavioral scientist at the RAND Corp., a research group, is using sophisticated modeling tools to estimate rates of gun ownership in every state, with detailed demographic information. The purpose, he said, is to search for patterns in firearm homicides and suicides — a first, basic step in research that could lead to reducing them.
The recent mass shootings in Atlanta and Boulder, Colorado, have once again left Democrats and Republicans in a stalemate over background checks for gun buyers and assault weapons bans. But public health experts say a new round of research could pave the way for gun policies that avoid partisan gridlock — and ultimately save thousands of lives.
The studies by Naik-Mathuria and the others are being paid for by the Centers for Disease Control and Prevention, which is once again funding research into gun violence after a nearly 25-year hiatus imposed by Congress. And while they might not reduce the number of massacres, mass shootings account for an extremely small percentage of the roughly 40,000 Americans who die each year from gun violence.
“There’s at least five different gun violence problems in the country, and mass shooting is one of them,” said Morral, who has a doctorate in psychology. “There’s also suicide; there’s urban gun violence, which mostly affects minority young men; there’s family shootings; and there’s police shootings. And they all have different risk factors, they all have very different motives, and they often involve different firearms.”
Like cancer, there is no single cure for the epidemic of gun violence in the United States. If politicians want to make a difference, experts say, lawmakers need to quit the fruitless fights over whether liberals want to take people’s guns away and start financing — and listening to — research that could inform policies that could address the carnage.
“It’s not either, ‘Keep your guns or prevent gun violence,’” said Dr. Mark Rosenberg, who helped establish the CDC’s Center for Violence and Injury Prevention but said he was fired in the late 1990s under pressure from Republicans who opposed the center’s gun research. “There’s a strategy that science can help us define where you can do both — you can protect the rights of law-abiding gun owners and at the very same time reduce the toll of gun violence.”
Federal money for gun research all but disappeared after Congress in 1996 enacted the so-called Dickey Amendment, which barred the CDC from spending money to “advocate or promote gun control.” It was named for Jay Dickey, a former Republican House member from Arkansas, who proudly proclaimed himself the National Rifle Administration’s “point man” in Washington.
In an extraordinary turn of events, Dickey, who died in 2017, befriended the man whose work he had cut off, Rosenberg. The pair grew so close that Rosenberg gave the eulogy at Dickey’s funeral.
In 2019, Rosenberg and Dickey’s ex-wife, Betty, a retired former prosecutor and chief justice of the Arkansas Supreme Court, helped persuade Congress to restore the funding; lawmakers appropriated $25 million, split between the CDC and the National Institutes of Health, for firearm injury prevention research.
The agencies are now financing nearly two dozen studies, though backers of the research say the money is a pittance compared to the breadth of the problem.
“Millions of dollars have been put forth trying to figure out how do we eradicate cancer; we’ve got to be able to do the same with gun violence,” said Rep. Lucy McBath, D-Ga., who won election in 2018 by promising to end gun violence after her 17-year-old son was shot and killed.
“We’ve got to be able to give the CDC and the NIH the ability to study the implications and get that raw data, the grave implications of gun violence,” she added, “just like we do in any other public health crisis.”
Treating gun violence as a public health problem is not a new idea. In 1991, Rosenberg’s program awarded a research grant to an investigator who published a landmark study in The New England Journal of Medicine that found having a gun in the home tripled the risk of gun homicides and quintupled the risk of gun suicides.
After it was published, the National Rifle Association took aim. The Dickey Amendment was a compromise between Democrats who wanted more research and Republicans who wanted to shut down Rosenberg’s center.
Research on the effectiveness of gun policies is scant, and much of it is not rigorous enough to either prove or disprove that any of the legislation being debated in Washington would do any good, said Morral, who directs RAND’s National Collaborative on Gun Violence Research and has done a comprehensive analysis of the serious scientific literature.
The existing research suggests that one policy under consideration in Congress — expanding background checks — could make a difference. RAND has found “moderately good evidence that the current background checks system is helpful” in reducing violent crime, Morral said, and so “it seems logical to think that background checks on all sales might help more.”
There is also moderately good evidence, RAND found, that waiting periods for gun purchases reduce both suicide and violent crime. And there is strong — or what RAND calls “supportive” — evidence that laws requiring guns to be safely stored away from children reduce firearm injuries and deaths among young people.
But while President Joe Biden has claimed that the federal assault weapons ban that lasted from 1994 to 2004 “brought down these mass killings,” the evidence of that is unclear. There are only a handful of studies, Morral said, and they do not “persuasively show a causal effect” — not because there is not one, he said, but because of shortcomings in the study design.
After the recent development of coronavirus vaccines highlighted the importance of scientific research, Rosenberg said, the public is primed to accept the argument that gun violence research can save lives. He likened it to the hundreds of millions of dollars the federal government poured into studying motor vehicle deaths in the 1970s and ’80s, which led to safety measures like seat belt requirements and lower speed limits, saving millions of lives.
That was the argument he used to help persuade Congress to appropriate money for gun violence research in 2019. The research itself was never banned outright, and in 2013, weeks after the massacre that killed 26 people at the Sandy Hook Elementary School in Connecticut, President Barack Obama directed the CDC to reconsider funding studies on gun violence.
The agency commissioned a report from the Institute of Medicine and the National Research Council outlining priorities, but little changed. By 2019, after Democrats reclaimed the House, liberal organizations like MoveOn.org were petitioning Congress to repeal the Dickey Amendment. Nearly every House Democrat signed on.
But Rosenberg argued it should remain intact to “provide cover for Republicans and gun-loving Democrats who can put money into the science and tell their constituents, ‘This is not money for gun control.’”
Rep. Rosa DeLauro, D-Conn., who led the House subcommittee that oversaw the CDC’s budget at the time, said she put $50 million into the appropriations bill that year, but the Senate, controlled by Republicans, eliminated it. The two chambers agreed on $25 million as a compromise, but she said she hoped to double the funding this year.
Naik-Mathuria, the Houston trauma surgeon, said she would like to see Washington address the problem of gun violence as a matter of injury prevention, not politics. She began researching methods to reduce gun violence about six years ago, she said, after seeing “kids come in dead because they shot themselves in the head when they found a gun at home.”
Her current study is aimed at determining risk factors for gun violence for children and adults, and her past work has led to some changes in medical practice, she said.
Pediatricians in Texas, she said, are hesitant to talk about gun safety out of concern that “it would anger parents or become political.” So she and her group made a broader safety video that tucked in messages about gun safety — like keeping guns locked and stored — with tips like how to keep children away from poison.
Wintemute, who directs the Violence Prevention Research Program at the University of California, Davis Medical Center in Sacramento, said he lost grant money after the Dickey Amendment was enacted. In the two decades that followed, he said, his work has been supported by the state of California; foundations; the NIH, which was not specifically named in the Dickey Amendment; and the Justice Department. He said he had also spent a little more than $2 million of his own money to continue the work.
His program is receiving $744,000 from the CDC this year to finance three studies. The new funding from the agency, he said, is drawing young scientists to the work.
Still, he laments the time that has been lost.
“It’s as if we had decided, ‘Let’s not do research on coronavirus. Let’s not do research on cancer or heart disease. Let’s just let this problem run its course,’” he said. “How many thousands of people are dead who would be alive today if that research had been allowed to continue 25 years ago?”