Gun Violence Is a Public Health Crisis, So Why Isn’t the CDC Researching It?

As the nation’s official agency charged with protecting public health, the Centers for Disease Control and Prevention's mission is to conduct "critical science" and provide "health information that protects our nation against expensive and dangerous health threats." Except, apparently, when it comes to gun violence.

As the nation’s official agency charged with protecting public health, the Centers for Disease Control and Prevention's mission is to conduct "critical science" and provide "health information that protects our nation against expensive and dangerous health threats." Except, apparently, when it comes to gun violence. Shutterstock

As the nation’s official agency charged with protecting public health, the Centers for Disease Control and Prevention (CDC)’s mission is to conduct “critical science” and provide “health information that protects our nation against expensive and dangerous health threats.” Except, apparently, when it comes to gun violence.

Despite the fact that firearms cause more than 33,000 deaths each year, the CDC operates under a congressional prohibition—first passed in the 1990s—that prevents the agency from undertaking the kind of in-depth research on gun violence that it does on all other sorts of threats to American lives, from infectious diseases and food hazards to Anthrax and motorcycles.

The original author of the rule, former Rep. Jay Dickey (R-AR), has since said he feels that our country has missed opportunities to make gun ownership safer because of it, and President Obama has tried to change the landscape of the research using an executive order. But Congress has held firm—refusing to repeal the ban or to bestow gun violence research funds to the CDC or other agencies. In the wake of yet another mass shooting in San Bernardino, California, it seems unconscionable that an agency designed to keep us safe can’t even try.  

Not surprisingly, the restrictions began at the behest of the National Rifle Association (NRA) and its allies, who argued the CDC was using its research to lobby for gun control. In 1996—after a failed attempt to defund the CDC’s $46 million Center for Injury Prevention altogether—Rep. Dickey stripped the agency’s budget of $2.6 million. It was not a coincidence that this was the exact amount of money being used to research gun violence. The funding was later restored before the passage of the bill authorizing appropriations for the agency, but allocated to different areas of study. And, significantly, restrictive language was added: “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.”

The wording is vague, but those at the CDC interpreted it to mean that they should pretty much avoid the topic altogether, though the agency does still collect simple data on firearm deaths. Mark Rosenberg, who was director of the CDC’s National Center for Injury Control and Prevention at the time, told the Washington Post in January: “It basically was a shot across the bow by Congress on the part of the NRA. All federally funded research was shut down.”

It wasn’t just research directly funded by the CDC that was affected. The National Institutes of Health was later added to the ban, and scientists all over the country have the felt the ripple effects since. The prohibition on research, the controversial nature of the topic, and the potential for backlash have limited the scope of the field, leading to a lack of existing data for other researchers to work with.

Eric Fleegler, a pediatric emergency medicine physician and health services researcher at Boston Children’s Hospital, told Rewire via phone interview that he could count on his fingers the number of people who have dedicated their careers to researching gun violence. “I can literally name the six people in the United States who are firearms researchers,” he said. “If you asked me to do that for cancer or anything else it would be laughable. I’d need hundreds of fingers.”

Fleegler explained:There’s no data on gun sales. There’s no good data on the criminology. There’s no good data on the injuries caused by guns.” In addition to the Dickey amendment and other federal policies, practices for collecting, or not collecting, these kinds of data are set at the local level as well, often making it harder for would-be studies to take place.

Fleegler and his colleagues ran into this obstacle when trying to study whether they could find a relationship between laws limiting gun ownership and gun deaths. With no broad federal database with more detailed information available, Fleegler and colleagues had to rely on the CDC’s limited numbers on gun deaths and on the nonprofit Brady Center to Prevent Gun Violence’s records of gun laws. After giving each state a “score” based on its numbers of gun laws, they found a direct relationship between a state’s score and the number of gun deaths in that state. The states with the highest score, or strongest laws, had 6.64 fewer deaths per 100,000 residents than the states with the lowest score, or weakest laws. States with strong laws had fewer homicides and suicides, even when demographics such as population density, firearm ownership, non-firearm violent deaths, education, poverty, age, sex, race, and unemployment were taken into account.

Moreover, when gun deaths went down, the rate of other violent deaths did not go up, which suggests a major flaw in the oft-heard mantra “guns don’t kill people, people kill people.” It turns out that when you impose harsher regulations on guns, people kill fewer people.

This correlation is very telling, but correlations are never enough to prove causation. Fleegler explained that there just isn’t enough data to get to causation, which could advance research tremendously. “If we had good data, we could track one million people with guns and one million people without guns for 20 years,” he said. Such tracking could confirm the correlations he found as well as other research that strongly suggest that having a gun in the house increases the occupants’ risk of death. And it’s that kind of data that could inform public policies.   

Earlier this year, former Rep. Dickey told the Huffington Post that he looks at simple, effective advances in safety, such as barriers on highways, and wonders what could have been done for guns. “If we had somehow gotten the research going, we could have somehow found a solution to the gun violence without there being any restrictions on the Second Amendment,” he said. “We could have used that all these years to develop the equivalent of that little small fence.”

Fleegler agrees that if this were any other issue, widespread research would be taking place right now. According to the Center for American Progress, gun violence is the second-most frequent cause of death among young adults. With any other “disease, any health issue, any genetic condition,” Fleegler said, “there would be an all-hands-on-deck approach to reduce and eliminate that threat. And yet with firearms we have gone in the opposite direction.”

In 2012, after the Sandy Hook shooting of elementary school children, President Obama used an executive order to effectively retract the Dickey Amendment and specifically ask the CDC to conduct research “on the causes and prevention of gun violence, including links between video games, media images, and violence,” as well as research to “better understand how and when firearms are used in violent deaths.” He has also asked Congress for $10 million to fund this research, but it has refused. Without the dedicated funding, there has been no move by the CDC or other agencies to increase research into this topic. And in fact, an attempt to explicitly overturn the Dickey Amendment this summer in Congress failed just days after the mass shooting in Charleston, South Carolina.

Courtney Lenard, a CDC spokesperson, told Rewire in an email: “Public health research is fundamental to understanding the problem and developing scientifically sound solutions.” In the email, Lenard referenced a report commissioned by the CDC and written by the Institute of Medicine and National Research Coalition, which concluded that a public health approach should be one of the strategies used to combat gun-related injuries. She also noted that President Obama’s request for funding for such research has been repeatedly denied by Congress. Lenard concluded that the CDC’s “Injury Center has very limited discretionary funding to dedicate to firearm violence research and prevention. In order to pursue many of the research priorities … the funding requested in the FY16 President’s Budget would be necessary.”

Just hours before the mass shooting in San Bernardino last Wednesday, a group of doctors and lawmakers released a call for the ban to be officially lifted and for research on this topic to move forward. At an event presenting a petition signed by more than 2,000 physicians, Rep. David Price (D-NC), vice chair to the House of Representatives’ Gun Violence Prevention Task Force said, “Gun violence is among the most difficult public health challenges we face as a country, but because of the deeply misguided ban on research, we know very little about it. Regardless of where we stand in the debate over gun violence, we should all be able to agree that this debate should be informed by objective data and robust scientific research.”

In an age in which there appears to be a mass shooting almost every day, it would seem that everyone should be desperate for information on how to prevent gun violence. Instead, scientists and public health researchers are stuck. Despite the claims made in the 1990s, research is not the same as advocacy; rather, it’s the quest for understanding in the hopes of giving elected officials the tools to set laws and policies that might save lives. We do it in all other aspects of our lives, from car seats to bicycle helmets; there is no reason we can’t do it here. Well, no reason, except for the efforts of the NRA, its congressional allies, and all other pro-gun apologists in this country.