Journal Article

Tendrils of Hope in the Gun Epidemic: A Public Health of Consequence, November 2019

Galea, Sandro, Vaughan, Roger D.

2019

Overview

We are writing this editorial just days after mass shootings in Dayton, Ohio, and El Paso, Texas, resulted in 31 people dead and more than 50 people injured. The US national conversation has been, over the past 48 hours, ablaze with commentary about the need for policy efforts that reduce the consequences of gun violence. And guns have come, once again, to dominate the political conversation. In some ways this cycle is familiar. Although firearm mortality in the United States has been roughly at the same level for nearly 20 years (although there has been an increase in the past couple of years), attention to the issue has crystallized around mass shootings, particularly since the Newtown, Connecticut, shootings in 2012 when 26 students were killed at Sandy Hook Elementary School. The Parkland, Florida, shooting in 2018, when 17 students were killed at Marjory Stoneman Douglas High School, catapulted a new generation of student-led activism to the fore, making gun violence part of the ongoing national conversation. Although mass shootings account for fewer than 2% of all the gun-related fatalities in the United States, they have served to focus public attention in a way that the more than 36 000 annual deaths from firearms, most from suicide, have not. In their response to gun violence, public health practice and academic public health have lagged substantially behind in their study of one of the defining epidemics of our time. Public health practice has been hampered in no small part by political forces. The Dickey Amendment, attached to an omnibus spending bill in 1996, prohibited the Centers for Disease Control and Prevention (CDC) from spending money \"to advocate or promote gun control.\" This amendment had a chilling effect in multiple ways, but in particular it served notice to public health practice not to engage in work that aimed to limit access to or availability of guns. Public health agencies at the municipal, state, and federal levels were all appropriately concerned with taking on an issue that could result in substantial political opposition and potentially a cut in funding to other areas of work. This climate of hesitation to take on issues related to firearms spread to research funding, with neither the CDC nor the National Institutes of Health (NIH) making substantial funds available for research for approximately two decades. A direct result of this was a dramatically lower research engagement with firearms and their consequences than would have been commensurate with the scope of morbidity and mortality that accompany guns in the United States.

• Publisher: American Public Health Association
• Subject: Activism / Attention / California / Conversation / Deaths / Disease control / Disease prevention / Editorials / Elementary school students / Elementary schools / Epidemics / Expenditures / Fatalities / Fellowships and Scholarships / Firearm laws & regulations / Firearms / Funding / Gun violence / Health behavior / Injury/Emergency Care/Violence / Mass murders / Money / Morbidity / Mortality / Murders & murder attempts / Other Statistics/Evaluation/Research / Political opposition / Politics / Prevention / Public Health / Public Health Practice / Research funding / School violence / Science / Secondary school students / Secondary schools / Shooting / Shootings / Students / Suicide / Violence / Writing/Reviewing/Publishing