Guns -- Their Value and Their Violence: Research Toward a National Discussion

Every year in our country, a firearm is used in nearly 500,000 crimes, resulting in the deaths and injuries of more than 110,000 people. Meanwhile, the problem of gun violence has been compounded by another: the shortage of knowledge about the issue. Isn't it about time to have a discussion about adopting the means to end gun violence in the United States?

Let's begin with the obvious. The ownership of guns and gun violence – what do we know about the correlation between the two? Not enough.

For many Americans, the very mention of such a tie evokes the loss of a God-given freedom. The social role of guns in American life has clearly created support for the continued widespread availability of guns. The social meaning of guns always sets the bounds within which any conversation around gun safety reform can take place.

However, what is the conflict with social meaning and values? Values push us to ask the question: what do we mean when we say we care about something? Values are what we choose to focus on, in a world of limited time and resources.

Galeo and Salma (2019) posit …

“This becomes particularly relevant in public health in cases where societal values may not be aligned with what the science suggests improves health. In this case, including, perhaps in the context of guns, the clash between our values – as embedded within gun culture – and what the science suggests – that we need to have fewer guns – becomes a barrier to action.”

Public health has not historically been particularly adept at understanding culture and symbols that inform the dominant narrative. With guns, knowledge and values do not align. While the argument for doing something about guns, from a public health perspective, is overwhelming and incontrovertible, national values are far from aligned with this public health goal.

Galeo and Salma explain … 

“... to many Americans, gun ownership is considered a right, not a privilege that can be regulated. These values create an impasse, one where knowing is not enough, and where tangling with the fundamental meaning of guns that challenges knowledge must be a core function of any public health approach to gun violence.”

Public health evidence overwhelmingly suggests that we should be moving toward fewer guns, but we are collectively far from doing so. Public health needs to ask: Why does what we know not become action? And, as a corollary, how does public health grapple with a deeper social meaning of guns that challenges the potential course of action to which the science points? Understanding the realities of gun violence and public health is first necessary to call for a much-needed change.

Michael Siegel, et al. (2013) observed “a robust correlation between higher levels of gun ownership and higher firearm homicide rates. Although Siegal's team could not determine causation, they found that states with higher rates of gun ownership had disproportionately large numbers of deaths from firearm-related homicides.

Michael C. Monuteaux (2015) et al. Also found evidence shows that states with higher levels of firearm ownership have an increased risk for violent crimes perpetrated with a firearm and that public health stakeholders should consider the outcomes associated with private firearm ownership.

Several other new studies found that increases in the prevalence of gun ownership are associated with increases in violent crime. Whether this association is attributable to gun prevalence causing more violent crime is unclear. If people are more likely to acquire guns when crime rates are rising or high, then the same pattern of evidence would be expected.

An important limitation of all studies in this area is the lack of direct measures of the prevalence of gun ownership. Because of the limitations of existing data and methods, there exists work that does not credibly demonstrate a causal relationship between the ownership of firearms and the causes or prevention of criminal violence or suicide. Studies have been blocked. For example the NRA has backed a federal funding freeze on gun policy research.

Ccademic researchers who were studying the impact of gun violence on public health were dealt a huge financial and political blow in 1996, when the so-called Dickey Amendment was passed by Congress under pressure from gun lobbyists. The law forbids the Centers for Disease Control and Prevention to fund research that might be seen as advocating for gun control. This choked off federal grant money and essential data-gathering on gun violence.

Facing these limitations, the RAND Corporation, a nonpartisan think tank issued a report (2018) that does not come out in favor of more or less gun control. Instead, the team compiled the best research that’s available so far. RAND concluded:

“On the gun control front, there’s moderate evidence that background checks reduce suicide and violent crime, limited evidence that prohibitions associated with mental illness reduce suicide, moderate evidence that those prohibitions reduce violent crime, and supportive evidence that child-access prevention laws reduce suicides and unintentional injuries and deaths.

“Meanwhile, there’s limited evidence that concealed carry laws increase violent crime and unintentional injuries and deaths. And there’s moderate evidence that “stand your ground” laws – NRA-backed measures that expand when someone can use a gun or other weapons to defend himself – increase violent crime.”

That being said, it behooves the public to examine evidence that not only supports a correlation between gun ownership and violent crime but also begs for a sorely needed national dialogue on gun violence in the U.S. Congress. Such a dialogue serves both those who rest their case on the social meaning of guns and those who see the issue as a matter concerning national health values.

Pertinent Studies

Case-control studies, ecological time-series and cross-sectional studies indicate that in homes, cities, states and regions in the U.S., where there are more guns, both men and women are at a higher risk for homicide, particularly firearm homicide. This relationship held for both genders and all age groups, after accounting for rates of aggravated assault, robbery, unemployment, urbanization, alcohol consumption, and resource deprivation (e.g., poverty). There was no association between gun prevalence and non-firearm homicide.

Having a firearm in the home increases the likelihood of homicide or suicide of a family member (Dahlberg, Ikeda & Kreznow, 2004; Kellermann, et al. 1992; Kellermann, et al. 1998), including fatal shootings of women associated with intimate partner violence (Campbell, et al. 2003).

In “More Guns, More Crime,” Duggan (2001) used a new proxy for gun ownership -- state and county-level sales rates for the nation's largest handgun magazine -- to show that guns foster rather than deter criminal activity.

The specific reason why firearm prevalence increases violent crime is not clear but there are several viable theories. One reason that firearm prevalence could increase violent crime is that guns can be “misused by the owners or transferred to dangerous people through theft or unregulated sale” (Cook and Ludwig, 2006, pgs. 379- 380).

Another reason that firearm prevalence could lead to increased violent crime is that using a gun is more lethal than other weapons (i.e. weapon instrumentality effect). Cook and Ludwig (2004, pg. 590) suggested that this was the case when they stated that the common saying “guns don’t kill people, people kill people” should be amended to “guns don’t kill people, they just make it real easy.” This is due to gun being more fatal than knives or other methods of violence against another individual.

Compared to other high-income countries, the United States by a substantial margin has the highest rates of firearm-related homicide, suicide and unintentional death and unintended injury among children and adolescents, leading the American Academy of Pediatrics to conclude that the “absence of guns from children's homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents” (American Academy of Pediatrics, 2012, e14160).

Cheng and Hoekstra (2013) and McClellan and Tekin (2012) have demonstrated that changing laws that make the use of guns more acceptable in certain situation does increase the level of homicide in that area.

The National Coalition for Dialogue and Deliberation (NCDD) suggests anyone considering planning and facilitating a dialogue about a controversial issue such as guns and violence should first have a solid background in commonly accepted best practices for facilitating civil and constructive group dialogues.

The coalition also says “framing a conversation as a binary question with only two alternatives is a sure way to create unconstructive shouting matches, especially when the subject is a hotbutton political issue.”

And, of course, such a discussion should invite fresh perspectives and understandings that don't alienate gun owners but rather to talk about how to promote responsible gun ownership. Steering the conversation from politicized policy arguments to deeper underlying issues like safety and responsibility can be one way to find common ground.

And, isn't that the goal of compromise so vital to the health and safety of the nation? Shouldn't we seek to move the dialogue about gun violence forward by arguing that if a society has the liberty to bear arms, then that society has a moral obligation to do all that it can to mitigate the harms that result from that freedom? Both the liberty and the obligation are equally important.

References

American Academy of Pediatrics, Council on Injury Violence and Poison Prevention. (2012). Firearm-related injuries affecting the pediatric population. Pediatrics , 130 (5), 1416-1423. doi:10.1542/peds.2012-2481

Campbell, J. C., Webster, D., Koziol-McLain, J., Block, C., Campbell, D., Curry, M. A.,…Laughon, K. (2003). Risk factors for femicide in abusive relationships: Results from a multisite case control study. American Journal of Public Health, 93( 7), 1089-1097. doi:10.2105/AJPH.93.7.1089

Cheng, C., & Hoekstra, M. (2013). Does Strengthening Self-Defense Law Deter Crime or Escalate Violence? Evidence from Expansions to Castle Doctrine. Journal of Human Resources, 48(3), 821-854.

Cook, P., & Ludwig, J. (2006). The social costs of gun ownership. Journal of Public Economics, 90, 379-391. Cook, P. J., & Ludwig, J. (2009). Firearm violence. In M. Tonry (Ed.), The Oxford handbook of crime and public policy. New York: Oxford University Press. Cummings, P., Koepsell, T. D., Grossman, D. C., Savarino,

Dahlberg, L. L., Ikeda, R. M., & Kresnow, M. J. (2004). Guns in the home and risk of a violent death in the home: Findings from a national study. American Journal of Epidemiology, 160 (10), 929-936. doi:10.1093/aje/kwh309

Duggan, Mark. (2001) “More Guns, More Crime.” Journal of Political Economy. University of Chicago and National Bureau of Economic Research

Galea, Sandro and Abdalla, Salma M. (2019) The public’s health and the social meaning of guns. Palgrave Communications 5, Article number: 111.

Kellermann, A. L., Rivara, F. P., Somes, G., Reay, D. T., Francisco, J., Banton, J. G.,…Hackman, .B.B. (1992). Suicide in the home in relation to gun ownership. The New England Journal of Medicine , 327(7), 467-72. doi: 10.1056/NEJM199208133270705

McClellan, C. B., & Tekin, E. (2012). Stand Your Ground Laws, Homicides, and Injuries (No. w18187). National Bureau of Economic Research.

Monuteaux, Michael C. ScD, Lee, Lois K. MD, Hemenway, David PhD, Mannix, Rebekah MD, Fleegler, Eric W. MD. (2015) “Firearm Ownership and Violent Crime in the U.S. An Ecologic Study.” Am J Prev Med 2015;](]):]]]–]]]) & 2015 American Journal of Preventive Medicine.

Siegel, M., Ross, C. S., & King III, C. (2013). The relationship between gun ownership and firearm homicide rates in the United States, 1981-2010. American Journal of Public Health, 103(11), 2098-2105.