I recently posted a blog entry (medicalbeat.net: October 13, 2022) about guns based on opinion pieces in a recent issue of the Journal of the American Medical Association (September 27, 2022).  I presented data on gun violence in the United States, but only touched on potential interventions that might ameliorate the problem.  One could make the case that our “problem” is urgent—the US experiences 25 times the death rate from firearms compared to other high income countries.

Interventions with successful track records

I noted that CAP (child access prevention) laws and waiting periods (so-called “cooling off” periods (i.e., a required period of time between purchase and possession of a firearm) have been associated with a decrease in deaths by firearms, especially suicides.  But there are many other interventions that have been linked to a reduction in gun deaths.

– Laws requiring a license-or-permit to purchase handguns are probably effective in diverting guns from use in the commission of violent crimes.

– States with lower level of gun related deaths and injuries have more gun laws: in states with the fewest gun laws, the rate of suicides by firearms was greater than the rate in states with numerous laws.  Idaho has one measure on the books regarding gun safety, while California has 111.  The former experiences a firearm mortality rate that is double the latter.

– Domestic violence restraining orders (DRVOs) are associated with reductions in intimate partner homicides.

– Background checks?  The data to support these are thin, but, combined with permit-to-purchase laws, research suggests that universal background checks may be effective in reducing deaths from firearms.

– Large capacity magazines (LCMs: devices that enable shooters to fire as many as 50 rounds without reloading) and assault weapons were banned by Congress in1994 for 10 years.  When the ban expired, mass shootings increased along with the number of mortalities: these numbers doubled in the years after the ban was lifted.

Judicial and legislative actions: the “anti-interventions”

Some actions, or non-actions, actually abet the gun problem.  

– In the name of the preservation of Second Amendment rights, the Oklahoma legislature has banned waiting periods for the purchase of guns. 

– The US supreme court recently struck down a 109 year-old law requiring “proper cause” (i.e., a special need for self-defense) for obtaining a license to carry a concealed weapon in public.  “Right to carry” laws have been associated with increased violent crime.

– Stand-your-ground laws allow people to use deadly force when they reasonably believe it is necessary to defend against violent crimes.  In a review by the Rand Corporation, research showed that these laws increase homicides.  38 states are currently stand-your-ground jurisdictions.

– Congress did not provide funding to the Center for Disease Control and Prevention (CDC) to study the gun violence epidemic for almost a quarter of a century.  This finally changed In the 2020 federal fiscal budget, but experts in the epidemiology (the scientific study of adverse health conditions, with an eye to identifying effective interventions) of gun violence believe the US lost over 20 years in developing a database that would help researchers find ways to reduce gun deaths. 

– Last summer, Congress passed the bipartisan “Safer Communities Act.”  It mandates background checks for potential gun purchasers under 21 and incentivizes states’ implementation of extreme risk protection orders (ERPOs).  It also provides expansion of access to mental health services.  Why do I include this measure in the “anti-intervention” category?  Because ERPOs are difficult to implement and, it could be argued, background checks should be universal, not limited to minors.  Moreover, the passage of this rather tepid bill may also allow lawmakers to believe much has been accomplished to prevent gun deaths, thereby undercutting more efforts in the near future.  The reality is that much work is to be done.    

Where there is a will, there is a way

When a young man killed 35 people with a semi-automatic rifle in Australia a few years ago, the government swung into action.  Legislation was passed that prohibits the manufacture, import, and possession of these rifles.  The law also provided for a buy back program, which resulted in the surrender of one-third of all privately owned guns.

Path forward

There is a compelling trove of information that points to common sense ways to curb gun violence in the United States.  Instead, in too many jurisdictions, “guns to go” is the way purchases are made.  The will to act is lacking in Congress, though, and clearly something needs to change in politics if we are to make significant progress in controlling our gun epidemic.

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