Nov. 22 2016

Charles Branas Takes Aim at Gun Violence

The incoming chair of Epidemiology has overcome intimidation and funding droughts to contribute scientific discoveries that shine a light on practical, apolitical solutions to gun violence

Charles Branas, the incoming chair of the Mailman School’s Department of Epidemiology beginning January 1, has spent a career upending conventional wisdom on questions like who is at risk of gun violence (short answer: everyone, including gun owners). Along the way, he has been cited by the Supreme Court and attacked by the gun lobby, while making a forceful case that firearm violence is a major concern for public health.

On an average day, almost 300 Americans are shot, 90 fatally—a mortality rate that dwarfs traditional public health threats like AIDS or food poisoning. “Gun violence is of course a law enforcement and justice issue, but it is also very much a public health and epidemiology issue,” he says.

Branas earned his PhD at the Johns Hopkins Bloomberg School of Public Health, completed his post-doc at the Berkeley School of Public Health, and then joined the University of Pennsylvania Perelman School of Medicine epidemiology faculty. His research has spanned injury prevention, substance abuse, and chronic disease—areas well represented by the breadth of scholarship at the Mailman School’s Department of Epidemiology.

“The history of epidemiology is built into the very fabric of this department,” he says. “There’s a lot of opportunity to bring together people who are focusing on different problems so they can benefit from each other and elevate their topic of study to something even more impactful.”

Everyone at Risk

As a paramedic early in his career, Branas saw the bloody aftermath of gun violence first hand, motivating him to explore the phenomenon on a population level. Ever since, he has studied trauma centers and their role in the decline of U.S. gun deaths, especially homicides. But medical care is just one opportunity to reduce the burden of gun violence. Because they are so overwhelmingly fatal, gun suicides are often outside the reach of the medical system—a prime example of the need for public health and prevention.

Branas published a 2004 study in the American Journal of Public Health revealing that there are more gun suicides in the United States than gun homicides. Counter-intuitively to anyone who thinks of gun violence as a uniquely urban problem, the risk of being fatally shot is greater in rural areas, where gun suicides are more common, than in cities, which see more gun homicides.

The study was one of two by Branas cited in the landmark 2008 Supreme Court decision, District of Columbia v. Heller upholding the right to bear arms, with some restrictions. The research showed that firearms can pose a danger to all Americans, no matter where they live, says Branas. “Gun violence is everyone’s problem, whether you live in a city or not.”

In the Crosshairs

A year later, Branas published a study examining a primary function of firearms—protection during an attack. He found that people who carried guns were more than four times more likely to be shot than those who were unarmed, perhaps because people with guns were more likely to overreact or become entangled in dangerous situations. A later meta-analysis graded this study “best in class” among a series of related studies over recent decades.

The gun lobby responded forcefully, lambasting Branas’ research and putting him on the cover of their magazine, distributed to 5 million members and Congress. Branas received threatening emails and calls, and industry groups pressured the University of Pennsylvania to remove him. They further argued that the NIH-funded research was part of a larger Obama Administration plot against gun owners when, in fact, the research had been funded under the Bush Administration.

Under intense pressure, Congress passed a rider blocking National Institutes of Health funding for firearm violence research in 2011. Branas remained undeterred, but the funding cuts and intimidation took a toll, with a marked decline in the number of published papers on gun violence nationally. After the tragedy in Newtown, the Obama Administration was able to make a strong push to lift gun violence research funding strictures. Since then, the NIH has called for new grant proposals focused on firearm violence research and the number of major grants funded for gun violence research has increased.

A New Environment

Branas has experimented with ways not just to understand gun violence, but to reduce it. Some successful programs were person-based, like conflict resolution. “But the instant the money dried up and the people teaching the program left, so did the positive effect,” he says. “We started to think: what can we do that’s bigger than simply focusing on individuals?”

Branas and his team at Penn’s Urban Health Lab tried a different approach—a public health take on the broken windows theory, without the need for actual policing. They repaired abandoned buildings and greened vacant lots in cities like Philadelphia, eliminating hiding places for illegal guns and galvanizing long-neglected residents by improving their surroundings. It was a potent intervention: significantly bringing down gun violence for years, with added benefits of higher exercise and lower stress levels.

“When you clean, green, or bring order to a space or remove graffiti and replace broken windows and doors,” he says, “people feel more connected to their surroundings and each other. They will go out of their way to make sure the negative things occurring around those spaces don’t persist and the windows don’t get broken again.”

The impact of Branas’s research into these seemingly small but highly scalable interventions can now be found in neighborhoods from Newark to New Orleans. Each is inexpensive, not prone to gentrification, and can circumvent political objections related to gun control. And there’s room for many more. All the abandoned and vacant spaces in cities across the United States add up to a land area the size of Switzerland, he says. “That’s a massive opportunity.”