Oct. 13 2017

Seeking Answers on Gun Violence

Epidemiology Chair Charles Branas weighs-in on gun violence, including what research says about where it happens and how to stop it.

The mass shooting in Las Vegas has left many wondering how this kind of tragedy could happen. Again. Sadly, the shooting is far from isolated. According to the Gun Violence Archive, on average, there is more than one mass shooting in the United States for each day, far more than any other nation. A report by Vox found that, between 2000 to 2013, guns killed more Americans than AIDS, illegal drug overdoses, the wars in Iraq and Afghanistan, and terrorism combined—mostly by day-to-day homicides and suicides.

To get a clearer picture on gun violence as a public health issue, Transmission spoke with Charles Branas, chair of Epidemiology, who has built a body of research on the topic—including the who and where of firearm violence and actionable ways to prevent it—that has been cited by the US. Supreme Court, Congress, and the director of the National Institutes of Health.

As somebody who studies gun violence, what’s your take on what happened in Las Vegas?

What happened in Las Vegas saddens me deeply. It was a horrible event. But this is only the tip of a much larger gun-violence iceberg in the U.S. On the same day, hundreds more people across the U.S. were shot adding up to somewhere around 100,000 shootings in a year. They’re all tragedies.

Gun violence is no longer an epidemic; it is endemic in the U.S. Mass shootings and day-to-day shootings have actually been common for decades now, although we’re reaching slightly new heights in terms of the numbers of people involved.  

Counting up gun deaths is important but just one way to get our heads around this crisis.  Tracking shootings is perhaps better at getting at the magnitude of the problem—but even then, we’re still only scratching the surface of a much larger problem. Every victim of gun violence has their family affected, their friends affected, and because a shooting is often such a public event, entire neighborhoods, towns and cities are also very negatively affected. People don’t move out because someone on their block died of cancer, but all it takes is one shooting on your street corner and families are packing it up for safer surroundings.  

About a month ago, a young father in Philadelphia was murdered by a 16-year-old with an illegal firearm. It’s a horrible situation for that man, his family, and, by the way, for the teenager who pulled the trigger and who’s life will now forever be an incarcerated existence.  It’s also horrible for the neighborhood and families on that block are sure to move away, eroding the economic base for that neighborhood and the city. We saw something similar after the Pulse nightclub shooting in Orlando, which is still back-peddling to stem the economic hit. We could see the same thing happen in Las Vegas.

Your research shows that place matters in gun violence. What have you found?

Most people think of gun violence as happening in urban areas, but the risk of gun death is actually higher outside our cities. In rural areas, the number one mechanism of gun death is gun suicide. And unlike gun homicide, gun suicide is growing across the U.S. The number-one way people are killing themselves is with firearms, and gun suicides now far outnumber gun homicides each year in the U.S.

Some years back, I was invited by a rural area to help investigate the rise in shootings in their counties. They were concerned that immigrants were relocating to their area and somehow increasing their gun murder rate. Although we found no evidence that this was happening for gun murders (not one actually), we did find a lot of evidence that residents were shooting themselves to death in very high numbers. Local officials had no idea and to this day many still deny that that they have a persistent gun suicide crisis.

The economists Anne Case and Angus Deaton introduced what they call “deaths of despair” with research that shows that life expectancy among middle-aged white Americans has declined in recent years. Opioids are of course a big factor, but after that, it’s suicide that’s driving this trend, which then really boils down to gun suicide. As a nation, we are only now beginning to recognize this but so much more can be done especially given the rural nature of this problem and the clearly disenfranchised electorate who is being chiefly affected by gun suicide but just has yet to realize it in any meaningful way that allows for scientific solutions.

What are the biggest unanswered research questions?

We’d like to know what role, if any, mental illness plays in gun violence. Right now, in most states, when you buy a firearm, there is a box that asks: Do you have a history of mental illness, yes or no? The ability to obtain a firearm has been relaxed to the point where it’s like buying a cellphone (buying a cellphone may actually require more paperwork in some states) and in a country with one-gun-per-person there are a lot of people with access to firearms. But, of course, properly training and accurately shooting a gun is not the same as shooting a photo with your smartphone.

Another thing we need to look at is training. A lot of people are now walking around or in a home with a gun at any given moment. Without proper training requirements, we can’t have any way to know if they are any safer with that weapon than not. Again, some people think that firing a weapon is as easy as shooting a picture with your cellphone, or that somehow their gun is going to protect them like it’s a scripted movie scene. We simply have not studied weapons training in the same way that we have for say, driver training, and this is reflected in the near absence of meaningful training requirements when you go to buy a gun in many states.

Is there a public health approach to preventing gun violence?

We need to think beyond simply guns and people, and start thinking about the environment that is promoting these shootings in the first place. Shootings are happening in impoverished neighborhoods, both urban and rural, and at some level, the neglect that these neighborhoods have suffered for decades is a root cause of gun violence. The good news, is that we’ve found fixing up these neighborhood environments in simple and inexpensive ways can offer huge returns-on-investment and break the cycle of gun violence. And there’s a whole lot of room for improvement. Blighted areas in our cities—if you add it all up, is a land area the size of Switzerland. What an opportunity for transformative change that can sustainably reduce gun violence in a politically acceptable way while at the same time providing numerous other co-benefits, like less stress, better mental health, and neighbors who feel safe enough to go outside.

Public health is uniquely positioned to provide creative solutions to gun violence in the U.S., whether it be mass shootings or day-to-day shootings. We should not forget the great public health successes of the past. We can focus on promoting new legislation that could change the tide of gun violence in the U.S., but also target new ideas, like environmental fixes to gun violence, and aspects of gun violence that are not the responsibility of law enforcement or the justice system and are uniquely left to public health to solve, like gun suicide.