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Tufts Public Health » Injuries, Mental Health, Violence » Gun Violence, a Public Health Issue?

Gun Violence, a Public Health Issue?

In the wake of another deadly school shooting, the question of gun violence as a public health issue has yet again been proposed. However, unlike most major public health questions, there is a severe deficiency in evidence supporting either side of the political rhetoric on gun control. The origin of this knowledge gap is often accredited to a 1996 congressional amendment. Commonly referred to as the “Dickey Amendment,” named after the Arkansas House Representative that championed it, Jay Dickey, the amendment prohibits the CDC from promoting or advocating gun control through its research. While the amendment doesn’t explicitly ban research on gun violence, it has served as a means of controlling the priorities of the CDC, similar to the CDC budget document censorship.

A 2017 article in JAMA concluded that gun violence is associated with less funding and scholarly research than other causes of death with comparable mortality rates. According the authors, gun violence had as low as 1.6 percent of the estimated funding and that while both gun violence and sepsis had similar mortality rates, it received 0.7% the annual funding that sepsis receives.  Despite the lack of research funding, some studies have recently been done on the public health effects of gun violence. The U.S. has the highest rate of firearm deaths among the 34 most developed economies in the world. Aside from the mortality rate due to gun violence, there are other adverse public health effects of violence on populations. A 2015 metanalysis in Trauma Violence and Abuse concluded that a variety of negative psychological outcomes are associated with mass shootings for both the survivors as well as members of the community.  This finding of adverse psychological effects on entire populations after mass shootings is supported by several other analyses, and one 2015 study found that mass shootings may have a contagious element to them, potentially inspiring future shootings. The same study also found that state prevalence of gun ownership was significantly associated with killings, mass shootings, and school shootings.

With the increase in mass shootings in recent years and greater demand for gun control research funding, things could change. The current Health and human services (HHS) Secretary, Alex Azar supports efforts to study gun violence as a public health issue through the CDC. In reference to last month’s Stoneman Douglas shooting, Azar said “We believe we’ve got a very important mission with our work with serious mental illness as well as our ability to do research on the causes of violence and the causes behind tragedies like this.” Increasingly, public health organizations such as APHA have been treating gun violence as a public health issue and in 2016, over 100 health organizations signed a letter to congress to fund CDC’s research on gun violence.

Interestingly, Jay Dickey himself has come out against the current state of gun violence research at the CDC. In October 2015, he told NPR “It wasn’t necessary that all research stop. It just couldn’t be the collection of data so that they can advocate gun control… But for some reason, it just stopped altogether.”

Tufts University School of Medicine has been vocal on the subject in light of the recent Stoneman Douglas shooting. On February 21, one week after the shooting, over one hundred TUSM medical students met on campus in solidarity with the #WhiteCoatsAgainstGunViolance movement which aims at raising awareness of gun control as a public health issue. TUSM’s alumni association will also be hosting an event in April titled “Integrating Mental health and Public Health.” Until more funding becomes available for the research of public health effects of gun violence, academic institutions should stand in solidarity with movements demanding political action.

Follow the gun violence—public health question on Twitter and on Facebook.


by Donald Clermont, MPH Candidate ’18

Filed under: Injuries, Mental Health, Violence

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