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Will Universal Background Checks Solve The Problem Of Gun Violence? It’s A Start.

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According to rumor, the White House will shortly close a legal loophole that currently lets a large number of guns move from one set of hands to another without a background check.  Evidently Obama will issue an EO that redefines what it means to be a gun dealer by substantially reducing the number of private transfers that can be made, thereby forcing gun owners to acquire a federal license which will effectively require that every gun transfer beyond a minimum number go through a NICS-background check.

Which brings up the ultimate question, namely, if we had universal background checks, what would this mean in terms of reducing gun violence overall?  Right now the CDC tells us there are 30,000+ intentional gun deaths and 65,000 intentional gun injuries every year.  There are also 17,000+ unintentional gun injuries, fatal and non-fatal, each year.  We can probably discount most, if not nearly all unintentional injuries because they usually involve the legal owner of a gun and/or his/her children or friends.  We can also discount the 20,000+ suicides, which leaves somewhere around 75,000 acts of gun violence each year for which, in theory, universal background checks should help reduce the toll.  But by how much?

In fairness to the researchers who are concerned with this problem, they were not trying to figure out the impact of universal background checks per se.  Webster and Wintemute have come up with a very comprehensive summary of research on the effects of policies designed to “keep firearms from high-risk individuals” published between 1999 and 2014. This article covers more than 60 peer-reviewed works and looks both at policies designed to regulate the supply of guns to high-risk individuals (i.e., dealer practices) and policies designed to make it more difficult for high-risk individuals to get their hands on guns (i.e., background checks and other licensing practices.)

I’ll leave a discussion about dealer practices for another time, insofar as our concern here is the issue of universal background checks. As for that question, W&W argue that the prohibited persons categories defined by GCA68 and used as the basis for disqualifying transactions through NICS “would not disqualify the majority of individuals who commit gun violence.”  What does seem to have a significant impact on gun violence is where states have gone beyond the federal definitions of prohibited persons and passed laws that make it easier to keep guns out of the wrong hands.

conference program pic              The most rigorous licensing in this regard is known as Permit to Purchase (PTP), which requires that the purchase of every gun, in particular handguns, be approved following an application to acquire the specific gun.  This is, in fact, the procedure in New York City since the 1911 implementation of the Sullivan Law, but there is virtually no connection between how this law has been administered over the past century and changes in the rates of violent crime.  On the other hand, W&W cite numerous studies, including Webster’s study of the effect of abolishing PTP in Missouri, which indicate that when states strengthen the licensing process beyond NICS-background checks, gun-violence rates tend to go down.

The evidence to date does not appear to support the notion that universal background checks will have a substantial impact on gun-violence rates unless it is accompanied by more rigorous gun-control policies at the state level.  Which is not an argument against universal checks, just a warning about setting expectations too high. What I find frustrating in the whole ‘guns in the wrong hands’ discussion, however, is the continued lack of interest or concern about stolen guns.  Webster and colleagues studied the source of 250+ crime guns used by prison inmates in 13 states and as many as 85% of those guns could have entered the illegal market through theft.  This situation won’t change because we strengthen the licensing process for acquisition of new guns; it just requires diligence for the guns we already own.

A New Article Explains How Crime Guns Get Into The ‘Wrong Hands’

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When a serious scholar like Philip Cook publishes research on gun violence, the pro-gun community usually ignores what he has to say.  This is because Professor Cook has been publishing important work on the risks of guns for nearly forty years, and the folks who don’t believe that guns are a risk would rather pretend he doesn’t exist.  Which is why I found it interesting that his latest work on how criminals get their guns has made the headlines in the pro-gun media, from the NRA to the National Review.

          Philip Cook

Philip Cook

The pro-gun headlines, however, tell a much different story than the one we get from Phil Cook.  Because what Cook and his research colleagues were trying to find out was information about the operation of the ‘informal’ gun network; i.e., gun transfers which occur outside of the regulatory environment that defines initial gun transfers between customers and FFLs.  And since only 10% of the guns acquired by the survey respondents came directly from legal sources, the whole point of this research was to illuminate the shadowy and unmapped world of illegal guns.  Or to be more precise, how guns were acquired by people who were then arrested for using or carrying them in illegal ways.  Incidentally, this article appears in the special Preventive Medicine issue on gun violence edited by Daniel Webster and David Hemenway whose lead editorial I discussed last week.

The pro-gun noisemakers are falling over each other telling their followers that this article justifies their opposition to every gun regulation of any kind, because the criminals themselves admit that only 10% of the guns they use come through legal channels to them.  So what’s the point, for example, of expanding background checks to secondary transfers if gun-toting criminals get all the guns they want without undergoing a background check at all?  To quote the geniuses at the NRA: “Since these criminals do not use gun stores, gun shows, or even legal private gun sellers, there is no point in the criminal supply chain where a background check would make any difference whatsoever.”

The NRA’s been peddling this crap since they lost the battle to prevent NICS background checks in 1994. Here’s the organization’s official statement on the issue: “NRA opposes expanding background check systems at the federal or state level. Studies by the federal government show that people sent to state prison because of gun crimes typically get guns through theft, on the black market, or from family members or friends, and nearly half of illegally trafficked firearms originate with straw purchasers—people who can pass background checks, who buy guns for criminals on the sly. No amount of background checks can stop these criminals.” And guess what?  Now they have the esteemed gun researcher Phil Cook validating the NRA point of view!

Except that’s not the point of Phil’s research at all. To the contrary, the article contains a very interesting graphic (Page 30) along with excerpts from respondent interviews which illustrate the degree to which nearly all the guns acquired by inmates passed through multiple hands following the initial, legal transaction that took place in an FFL’s store.  And even though the lack of NICS checks over secondary (or tertiary or quaternary or quinary) transactions was the rule for guns by themselves of their friends, few of the jailed inmates interviewed in this study had any idea of exactly how or when their guns first disappeared from lawful commerce and ended up in the mean streets.

What makes this article so powerful and compelling is that it’s not based on data so much as on the words of gun-carrying criminals themselves.  The fact that again and again inmates mentioned their fears of getting caught with a gun validates the notion that gun regulations work.  The respondents in this study clearly understood that giving them a gun was putting it in the ‘wrong hands.’ In that respect, the felons in Cook County Jail are way out in front of the NRA.

A New Collection Of Public Health Gun Research Is A Must Read

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The Journal of Preventive Medicine has just published A Special Issue on the Epidemiology and Prevention of Gun Violence, bringing together the foremost group of scholars ever assembled in one publication devoted to understanding gun violence.  If anyone wants to quibble with me over the superlatives of the previous sentence, that’s fine.  The bottom line is that if you want to know what some of the best and brightest in this field have been doing lately, this journal number is a good place to start.

It’s altogether fitting that the collection should be introduced in a guest editorial written by David Hemenway and Daniel Webster, who direct the two most important academic centers devoted to gun violence research from a public health perspective.  Hemenway and Webster can thus take a global view of gun violence research which, unfortunately, doesn’t yield very positive results.  The authors note that public health research is underfunded in medicine, injury prevention is underfunded in public health and gun research is underfunded in injury prevention – a triple whammy, if you will. Between 1991 and 2010, gun injuries were the second leading cause of injury deaths among youths ages 1-17, yet public health/medicine research accounted for less than 1% of all injury research.

conference program pic                This is a rather dismal state of affairs, and while much of the blame can be placed at the doorstep of the NRA, which pressured Congress into ending CDC-sponsored gun research after 1996, we shouldn’t discount other factors contributing to this research void as well.  Chief among the reasons that inhibit public health gun research is the fact that injuries caused by guns are almost always considered major crimes. And while someone who punches someone else has committed an assault, the impact of such an event simply cannot be compared to what happens when someone shoots someone else with a gun.  More often than not, gun violence is viewed as something more fittingly lodged within criminology rather than anything having to do with health.

Which is why I find the linkage of epidemiology to prevention in the title of this collection so exciting and perhaps signaling an important and fruitful change in the direction of gun violence research.  Because epidemiology is the study of the incidence, distribution and control of disease, and if the editors of this collection believe that gun violence is a disease which can be controlled through the application of medical knowledge and techniques, then perhaps we will see an attempt by members of the medical community to reclaim the formative position they held in this field prior to the elimination of CFC-funded gun research.

I am going to leave a discussion about each article in this collection to specific columns to be published over the next few days.  But I do want to briefly mention the editorial which introduces the volume because it’s the work primarily of three scholars from outside the United States.  And while we tend to think of gun violence in America as a particularly American problem studied only by Americans themselves, it’s good to have an international perspective on the issue, in this case submitted by three medical researchers from over our northern border at McGill.  The editorial, An elusive low-hanging fruit for public health: Gun violence prevention, notes that gun violence in America can’t be entirely separated from events throughout the world, in particular the cycle of violence unleashed by the attacks on 9-11.

This is hardly the first time that America’s obsession with guns and its toleration of excessive levels of gun violence have been tied to the continuing warfare and militarization provoked by terrorism both here and abroad.  There’s only one small problem: not true.  There was a spike in gun sales after the Twin Towers came down, but by the time it was noticed it was over.  Gun sales continued at modest levels throughout the eight years of George W. Bush, and zoomed upwards only after a certain Kenyan moved to 1600 Pennsylvania Avenue in 2009.  Want to understand the epidemiology of guns?  The U.S. Army, I’m afraid, won’t get you there.

Can Technology And Entrepreneurship Solve Gun Violence? Worth A Try

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This week more than 1,000 people have gathered in Washington, D.C. and San Francisco for the annual TedMed conference, which is one of those fast-paced, international meetings bringing together people who want to come together to make deals, make connections, make friendships, make whatever people like to make who get together and then be able to tell everyone who wasn’t there how much they missed by not being there.  Think the Aspen Institute conference, think Davos, think TedMed, get it?

TedMed claims that its meetings explore “the technology, creativity and innovation that contributes to a healthier future,” which is an understated way of saying that if you have a new idea that will make a gezillion dollars in today’s health technology market, you’ll meet plenty of deep pockets belonging to people who want to help you get it out there as long as most of the profits end up belonging to them.  But that’s the way entrepreneurship works and that’s the reason why the TedMed meeting was video-streamed to more than 140 countries worldwide.

tedmed               I normally avoid having anything to do with such meetings because I know that the real action takes place not on the speaker’s platform, but in the hallways and the lounges where the conference delegates meet and greet.  But I had to watch today’s session because one of the main speakers was Daniel Webster, who runs the Center for Gun Policy and Research at the Johns Hopkins University School of Public Health.  And if readers of my column find that this name strikes a familiar chord it should, since the School in which the Center is located is endowed by the NRA’s chief antagonist, the former Mayor of New York.

If you’ve read the Center’s publications, you won’t find anything in Webster’s remarks at TedMed that would surprise.  And the prescription for reducing gun violence, which he described artfully and fully to the TedMed audience, can be found in the many published articles of the Center and are summarized in the book, Reducing Gun Violence in America, which the Center released following  the massacre at Sandy Hook.  In sum, Webster and his colleagues believe that gun homicides can be reduced by roughly half of the 11,000 that occur each year, a goal which could be met if gun ownership standards were more higher and more consistent, gun dealers were better regulated, private gun transfers came under NICS, and safe-gun technologies, particularly ballistic prints of ammunition, were implemented by manufacturers prior to retail sales.

As I was listening to Dan Webster’s remarks, however, it occurred to me that perhaps something needed to be considered beyond the strategy for change that he outlined in cogent and hopeful tones.  Because while there’s no question that a majority of Americans, even a majority of gun-owning Americans, support (at least in theory) sensible measures to reduce the carnage from guns, perhaps the audience at the TedMed conference included entrepreneurs and investors who view this issue, like they view all such issues, as a question of market, products, profit and loss.  So why not enlist them in figuring out how to translate some of these policy ideas into profitable ventures – the real American approach to solving problems – which will create financial incentives to help reduce harm from guns?

The smart-gun technology stuff has been kicking around for years, but the Number 1 reason why guns go off when they shouldn’t is because the owner forgot to unload it before he put it away.  We have sensors that tell us if we forget to turn off the lights on our cars.  Would anyone believe that their 2nd Amendment rights were under attack because they were reminded electronically to unload their guns?  Don’t get me wrong – the Hopkins gun violence research team understands the policy imperatives that would bring gun violence way down.  But asking entrepreneurs to advance the goals of those policies through market-based ideas and products certainly wouldn’t be wrong.

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