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It’s simple: Science.
By MARK L. ROSENBERG February 18, 2018
In March 1999, President Bill Clinton and Attorney General Janet Reno called a meeting of representatives of several federal agencies to discuss what to do about school violence levels, which were high but not increasing. I showed the group a large poster on which the Centers for Disease Control and Prevention, where I was then the director of the injury center, had plotted the frequency of school shootings involving multiple deaths. It showed a steady and frightening increase. I had hoped that this would move the Clinton administration to take rapid steps to prevent more such shootings.
It didn’t. Exactly one month later came Columbine, which took the lives of 13 students and two student perpetrators—at that time, the worst school shooting in U.S. history. We all know what happened next: Virginia Tech, Sandy Hook and, most recently, Parkland, with many others in between. According to the Washington Post, “more than 150,000 students attending at least 170 primary or secondary schools have experienced a shooting on campus since the Columbine High School massacre in 1999.”
If we are waiting for the numbers of school shooting victims—or, for that matter, nightclub victims, concert-going victims, shopping mall victims, young inner-city black men or suicidal veterans—to grow high enough to move legislators to act, it ain’t gonna happen. Numbers have not brought politicians to their senses. Nor has sympathy or compassion: The shootings continue, despite victims, their family members and even the families of perpetrators recounting the horrors of gun violence in predictably tragic media coverage. “Common-sense” policy solutions aren’t enough either, because we are so polarized that what is called common sense by one side of the gun debate is seen as propaganda or false by the other. There are those who favor “gun control,” but the term is not well-defined except by the other side, who see them as so single-mindedly focused on safety that they would happily take all firearms out of civilian hands. On the other side are those who favor gun rights and have been conditioned by the NRA leadership to have zero tolerance for any discussion whatsoever about preventing gun violence. They are seen as irrational “gun nuts” by the gun-control side.
Where does that leave us? The exact causes of America’s rise in mass shootings—and the best ways to prevent such violence—remain uncertain all these years after Columbine. Should we focus our efforts on mental health? Would a ban on semi-automatic rifles necessarily solve the problem? What if the surest bet is for schools to install metal detectors in their halls? To those of us in the public health community, the path forward is clear: To solve this nationwide crisis of firearm injuries and deaths, we must pursue the same kind of scientific research that showed us how to save millions of lives from cancer, heart disease and high blood pressure. The same type of scientific research that helped us save half a million lives from road traffic crashes, without banning cars. The same kind of scientific research that proved that second-hand smoke harms people. Common sense doesn’t tell us whether a ban on semi-automatic rifles will reduce mass shootings—that question is too complicated for us to simply work out in our heads. But it’s possible a well-designed study could, and would in turn build public trust in any resulting legislation.
The problem is that scientists don’t have the resources to do the research we so urgently need.
We used to be able to conduct such work. In the 1980s, researchers at the CDC began a program to find out how to prevent gun violence. But in 1996, Congress, with prodding from the NRA, stepped in. That year, the House and Senate passed the so-called Dickey amendment, which declared that none of the federal funds for the CDC’s injury center could be used “to promote or advocate gun control.” The amendment did not explicitly prohibit the CDC from conducting gun violence research; it prohibited the CDC (and later, other federal agencies like the National Institutes of Health) from lobbying for gun control legislation. Nevertheless, the provision was a shot across the bow and had a chilling effect. A second shot was Congress’ taking away the $2.6 million that the CDC’s injury center had been spending annually to support gun violence research. The third shot was fired by CDC itself, when the agency director fired the person most closely identified with the gun violence prevention research. (That person was me.) Soon, the CDC’s research effort was reduced by more than 90 percent.
In 2003, the U.S. Task Force on Community Preventive Services—a national independent group of experts that makes evidence-based recommendations about clinical preventive services—reviewed all the available scientifically valid research about preventing firearm injuries. That included research on bans on specific guns or ammunition, restrictions on gun acquisition, waiting periods, registration and licensing for firearm owners, “shall issue” concealed weapons carry laws, child-access prevention laws, zero tolerance of firearms in schools and combinations of firearm laws. For every one of these major categories of interventions, the conclusion was the same: There was insufficient evidence to say whether the interventions were effective. The reason: Research efforts had slowly but steadily ground to a halt following the passage of the Dickey amendment.
The NRA likes to argue that research about gun violence inherently threatens gun rights. But it is possible—indeed, necessary—for scientists to find ways to both reduce gun violence and protect gun rights. Look at cancer research. In finding the best chemotherapy for a patient, there are two goals: first, to stop the cancer, and second, to protect the patient’s kidneys, heart and liver. There are many drugs that will stop the cancer, but most of them will also damage the patient’s vital organs to the point that he or she will die. That’s why cancer research aims to find treatments that are both effective and safe. It is the same with gun violence: We need to find interventions that will both stop the violence and protect the rights of law-abiding gun owners. For instance, right now we don’t know whether arming all teachers in a school will save lives or take more lives. We don’t know whether making it easier for people to carry concealed weapons will save lives or result in more deaths. And we don’t know whether banning the sale of semi-automatic rifles will prevent mass shootings or lead to more gun deaths because there will be fewer good guys with a gun to stop the bad guys with guns. To answer the question, we also have to measure the degree to which each intervention infringes on the rights of law-abiding gun owners. Only rigorous, objective and well-designed scientific research can find the answer.
What’s more, it is irresponsible and even dangerous for lawmakers to change gun policies without knowing what measures are both safe and effective. In the late 1950s, a medication that was first marketed in West Germany was touted as a miracle drug for pregnant women because it cured both nausea and insomnia. But in the United States, the Food and Drug Administration refused to approve the drug, thalidomide, even though the company promoting it tried six different times. A brave physician at the FDA, Dr. Frances Kelsey, would not approve the drug unless it could be shown to be both safe and effective, and her principles saved this country from disaster: By the early 1960s, more than 10,000 children in 46 countries were born with deformed or absent limbs and other serious birth defects. When we ask lawmakers to make decisions without data—measures like campus carry, universal background checks, identifying individuals at high risk for violence or bans on semi-automatic rifles—we are pushing them to approve the equivalent of thalidomide for gun violence.
Even the congressman for whom the Dickey amendment was named would come to acknowledge the importance of gun-related research late in his life. In 2015, Jay Dickey, a Republican from Arkansas, and I together called for bipartisan collaboration to restore funding for research to find programs and policies that would both reduce gun violence and protect gun rights. Today, I believe the Dickey amendment should be preserved, to assure those on the gun-rights side of the debate that none of the funds they send to CDC will be used to lobby for gun control legislation and that these funds will be used only to support scientific research.
In the 1960s, Congress saw that young people were being killed on our highways at unacceptably high rates and appropriated $200 million annually for the National Highway Traffic Safety Administration to conduct research that led to safer cars, safer roads and safer drivers. This research has saved more than 350,000 lives, according to NHTSA—and none of this involved confiscating automobiles. It would not take much to restart the CDC’s gun-related research efforts, and such research could yield results that are every bit as impressive. The agency houses the largest collection of violence prevention professionals of any place in the world. Many of the studies that are needed require large-scale, multi-jurisdictional and intricately designed evaluations that run over a period of several years to generate enough high-quality data. CDC, being a federal agency, is well positioned to both design and implement such studies, and it can collaborate well with the many other federal, state and local law-enforcement and public health agencies that will be required to carry out and monitor these studies.
I know that scientists at CDC are anxious to do this research. But recent directors of CDC have been willing to let this eminently solvable problem fester, seemingly because they fear the NRA will prod Congress to cut public health programs that are viewed as more central and critical to CDC’s mission—fighting infectious diseases like Ebola or influenza and chronic diseases like heart disease, hypertension, diabetes and stroke.
Science, however, has helped us solve problems we have long thought we just had to live with, or thought were unsolvable manifestations of evil. If we can get a bipartisan coalition of legislators who both want to protect the rights of law-abiding gun owners and reduce gun violence, and if they appropriate even $10 million—the small amount that President Barack Obama asked to be committed—we can get going on finding out how to do this. We can pass measures that are both safe and effective. Supporting scientific research is not the only thing we should be doing, but it offers a way out of the deadly stalemate we are in.
Lawmakers often say that the days after a mass shooting are not be the best time to talk about how to prevent future school gun violence. They’re right, in a sense. The best time would have been 20 years ago. But now, today, this minute—this is the second-best time to talk about it and to restart the science that will help us prevent more carnage.
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