Isn’t Better Research Into Gun Violence Something Everyone Can Get Behind?

RW: This is Colorado Matters from CPR News, I'm Ryan Warner. There's a lot we just don't know about how to prevent gun violence. That's because of a dearth of research related to guns in America. The head of Colorado's Public Health Department says, isn't the need for more research and more money to do it a cause everyone can get behind? Dr. Larry Wolk joins us, along with EB. She got a rare federal grant to study guns and suicide prevention in Colorado and welcome to you both.

EB: Thanks for having me.

Dr. Larry Wolk: Thank you.

RW: Dr. Betz, can you put into context just how unusual the low amount of federal funding is for gun research when you compare it to other causes of death in the United States?

EB: There was an interesting analysis a few years ago where they looked at mortality of leading causes of death and federal funding into those causes. And overall firearms got about one and a half percent of what would have been expected. So if you compare it to other leading causes of death, it's really not even in the same ballpark.

RW: The idea there that given the number of deaths in the United States by guns, you'd expect much more funding.

EB: Correct.

RW: Commensurately. I have to imagine that there are too many unanswered questions to count, but Dr. Wolk, could you give us an idea of some of the questions you have that you think more gun research funding could answer?

LW: Sure, I think people make presumptions about gun violence is due to availability or accessibility; is it as a result of unmet mental health needs or inadequate mental health screening; is it a result of bullying or marginalization of people who then feel that they need to participate in some violent act with a gun as a result. A lot of people have opinions and a lot of people are making those statements, I think from an uninformed standpoint because we just don't have the research to back any of those. So at this point, they remain just questions or theories.

RW: Yeah, what you did there is you ran through a lot of the debates we hear after mass shootings in particular. What you're saying is, there are any number of politicians who float those ideas about why there are mass shootings, why there's gun violence, but you're saying there's just not the research to back any of that up, those assertions up.

LW: Right. I think people on both sides, although more so on the pro gun side, there's concerns that that research won't be objective. That we won't ask the questions in an objective way so that we can get answers to that. That these are just biased ways to get a controlling or limiting ownership or the use of guns.

RW: And to support what you're saying there, I'll say the Rand Corporation reviewed the research and says there's no clear evidence for how policies affect mass shootings, officer involved shootings or defensive gun use. This includes things like the effects of arming teachers, for instance. There's just no evidence. What do you make, Dr. Wolk of those concerns that research would necessarily be biased, perhaps against gun rights?

LW: Well, I think it challenges the status quo and anything that challenges the status quo has the potential to be biased. So certainly if a change were to occur, that change would most likely be some sort of restriction or prohibition. Although at the same time, maybe the research supports the notion that ownership or accessibility of weapons or guns doesn't have a role in gun-related violence.

RW: The answer might come back that any number of guns could be in people's hands and that has absolutely no bearing on the rate of mass shootings. You're saying that's a possibility.

LW: It is. When you think of, from a public health standpoint, some of these other issues that we deal with that people presume is a result of having increased access to birth control, let's say, you're going to see an increase in sexual activity and that's not the case. Legalization of marijuana, you're going to see an increase in use amongst adults or youth here in Colorado and that's not the case. So maybe that would be the same case made for why we should be allowed to study guns, and study why gun violence occurs. And maybe the answer is similar to these other examples I gave is that accessibility and availability are not in of themselves, reasons why gun-related violence occurs.

RW: We'll get into the background of why there's this dearth of federal money for research in just a bit, but I want to be very clear. This isn't just about mass shootings. Dr. Betz, you study suicides. Briefly, what are you investigating right now?

EB: So our team is looking at how we can better help, we as health care providers, can better help those at risk of suicide and their families make decisions about how to make the environment safer during times of risk.

RW: The environment, their home, so ...

EB: Right, their home environment, exactly. So just like having a designated driver if somebody's not safe to drive, you don't call the police to take away their car keys, you know. In the same way this is, how can we help people during a time of suicide risk make decisions about locking up guns or temporarily moving them out of the home. Because we know that in those periods of risk and crisis, access to a firearm can increase the risk of death.

RW: That is that gun storage, gun accessibility might have some bearing on whether someone is able to follow through with suicide.

EB: Yeah, exactly. And so what our work is looking at, you know, we've worked with a range of stakeholders, so firearm owners, people, representatives from firearm groups, trying to develop an educational tool that will hopefully help patients and families make these difficult decisions in a way that they'll ...

RW: That's so interesting. I mean, it's so straightforward, gun storage, and yet that might have a huge effect, that's what you're trying to establish. I understand that you're the rare public health researcher who got federal money to do this. How is that possible, then?

EB: Right, so since, shortly after Sandy Hook when President Obama issued a directive about funding for firearm violence research, NIH has been funding work in firearms. It's generally very difficult to get NIH money, really, for anything, because it's very competitive. But our funding came from the National Institute of Mental Health, which is under the umbrella of NIH, and they've recognized that firearm suicide is a big problem and that we can't reduce suicide rates without addressing firearm access and firearm safety. And so that's how we received funding, through a competitive process.

RW: Okay, so do you think that's just about the issue of suicide in particular? In other words, if you were studying mass shootings, do you think it might have been a different outcome?

EB: I think potentially. I think at NIH it's difficult, it has to be linked to a particular health condition.

RW: Health condition.

EB: So in that sense it fits clearly within the realm of suicide prevention. I also think firearm suicide prevention is a little less controversial, because nobody wants to lose a family member.

RW: So here's a little bit of the context here. There's something called the Dickey Amendment, it's the de facto ban on federal funding for gun research. It's named after Jay Dickey, who was a congressman from Arkansas, and in the late '90s he wrote a law that was meant to prevent advocacy with federal money. And he told NPR a while back that he regrets that it's been used to stop nearly all gun violence research.

Voice of Jay Dickey: All this time that we have had, we would have found a solution, in my opinion, and I think it's a shame that we haven't. They need to reactivate that fund and be specific as to what that money's to be used for.

RW: Dr. Wolk, is the tide moving at all here to get more federal money for gun research, do you think?

LW: Well, it's been an ebb and flow tide, and I think we're starting to see some advocacy again at the federal level to see if, you know, this amendment can be repealed so that the CDC, who really is the primary funding organization at the federal level for us here at the state level, can in fact then make this a priority area.

If you look at the research that we're able to fund and the programs that we're able to fund when it comes to tobacco or cancer prevention or to obesity or even suicide, it's two-thirds of that funding really comes from the federal government here in the state of Colorado through our Department of Public Health and Environment. And so without that conduit, without that pool of federal funds that we can tap into, it really then falls on, you know, on the state, whether it's through general fund, which we have no funding to date, we haven't received any funding to date to do this, or even the private foundation community, who has shown some interest, but again not really funded anything direct in this area.

RW: What you're saying is that without the federal government, that's a lot of money that is not on the table, they're a significant player in health research. I'll say the new head of Health and Human Services, which oversees the Centers for Disease Control and Prevention, said recently that he's open to expanding federal gun violence research. He was pressed by a congresswoman from Florida, Kathy Castor.

Voice of Congresswoman Kathy Castor: Will you be proactive on the research initiative?

Voice of Alex Azar: We certainly will. Our Centers for Disease Control and Prevention. We're in the science business and the evidence-generating business, so I will have our agency certainly be working in this field as they do across the broad spectrum.

Congresswoman Kathy Castor: Thank you. And we're going to hold you to it. And Mr. Chairman Burgess-

RW: I'll say The Denver Post tried to survey Colorado's Republican Congressmen and didn't find any who supported more federal funding for gun research. I'll note that Democrat Diana DeGette has repeatedly introduced legislation to try to fund this kind of CDC research, but Dr. Wolk you mentioned briefly the possibility of private funding on this? Would you just say briefly more about that?

LW: Well, we have some foundations, some private foundations that have been set up here in the state. Caring for Colorado, The Colorado Health Foundation, Rose Community Foundation, who are concerned about health and funding health initiatives. So certainly it's an opportunity for us to work with any or all of them and others if we lack the federal funding source to say this is important to us here in Colorado, let's do something together here at the state level. Just like it wouldn't be unheard of to see maybe some legislation that would allow for state general fund if our own state legislators found that this was a compelling reason to go ahead and fund research.

RW: I'll say that some states have started to designate more money for this. California, possibly New Jersey. Dr. Betz, even if there was a flood of new money for gun research, be it from the federal government or elsewhere, I imagine there'd be a lag in reaping the benefits. Are there enough scientists, researchers doing this kind of work, given that there's been so little federal money now for decades?

EB: So I think if there was a flood of money tomorrow, there's certainly a lot of researchers who would step up to the plate to try to do the work. At the same time, I think we need to recognize that this de facto ban on funding has really had a chilling effect on the development of new investigators in firearm violence research. I personally have had people tell me, you know you might want to think about going in a different direction in your career because are you sure you're going to be able to be funded and so forth.

So I think there are enough of us that we'd be happy to step up and I think that shouldn't keep us from trying to fund this work, but we really do need to have sustained funding to grow the body of people and institutions who can do this.

RW: I asked this of Dr. Wolk, I'll ask this of you. What burning question do you have about gun violence that you'd like to answer in the United States?

EB: Oh, that's both hard and easy because there are so many.

RW: Throw out one.

EB: I think that a better understanding of the overall patterns of gun violence. Who's affected and how. Understanding in different sub groups what those risks are.

RW: Different sub groups?

EB: Yeah, sub groups of populations, both geographically, urban, rural differences, racial ethnic differences and so forth. And then also understanding the differential patterns between suicide and homicide and mass shootings.

I also think, echoing what he was saying earlier, I think we all need to be ready to accept what the science tells us. So if we, we may learn that in some situations, having a firearm is protective against violence in your home and so forth. I think as scientists we need to go into this with an open mind and then be ready to move on what we find.

RW: Dr. Wolk, is it frustrating to watch legislatures, here in Colorado but across the country, legislate on the issue without a lot of research to back that up? Does that frustrate you?

LW: It does, but it depends on the intent. I think outside of this discussion is again, whether or not the right to bear arms includes having these automatic high volume firearms in any situation or circumstance. There's still a risk mitigation factor that needs to be considered. And we do this all the time, we limit the percentage, the proof percentage of alcohol; we limit the amount of nicotine or even the amount of THC in legalized marijuana products. So using that same sort of risk mitigation principal, that part's not frustrating to me because I think regardless, we have to protect society and our kids by looking at risk mitigation almost separately from this issue as it relates to gun violence.

So, as I said before, you know then you get into the question about why this occurs aside from the risk mitigation piece and those are the questions that we need answered.

RW: Dr. Larry Wolk heads the state's Public Health Department and Dr. Emmy Betz manages the state's Violence and Injury Prevention Program and teaches Emergency Medicine at CU. This is Colorado Matters from CPR News.