The good news is that for the first time in 16 years, the United States government has heeded the call for renewed scientific research into gun violence.
The bad news is that there may not be any money devoted to it.
On Jan. 16, in the wake of the Sandy Hook shooting that claimed 27 lives, President Barack Obama unveiled a US$4.5-billion plan to curb gun violence, including putting an “end to the freeze on gun violence research” that had been in place since 1997. The funding includes $10 million earmarked for the US Centers for Disease Control and Prevention (CDC) to research the prevention and causes of gun violence and $20 million to collect research data on violent deaths. There are 32 000 gun-related deaths each year in the US.
Obama’s Firearm Safety and Public Health Research Act is now under review by Congress’ health committee, and it’s unclear when they will make a decision.
The call for investment in gun violence research comes on the cusp of US government cutbacks of $1.2 trillion over the next 10 years. The CDC faces cuts in excess of $440 million while health research across the board will be cut by $3.6 billion, according to Research! America.
The fiscal crisis may overshadow the public health crisis of gun violence, says Stephen Teret, Director of the Center for Law and the Public’s Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
“We’re moving in the reverse direction of adequately funded programs that would reduce gun violence and other public health programs,” says Teret.
Beginning in 1997, CDC funds couldn’t “be used to advocate or promote gun control," according to CDC senior press officer Gail Hayes, who cites the 1997 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (www.gpo.gov/fdsys/pkg/PLAW-104publ208/pdf/PLAW-104publ208.pdf).
That same year, Congress cut the CDC’s budget by $2.6 million, an amount equal to gun violence research, and “threatened to impose further cuts if that research continued,” according to Hayes’ emailed statement.
Hayes says similar policies were extended to other health organizations in the 2012 Consolidated Appropriations Act (P.L. 112–74) (http://www.gpo.gov/fdsys/pkg/PLAW-112publ74/pdf/PLAW-112publ74.pdf).
Teret, who worked at the CDC-funded injury prevention research centre in the 1990s, says he encountered restrictions first-hand when his team was researching injuries from gun violence. After speaking independently about his research, he says he received a phone call from a high-ranking CDC official asking him to stop.
“When the funding dried up so did the interest,” Teret says. Obama’s plan “is a re-blooming of guns as a public health problem.”
In addition to providing funds for research, the act also affirms that physicians can report threats of violence and talk to their patients about gun safety and proposes $20 million to further develop the violent death registry, which includes data on gun deaths, If the act goes through, this registry will be expanded to all 50 states.
If the act doesn’t go through, the registry will be cut completely, taking away the “ability to identify trends and points for intervention,” according to the American Public Health Association’s report on expected areas for funding cuts.
The cuts will be “devastating” for research, but this is only one part of solving the public health issue of gun violence, says Dr. Dariush Mozaffarian, a professor of epidemiology at Harvard School of Public Health in Boston, Massachusetts. “We don’t need to wait to do things that we know will work from other paradigms,” he says, adding that policies should be implemented and research can later evaluate them.
In a recent editorial on curbing gun violence (JAMA 2013;309:551-2), Mozaffarian and others suggest public health approaches such as taxing guns in ways similar to tobacco with revenue going to health care.
Many new research questions are arising, but some from more than a decade ago remain unanswered. These include the possibility of modifying guns’ safety mechanisms or finding other ways to decrease the number of injuries and deaths from gun violence, and examining connections between gun violence and mental health issues, and drug and alcohol use.
If Congress were to approve the $10 million proposed by Obama, it would not be enough to fund all the research that needs to be done, Teret says.
“The challenge is coming up with the research questions that are of the highest priority,” he says, adding that the CDC is beginning to look at a research strategy in line with Obama’s plan.
And although there’s a strong push for research and it has been highly politicized, it’s not guaranteed protection from cuts, Mozaffarian says. “The reason it wasn’t being done in the first place was because of that, so if they’re going to be cutting things, it might be the first thing they cut and not the last,” he says.