Psychologist Andrew Morral is a senior behavioral scientist at the RAND Corp. He leads RAND's initiative to understand the effects of U.S. public policies on guns, which are involved in 33,000 deaths—nearly two-thirds of them suicides—and 79,000 injuries each year. RAND recently released a comprehensive review of research on the effects of 13 broad classes of policies. Modern Healthcare senior reporter Harris Meyer spoke with Morral about the impact of various policies in reducing gun violence and the many areas where more research is needed to guide policymaking. The following is an edited transcript.
Modern Healthcare: Why did RAND launch its Gun Policy in America initiative?
Andrew Morral: RAND's president, Michael Rich, told me that after each mass shooting event, the trustees and staff would ask, "What are we doing about this?" He saw that our research portfolio on gun policy was spotty, and he decided this was something we needed to do.
MH: How much research is out there now?
Morral: A study in JAMA last year found that federal funding for gun violence research has totaled less than 2% of funding for other comparably common causes of death like traffic accidents, liver disease, sepsis and poisonings. Not surprisingly, the volume of publications and studies on gun violence is just 4% of what's been done on those other causes of death.
MH: Is the Dickey Amendment passed by Congress in 1996 the reason there has been so little federal funding, and would it have to be repealed for funding to increase?
Morral: The Dickey Amendment doesn't say the Centers for Disease Control and Prevention and the National Institutes of Health aren't allowed to do gun violence research. But the practical effect is that government administrators don't think it's politically safe and don't want to risk their budgets. Without a clear signal from Congress and the administration, I'm not sure it will be possible to expand funding.
MH: What were some key findings of RAND's research review?
Morral: The policy for which we found the best evidence—which we call supportive evidence—is for laws that prevent children's access to guns. The evidence is that such laws reduce suicide and unintentional injury among young people.
You'd think such laws would be a no-brainer. But the argument against these laws is that homeowners who have their guns locked up to keep them out of the hands of children can't easily access their guns to defend themselves during a crisis. There's no research on that topic, however.
MH: What other policies have been found effective?
Morral: We found moderate evidence—our second highest research quality rating—that prohibitions on gun ownership for people with mental health histories were associated with reductions in violent crime, with limited evidence they reduce suicide. This is a pretty controversial idea in some circles, because people with mental illness are much more likely to be victims than perpetrators. Some argue it's unjust to take away their right to defend themselves.
MH: What about other types of policies?
Morral: We found moderate evidence that background checks can reduce suicides and violent crime. We found limited evidence that minimum age of purchase requirements reduce suicides among young people. I don't know of any studies on the effects of arming teachers.
MH: What about gun policies in foreign countries, such as Australia's 1996 ban and mandatory buyback of assault rifles?
Morral: Studies from Switzerland and Israel found that when those two countries reduced the number of military personnel going home with firearms, there was a reduction in suicides. In Australia, it's just incredible—there have been no mass shootings since the buyback program. But studies from a single state or country provide fairly weak evidence for making causal claims because you need comparison units.
MH: Are there other problems with comparing the U.S. to foreign countries?
Morral: The Second Amendment is a complication. The huge stock of guns in the U.S. creates a different environment in which these policies could play out. If you take away 650,000 semi-automatic rifles in Australia, you've really cut into the stock of firearms. If you did that in the U.S., because so many people have so many guns, many would continue to be gun owners.
MH: What did you learn from interviewing gun policy experts on both sides of the issue, those who favor restrictive gun laws and those who favor permissive laws?
Morral: Both groups are trying to achieve the same goals. But there is disagreement about facts concerning what the true effects of gun policies will be. This argument about the facts has been going on for decades.
MH: What are the policies on which the two sides most strongly disagree?
Morral: The policies where disagreement is greatest were permitless carry laws, elimination of gun-free zones, and stand-your-ground laws. Stand-your-ground laws, which have been implemented in more than half the states, would be a very good area to try to get more credible evidence.
MH: Would having more and better research help develop political consensus?
Morral: We think some settling of the facts about gun policies would be a good first step. Not everyone would immediately embrace new facts and say they were wrong. But I think there's a big middle ground of people who are interested in knowing what the truth is. My hope is if we had more information about what is credibly known, the big middle would gravitate toward a common set of facts.
MH: How long will it take to do the research needed to do evidence-based policymaking?
Morral: It will take a while because the government doesn't collect the data needed for a lot of these studies, unlike the incredible database it has on traffic accidents. After 2005, the federal government stopped asking in a major survey about household gun ownership. That's very basic information.
MH: Do you think this country is at a tipping point on gun policy, at least in terms of expanding research?
Morral: I am encouraged because I've heard a number of members of Congress saying we ought to be studying this better. This is an important problem and it deserves to be researched in the same way traffic accidents are studied. But if I were a grad student interested in gun policy, I'd be a little nervous about the funding environment I'd be entering when I got my first job.