With scarce gun violence research available, clinicians and states look to fill the vacuum
As Congress moved to clarify that the Centers for Disease Control and Prevention can conduct research on gun violence, a number of states and healthcare providers have taken it upon themselves to fill the gap in research left by decades of federal government inaction.
"If Congress will not appropriate the necessary funds to do that research, then we need to mobilize those funds in a different way," said Dr. Megan Ranney, a practicing emergency physician and researcher and director of the Emergency Digital Health Innovation program at Brown University.
Ranney is taking part in a new physician-led initiative supported by the Massachusetts Medical Society, the American College of Emergency Physicians and the American College of Surgeons to solicit private sector donations to provide grants for gun violence research projects.
Called the American Foundation for Firearm Injury Reduction in Medicine, or AFFIRM, the not-for-profit organization plans to collect evidence that will help inform healthcare providers to develop more effective public health interventions.
"As good scientists you go into stuff with hypotheses, not with answers," Ranney said. "But then you need funding to prove or disprove your hypothesis, and so many of us are saying enough waiting."
A lack of federal funding to research gun violence has led to a dearth of reliable evidence leaders can draw from to make gun control policies. According to a RAND study released last month, there was little evidence to support the effectiveness of most current gun laws.
"Unless we understand what's going on we cannot prevent it," said Ali Mokdad, professor of global health, epidemiology at the University of Washington School of Public Health. "Telling somebody to go ahead and study it without giving the money to do it is not enough."
The search for more data on gun violence and its effects prompted California lawmakers in 2016 to create a research center focused on studying firearm violence—the first such state-funded effort, which was funded with $5 million over five years. Last July, the Firearm Violence Research Center at the University of California at Davis launched, examining how gun policies have affected gun violence rates over time.
The New Jersey Legislature is considering a similar bill to provide Rutgers University with $400,000 to "undertake a comprehensive study of firearm violence."
In February, governors from Connecticut, Delaware, Massachusetts, New Jersey, New York, Rhode Island and Puerto Rico formed a multi-state "States for Gun Safety" consortium to gather and share information on gun violence.
The timing of these alternative efforts to fund research highlight a public outcry for action to address gun violence, which has grown louder in recent years as the number of deaths stemming from mass shootings increased. The frustration reached a fever pitch after February's mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., that killed 17 people and sparked a series of protests across the country.
Since 2015, an average of 132 people have been killed from mass shootings each year, according to data collected by the site Mass Shooting Tracker, compared to an average of 75 for 2013 and 2014.
Efforts to research gun violence have been severely hindered since 1996, when Congress passed the Dickey Amendment, which banned the CDC from using its funding to "advocate or promote gun control."
While the amendment's language does not constitute an outright ban on research into gun violence, the spirit of the law became clear when Congress cut CDC funding that year by $2.6 million, which was the same amount the agency had budgeted in previous years to study gun violence. The move was seen as a warning, and the CDC mostly stopped funding gun violence research.
Between 1996 and 2013, CDC funding for gun violence research dropped by 96%, according to a 2013 report by the advocacy group Mayors Against Illegal Guns.
A 2017 study published in JAMA found firearm research in the U.S. received $22 million in funding from 2004 to 2015, or less than 2% of the $1.4 billion researchers estimated would be allocated to study a public health issue that caused a similar number of deaths annually.
Ranney said some researchers felt their prior work in gun violence research had made them targets for public scrutiny by gun-rights groups, which in turn made it difficult for them to secure funding for other types of research.
"There are researchers who really felt that they were kind of blackballed for a period of time because of the fact that they had been involved in firearm injury research," Ranney said.
President Barack Obama attempted to address the funding issue following the mass shooting at Sandy Hook Elementary School in 2012 by ordering health agencies to fund research that looked into how to prevent gun violence. That led to an $18 million National Institutes of Health funding initiative from 2014 to 2017 to support 22 related projects. The program ended in January 2017 and the agency has yet to renew it, despite repeated calls from several lawmakers.
Some advocates viewed the clarification included in the March omnibus as a small, but symbolic move that showed Congress intends to end its 20-year de facto ban on gun violence research. The funding bill included increased funding for the National Violent Death Reporting System, which tracks and reports violent death data collected from 40 states, to include data from all 50 states.
But many experts remained unimpressed by the move.
"I don't think it really changes anything," said Andrew Morral, senior behavioral scientist at RAND Corp and author of the RAND study released in March. "CDC is probably not going to invest into firearms research until Congress appropriates money for that purpose and gives a proactive statement that they would like to see research done in that area. But that's not what the language that was added does."
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