According to carl bell, a public health specialist at the University of Chicago, three things are required to stop an epidemic: an evidence base, a method for implementation, and political will.[40] Yet when it comes to gun violence, the US has struggled even with the first step. The US Centers for Disease Control and Prevention (CDC), who would usually take the lead on public health matters, have done very little research into the problem in the past two decades.
Without a doubt, the US is a big outlier when it comes to guns. In 2010, young American adults were almost fifty times more likely to die in a shooting than their peers in other high-income countries. The media tend to focus on mass shootings, which often involve assault weapons, but the problem of gun deaths is far more widespread than this. In 2016, mass shootings – defined as four or more people being shot – made up just 3 per cent of US gun homicides.[41]
So why hasn’t the CDC done more research into gun violence? The main reason is the 1996 Dickey Amendment, which stipulates that ‘none of the funds made available for injury prevention and control at the CDC may be used to advocate or promote gun control.’ Named after Republican congressman Jay Dickey, the amendment followed a series of disagreements about gun research in the US. In the run up to the vote, Dickey and his colleagues had clashed with Mark Rosenberg, director of the National Center for Injury Prevention and Control at the CDC. They claimed that Rosenberg, who co-chaired a firearms working group, was trying to present guns as a ‘public health menace’ (the phrase actually came from a Rolling Stone journalist who’d interviewed Rosenberg about gun violence).[42]
Rosenberg had contrasted gun research to the progress made in reducing car-related deaths, an analogy later used by Barack Obama during his presidency. ‘With more research, we could further improve gun safety just as with more research we’ve reduced traffic fatalities enormously over the last 30 years,’ Obama said in 2016. ‘We do research when cars, food, medicine, even toys harm people so that we make them safer. And you know what, research, science, those are good things. They work.’[43]
Cars have become much safer, but the industry was initially reluctant to accept suggestions that their vehicles needed improvements. When Ralph Nader published his 1965 book Unsafe at Any Speed, which presented evidence of dangerous design flaws, car companies attempted to smear him. They got private detectives to track his movements and hired a prostitute to try and seduce him.[44] Even the book’s publisher, Richard Grossman, was sceptical about the message. He thought it would be hard to market and probably wouldn’t sell very well. ‘Even if every word in it is true and everything about it is as outrageous as he says,’ Grossman later recalled, ‘do people want to read about that?’[45]
It turned out that they did. Unsafe at Any Speed became a bestseller and calls to improve road safety grew, leading to seat belts and eventually features like airbags and antilock brakes. Even so, it had taken a while for the evidence to accumulate prior to Nader’s book. In the 1930s, many experts thought it was safer to be thrown from a car during an accident, rather than be stuck inside.[46] For decades, manufacturers and politicians weren’t that interested in car safety research. After the publication of Unsafe at Any Speed, that changed. In 1965, a million miles of car travel came with a 5 per cent chance of death; by 2014 this had dropped to 1 per cent.
Before he died in 2017, Jay Dickey indicated that his views on gun research had shifted. He believed the CDC needed to look at gun violence. ‘We need to turn this over to science and take it away from politics,’ he told the Washington Post in 2015.[47] In the years following their 1996 clash, Dickey and Mark Rosenberg had become friends, taking time to listen and find common ground on the need for gun research. ‘We won’t know the cause of gun violence until we look for it,’ they would later write in a joint opinion piece.
Despite constraints on funding, some evidence about gun violence is available. In the early 1990s, before the Dickey Amendment, CDC-funded studies found that having a gun in the home increased the risk of homicide and suicide. The latter finding was particularly notable, given that around two-thirds of gun deaths in the US are from suicide. Opponents of this research have argued that such suicides might have occurred anyway, even if guns hadn’t been present.[48] But easy access to deadly methods can make a difference for what are often impulse decisions. In 1998, the UK switched from selling paracetamol in bottles to blister packs containing up to thirty-two tablets. The extra effort involved with blister packs seemed to deter people; in the decade after the packs were introduced, there was about a 40 per cent reduction in deaths from paracetamol overdoses.[49]
Unless we understand where the risk lies, it’s very difficult to do anything about it. This is why research into violence is needed. Seemingly obvious interventions may turn out to have little effect in reality. Likewise, there may be policies – like Cure Violence – that challenge existing approaches, but have the potential to reduce gun-related deaths. ‘Like motor vehicle injuries, violence exists in a cause-and-effect world; things happen for predictable reasons,’ wrote Dickey and Rosenberg in 2012.[50] ‘By studying
