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Abstract
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The numbers that describe firearm-related injury and death in the United States are astounding. Over recent years, more than 32 000 firearm-related deaths occurred annually (1). In 2013, firearms nonfatally injured 84 258 persons and killed 33 636 more, with 21 175 of these deaths being suicides (2). In 2010, firearm-related incidents cost society more than $174 billion, including more than $3 billion in direct health care costs to an already beleaguered system (3). These numbers do not include the rippling physical and emotional burdens gun-related incidents leave on those who are nonfatally wounded and the communities who lose or support injured colleagues, friends, and family. It does not matter whether we believe that guns kill people or that people kill people with guns—the result is the same: a public health crisis.
When public health crises arise, our powerful health care complex responds by doing what our scientific training and duty to help others require. We formulate questions that need answers, collect and analyze data to answer them, test hypotheses to discover remedies, study how to implement them, and monitor progress. This is how polio was nearly eliminated, automobile-related injury and death rates were reduced, tobacco-related illness decreased, and an Ebola epidemic is being curtailed. The list goes on. But it seems to stop when it comes to firearm injury. Why?
Two years ago, we called on physicians to focus on the public health threat of guns (4). The profession's relative silence was disturbing but in part explicable by our inability to study the problem. Political forces had effectively banned the Centers for Disease Control and Prevention (CDC) and other scientific agencies from funding research on gun-related injury and death. The ban worked: A recent systematic review of studies evaluating access to guns and its association with suicide and homicide identified no relevant studies published since 2005 (5–6). However, in the wake of the horrific mass murder of children, a January 2013 Presidential executive order lifted this ban and directed the CDC to conduct research on the causes and prevention of gun violence. Obviously, this directive alone will not end the suppression of science; although research may now be “allowed,” the CDC cannot direct new resources to this task because the President's CDC budget requests to support a focus on gun-related violence were not funded. Compounding the lack of research funding is the fear among some researchers that studying guns will make them political targets and threaten their future funding even for unrelated topics....
Language: en |