|
Abstract
|
Gun violence has long been a preventable cause of death and injury in the United States and one that has been increasing in recent years. In 2020, there were more than 45 000 gun deaths in the US, a 14% increase from the year before and a 25% increase from 5 years earlier. However, firearm violence has proven to be a particularly vexing issue in US policy making. After a mass shooting in May 2022 in Uvalde, Texas, that resulted in the death of 19 children and 2 adults, President Biden signed into law the first federal gun legislation in 30 years. That bill, which gained bipartisan support, included efforts to limit gun ownership by persons who were deemed dangerous and expanded background checks on persons between the ages of 18 and 21 years. Even these modest measures were opposed by gun advocacy organizations. Further reflecting the national impasse on the issue, this legislation was signed just days after the US Supreme Court reaffirmed the right of gun owners to carry handguns in public for self-defense, striking down a New York State law that restricted concealed carriage of guns.
The State Response to Gun-Related Harms
It is against this backdrop of limited national action that firearm-related mortality has continued to increase in the US. Perhaps predictably, given the federal system of government, states are at the front lines of efforts to limit firearm-related harms. Implementation of such efforts has been tremendously heterogenous, and as a consequence, firearm-related harms vary by state. In 2020, Massachusetts, the contiguous US state with the lowest rate of firearm-related deaths, had 3.7 deaths per 100 000 persons. This was more than 7 times lower than Mississippi, the state with the highest rate of firearm-related deaths in the same year (28.6 deaths per 100 000).
Given the political opposition to efforts to limit access and availability of guns, no single state has enacted any individual piece of legislation that has been singularly effective at reducing gun-related harms. However, the states that have lower rates of gun-related deaths and injuries have implemented a number of legislative efforts that together have contributed to reduced gun violence. For example, over the decades, Massachusetts implemented laws to regulate firearms such as a robust licensing system with restrictions beyond the federal standard, safe storage laws, and red flag laws among other legislations, including several sentinel pieces of legislation that were passed with strong bipartisan support. Therefore, it is likely that a comprehensive set of legislative actions has created protection against gun violence in the states with lower levels of gun-related morbidity and mortality.1,2
As public awareness about the severity of the gun violence problem in the US increases, a central question becomes more salient: what state-specific efforts may be most effective at reducing firearm-related morbidity and mortality? This question could point the way to advocacy for the most effective approaches to reducing gun violence, particularly in states where there has been a reluctance to embrace any efforts to do so. However, the answer to this question remains elusive, in large part because of the limitations on funding of research and data collection. The 2020 fiscal budget included $25 million for the Centers for Disease Control and Prevention and the National Institutes of Health to fund research in this area for the first time in almost a quarter century. This means that systematic efforts to empirically document the most effective approaches to mitigate gun violence lag by decades, falling short on the availability of data and on rigorous studies. By way of illustration of this problem, while there has been substantial public support for constraints on civilian ownership of assault weapons, there is scant evidence of efficacy of the state programs that have implemented such measures...
Language: en |