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Thoughts and Prayers Won't Cure Gun Violence
- 1. Thoughts and Prayers Won’t Cure Gun Violence Kyle Fischer, MD, MPH Adjunct Assistant Professor Health Policy Fellowship Director @KBFischer
- 4. Ground rule: “Gun violence isn’t one thing” •Suicide •“Peer” •Intimate partner violence •Legal intervention •Mass casualty incidents
- 5. Data Challenges •Often only single state •Multiple variables, low sample size •Often multiple laws passed at same time •Comparison between states adds non- firearm related variables
- 6. Funding and Publication of Research on Gun Violence and Other Leading Causes of Death. Stark DE, Shah NH. JAMA. 2017;317(1):84-85
- 7. Why the dearth of gun violence research?
- 9. “Evidence-based health policy is an ideal, but not a reality. Research findings interact with social values, priorities in time, and political circumstances. The result is that decisions are not made after randomized control trials demonstrate superiority of one intervention over another. Rather, evidence-based policies are created when the evidence for action outweighs the evidence for inaction.” -Kyle Fischer, MD, MPH April 20, 2018
- 10. PolicyRX Bills •S.2009 (Murphy) •Universal Background Checks •HR.3207 & S.1539 (Dingle, Klobuchar) •Restricts firearm sales/transfer to stalkers •CT Permit to Purchase
- 12. Meant to prevent access to guns for convicted felons or other prohibited groups… • Minors • Fugitives • Living in U.S. illegally • Users of illegal drugs • Certain histories of mental illness • Military dishonorable discharge • Renounced U.S. citizenship • Subject to a restraining order • Convicted of domestic violence offenses Credit: RAND “The Science of Gun Policy,” 2018
- 14. Kalesan et al, Lancet, 2016
- 15. Replication: Background checks decrease homicides • Webster et al (2014) • Fleegler et al. (2013) • Webster et al. (2013) • Sumner et al. (2008) • Ruddell and Mays (2005)
- 19. Variation in state law •Permit to purchase (10) •License to own (3) •Firearm safety certification (CA) •Registration (D.C.)
- 21. Rudolph et al, AJPH, 2015
- 24. From: Vigdor and Mercy (2006) Do laws restricting access to firearms by domestic violence offenders prevent intimate partner homicide?, Evaluation Review; (30)3: 313-346
Editor's Notes
- CDC WISQARS 2016 Data: Homicide: 14,415 Legal Intervention: 510 Suicide: 22,938 Mother Jones (At least 4 people in public place): 71
- 1996 Omnnibus Bill: Dickey Amendment, "none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention (CDC) may be used to advocate or promote gun control.”
- HR3207: The bill makes it a crime to knowingly sell or dispose of a firearm to a person who has been convicted of a misdemeanor crime of stalking. It also makes it a crime for such convicted stalker to receive or possess a firearm.
- S. 2009: Chris Murphy: A bill to require universal background checks for all purchasers
- Mortality includes homicide and suicide
- Specifically, checking HOMICIDE: for restraining orders (IRR=0.91, 95% CI 0.85–0.98), fugitive status (IRR=0.77, 95% CI 0.71–0.84) mental illness (IRR=0.93, 95% CI 0.86–0.99) SUICIDE: checking for mental illness (IRR 0.97, 95% CI 0.95–0.99) Fugitive status (IRR 0.91, 95% CI 0.87–0.95)
- Permits to Purchase: No Federal law A 1995 Connecticut law requiring a permit or license – contingent on passing a background check – in order to purchase a handgun -Often require fingerprinting -Could involve safety course/test -Changes economics: Increased cost per firearm, increased time (opportunity cost)
- Variation within: -Permits last for different amounts of times (days, weeks, months, years), different types of guns (pistols vs long guns), single permit per gun vs one permit for multiple guns, guns only or guns and ammo
- “We conducted this study to estimate the impact of Connecticut’s 1995 PTP law. This law strengthened background check requirements, especially for handguns purchased by private sellers. In addition, it raised the handgun purchasing age from 18 to 21 years and required any prospective handgun purchaser to apply for a permit in person with the local police and complete at least 8 hours of approved handgun safety training.”
- “We estimated that the law was associated with a 40% reduction in Connecticut’s firearm homicide rates during the first 10 years that the law was in place. By contrast, there was no evidence for a reduction in nonfirearm homicides.”
- H.R. 3207 & S.1539 Protects victims of stalking & intimate partner violence Theoretical basis: Almost half of all women murdered in the U.S. are killed by a current or former intimate partner In 10% of this murders, the women had already been victims in the preceding month Roughly half of mass casualty shooters
- 2006
- Replication 2010