![Figure](http://www.thenationshealth.org/content/nathealth/50/3/1.2/F1.medium.gif)
In 2016, family and friends of people who were killed by gun violence gather for a news conference to call for action on gun violence prevention. While gun deaths have continued in recent years, funding on research to prevent them has not. Scientists hope new funding from Congress will boost prevention work.
Photo by Chip Somodevilla, courtesy Getty Images
After more than 20 years of minimal funding, the U.S. is opening its purse strings to research on gun violence prevention.
Congress allocated $25 million in December to spur new insights into the ways gun violence can be prevented, with funding split between the National Institutes of Health and the Centers for Disease Control and Prevention.
Since then, researchers, advocates and other prevention supporters have been abuzz, weighing in on such things as funding priorities and proposal criteria. And the challenge is formidable, as gun violence prevention overlaps public health, criminal justice, public safety, deaths of despair, intimate partner relationships, workplace conflicts and more.
While the new federal funding commitment is modest, the fact that it was allocated is a good sign, according to Shannon Frattaroli, PhD, MPH, an associate professor at the Johns Hopkins Bloomberg School of Public Health and faculty member of the Center for Gun Policy and Research.
“It sends an important message to the public, to the scientific community, to policymakers and to program coordinators at the state and local levels,” Frattaroli, an APHA member, told The Nation’s Health. “It signals that the federal government is committed to bringing resources to the table to solve this problem in a way we have not seen in a while.”
Commitment and resources are needed more than ever. In 2017, the most recent year for which complete data from CDC is available, 39,773 people died nationally from gun-related injuries. Three-quarters of all murders and half of suicides that year involved a firearm. In 2019, there were 417 U.S. mass shootings, in which at least four people were killed, according to the Gun Violence Archive. That was the highest number of mass shootings recorded since the nonprofit started tracking them six years earlier.
Meanwhile, federal funding was on hiatus. In 1996, Congress approved a budget restriction known as the Dickey amendment, which maintained that federal funding could not be used to advocate for gun control. Though the amendment did not specifically restrict gun violence research, it had a chilling effect on the field.
Between 1996 and 2018, CDC gun research funding dropped by 94%, and NIH allocated less than 1% of its budget to studying the issue, according to Everytown for Gun Safety. Some federal dollars went to the National Institute of Justice and private funding supported other studies. But in general, robust and sustained firearm research nearly stopped for over two decades. A generation of public health researchers largely ignored the field.
Then in 2018, the U.S. House of Representatives clarified in a spending bill that the Dickey amendment did not prohibit gun violence prevention research. The move led to the congressional funding allocation in December.
CDC and NIH are adept at evaluating and assessing study proposals and doing in-house research, and they complement each other in their expertise, Frattaroli said. CDC offers a strong public health approach, and NIH is known for its scientific rigor.
“They are well-positioned to put in place the processes that are needed to ensure that high-quality work is funded and responsive to what we need at this time,” she said.
Even during the lean funding years, some research and programs helped develop intervention policies with the potential to reduce firearm-related deaths. At a Sept. 23 forum on gun violence solutions in Washington, D.C., co-hosted by APHA and the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health, several of those interventions were highlighted. They include “red flag” laws, which give police authority to remove firearms from high-risk people, and tougher background checks and licensing processes for firearm purchases.
“It signals that the federal government is committed to bringing resources to the table to solve (gun violence) in a way we have not seen in a while.”
— Shannon Frattaroli
Frattaroli recommended that CDC and NIH fund research proposals that add to the data of promising policies, such as extreme risk protection orders. The protection orders have been enacted in 17 states and the District of Columbia.
“We think these are promising policies, but until we bring science into the fold, we are not going to know if these laws are ultimately making a difference,” Frattaroli said. “And if they are making a difference, why? What is happening on the front lines that is working or thwarting the success of these laws?”
Besides protection orders, other gun policies also need research testing. In 2019, Rand reviewed studies on 13 U.S. gun policies, including concealed-carry laws, gun-free zones and waiting periods, to determine their impact on gun use. Most of the studies were unable to show if the policies actually reduced firearm violence.
Research is needed to confirm which gun violence intervention programs and policies are most sound, said Richard Hamburg, MPA, executive director of Safe States Alliance, which promotes injury and violence prevention.
“In a time of limited resources, it’s good to know what has the most effect,” Hamburg, an APHA member, told The Nation’s Health. “What is the most effective intervention if you could invest in only a couple of things?”
Gun violence prevention has been so little explored that even basic knowledge, such as the number of U.S. households with guns and a better profile of firearm victims, is lacking. With federal funding, researchers should expand the collection of data and research to better understand causes and develop appropriate solutions, Hamburg said.
As CDC and NIH review gun research proposals, they will likely make decisions based on merit, said Linda DeGutis, DrPH, who served as director of CDC’s National Center for Injury Prevention and Control from 2010 to 2014.
“They will fund the proposals that have the best potential for showing something — for answering the research question in the proposal,” DeGutis, an APHA member and executive director of Defense Health Horizons, told The Nation’s Health. “You want to fund the best study.”
Rather than have a preconceived notion of priority areas to explore, the agencies should approach the task with an open mind, said David Hemenway, PhD, director of Harvard University’s Injury Control Research Center in the T.H. Chan School of Public Health.
“I’m really a big fan of letting a thousand flowers bloom,” Hemenway, an APHA member, told The Nation’s Health. “I am not so big on the government saying we need to do this or that. And sometimes you don’t have good data to do research on a topic, so you get lousy studies being funded. Let the researchers suggest different areas to explore.”
Strong evidence-based research can bring about persuasive gun violence intervention programs. But for programs to become state and local policies, stakeholders need to convince not only decisionmakers but also gun owners that an intervention is fair.
That means not using language such as “gun control” and other charged phrases that can shut down conversation, DeGutis said.
“We need to reframe it so that people with varying perspectives will participate in the conversation,” she said.
Though she welcomes the federal funding, DeGutis said she is skeptical it will continue, given the current political climate — and that is a problem. Gun research needs to be viewed as a career path by public health scientists, she said. Years of research creates knowledge that builds on itself, bringing about better answers to reducing gun violence, but that requires funding.
While the December funding from Congress was celebrated, it is still less than is needed overall. In March, APHA and other public health advocates asked Congress to double the firearm research funding for CDC and NIH.
Over the years, many advisors dissuaded students from pursuing gun research because of the lack of funding, Frattaroli said. But she is hopeful that the U.S. is entering a time when gun violence is treated as any other public health problem that needs to be addressed.
“It is all shaping up to be a more rigorous and well-supported area of research and a critical part of public health in this nation,” Frattaroli said. “The more we can support good evaluation that is scientifically rigorous and has definite results on policy, the better off we will be.”
For more information, visit www.apha.org/gun-violence.
This article is the first in a series focused on violence prevention, which ties into the theme of APHA’s 2020 Annual Meeting and Expo: “Creating the Healthiest Nation: Preventing Violence.” Registration for the Oct. 24-28 Annual Meeting will open July 1.
- Copyright The Nation’s Health, American Public Health Association