A recent article in the Journal of the American Medical Association from Jan. 7, 2013, was a strong motivator and the basis of the topic of this month’s column.

It seems that the present approach to the decrease of gun violence is misguided. We are mostly talking about gun control when we should be talking about gun violence.

Gun control or gun ownership is a very narrow aspect of this issue and triggers passionate reaction from many people. On the other hand, if we would treat gun violence as another type of public health problem, the approach would be based on solid data and it would involve a variety of approaches.

Gun violence should be approached by clearly researching and finding answers to social, cultural, educational, behavioral, mental health and product-safety issues involved in this matter. The solutions would be based on solid data. The tactic, so far, has been limited to legislative approaches affecting high-capacity magazines, rapid-fire weapons, a heterogeneous (state-by-state) approach to waiting periods before purchase of a firearm, background checks and registration of firearms just to name few.

The focus on car accidents was not on automobile ownership, although it seems reasonable to think that the fewer cars on the road, the fewer the opportunity for accidents. The focus was on making cars better prepared to tolerate impact, make the occupants safer by the use of seatbelts and airbags, safety glass, better outside lights, better design of highways including safer merge zones, better exit and access ramps and speed control.

Engineering improvements were not all of the dimensions to this issue. Educational approaches including the danger of drunk drivers and driving without seatbelts were addressed. Legislative approaches about permissible alcohol levels, more punitive penalties for drunk drivers and changes made by the Department of Motor Vehicles for licensing were also implemented.

Little has been done about the fear factor used by the gun industry and others to increase the number of guns sold. Although the murder rate in the U.S. is at the lowest it has been in more than 50 years, people consistently buy a large number of guns because of the risk of death or serious injury by assailants.

This is despite available data showing a decrease of risk and the fact that most homicides occur among people who know each other and not by strangers. Other than police officers and security personnel, concealed weapons are carried because of fear of an attack. Only four states in the U.S. in 1970 allowed people to carry a weapon without given a specific reason.

Liberal concealed weapons laws are now legal in 40 states, indicating that, with no data to support, people now live in more fear. This is an opportunity for an educational intervention.

Our youth read, play and constantly watch comic books, games and videos associated with graphic violence. It is ironic that one of the most antigun communities, Hollywood, constantly depicts gun-associated violence in films and television. It has been reported that the average child watches 8,000 televised murders and 100,000 acts of violence before finishing elementary school.

The typical attitude has been that all is well since the homicide rate is down. But, when we look further, the ratio of victims of homicide during the 1980s was 17.5 and 13.2 for the 18-24 and 35-49 age groups respectively. In 2005, the same ratios were 14.9 and 5.7 indicating that most of the decrease in the overall homicide rate was at the expense of the older group.

The critics of controlling explicit violence in the media claim definitive studies have not been done. But even assuming this is accurate, can a reasonable person see any societal benefit to exposing millions to graphic violence?

We do not use the same criteria for pornography. Although there are no large, long-term studies showing an association between exposures to pornography by children and antisocial behavior, common sense indicates that it cannot have a positive impact on children. Thus we attempt to control exposure by limiting at what time, on what channels, and have developed a parental guidance scoring system.

The fact that this column is endorsing wide public health approaches to gun violence should not be interpreted as a vote for not acting now on common-sense measures. For instance, if the major reason for gun ownership is protection, should we allow unrestricted purchase of firearms?

In Virginia, a 19-year-old law restricting the purchase of a handgun to one per month was recently rescinded. It is hard to make a case for purchasing multiple handguns on a weekly basis if the guns are used for protection.

This is an encouragement for secondary illegal sales and smuggling of guns to other states where more control exists. Arizona has no registration, no permit required and no waiting period on handgun purchases. Additionally there is no limit on the guns that can be purchased in one month. According to the Yellow Pages there are 111 gun dealers in the Phoenix area alone with a population of 1.5 million people.

This does not take into consideration online retailers, gun dealers without a land-based phone or national department store retailers who do not advertise themselves as “gun dealers.” It is not a stretch to think that many of these guns will find their way to undesirable hands, many of them in Mexico. For comparison purposes, Los Angeles, home for more than 4 million people, has 21 gun dealers.

Reasonable gun ownership is not the issue, gun violence is. As we have successfully done with car accidents and cigarette smoking, public health measures should be applied to this problem which is responsible for 30,000 yearly deaths in the U.S. Most of them young people.

We owe it to our youth to consider a multidimensional approach to this problem.


  1. Unfortunately memories are short. Most people reading this article don't remember or know why Congress took away federal funding for the Centers for Disease Control's (CDC) gun research. It was because the CDC and its grantees were using our tax money to advance a political agenda of gun control. And now they want to be allowed to do it again.

    Read about the history of the public health gun control movement in my three part series, with today's Part II (see website link).

  2. It is fascinating that, according to some, the gun violence that is responsible for more than 30,000 deaths per year cannot be researched by any reputable organization. Ignorance is apparently a blessing!
    Senator Bob Barr, a former Republican congressman from Georgia summarized this position very well: “To me, firearms and guns is nothing CDC should be involved in” “It has nothing to do with health. Health has to do with diseases. I don’t think when the CDC was created that there would be any contemplation that they would be studying firearms as a health issue.” Senator Barr is a member of the NRA board.
    The CDC, in addition to diseases caused by pathogens, studies all causes of significant injury and death. Unintentional poisoning, which causes more than 30 billion dollars per year in health care and productivity costs, is not caused by pathogens but it deserves to be properly studied. The implementation of seat belts in automobiles was the direct result of research into the causes of motor vehicular injuries and deaths. This research lead to changes in public policy and changed the way automobile were manufactured. Automobile deaths, per mile driven, have dropped by 80% in the US.

  3. In the absence of credible research we have exercises in absurdity. Gayle Trotter a conservative activist, testifying before the US Senate stated “The peace of mind that she (a woman) has, knowing that she has a scary-looking gun, gives her more courage when she’s fighting hardened, violent criminals”. “If we ban these types of assault weapons, you are putting these types of women at a great disadvantage” Her comments were based on a single true example

  4. Trotter mentioned the story of a young mother, with her infant child, who killed an intruder with a gun. When Trotter was asked if the gun used was an assault type of weapon (ban of these weapons was one of the reasons for the hearings) she claimed not to know, which is disingenuous. The reality is that the young woman accosted defended herself with a shotgun. In the absence of serious studies this is the type of “data” used to make public policy.
    The consequence of our sad state of affairs, in reference to research related to gun violence, was best stated by the New York Times “What We Don’t Know Is Killing Us”

  5. America covers the majority of the population involved in the gun violence. Since it is now hold to as a threat for the people, it has just become a negative thing for the society and the life style. It has led to the difference in the humanity feelings and can be considered as a real threat for the society. Recently the Connecticut issue which has been under the major headlines is just an example. They are just the violence criminals than a good human.