Let’s talk guns, and how to use public health measures to decrease gun injuries and deaths.
“Injuries, Not Accidents,” is the title of a chapter in the 2005 book “Prescription for a Healthy Nation: A New Approach to Improving Our Lives by Fixing Our Everyday World.” Written by doctors Tom Farley and Deborah Cohen, the book talks about how we can change our health by changing the environment we live in—as they describe it, “the streets, houses, buildings, neighborhoods and stores that surround us, the items in them, the images we see every day, and society’s rules for behavior in schools, in the workplace, and in communities.”
The chapter on injuries, not accidents, explores what has been and could be done to decrease the rates of death and disability from motor vehicle crashes and gun shot wounds. They are the sixth and seventh top leading underlying causes of death in the United States—with 45,000 and 30,000 deaths each year, respectively.
What are the statistics on gun deaths?
With gun violence, 5% of deaths are unintentional. About two thirds of remaining deaths are suicide. One third are homicide.
Children living in the five states with the highest levels of gun ownership were more likely to die from guns-- 16 times more likely to die from unintentional injury, 7 times more likely to die from suicide, and 3 times more likely to die from homicide.
Having a gun in the home makes a person three times more likely to die from homicide as people who don’t. As Arthur Kellerman showed in his 1993 paper “Gun Ownership as a Risk Factor for Homicide”, 70% of homicide victims are killed by people they know, after an argument. Having a loaded gun within reach makes people much more likely to kill each other in the heat of the moment.
Much gun death is impulsive death.
In 1976, the District of Columbia implemented a ban on the sale of handguns. People could drive across borders to buy handguns in Maryland or Virginia. Still, as Colin Leftin showed in his 1991 paper “Effects of Restrictive Licensing of Handgun on Suicides and Homicides in the District of Columbia”, banning handgun sales in one locality dropped the number of suicides by 23%, and the number of homicides by 25%. Other means of intentional injury did not rise to take their place.
According to the FBI’s crime clock, in a given year, every 22 seconds there is a violent crime; every 32.9 minutes there is a murder.
How do we decrease death and disability from guns?
The authors of “Prescription for a Health Nation” argue that we can decrease the rate of death from any type of injury by changing individual behaviors, changing the objects that cause injury, or changing the environment that allows the objects to kill people.
Individual behaviors, object, environment.
To change individual behaviors car owners are encouraged to wear seat belts, drive at the speed limit, give enough distance to the car in front of them, without drinking or texting while driving. Gun owners are encouraged to take bullets out of stored guns and place them out of the reach of children.
To change the objects that cause the most injuries--cars and guns—manufacturers can change their product. To prevent death in case of motor vehicle accident, car manufactures now pad car interiors, add airbags, and provide collapsible steering columns. Gun manufacturers may be similarly encouraged to modify their products to make them less accidentally deadly, by adding technologies to make the gun only be able to be fired by the gun owner to whom it was sold, for example, or increasing the resistance to pulling the trigger to make it harder for a three year old to shoot themselves or others, or limiting the number of bullets in a belt. Magazine safeties, grip safeties, trigger locks and gun locks. Guns can be made to be safer.
To change the environment, policies and priorities can shift. To prevent motor vehicle injuries, local, state and federal governments now have measures in place to repair potholes, set speed limits and driving laws, and build safe infrastructure.
To prevent gun injuries, we could tighten restrictions on gun sales, ban the sale of handguns to the general public, make it illegal to enter public spaces with guns. We could support laws to ensure gun safety. As the authors say, “any step that cuts back on the number of guns in houses, or the number easily accessible, unlocked or loaded, would save many lives.”
If no guns were on the streets in Florida, Trayvon Martin would still be alive.
We can change our environment to ensure safer streets where neighbors can walk with neighbors to grocery stores selling fresh fruits and vegetables on safe street corners without worrying about gun related death and disability. With concentrated efforts to decrease gun related injuries and death, we can combat obesity, increase economic activity, and provide greater opportunity for the inhabitants of all communities to live well.