As details emerge from the latest episode of gun violence—a workplace shooting at YouTube headquarters in San Bruno, California—survivors, along with the rest of the country, are still trying to make sense of the attack. But there's one thing they're unlikely to find: good data on gun violence.
In 1996, just a few years before the school shooting in Columbine, Colorado, Congress affixed the Dickey Amendment to an omnibus spending bill. The legislation prohibits the Centers for Disease Control and Prevention (CDC) from using federal funds to advocate or promote gun control. As a result, health professionals like me have been intimidated by the threat of reduced funding, and prevented from gathering critical data on the health effects of gun violence. While public demand to address gun violence has been growing in the wake of the Parkland shooting, we can't expect to solve the issue if we don't have the information we need to do so.
Fifteen years ago, one of my former professors at Emory University, Arthur Kellerman, undertook transformative work in the area of gun research. His 1993 study, supported by grants from the CDC, linked gun ownership to homicide in the home. It also reportedly infuriated the NRA, creating the impetus for eliminating the CDC division responsible for studying gun violence, and heralding a reduction in federal funds for the CDC equal to the amount allocated for that research. In the intervening two decades, national data collection on gun-related injuries and deaths has been underfunded at best and systematically undermined at worst.
As a result, some private funders and non-profits such as those led by gun violence survivors Gabrielle Giffords and Jim Brady have stepped in to fill the information gap. We do know that 56 mass shootings, not including the one at YouTube, have taken place in the first three months of 2018. We also know that guns are responsible for two-thirds of homicides committed in the United States. Yet existing publicly available data systems do not include all 50 states; Texas and Florida, sites of five of the deadliest mass shootings in U.S. history, most recently in Parkland, are excluded. While something is better than nothing, we are still missing critical information.
Still, because of the lack of federal funding, scientists and scholars genuinely interested in studying the subject of gun violence face difficulty securing the resources to do so. Without dedicated public funding, groups with more nefarious motives, like the NRA and the gun lobby, have taken gun research into their own hands, swaying data in their favor—a tactic the tobacco industry was known for in the 1990s as it worked to hide the health risks of smoking. To avoid this dangerous possibility, a better strategy would be to allow health scientists at the CDC and universities to do their jobs addressing gun violence as a public-health issue.
Public health identifies problems through the collection of data, and then uses it to determine risk and protective factors. Interventions are designed and evaluated to address these factors, ideally contributing toward evidence-based policies and programs. Gun violence research is stalled at the first step in this process: We have only modest evidence on the usefulness of background checks and restrictions of firearms for people with mental illness in reducing gun-related suicides and homicides. As a result, it is nearly impossible to develop informed interventions, regardless of which political party is in power.
While we might reasonably expect that government policy and programming decisions be based in firm evidence, the truth is that, since December, the use of the term "evidence-based" has been banned at the CDC. But facts still matter, especially to people who care about preventing unnecessary injuries and death. In my work on intimate partner violence and femicide, ownership of a gun is a known risk factor. Each month, approximately 50 women are shot to death by intimate partners. Such information is important to scientists and survivors. Having lost two cousins to gun-related suicides, knowing what might have prevented those deaths is information that I would do anything to have. And I know the same is true for others who have lost friends and family to gun deaths.
The good news is that language in the recent government-funding package has clarified that the Dickey Amendment is not a ban on gun violence research—which is true. But without dedicated funding, the de facto practice of self-censorship at the CDC will undoubtedly continue. Given the high turnover among senior administration leadership, the new CDC director is unlikely to change the status quo without a directive to do so.
And that's exactly what we need. Secretary of Health and Human Services Alex Azar has promised to be "proactive" on gun violence research. Directing the CDC to develop a comprehensive research agenda—including the expansion of gun-related data systems and research on gun violence risk and protective factors—is the necessary first step. Meanwhile, members of Congress competing in the 2018 mid-term elections would be wise to heed the demand of Parkland students and provide CDC funding for gun violence research.
Given the scale and life-threatening nature of gun violence in the U.S., a CDC mandate and robust funding to conduct gun violence research would be part and parcel of the agency's mission: "[The] CDC saves lives and protects people from health threats." The alternative is for health officials to shoot blindly in the dark while what we don't know about gun violence continues to kill us.