As of May 31, there were 315 mass shootings in the US in 2021 (based on 4 people killed or wounded during an incident). There were over 600 mass shootings in 2020. The Center for Disease Control reported that 39,707 people died by firearms in 2019, 23,941 by suicide and 14,414 by homicide. The rate of death in the US related to firearms is higher than in any other industrialized country, and almost 100 times higher than in the United Kingdom. If deaths from firearms are about equal to deaths from breast cancer every year, why is gun violence not a public health priority?
Actually, the American Medical Association has called for gun safety legislation for over 20 years and in 2016 called gun violence a “public health crisis”. The American College of Surgeons (including the trauma surgeons who care for gun-shot wounds) advocated for gun safety legislation in their Statement on Firearm Injuries in 1991, and updated the call for legislation in 2000 and again in 2013. The American Academy of Family Physicians joined the American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, and the American Psychiatric Association in a call to action in 2018. Even the Center for Disease Control has recommended a public health approach to dealing with gun violence, and the CDC is prohibited by federal law from advocating for gun control.
Unbelievably, a single organization is responsible for the lack of implementation of a public health strategy for dealing with gun violence – the National Rifle Association. For over 100 years, the NRA promoted marksmanship, gun safety, wildlife management, and citizenship through responsible gun ownership. That all changed in the 1970s when radical gun rights activists took control of the NRA. The gun rights movement began after the passage of the Gun Control Act of 1968, which required gun dealers to be licensed, prohibited mail order sales, and required firearms to have serial numbers. While this law added little to the Federal Firearms Act of 1938 (which prohibited ownership of automatic weapons), the NRA began to spread the rumor that citizens could lose the right to bear arms.
But the NRA’s power in the last 50 years did not come from the citizens that joined the organization for magazine subscriptions and discounts at corporate sponsors. The NRA’s power comes from Corporate Partnerships, and the leading corporate partners are gun manufacturers. A report in 2013 by the Violence Policy Center found that about 75% of NRA corporate donations came from firearm manufacturers, and eight firearm manufacturers each donated a million dollars or more. Manufacturers dominate the Ring of Freedom (highest donors) and provide most special sponsorship for programs and meetings. While donations from individuals provide the majority of NRA funding (including NRA Political Action Committee funding which cannot be corporate), very few individuals have the influence gained by million-dollar donations. This dominance increased when many non-firearm corporate sponsors abandoned the NRA after the mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida in 2018. The NRA failed to respond with any empathy after the shooting, and when corporate partners withdrew, released this statement:
“Some corporations have decided to punish NRA membership in a shameful display of political and civic cowardice.”
While the NRA argues that they do not lobby on behalf of firearm manufacturers, their actions would suggest otherwise. The NRA lobbied for and secured the passage of federal laws banning the ATF from keeping a searchable registry of guns, gun owners or gun sales in 1986, preventing the CDC from advocating for or promoting “gun control” in 1996, providing immunity from liability for gun manufacturers in 2005, and successfully blocked most gun safety legislation, including universal background checks. The NRA also lobbied to let the assault weapons ban expire in 2004, a ban which had resulted in a 43% reduction in mass killings. Beginning in the 1990s, the NRA convinced 45 states to legislate firearm pre-emption statutes, preventing local governments from creating restrictive firearm ordinances. All of that when, except for the idea of gun registration which has been translated to “disarmament” by the NRA, gun safety legislation is supported by the majority of gun owners in the US. And that includes the 5 million gun owners the NRA says are members of its organization (the number is actually much lower if you consider dues paying members instead of their mailing list which includes all past members – that’s how I got the letter from LaPierre last week). Fortunately, corruption within the NRA may put an end to the influence of firearm manufacturers.
How do you begin to make gun violence a public health priority? The first step would be to identify the priority and quantify the impact. For that first step see the first paragraph above, or read today’s local news. The next step would be to identify contributing factors and immediately address critical contributing factors. In my opinion this would be Federal Firearms Licensure and background checks.
The problem with Federal Firearms Licensure (an FFL) is that almost anyone can become a registered gun dealer with the Bureau of Alcohol, Tobacco and Firearms. You only need to certify that you can legally possess firearms, that you intend to be in the business of selling firearms, and then pass a fingerprint background check. Once licensed, you can buy and sell as many weapons as you want, for the ridiculously low registration fee of $200 for the first three years and then $90 for each three-year renewal. About 60% of FFLs are held by dealers selling from their home (so-called kitchen table dealers). This was as high as 75% in the late 90s before the registration fee was raised from $30, and the fingerprint background check was added. Still, most kitchen table dealers do not operate a business as required, with about one-third making no sales each year, and one-third failing ATF records inspections. FFL is so easy to obtain that many register just to get wholesale discounts on guns for themselves and their friends, even though this should not be the reason for registration. Then when they fail ATF records inspections, they simply turn in their license and transfer their guns to private ownership. Almost no one is prosecuted for violating the law. Guns sold by kitchen table dealers make up a disproportionate number of guns used illegally. There is an easy solution – raise the license fee to $3000-$5000 and increase the penalties for fraud and non-compliance. In case you think that fee is too high, recognize that it would be about the same as an alcoholic beverage permit.
The other critical contributing factor to gun violence is the lack of a universal background check. With gun violence at the current level in the US, and with so many guns used in crimes obtained illegally, this is a no-brainer.
The next step in implementing a public health priority would be to implement prevention strategies. The American Medical Association provided common sense recommendations for preventing gun violence in a press release in 2016:
- Advocate for schools as gun-free zones
- Ban the sale of assault-style weapons and high-capacity magazines
- Expand domestic violence restraining orders to include dating partners
- Remove firearms from high-risk individuals
- Increase the legal age of purchasing any firearm or ammunition to 21
- End concealed carry reciprocity across state lines
- Create gun buyback programs to reduce the number of circulating firearms
I will not even try to argue the stupidity of the universal carry law just passed in Texas. It is obviously stupid. If we had common sense gun safety laws, we would not need any handgun carry laws of any kind.
Does common sense go far enough? It is clear from national and state level data that the rate of death by firearms is directly associated with the rate of firearm possession. And the US has the highest rate of firearm possession of any country by a lot. I would argue that we must change the gun ownership culture in the US if we are going to significantly reduce gun violence. This means registration of all handguns (in addition to banning assault-style rifles and high-capacity magazines). Handguns are only practically useful for killing human beings and should be licensed. Even with universal background checks, you will not significantly reduce the criminal possession and use of handguns without registration – there are already too many handguns out there, and they last forever. This is a small price to pay to keep children safe in schools (not to mention in the back seat of their mother’s car). And for those who would argue that gun registration will allow the federal government to confiscate your guns, you have to decide which is more dangerous to you and your family, the federal government or an armed criminal?
Waterloo to Austin 