Wednesday, May 23, 2018

The Mythology of Gun Safety


The only way for the gun lobby to sustain any arguments that “guns don’t kill people, people kill people” or “the only way stop a bad guy with a gun is good guy with a gun” is to lie and cover up facts. Easy access to guns, despite the best educational gun safety efforts to the contrary, is the ubiquitous common element in virtually every mass killing in the United States for the two decades. That gun violence and resulting mass killings have increased in the last several years is a reflection of more lax gun laws (open carry, stand your ground, limited or no background checks particularly at gun shows, etc.) and an large number of military assault weapons readily available at gun stores everywhere. The token laws passed to limit gun access have done nothing to stem the slaughter.
Federal agencies don’t generally gather or analyze gun homicide statistics, in significant part because Congress sent federal agencies a very serious message in 1996. Under intense pressure from the National Rifle Association – they did not want the obvious numbers to be released since statistics would contradict their message and the slogans – Congress passed the “Dickey Amendment” in 1996. That statute stipulates that “none of the funds made available for injury prevention and control at the Center for Disease Control and Prevention may be used to advocate or promote gun control.” The amendment was introduced after NRA lobbying in response to a 1993 CDC-funded study that showed that guns in the home were associated with an increased risk of homicide in the home.

So most of the research statistics on gun homicides have to be culled by private (or non-federal) researchers from general police and FBI ledgers and reports. Over the years, my blogs have presented various studies based on such backdoor statistics, most recently a Washington Post statistical analysis on the number of American children exposed to mass shootings since the 1999 Columbine massacre, described in my May 18th blog – My Father’s Guns – which addressed the recent gun-executions at a Santa Fe, Texas high school.

Another study, this time released on May 10th by the School of Nursing at Rutgers University (a New Jersey state university) – entitled School-Based and Community-Based Gun Safety Educational Strategies for Injury Prevention – addressed the effectiveness of gun safety instruction on children. The report noted that 85% of guns in private homes where children are present are not kept locked up in approved gun safes. Sage Journals (Health Promotion Practice) summarizes the report:
Nearly 1,300 children in the United States die because of firearm-related injury each year and another 5,790 survive gunshot wounds, making the prevention of firearm-related unintentional injury to children of vital importance to families, health professionals, and policy makers… Results support the premise that programs using either knowledge-based or active learning strategies or a combination of these may be insufficient for teaching gun safety skills to children. Conclusions. Gun safety programs do not improve the likelihood that children will not handle firearms in an unsupervised situation. Stronger research designs with larger samples are needed to determine the most effective way to transfer the use of the gun safety skills outside the training session and enable stronger conclusions to be drawn.
Guns are a ubiquitous part of American culture. There are more than 310,000,000 guns in circulation in the United States (Ingraham, 2015). This numerical reality makes the prevention of firearm-related unintentional injury to children and youth of vital importance to parents and families as well as to school, public health and child health professionals, and policy makers. As K. Fowler, Dahlberg, Haileyesus, Gutierrez, and Bacon (2017) report, firearm injuries are the third leading cause of death for all children aged 1 to 17 years. Gun deaths account for twice the number of deaths from cancer, 5 times the deaths from heart disease, and 15 times the deaths from infections (GBD 2013 Mortality and Causes of Death Collaborators, 2014Palfrey & Palfrey, 2013). Only motor vehicle traffic injuries claim more lives, whose rate fell approximately 50% since 2000, while firearm mortality dropped only 10% in that same time (K. Fowler et al., 2017Nelson, 2017).
While death is the most egregious result of firearm-related unintentional injury for children, it is not the only serious outcome. Firearm-related injury, in addition to being more frequently fatal, also more frequently requires major surgery as compared to other types of injury. Firearm injury sends thousands of children to the emergency department with open wounds, fractures, brain trauma, and spinal injuries. Overall, nearly 1,300 children in the United States die in shootings each year and another 5,790 survive gunshot wounds (K. Fowler et al., 2017). About 15% of children with a firearm-related injury will sustain traumatic brain injury or an injury to the nerves or spinal cord, necessitating years of often painful, emotionally challenging, and costly rehabilitation (Kalesan, French, Fagan, Fowler, & Galea, 2014).
Beyond direct physical harm, there are also mental health challenges stemming from direct and indirect exposure to a firearm-related injury, making each single firearm injury one that affects many victims. The fear, anxiety, and elevated stress children experience resulting from direct and indirect exposures may have serious psychological health consequences and has been reported as a predictor for the development of posttraumatic stress disorder in children and adolescents (P. J. Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009Penn State, 2012). In addition, activating the body’s physiologic stress mechanisms increases risks of serious chronic health conditions, including heart disease and depression.
The economic burden associated with firearm injury is significant. Using injury data from the Centers for Disease Control and Prevention, Miller (2012) estimates annual firearm injury costs average $645 per gun in America. These costs include medical and mental health care costs, criminal justice costs, and the value of pain, suffering, and lost quality of life…
While the American Academy of Pediatrics (2015) notes that the safest home for children is one that does not include the presence of a gun, most unintentional shooting deaths among children do occur in the home with an additional one third occurring at the house of a friend or relative (Luo & McIntire, 2013). Gun safety in the home is complicated by differences in family beliefs, expectations, and actions. Despite parents believing that safe firearm storage is important for child protection and safety, Baxley and Miller (2006) report that 85% of parents did not practice safe gun storage. Jackman, Farah, Kellermann, and Simon (2001) found that 72% of the gun-owning parents believed their child could differentiate a toy gun from a real gun, even though this is an unlikely developmental capability for young children.
We’ve seen a litany of inane suggestions to address such mass killings from pro-gun politicians: from having armed guards at public schools (the guards stationed at Parkland and Santa Fe didn’t make a difference) and arming teachers (who really did not sign up to be armed law enforcement officers) to limiting the ingress and egress of students to one or two doors, a practical impossibility particularly at larger schools. In the end, the one common thread to all of these mass shootings is the ready access to guns, particularly to military-grade, high capacity, semi-automatic assault weapons. And we have more guns among our civilian population than any other nation on earth… proportionate to our population.
The rest of the world looks at the American obsession with guns, our unjustifiable belief that gun ownership (including military assault weapons) is a fundamental right, as aberrant, terrifying and completely misguided. This excerpt from a letter to the Los Angeles Times (May 23rd) from an Australian resident (Elizabeth Harrington from Milton, Australia) summarizes this perspective well: “Until Americans admit that and do something about [gun ownership and violence], their country will never be ‘great again’ in the eyes of the rest of the world. And many of us will be too afraid of caught in gun violence to ever visit your country.” We spend so much effort on defeating foreign terrorism, which accounts for relatively little in the way of American deaths. What we have is an epidemic of domestic terrorism that is so much worse because of the abundance and variety of guns in this country… our American-born terrorists’ choice for weapons of mass destruction.
As long as that easy access to guns exists – and where there is a will, with so many guns everywhere, there is always a way even when likely gun abusers are formally banned from gun ownership – there will be mass shootings. There are no lesser palliatives that can fix this accelerating problem. None! 30 unjustifiable gun homicides for every justifiable one, a huge statistical slam at the self-defense argument that Second Amendment expansionists love to cite. It does come down to whether we love guns or our children more. So far, guns are the big winner.
I’m Peter Dekom, and unless and until the United States gets serious about saving the lives of innocent victims of gun violence by extracting most of the guns out of society, these massacres will continue to dominate the headlines… and create so many more “moments of silence” and “our prayers are with the families…”

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