If guns don’t kill people, ignorance might

President Obama had a lot to say about gun control in his state of the union address this week (doi:10.1136/bmj.f1034).

In a grand rhetorical flourish, he said that the victims of gun crime and their families deserved a Congressional vote on issues such as background checks, sales restrictions, and ammunition limits.

“In this chamber tonight [are] more than two dozen Americans whose lives have been torn apart by gun violence. They deserve a vote. Gabby Giffords deserves a vote. The families of Newtown deserve a vote. The families of Aurora deserve a vote. The families of Oak Creek, and Tucson, and Blacksburg, and the countless other communities ripped open by gun violence—they deserve a simple vote.”

But he was only half right. What these people deserve is not just a vote but an informed vote. One that weighs the benefits and harms of gun control. One that considers all the research. One that takes stock of the evidence. And right now, that’s unlikely to happen. This week, Michael McCarthy’s feature for the BMJ looks at the reasons (doi:10.1136/bmj.f980).

In the mid 1990s, the National Rifle Association successfully campaigned to see the Centers for Disease Control and Prevention stripped of the $2.6m of its budget slated for gun violence research, and the agency was forbidden “to advocate or promote gun control.” Similar language was put in legislation governing the National Institutes of Health’s budget, and federal funding for public health research into gun violence all but disappeared. Gun rights advocates also moved to pass both state and federal laws seeking to prevent doctors from asking their patients about guns in their homes, and Florida passed a law that made it possible to sanction doctors who held conversations about gun safety or recorded information about gun ownership in a patient’s medical record.

If a disease killed 31 000 people a year there would be a national outcry over such restrictions on research, and if any good can come from the tragedy in Newtown a thawing of the research freeze would be a start.

But there is also a challenge to the research community. Arthur Kellermann was the lead author on two papers published in the New England Journal of Medicine in the early 1990s. These reported that keeping a gun in the home was associated with a 2.7-fold increase risk of homicide for members of the household and a 4.8-fold increase in risk of suicide.

He is now chair in policy analysis at the RAND Corporation and thinks that even if restrictions are dropped and even if funding is found for research, there is a more fundamental problem: “There were never large numbers of researchers active on this issue. You could almost count the public health community working on this topic on both hands without having to go to your toes. What we don’t know is are there young or early-career medical and public health researchers who will rise to this challenge and be willing to take on work that could easily disappear as quickly as it re-emerges.”