CDPHE, Cory Gaines, Exclusives, Politics, Right To Arms, Uncategorized

Gaines: The limits of public health on reducing gun violence

It is a cycle that is as old as politics itself.  First a bill is proposed to form a group to study something.  In the following  years the results are quoted in the making of new laws.  In the case of the Colorado legislature’s work in the 2021 session, it was the creation of the Office of Gun Violence Prevention (OGVP) within the Department of Public Health and Environment (CDPHE).  We have the group now.  Will (more) gun policy be far behind?

Given what happened during COVID, hearing that public health officials were going to get anywhere near gun policy makes me mildly nervous; there was so much intrusion into our lives and rights by health officials, that, when I heard of the bill creating the OGVP, I made a special point of watching closely and reading up on the public health view of guns and gun violence.  This has, as you might imagine, taken on a new relevance given recent events.

There is not yet much to report out about the OGVP–they’re just now getting up and running–but the recent calls for a public health study of guns and gun violence makes the question of what exactly public health can tell us about guns and gun violence an important one to examine.  Amid the calls to do something, amid the suggestions that framing the question as a public health issue can lead to a swift, targeted, and “scientific” solution by experts, there is something missing.  There doesn’t appear to be much discussion around the basic assumptions behind this viewpoint.

Public health has greatly improved the health and safety of people in this country.  But, do the same things that help for automobile crashes and tobacco use work for gun violence?  Further, and going to an even more fundamental level, is it reasonable to think that public health, armed with its social science toolset, will be able to give us concrete steps to reduce gun violence?   The answer is a mix of yes and no.

Public health, as almost every other endeavor, has limits on what it can tell us.  Disease rates?  Gun violence rates?  To a reasonable certainty, yes on both.  While you can’t ever get fully accurate accounting without asking every individual in the state, our disease surveillance infrastructure and papers I’ve seen on gun violence numbers lead me to conclude that their estimates are reasonable.  More speculatively (because it involves sampling and surveys which are a step down from an already limited measuring scheme for diseases and injury), public health can give us a hint, a snapshot, of current attitudes and practices around guns.  For example, a quick look through the resources available on the OGVP’s website let’s you get a glimpse of survey results about children’s access to firearms in the home.  A quick look at the Firearm Injury Prevention Initiative’s site (they are the contractor hired by the OGVP to consult with stakeholders around the state and build a resource bank as part of the OGVP’s statutory duties) leads to a lot of similar things:  surveys on attitudes about guns, panel discussions on firearm safety, and the like.  So far, these items make up the vast bulk of the things that OGVP could tell us.

What you won’t see a lot of is hard evidence of the efficacy of particular policy recommendations.  That’s not an accident or an oversight.  For a variety of reasons–a lack of reliable studies, a lack of data (mass shootings are actually quite rare statistically), the fact that social sciences deal in correlations and not experimentally-driven causal connections, a prohibition against studying guns by the CDC–we simply cannot make any big claims that this or that policy will reduce violence.  There are some inklings about some aspects of gun-related harm:  a RAND analysis of gun policy studies found a tenuous connection between some gun policies and gun harm (violence, self-harm, or unintentional injury), but there is no definitive claim to be made that efforts we’ve seen up until now at gun control work.

Nonetheless, the hope seems to persist among the public and the media.  One frequently hears that we have the “science” to solve this.  If we simply listen to public health, get the obstructionist, maniacal Second Amendment purists out of the way, and apply the lessons from things like car safety or smoking cessation to guns we’ll all be better off.  The truth is more complicated; it depends on what problem you are looking to solve and what you define as a solution.

One thing that public health has succeeded at in the past has been in educating and shaping opinions about health issues.  Think about the last time you were at the doctor’s office.  My guess is that there was more than one poster about tobacco use and, if you admitted to partaking, you got counseled on the wisdom of that decision by at least one health professional.  Another example would be my wife’s first prenatal visit.  It wasn’t until later that I learned why she was called back and I wasn’t allowed in for a few minutes:  research has shown that domestic violence spikes during pregnancy so the first prenatal visit is a critical one for a screening.

In this sense, public health can be helpful.  If you knew, for example, that a specific group of people were keeping loaded guns unsecured around children, you could target that group for a public health message about making sure their guns are safely secured.  For this reason, I think the OGVP will be useful and I’m happy to support their efforts.

If, however, the assumption is that CDPHE has filing cabinets filled with information on policies that will prevent mass shootings, or definitive proof that, say, background checks will stop maniacs from having guns and using them, that’s not an accurate statement.  That data doesn’t really exist at this point and it’s doubtful that we’ll ever get it given the limitations of statistical analysis (as contrasted with experimental verification).

Public health, the OGVP, does have a reasonable and beneficial role to play in helping to reduce gun violence, but I think we need to be clear about the boundaries, both those we impose and those that nature imposes on us.  Public health excels at helping to advise and target public education efforts.  It can tell us (with some caveats) where behaviors and attitudes are.  It can tell us the prevelance of behaviors that put people at risk of harm.  What it can’t tell us is the success or failure of any given gun control policy.  It cannot substitute its judgment with regard to weighing competing interests and rights.

It’s in everyone’s interest, as we continue talking about guns and gun violence, to remember this.

Cory Gaines, a Sterling resident, runs the Colorado Accountability Project on Facebook.


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