Our ability to arm ourselves is considered so essential in the U.S. that it’s one of the foundational rights of our constitution.
The protection of this ability has resulted in there being more guns than people in the U.S. at this point.
And that level of access to guns is having a serious impact on our public health.
In 2022, firearm injuries were among the top five leading causes of death in people aged 1 to 44, and they were the number one cause of death in kids aged 1 to 19.
In 2023, there were a little over 46,000 gun deaths in the U.S., averaging about 126 deaths a day.
But for every gun death, there are nearly twice as many non-fatal injuries which can result in life long disability.
Even just the threat of violence can have an impact on the physical and emotional wellbeing of a population, and people who are scared to walk outside in their communities risk losing access to physical activity.
The impact of gun violence on society was officially acknowledged by one of the top-ranking public health officials in the country in 2024: The Surgeon General.
In June of that year, Surgeon General Vivek Murthy released an advisory declaring gun violence a public health crisis and calling for immediate action to improve research and create laws to reduce harms.
Gun ownership in the U.S. has become sort of a vicious cycle. We hear about gun violence, so we buy more guns, which leads to more gun violence.
After all, the most commonly cited reason for gun ownership is for personal protection: Gun sales have historically spiked in the time periods after mass shootings.
But mass shootings, which are typically defined as three or more killings in a single incident, make up an incredibly small fraction of gun deaths.
In reality, people living with hand gun owners die by homicide at twice the rate of their gun-free neighbors and are three times as likely to die by homicide at home.
And lest you think this is a result of shootouts between gun owners and home invaders, people living with gun owners are seven times more likely to be shot by their spouse or intimate partner.
When it comes to homicides by strangers, one study found that people living in homes with guns were no less likely to be killed by a stranger than people who lived in gun free homes, putting to question the concept that the only thing that stops a bad guy with a gun is a good guy with a gun.
Even greater than homicide by firearms, is the rate of intentional, self-inflicted gunshots.
More than half of all firearm-related deaths are suicides.
Research shows that living in a home with access to a firearm increases the risk of suicide threefold, and suicide by firearm has a significantly higher rate of lethality.
Suicides by firearm end in a fatality 85% of the time, but suicide by other common methods has a fatality rate of around 5%.
Firearm violence is a uniquely American problem when it comes to high-income countries.
The United States has 25 times the rate of firearm homicide and 10 times the rate of firearm suicide compared to other high-income countries.
So how do we prevent it? What does the research say works?
The problem is that there has been about a 20 year gap in gun violence research.
The story goes like this: In 1993, the New England Journal of Medicine published a landmark paper, funded by the CDC, that shows having a gun in the home is more dangerous than not having one.
National Rifle Association, or NRA, was originally founded as a direct response to the abysmal shooting capabilities of Union soldiers during the civil war.
One study estimated that for every bullet that hit a confederate soldier, about 1,000 bullets were fired. So, the NRA wanted to cultivate and train future generations of marksmen.
The group was actually very involved in, and pro, gun control efforts up until the 1970s. Then, federal agents shot an NRA member who was suspected of stockpiling illegal weapons during a raid on his residence.
The event created a rift in the organization and eventually inspired the creation of their lobbying branch, and by the late 1970s, the NRA’s official position was to oppose any and all restrictions on gun ownership.
So, you can imagine that in 1993 they were less than thrilled to find out the U.S. government had funded a study that suggested exercising one’s second amendment rights might actually be harmful to others.
They accused the CDC of being biased against guns and began lobbying to eliminate the CDC’s injury prevention center all together.
While they were unsuccessful in that effort, they did manage to get the Dickey Amendment passed in 1996, which explicitly forbade federal funds from being used for research that would “advocate or promote gun control.”
So, you can’t do research that concludes that controlling guns is a good idea, but you can still do research on guns right?
Not without any money! In 1996, Congress also said that $2.6 million of the CDC’s budget should now be earmarked for research on traumatic brain injuries. An amount that was, conveniently, exactly what the center had spent on gun research the prior year.
At this point, everyone at the CDC took the amendment, which was continually renewed and even extended to include the NIH in 2011, for what it was: a warning that any studies that could possibly be viewed as anti-gun would cause problems.
And since no one was willing to test it, gun research at the federal level mostly stopped. And it’s not like there was a ton to begin with.
For example, between 1973 and 2012, the NIH granted 430 research awards to study three diseases—rabies, polio, and cholera—when there were only 721 cases of all three diseases in the U.S. during that same time.
By comparison, there were 4 million gun injuries during that period, but only three research awards were granted.
Given that a huge portion of research in this country is (was) made possible by federal funds, that lack of funding impacts the amount of research being facilitated overall.
A 2017 study found that, of the top 30 causes of death in the U.S., gun violence was the least researched, and second least funded.
During this time, blood infections were responsible for a similar number of deaths, which might make you think we’d spend a similar amount of effort researching the two subjects. But gun violence only had 0.7% of the research funding that sepsis did, and 1/25th as many papers published on the topic.
As years went on, and more mass shootings continued to fuel the gun debate, more people began to realize the importance of this research...or rather, lack thereof.
Even Jay Dickey, the Congressman who had sponsored the amendment, stated he regretted how the vague language was stifling all research.
It wasn’t until the spending bill of 2018 that Congress, influenced by the recent mass shooting at a high school in Parkland, Florida, in which 17 people (mostly teenagers) were killed, passed a spending bill that did not eliminate the Dickey amendment, but included clear language that the CDC was allowed to study the causes of gun violence.
Then, in December 2019, $25 million was allocated for gun research to be split between the CDC and NIH.
Suddenly researchers had federal funds available to study things like the effect of firearms regulations on intimate partner violence, the connections between safe storage and suicide in rural areas, the effectiveness of hospital-based violence prevention programs for youth, whether lawful gun ownership increases homicide risk, community-based violence prevention programs, and suicide prevention efforts led by firearms retailers and ranges.
Then, of course, the April 2025 cuts to HHS staff happened.
The CDC’s Injury Center and its Division of Violence Prevention, the units that work to research and prevent firearm injuries and deaths, are estimated to have lost about 75% of staff when HHS secretary Robert F. Kennedy Jr ordered cuts to personnel.
The Web-Based Injury and Statistic Query and Reporting System, which contains all the data relating to injuries and deaths due to guns, also had its entire team of 40 staffers cut. The database was used to help policy makers understand things like the cost analysis and benefits of gun policy.
These cuts also threaten the upkeep of the database that was used to determine that firearms are now the leading cause of death in children.
Even if the funding isn’t removed, it’s hard to imagine the goal of gun violence research can continue without the staff necessary to do it. And it’s not just research that’s at risk.
One of Trump’s earlier executive orders was aimed at “protecting second amendment rights,” which included a review of all previous presidential and federal action to make sure they did not “infringe” upon second amendment rights.
This included removing the previously mentioned Surgeon General’s Advisory on Gun Violence from the HHS website.
At the time of this episode recording, the Trump administration is expected to roll back a number of Biden-era gun control measures, including the “zero tolerance” policy, which strips licenses from firearm dealers found to repeatedly violate deferral laws and regulations, and the requirement for background checks as part of private gun sales.
