Institute of Medicine Identifies Research Areas that Could Impact Gun Violence

The United States has the highest rate of firearm-related deaths among industrialized countries.  In 2010, 73,505 Americans suffered non-fatal firearm-related injuries and more than 31,495 were killed, including roughly 19,000 suicides.  On January 16, 2013, in the wake of the violent shootings in Newtown, Connecticut, President Obama identified gun violence as a public health issue.  He directed the Centers for Disease Control and Prevention (CDC) to conduct and sponsor research into its causes and into potential methods of prevention.  In response, the CDC and its Foundation asked the Institute of Medicine (IOM) and the National Research Council to propose a research agenda that identified areas with a potentially significant impact on public health.

The IOM released its findings on June 5, 2013 in a report entitled, “Priorities for Research to Reduce the Threat of Firearm-Related Violence.”  Overall, the report recommends treating gun violence as a public health issue in the same way that tobacco and car accidents have been treated.  The public health approach involves “a focus on prevention, a focus on scientific methodology to identify risk and patterns, and multidisciplinary collaboration to address the problem.”  Strategies interrupt the connection between the source of injury, the injured person, and the environment in which the conditions occurred.  The report identifies five areas for research:  (1) characteristics of gun violence; (2) risk and protective factors; (3) firearm violence prevention and other interventions; (4) gun safety technology; and (5) influence of video games and other media.  Per the CDC’s request, the report did not focus on mental health and public health surveillance, which will be addressed separately.

Characteristics of Firearm Violence

The IOM suggests that research focus on three separate populations:  the general population, the general youth population, and the offender population.  Research should characterize motivations for obtaining, owning, and using firearms, and address geographic violations in gun violence.  The report emphasizes the value in learning, across the three populations, the total number of guns owned, their attributes, the manner in which they were acquired, and information about the sources of guns.

Risk and Protective Factors

Research should identify factors associated with young people’s access to, possession, and carrying of guns; evaluate the potential health risks and benefits (e.g. suicide versus personal protection) of having a firearm in the home under various circumstances, including various gun storage techniques; and learn more about gun violence risk factors in specific high-risk settings.  Studies addressing violence should consider contributing societal factors, such as attitudes that view suicide as inevitable; community factors, such as high rates of illicit drug trafficking; situational factors, such as the presence of drugs or alcohol; and individual factors, such as impulsivity and low educational attainment.

Firearm Violence Prevention and Other Interventions

Interventions may focus on firearms, possessors of firearms, victims, and social, physical, and virtual environmental factors.  Various interventions intended to reduce violence have been implemented, but few have been effectively tested.  Such interventions include firearm safety education programs, school safety plans, and background checks.  The report suggests that research should improve the understanding of the effectiveness of certain prevention methods across the three populations.  Specifically, it should evaluate the effectiveness of interventions intended to reduce the illegal carrying of firearms, reduce access to legally purchased guns by criminals and others prone to violence, educate children about firearms violence, and alter physical environments in high-crime areas.

Impact of Gun Safety Technology

Changing products to make them safer via both passive and active technologies may be more effective at preventing violence, such as unintentional shootings and the shooting of police officers by assailants using the officers’ own weapons,  than changing personal behavior.  Therefore, the IOM found, research should examine the effects of past technologies intended to reduce firearm injury and death, such as manual safety mechanisms, past consumer acceptance of the technologies, and state and international policy approaches for consideration of application to the entire United States.

Video Games and Other Media

The IOM proposes that studies should, for the first time, focus on firearm violence as a specific outcome of violence in the media.  In particular, research should be expanded to include exposure to violence music, video games, social media, and the internet and its relationship to real-life violence.

Conclusion

The report emphasizes the importance of securing accurate but anonymous data on which to base studies.  Data about the sources of guns used in crimes are particularly important.  Also important is scientists’ ability to move from limited study designs, including case-control and ecological studies, to experimental and quasi-experimental designs that actually allow the scientists to test their theories.  Without abundant data, and without effective study designs, research is unlikely to become more effective.  The report is intended as a beginning point for future research rather than an exhaustive list of topics.  The authors believe, however, that the report’s suggestions can produce real impacts in three to five years.