Policies that work: A look at the scientific data behind gun violence prevention

More than 39,000 people in the U.S. died as a result of gun violence in 2017, and tens of thousands more suffered gun injuries. Progress at the national level to address the problem has stalled. But thanks to a recent forum, policymakers now know which measures are effective to address gun violence.

"We're at an extraordinary moment in our nation,” said Georges Benjamin, MD, APHA’s executive director, at the Sept. 23 "Policies That Work to Reduce Gun Violence" forum in Washington, D.C. "Every day, a new tragedy occurs. We have an opportunity to actually do something here — together."

The event, held at the Newseum’s Knight Studio, highlighted how evidence-based policy solutions can be used to address the nation’s gun violence epidemic. APHA and the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health co-hosted the forum, which featured two panels of top experts.

The first panel, moderated by Benjamin, focused on extreme risk protection order laws, protections for domestic violence victims, background checks and licensing and bans on assault weapons and large-capacity magazines.

Panelists emphasized the importance not only of advocating for, but also of implementing, policies that show evidence-based results. "If we don’t work on implementation, then this is all just words on a piece of paper," said April Zeoli, PhD, MPH, associate professor at the School of Criminal Justice at Michigan State University.

She noted that domestic violence is highly predictive of future violence. Zeoli stressed the importance of logging perpetrators into the background check system to restrict their firearm possession. But many people, who pose a high risk of harming someone with a firearm, can legally possess guns and, therefore, would pass a background check at the point of sale.

While most gun violence does not happen on a mass level, in 2018 there were 340 mass shootings. Daniel Webster, ScD, director of the Johns Hopkins Center for Gun Policy Research, said that to prevent such deaths, policymakers need to restrict ammunition feeding devices, also known as magazines.

Assault weapon bans, such as the U.S. law that expired in 2004, are not as effective. "You can now make yourself an assault weapon by buying those parts separately to get around restrictions on assault weapons," Webster said. "That’s why bans have not had measurable impacts."

Joshua Sharfstein, MD, vice dean of public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, moderated the second panel. Panelists shared information on hospital-based interventions, blight, gun violence research and interventions with people who are at high risk for carrying out gun violence.

Shani Buggs, PhD, MPH, postdoctoral fellow with the Violence Prevention Research Program at the University of California Davis, discussed the role of programs such as Cure Violence, which work to interrupt violence in communities.

The program treats violence as a disease that can be prevented. Cure Violence has been replicated around the world, with mixed success. Such programs show the importance of engaging with communities when working to find solutions for gun violence prevention, Buggs said.

Carnell Cooper, MD, chief medical officer at Northeast Methodist Hospital, advocated for hospital-based intervention programs, such as the one in place at his hospital. Hospital-based intervention programs look at factors that put people at risk of being shot and help patients to prevent it from reoccurring.

"Firearm injury victims return to us again and again, and each time they do, they have a higher likelihood of dying," Cooper said. "At our trauma centers, we have an opportunity and obligation to offer something other than patching them up and sending them out again."

Closing the program on a note of optimism, Sharfstein said that, as the forum showed, evidence-based programs that can reduce gun violence are available. "We can be, as a nation, on a trajectory for substantial improvement," he said.

To watch a recording of the forum, visit https://www.apha.org/gun-violence.