Because doctors at Kaiser Permanente treated more than 11,000 gunshot wounds in 2016 and 2017, the not-for-profit health care company announced this week that it is investing $2 million into gun violence research across its hospitals and health centers in the United States.
“We should be thinking about this problem and studying interventions for it in the same way we study heart disease or diabetes or any other leading cause of death,” Bechara Choucair, Kaiser Permanente’s chief community health officer, told the Washington Post.
The Oakland, Calif.-based health system has more than 12 million member patients that it serves at hospitals and centers in eight states and Washington, D.C.; its size gives it access to a large pool of subjects for interventional research, such as finding the best ways to discuss gun ownership with patients who say they’ve experienced suicidal thoughts.
Kaiser’s announcement signals a move to step in where publicly funded research has been almost totally nonexistent for the past two decades, since Congress passed a rule called the Dickey Amendment in 1996. It said no funds from the Centers for Disease Control (CDC) could be used to “advocate or promote gun control.” Although research into gun violence wasn’t specifically prohibited, the rule nonetheless caused federal funds to dry up almost completely.
Plus, the results of studies the group had funded before the Dickey Amendment took effect kept showing that the presence of guns in homes increases the risk of injuries and death; publishing such information would obviously make it look like the CDC was advocating for gun control.
In the wake of the Parkland, Florida, school shooting and the recent burst of gun-control activism, legislators included language in the omnibus spending package passed last month explaining that the Dickey Amendment does not prevent the CDC from studying gun violence and its causes. Whether or not that small clarification will lead to significant increases in federal research on the topic remains to be seen.
Meanwhile, private efforts such as Kaiser Permanente’s are valuable: The first step for Kaiser will be to have clinicians and researchers identify research priorities and then award funding toward studies, primarily focusing on research within the health system but including collaboration with external scientists. Dr. David Grossman, senior investigator at Kaiser Permanente’s Washington Health Research Institute in Seattle, is a co-leader of the initiative. He tells Modern Healthcare that the project will aim to find strategies and approaches to minimizing the risks of injury and death from firearms through counseling, and will try to find better ways to identify patients who are at risk of committing suicide (since they make up two-thirds of gun-related deaths).
Elizabeth McGlynn, vice president for Kaiser Permanente Research, who will lead the initiative with Grossman, says in a release that the group will make its results publicly available to provide guidance in clinical and community settings. “We encourage other private-sector and philanthropic organizations to join us in funding this much needed public health research.”
Other groups have been gearing up to research gun violence without the CDC’s help—a review of the existing evidence released by nonpartisan think tank the RAND Corporation last month found that the lack of empirical studies has made it too easy for both sides of the gun control debate to cherry-pick evidence to back up their own claims.
An initiative supported by the Massachusetts Medical Society, the American College of Emergency Physicians, and the American College of Surgeons aims to find private-sector funding for gun violence studies looking for effective public health interventions. States are getting in on the act too—last summer, the University of California at Davis launched the Firearm Violence Research Center, and in February, governors from Connecticut, Delaware, Massachusetts, New Jersey, New York, Rhode Island, and Puerto Rico formed a consortium called the States for Gun Safety with the goal of compiling and sharing data on gun violence.
State-level politicians seem to be abandoning the National Rifle Association (NRA) more rapidly than national figures have been able to—in Vermont, Republican Governor Phil Scott, who had received an A rating from the NRA, signed the state’s most restrictive gun control laws ever Thursday, while surrounded by both hecklers and supporters. The new laws ban the possession and sale of bump stocks and high-capacity magazines and require that all guns be sold through licensed dealers to buyers who are at least 21 years old or have taken a Vermont hunter safety course or joined the military or law enforcement. Police can temporarily confiscate guns from people who have been arrested for domestic violence as well.
Meanwhile, a 20-year-old Massachusetts ban on AR-15s and large-capacity magazines was upheld by a federal judge last week, when he dismissed a lawsuit challenging it.
The decision effectively confirmed that assault weapons are not protected by the Second Amendment.