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Experts encouraged by talk of revisiting federal funding for gun violence research

Health and Human Services Secretary Alex Azar has indicated he would be open to increased focus on gun violence in federally-funded research. (Image: Sinclair Broadcast Group)

Encouraged by recent comments from new Health and Human Services Secretary Alex Azar, Democrats in Congress and at least a few Republicans are pressing for reconsideration of a decades-old provision in appropriations for the Centers for Disease Control and Prevention that they say has chilled efforts to conduct serious research about the public health implications of gun violence.

“Research on gun violence is one important way to help reduce the incidence of gun violence and unnecessary deaths of school children and all Americans,” said seven House Democrats in a letter to Speaker Paul Ryan Wednesday. “This is a common-sense step that warrants immediate consideration in the House of Representatives.”

Passed in 1996, the “Dickey Amendment,” named after then-Rep. Jay Dickey, R-Ark., states that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”

At the time, research funded by the CDC had been published in the New England Journal of Medicine that concluded gun ownership increases the risk of homicide by a family member or intimate acquaintance. The National Rifle Association was lobbying for the defunding of the CDC’s National Center for Injury Prevention and Control.

“They didn’t like that some of the initial studies the CDC funded indicated that guns in the home were detrimental to the gun owner and the gun owner’s family,” said David Hemenway, director of the Harvard Injury Control Research Center, in an interview Thursday.

Dickey, who described himself as the NRA’s “point man” on Capitol Hill, succeeded in attaching his amendment to an omnibus spending bill. The same bill directed the exact amount of money that had been appropriated for firearms research the previous year to traumatic brain injury research.

Federal spending on gun violence research did not entirely dry up, but it has been vastly outpaced since then by studies of other leading causes of death. Scientists have said the measure discouraged them from applying for grants for projects that include any mention of firearms.

In January 2013, a month after the Sandy Hook Elementary School shooting, President Barack Obama signed an executive order directing federal agencies to study gun violence. A report, titled “Priorities for Research to Reduce the Threat of Firearm-Related Violence,” was produced later that year that outlined researchable questions that federal studies could address.

Resources and funding remained limited, though, and the Dickey Amendment remained in place. Advocates are hopeful that the nation’s horrified reaction to last Wednesday’s shooting at Marjory Stoneman Douglas High School in Parkland, Florida will finally change that.

At a hearing last week, Secretary Azar was pressed by Rep. Kathy Castor, D-Fla., about whether he would support new gun violence research at the CDC.

"My understanding is that the rider does not in any way impede our research mission. It is simply about advocacy," he replied, suggesting that the issue could become a priority for the agency.

"We believe we've got a very important mission with our work with serious mental illness as well as our ability to do research on the causes of violence and the causes behind tragedies like this," Azar said.

Democrats welcomed the possible policy shift.

“Taking action on gun violence prevention is not advocacy, it is common sense. We need better information about what is causing gun violence and what can be done to prevent it, and we should remove any barrier to achieving that life-saving goal,” said Sen. Ed Markey, D-Mass., in a statement that also criticized Trump for failing to mention guns in his initial remarks on the shooting.

In their letter to Ryan, the House Democrats cited Azar’s words and also the speaker’s own claim that more facts and data are needed on gun control.

“Gun-related deaths now nearly equal deaths from traffic accidents, but for too long, policymakers have lacked the comprehensive tools to craft an effective response to the public health crisis of gun violence,” they wrote.

In an interview with C-SPAN, House Judiciary Committee Chair Rep. Bob Goodlatte, R-Va., suggested it is not “inappropriate” for the CDC to study preventing violence that could result from mental illness.

Rep. Leonard Lance, R-N.J., also issued a statement backing Azar’s apparent willingness to revisit the issue.

“By removing restrictions that prevent the federal government from studying mental health issues that lead to gun violence, Congress could have a clearer picture of what effective policies and solutions might be taken to stem the tide of violence,” he said.

Still, top Republicans handling HHS appropriations told Roll Call they do not expect to consider removing the rider from the 2018 omnibus spending measure next month.

Proponents of the amendment stress that it does not explicitly prohibit federal funding of gun violence research, and they believe concerns that such studies could veer into gun control advocacy are warranted.

“Our concern is not with legitimate medical science,” NRA lobbyist Chris Cox told the New York Times in 2011. “Our concern is they were promoting the idea that gun ownership was a disease that needed to be eradicated.”

A 1999 NRA fact sheet accused the CDC’s National Center for Injury Prevention and Control of harboring “a continuing and almost vicious sentiment against personal firearms ownership that is reflected in the lack of objectivity and balance in its work.”

The NRA quoted then-NCIPC Director Mark Rosenberg as calling for a long-term campaign to convince Americans guns were “a public health menace” and accused the center of funding “a clearly anti-gun newsletter.” It also alleged that the NCIPC’s gun research was “methodologically flawed on the most basic level.”

When the National Academy of Sciences held a public workshop in 2013 on implementing Obama’s executive order, Timothy Wheeler of Doctors for Responsible Gun Ownership complained that it was led by “longtime anti-gun researchers.”

“It was business as usual after a 16-year hiatus,” Wheeler wrote in the National Review. “The conference’s leaders brought to the meeting their academic’s jaundiced view of guns as a dangerous virus to be studied with a view toward its control.”

"We would benefit from solid scientific research but we don't expect the CDC would give that to us," Michael Hammond of Gun Owners of America told CNN after the Las Vegas mass shooting last fall.

Dickey, who died in 2016, came to regret his amendment’s existence later in life. In a 2012 Washington Post op-ed, he and Rosenberg lamented that scientists are now unable to answer “the most basic questions” about what does and does not work to prevent gun violence.

“I wish we had started the proper research and kept it going all this time,” Dickey told the Huffington Post in 2015.

Some researchers currently trying to study gun violence agree.

“You really need good research data to indicate whether there is a problem” and how to solve it, Hemenway said.

Though the amendment does not bar funding of all gun research, Hemenway said it sent a clear message to the CDC and to researchers by singling out the issue. He also views it as unnecessary because the conditions of federal funding could already prohibit advocacy work.

“No federal research dollars should ever be spent on lobbying,” he said. “So why have a paragraph specifically about gun research? It’s a signal you want to send to the funders that we’re looking very closely at this.”

The prospect of overturning the Dickey Amendment is promising, according to Lacey Wallace, an assistant professor of criminal justice at Penn State Altoona who studies gun ownership and gun acquisition behavior, because better data could lead to proven, nonpartisan solutions.

“The recent statements by those in power, HHS for example, hinting at more funding for gun research are encouraging, especially since they seem to be calls for research rather than just another push for one sort of gun control or another,” Wallace said.

Some say gun violence researchers can turn to universities and private foundations for funding if the government refuses—and they have over the last 20 years to some extent—but experts faulted that premise.

“The same reason the federal agencies are nervous, so are foundations,” Hemenway said, “because they know they’ll get hassled and they’ll get attacked.”

“Private foundations may have a reputation for swinging pro-gun or anti-gun,” Wallace said. “As a result, any research funded by that organization might be interpreted as biased, even if it is very accurately and ethically conducted.”

More importantly, there just is not enough private money available for the kind of in-depth work researchers want to do on guns.

“Good quality studies, especially those that are nationwide and include detailed measures of behavior or attitudes, are extremely expensive,” she said.

As a result, those studies are not happening.

“The big thing is just: is there money available for research?” Hemenway said. “Researchers follow where the money is.”

Andrew Zweifler, co-founder of Physicians for the Prevention of Gun Violence, said the Florida shooting raises questions about the role of anger and mental illness in gun violence, and research could be done to quantify risk related to anger.

“Somebody could design a protocol, come up with a scale of some sort that could be applied and tested, and see if it makes a difference,” he said.

Reaching any sort of conclusion would require a lot of data and clinical trials, though, and that is where he believes federal resources would be needed.

Hemenway ticked off a number of questions that are ripe for federally-funded study: gun theft, gun training, open carry laws.

“There’s a million,” he said. “You name it. You scratch the surface, we know so little about it.”

“Much of my research focuses on juveniles,” Wallace said, “so I would like to see more research out there on how proposed policies impact juvenile gun access, and how parents educate their children about guns and gun safety.”

Reopening federal coffers for gun research will not solve all of the problems public health researchers face in tackling the issue, but they say it can only help.

“At least it can’t get any worse,” Hemenway said. “There’s only one way to go. It just depends if people really want the science or they want to believe whatever they want to believe about the world.”

Azar’s words may only be a small step in the direction of increased federal focus on gun research, but as a national debate on preventing mass shootings again begins to veer into partisan sniping, hyperbolic attacks, and two sides shouting past each other, researchers see a glimmer of hope that a fact-based, evidence-driven discussion is somewhere on the horizon.

“It’s easy to lie with statistics,” Hemenway said. “It’s a lot easier to lie when there are no statistics.”

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