Strict gun control is popular

Unfortunately, public opinion doesn't matter when it comes to one of America's greatest public health threats.

Abortion is not the only “culture wars” issue at stake this November. Let’s talk about gun control.

Like abortion, where vote after vote shows a substantial majority of Americans back women’s right to control their own bodies, a solid majority of Americans support stricter controls on gun ownership. Recent proposals with strong public backing (but went nowhere in Congress) include a ban on bump stocks and automatic weapons; universal permitting and background checks; and a national red flag law, which would give federal law enforcement agencies the right to take guns away from persons deemed a threat to themselves or others.

When asked in general about whether they favor stricter gun control laws, 56% of Americans say yes, according to the latest Gallup poll. When asked about specific measures, 90% support background checks for all gun sales; 80% back preventing people under 21 from buying any type of gun; and 59% want a ban on the manufacture, sale or possession of semi-automatic rifles.

Like abortion, there’s a substantial gender gap in support for stricter laws with 62% of women in support compared to 51% of men — still a majority. That due in part to the fact that some Republicans as well as nearly all Democrats back stronger regulations. Nine in ten Democrats support stricter gun laws, but so do one in three Republicans.

Overall support for gun control has fallen about ten percentage points since 2022 when, in the wake of the Uvalde school shooting in Texas where 19 children and two teachers died, support jumped up to 66%. A similar jump and then a fallback occurred after 2017 when a lone 64-year-old gunmen with a bump stock-enhanced rifle killed 60 and wounded 413 (with another nearly 500 injured in the ensuing panic) at a Las Vegas music festival. Bump stocks allow a shooter to fire bullets at a rate as high as 400 to 800 rounds per minute.

Apparently some Americans need constant reminding that allowing individual citizens to own weapons of war isn’t a good idea. Unfortunately, it is the law of the land as interpreted by the current U.S. Supreme Court.

On June 14 of this year, the high court in a straight 6-3 party-line vote ruled the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) did not have the authority to classify bump stocks as machine guns. It overturned an ATF rule that was based on a law, signed on May 19, 1986 by then-president Ronald Reagan, that banned individual ownership of machine guns manufactured after that date.

Congress wanted to restrict the availability of machine guns “because they eliminated the need for a person rapidly to pull the trigger himself to fire continuously,” Justice Sonia Sotomayor wrote in her dissent. “A bump stock serves that function … The majority eviscerates Congress’s regulation of machine guns and enables gun users and manufacturers to circumvent federal law.”

So it goes in a country where public opinion doesn’t matter and the Supreme Court can ignore Congressional intent with a few keystrokes on a word processor.

The public health consequences

The ubiquity of guns is taking a devastating toll on the American people. Last year, and for the past decade, more people died from gun violence than from traffic accidents.

More than half of the 42,000 deaths from guns last year were self-inflicted. In 2019, the U.S. had a highest suicide rate among the world’s ten wealthiest nations. Its 14 successful suicides per 100,000 population even exceeded the 12.8 average for the 36 member states of the Organization for Economic Cooperation and Development.

In large part that’s due to the U.S.’s higher success rate. Only 5% of suicide attempts in the U.S. involve guns, but they result in over half of suicide deaths. Why? Suicide by gun is successful about 90% of the time. Suicide attempts by drugs, knives or other means are rarely successful.

When discussing suicide, the media showers attention on high levels of mental distress, especially during the pandemic; teenage suicides; and the deaths of despair among working class whites suffering from economic dislocation, opioid addiction, hopelessness and social isolation. It rarely mentions that non-college educated whites are twice as likely as college-educated whites to own a gun or the incredible success rate of guns as a suicide tool.

Does policy make a difference?

Among states, there is a direct correlation between suicide rates and gun ownership. Montana, Wyoming and Alaska, which have the highest rates of gun ownership in the U.S., also have the highest suicide rates. New Jersey, Hawaii and Massachusetts, which have the lowest rates of gun ownership in the U.S., have the lowest suicide rates.

The failure of Congress to enact meaningful firearms controls has left in place a patchwork quilt of state regulations that are generally ineffective at preventing any illegal use of guns, whether in suicides, mass shootings, domestic violence or inner city mayhem. Gun trafficking remains rampant, whether at poorly regulated gun shows or between states.

Photo by Heather Mount on Unsplash

My own city of Chicago, which routinely makes national and international headlines for its gun violence despite being ranked only 11th for gun deaths among America’s 35 largest cities, has fought a fruitless battle to limit the guns pouring in from out-of-state. A 2017 study showed 60% of guns used in Chicago’s violent crimes came from beyond its borders with 20% coming from just across the Indiana state line, whose capital Indianapolis has a significantly higher gun violence death rate than Chicago.

However, a new study in JAMA (the Journal of the American Medical Association), which was released yesterday, shows that different policies at the state level can make a difference, at least for some of the factors contributing to the gun violence epidemic. Some restrictions on gun owners succeed at protecting human life while some so-called freedoms are directly contributing to the rising death toll.

The study by Terry Schell and colleagues at the Rand Corp., which was funded by Arnold Ventures and the National Institutes of Health, analyzed the impact of 10 different types of state regulation of firearms to see which ones had the greatest impact on mortality, for good or ill. They restrictions included background checks for purchase from dealers; background checks for private sales; prohibited individuals younger than 18 years from owning guns; extending the prohibition to those under 20; a 24-hour waiting period before consummating a purchase; a 7-day waiting period; and firearm storage restrictions to prevent child access. The added freedoms included eliminating discretion in granting concealed carry permits; allowing concealed carry without a permit; and passing stand-your-ground laws that reduce legal liability when using lethal force in self-defense.

The study found that most policies on their own did little to change the overall death rate from gun violence. Child-access prevention laws, which include preventing minors from buying guns and home gun safety regulations, reduced the overall death rate from firearms by 6%. Giving gun owners greater freedom to fire away (stand your ground and concealed carry laws) increased the gun death rate by 6%.

But then Schell and colleagues ranked states by how restrictive or open they were for gun owners or potential owners and compared their respective gun violence death rates. It showed the most restrictive states had a 20% lower death rate than the most open states. If every state in the nation had adopted the most restrictive gun control laws and not passed open carry or stand your ground laws, the authors estimated the U.S. would have experienced 70,000 fewer gun deaths between 2010 and 2020.

While it’s hard to imagine many red states adopting such policies, a second study in JAMA showed adopting one policy at a time, which is often the tactical approach taken by gun control advocates, may not be as effective as the advocates hope. Michael Siegel of the Tufts University School of Medicine compared state gun violence death rates in states that had adopted universal background checks, permit requirements, both policies, or none.

Universal background checks at the point of sale failed to reduce firearm homicide rate, he found. But laws requiring a state permit for anyone who wished to purchase a firearm was associated with an 18.3% reduction in the firearm deaths.

“Unlike point-of-sale background checks, the requirement to obtain a permit to purchase a firearm generally requires interaction between the prospective buyer and law enforcement,” Siegel wrote. On the other hand, “background checks at the point of sale may require only a federal database check. Gun permits require checks of state databases, which are more sensitive in picking up non-felony crimes that are prohibitive for firearm ownership like domestic violence misdemeanors, stalking offenses, misdemeanor violent crimes, and restraining orders.”

“Combining universal background checks … with a permit-to-purchase requirement for all firearms could be an effective strategy for reduction of firearm-related fatalities,” he concluded.

Of course, all these state comparisons may only reflect reverse causation: states with already low gun fatality rates may be the ones most likely to adopt strict background check and gun permitting laws. That’s why strong national legislation is needed. Someone has to care about the innocent and suicidal folks living in states whose leaders seem not to care about their mounting gun death tolls.