We Are All to Blame for Texas.

Last week marked the one-month anniversary of the Las Vegas shooting, the deadliest mass shooting in US history. As it happens, I had intended to write a Dean’s Note belatedly acknowledging this milestone. Time can clarify thinking about these events, and I had hoped to produce a reflection less colored by the initial shock of the attack. Then, yesterday, a gunman opened fire on a church in rural Texas, killing at least 26 people, and making a new kind of history—the deadliest church shooting our country has seen. And I find myself, once again, writing from a place of shock.

When it comes to gun violence, it is easy to feel like we are trapped in a cycle. A shooting occurs; there are, for a few days, expressions of grief, and maybe even tentative steps towards reform, like the call to ban bump stocks in the wake of Las Vegas. But then nothing happens, until the next shooting, and the cycle repeats itself. Given the seeming inevitability of this, is there anything left to say in the wake of mass shootings? I would argue that there is. While the pattern of violence may seem unchanging, the potential solutions to this violence also have not changed. There is still much research to be done on gun violence, yet we know enough to point to several measures that could reduce the likelihood of mass shootings, if implemented at the national level. Let me highlight only a few, really only by way of example:

1. Prevent guns from falling into the hands of dangerous people.

According to state-level data, background checks are among the best tools we have to reduce US firearm mortality. A 1995 Connecticut law making individuals who wish to purchase guns first apply for a permit requiring a background check was associated with a 40 percent decline in the state firearm homicide rate. Here at SPH, a team corroborated earlier findings linking local background checks to a 22 percent homicide rate decline. Background checks also enjoy broad public support, having been consistently supported by at least 70 percent of Americans.

We can also reduce firearm mortality through measures that keep guns away from domestic abusers. Firearm-related intimate partner violence (IPV) rates were 14 percent lower in states that made people subject to IPV-linked restraining orders relinquish any guns in their possession. It is heartbreaking to consider the difference such laws could have made in Texas, where the shooter had been court-martialed, in 2012, for assaulting his wife and child. Such a person should never have had a gun in the first place.

2. Widely adopt ballistic imprinting/microstamping. Promote “smart gun” use.

Laws that require gun identification through the use of ballistic fingerprinting or microstamping could significantly mitigate firearm mortality. Smart guns—weapons designed so that they can only be fired by an authorized user—could make guns less dangerous, while respecting Americans’ right own them for protection and sport.

3. Repeal concealed-carry laws.

We can reduce firearm deaths by rethinking concealed-carry laws. A recent American Journal of Public Health study co-authored by Michael Siegel, Ziming Xuan, Craig Ross, Bindu Kalesan, and myself compared gun violence rates in states with “shall issue” concealed carry laws with rates in states with “may issue” concealed carry laws. “Shall issue” states are areas where gun permits must be issued whenever the designated criteria for them are met. In “may issue” states, law enforcement authorities can exercise more discretion over whether or not to issue the permits. The study found “shall-issue” concealed carry laws were associated with a 6.5 percent higher total homicide rate, an 8.6 percent higher firearm homicide rate, and a 10.6 percent higher handgun-specific homicide rate.

It is important to note that none of these suggestions challenge the core principles of the Second Amendment. We do not need to limit firearms to limit firearm mortality. We simply need to choose not to have a country where, in some states, buying or carrying a gun is easier than getting a driver’s license, qualifying for food stamps, selling lemonade, or getting a marriage license. We must face the consequences of this permissiveness, in injury and loss of life, and decide, collectively, that it is unacceptable.

In 1958, the systems scientist Sir Geoffrey Vickers published a paper in The New England Journal of Medicine, titled “What Sets the Goals of Public Health.” Vickers argued that public health action is motivated by people deciding that something they had previously accepted as a given is, in fact, unacceptable. For example, it was once widely viewed as acceptable for many people to die from regular cholera outbreaks. This was partly a function of society’s ignorance—since no one knew the cause of cholera, it was possible to dismiss the problem as a sad fact of life that simply had to be lived with. As understanding of germ theory grew, however, and it became clearer that cholera transmission was largely the result of poor sanitation, people began to see that what had seemed inevitable was, in fact, preventable. With this understanding came the awareness that allowing the status quo to continue would constitute a society-wide endorsement of cholera and its effects. Fortunately, governments and citizens declined to make this endorsement, declaring cholera unacceptable, and taking the steps necessary to prevent it.

We face a similar choice on guns. The data are clear. Mass shootings are preventable, and there are policy steps we can take to reduce the likelihood that they will occur. The question is: Will we choose to regard further death and injury as unacceptable? After mass shootings, it is easy to feel that, yes, many Americans indeed think that regular shootings are simply the price we pay for our freedom. Yet I am encouraged by the growing coalition of researchers, activists, lawmakers, gun owners, and the majority of American citizens who support commonsense measures like background checks, who are together working to make the acceptable unacceptable. They know that, as long as we do nothing, we are all to blame each time a mass shooting happens. That is why, as numb as we may feel after these events, we must never lose sight of the fact that we have the power to stop them.

Warm Regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea

Acknowledgements: I am grateful to Eric DelGizzo for his contributions to this Dean’s Note. A version of this Dean’s Note appeared previously in The Boston Globe.

Previous Dean’s Notes are archived at: https://www.bu.edu/sph/tag/deans-note/