Gun Violence
if they believe they are following existing restrictions,
their funding could be pulled.”
A 2017 study published in JAMA showed that, com-
pared with funding for and publication of research into
other leading causes of death, funding and publication
of gun violenc e research were disproportionately low. 10
The authors analyzed mortality statistics from the CDC
between 2004 and 2014 to determine the top 30 causes of
death in the U.S., then performed two linear regression
analyses to determine if mortality rate correlated with
funding or publication count.
If mortality rate was an accurate
predictor of funding and publication,
the researchers predicted gun violence
research would have received $1.4
billion in funding and 38,897 pub-
lications during the 10-year period.
However, it received only $22 million
in funding and 1,738 publications –
or 1.6 percent and 4.5 percent of the
predicted figures, respectively. Overall,
gun violence was the least-researched
cause of death and the second-least
funded cause of death after falls.
“We’re spending and publishing far
less than what we ought to based on
the number of people who are dying,”
said lead author David E. Stark, MD,
MS, from Icahn School of Medicine at
Mount Sinai in New York, in a news
release discussing the study. 11 “Research
is the first stop on the road to public
health improvement, and we’re not
seeing that with gun violence the way
we did with automobile deaths.”
In September, the National Insti-
tutes of Health (NIH) quietly let lapse a
program funding research into firearm
violence and its prevention, known as
the Research on the Health Determi-
nants and Consequences of Violence
and its Prevention, Particularly Firearm
Violence program. 12 Launched at the
urging of President Barack Obama
following the mass shooting at Sandy
Hook Elementary School, the program
ran from January 2014 to January 2017
and cost $18 million to support 22
projects, such as investigating how to
implement gun safety counseling by pe-
diatricians to prevent youth suicide.
The action gained new public atten-
tion following the shooting at the Heart-
land Music Festival, when 26 U.S. sena-
tors wrote NIH Director Francis Collins,
MD, PhD, asking for the program’s
renewal. According to Science magazine,
the decision to let the program’s funding
lapse came after the election of Presi-
dent Donald Trump, whose campaign
received $30.3 million in 2016 from the
National Rifle Association.
In response to the report, NIH Prin-
cipal Deputy Director Lawrence Tabak,
DDS, PhD, stressed that “we haven’t
stopped funding work in this area, and
we intend to continue funding work in
this area.” He identified two multi-year
grants issued since the program was
shelved, totaling $1.4 million in funding
this year alone, that are supporting the
114
ASH Clinical News
development of a web-based tool for firearm suicide preven-
tion and the creation of a database of childhood firearm
injuries. 12
“The absence of knowledge about this issue is sort of
insane,” said Dr. Radich. “What other major problems do
we have in the U.S. where we lose thousands of lives, but
refuse to look into the causes or solutions?”
“ASH supports expanding resources in the NIH,
CDC, and other agencies … increasing research support
and reducing restrictions on the support [across all areas
of investigation,” Dr. Hoggatt clarified. “Research is not
advocacy; it just provides a service to help everyone make
informed decisions.”
Taking Action
Physicians who want to promote firearm safety have
many avenues within and outside of ASH or any medi-
cal association. ASH has an advocacy arm to support
issues important to its membership. “If gun safety is an
issue important to you as an ASH member, reach out
and contact ASH leadership or its government affairs
committee,” Dr. Hoggatt said.