Guns, like cars, are a major cause of deaths and injuries in the United States, especially for young people. Motor vehicle crashes have been a leading source of mortality and injury in people ages 15 to 24 since at least 1950. Guns are involved in the majority of homicides and suicides, which are the second and third largest causes of death in young people. Motor vehicles and guns are, together, the source of the majority of fatalities in young people in the United States.
Yet we know so much more about deaths in young people caused by motor vehicles than guns. For nearly 20 years, Congress has prohibited the Centers for Disease Control (CDC) from conducting research that “may be used to advocate or promote gun control.” And in June, the House Appropriations Committee rejected an amendment that would have permitted such gun-violence research.
While total gun fatalities have remained largely level since 2000, total deaths due to vehicles have declined. The largest drop in motor vehicle deaths, more than 25 percent, has occurred since 1980. If current trends persist, the total of motor vehicle crash deaths will soon drop below the number caused by guns.
Why have we been able to reduce the harm from motor vehicles but not from guns? First, we have worked hard to make cars safer. Seat belts, air bags and other technological changes have made car accidents less likely to result in the loss of life.
We also have increased awareness of the hazards of driving under unsafe conditions. Penalties for drunk driving have increased dramatically since 1980. Successful campaigns to reduce drinking and driving have helped to raise awareness. In addition, states have instituted new graduated driving regulations that make it harder for adolescents to obtain a license without a period of training with an adult.
In sharp contrast to our success with vehicles, FBI data show that mass shootings have increased over the past decade, school shootings continue at an alarming rate and the overall mortality rate attributable to guns shows little sign of declining since 2000.
Some argue that the problem of gun violence is lessening. Gun fatalities have in fact declined by more than 25 percent since their peak in 1993, and although mass shootings have increased in frequency, they account for only a small proportion of the gun violence problem.
Despite that, overall rates of gun injury remain higher today than they were in the 1960s, when violence rates began the climb that led to their peak in 1993. The same cannot be said about motor vehicle crashes.
Our failure to further reduce gun fatalities is surprising for several reasons. We have much better trauma care than we did in the 1960s, saving many more lives from gun injuries as well as car crashes. So, just from our sheer ability to prevent fatalities, we should have seen a reduction in gun fatalities since 1960.
Finally, we have reduced rates of other major sources of mortality, such as heart disease, by encouraging behavior that reduces the risks, such as better diets and greater use of medications. Why haven’t we been able to do the same with guns?
I suggest that one factor that contributes to our failure to do more to reduce gun violence is the absence of knowledge about how to do it. We know a lot about what leads to motor vehicle crashes. Years of research conducted by the National Highway Traffic Safety Administration (NHTSA) tells us about the conditions that lead to crashes, including the person using the vehicle, the road conditions when the accident occurred and the events precipitating the crash. This knowledge has led us to build better vehicles, develop better training in how to use them and pass laws against behaviors that raise the risk of fatalities.
If we examine what our law enforcement agencies tell us about gun injuries, we get a confusing picture. As a point of comparison, a recent report from the Department of Justice reviewed the state of gun injury in the U.S. It shows dramatic drops in gun deaths since 1993 across the U.S., reductions in reports of violent encounters, and overall declines in crime. All of this information is reassuring, but it doesn’t tell us why those declines occurred, why we still have the highest rates of gun injury in the developed world and why those rates are higher today than in the middle of the last century.
Buried in this same report is disturbing evidence that gun injuries, rather than fatalities, have actually risen in the last decade. This evidence is based on a survey that was started in 2000 to monitor emergency room visits for injuries in 100 hospitals across the country. These hospitals record the reason for an injury, including whether it was gun-related. In a typical year, the survey projects about 60,000 visits related to gun injury, most of which are attributable to assaults.
The Department of Justice does not make much of this inconsistency, other than to note that these visits represent a different slice of the problem. But this does not lead us to a solution. If we are to reduce gun injuries and deaths, we will need accurate and useful data about the extent of this problem, who is likely to be affected by it and the conditions that precipitated the injury, data we have had for cars for a long time. Isn’t it time we gave the Department of Justice and the CDC the mandate to figure this out?