We’ve been covering a lot of medical association news related to the Newtown shooting and gun-related legislation, but that’s because we’re very focused on looking at what research can tell us about reducing firearm injury, and medical associations are closely involved with much of this research.

Just as the American Psychiatric Association issued their remarks last week, the American Academy of Pediatrics sent their own letter, which you can download here, to President Barack Obama and Congressional leaders on December 19.

The organization had published a report on firearm-related injuries affecting children in their journal Pediatrics in October, in which they wrote “The American Academy of Pediatrics continues to support a number of specific measures to reduce the destructive effects of guns in the lives of children and adolescents, including the regulation of the manufacture, sale, purchase, ownership, and use of firearms; a ban on semiautomatic assault weapons; and the strongest possible regulations of handguns for civilian use.”

Unsurprisingly, in their letter to political leaders, they were just as direct regarding policy proposals related to gun control, mental health and children’s exposure to violence:

•    ”New federal firearms legislation that bans assault weapon sales and the sales of high capacity magazines, strengthens mandatory waiting periods and background checks for all gun purchases and promotes strict gun safety policies is a necessary first step.
•    Next, the federal government must take action to improve access to services that meet the mental health and developmental needs of infants, children and adolescents, and ensures that children and families exposed to violence have access to a medical home and other community supports.
•    Finally, we must engage in a national dialogue designed to reduce children’s detrimental exposure to violence in their communities, environments and entertainment.”

We’ll be revisiting the full account of their policy report on firearms for a later blog post, but we also wanted to mention another article with similar recommendations. “Weapons of Mass Destruction,” published in the Archives of Internal Medicine, which is published by the American Medical Association, also offered commentary related to firearm regulation. More »

In the wake of the Newtown shooting, several medical organizations have spoken up about either gun violence itself, firearm safety or about the response of other organizations, such as the NRA.

Since much of the nationwide dialogue after this tragedy has involved discussions on mental health, it makes sense that the American Psychiatric Association issued their remarks. Dilip Jeste, MD, president of the APA, sent a letter December 20 on behalf of the organization to Senate Majority Leader Harry Reid, Senate Minority Leader Mitch McConnell, Speaker of the House John Boehner and House Minority Leader Nancy Pelosi.

The letter, which you can download here, focused on two main points. First, as part of their responsibility to their profession, Dr. Jeste said “psychiatrists stand ready to do whatever we can to help alleviate the suffering caused by the tragedy and to help the survivors cope with life after a trauma of this unimaginable magnitude.”

But more importantly, Dr. Jeste followed that with a reminder that focusing too much on the mental condition of the shooter risks inappropriately increasing the stigma already associated with mental illness. “Stigma remains one of the greatest barriers to early identification, intervention, and treatment for Americans seeking help for mental illness, and we hope that Congress will avoid making generalized assumptions about persons now in or seeking treatment for mental illness,” Dr. Jeste wrote.

After noting that the “vast majority of violence” does not occur at the hands of individuals with mental disorders, Dr. Jeste said that those who do commit the crimes generally are not receiving adequate or appropriate mental health treatment. The statistics he notes are sobering: Public mental health spending has been reduced by $4.35 billion from 2009 to 2012, and 29 states have gotten rid of over 3,200 psychiatric inpatient beds since 2008.

He also brought up an issue which had been in the medical news recently related to doctors’ ability to discuss firearm possession and safety with their patients: “We are also profoundly disturbed by recent efforts in some states to curb or bar the ability of physicians, including psychiatrists, to prudently and confidentially inquire about the presence of firearms in the home when the behavior of their patients warrants such an inquiry,” Dr. Jeste wrote.

An article published in JAMA Pediatrics (formerly Archives of Pediatrics and Adolescent Medicine) provided the history of the Florida law that attempted to prevent doctors from speaking to their patients about firearms, concluding “Dialogue stemming from these questions will help families protect children from multiple forms of harm.”

A few days after sending that letter, the APA spoke up again to express their “disappointment” to the statement by the NRA and specifically the mental health stigmatization that NRA CEO Wayne LaPierre promoted with his comments. The APA wrote in their news release (pdf):

“The association objected to LaPierre’s assumption that horrendous crimes such as the one committed by shooter Adam Lanza are commonly perpetrated by persons with mental illness. In addition, he conflated mental illness with evil at several points in his talk and suggested that those who commit heinous gun crimes are ‘so possessed by voices and driven by demons that no sane person can ever possibly comprehend them,’ a description that leads to the further stigmatization of people with mental illnesses.”

Noting that “only four to five percent of violent crimes are committed by people with mental illness,” Dr. Jeste reminded the press that those with mental illnesses are rarely violent and are much more likely to be crime victims than crime perpetrators. Calling the use of the word “lunatic” by LaPierre “offensive,” Dr. Jeste said, “About one quarter of all Americans have a mental disorder in any given year, and only a very small percentage of them will ever commit violent crimes.”

The letter concludes with a statement from APA CEO James Scully, MD: “The idea that mental illness and evil are one and the same thing is simply a relic of the past and has no place in our public dialogue. People who are clearly not mentally ill commit violent crimes and perform terrible acts every day. Unfortunately, Mr. LaPierre’s statements serve only to increase the stigma around mental illness and further the misconception that those with mental disorders are likely to be dangerous.”

As our organization has been working to uncover research related to firearm injury, we stumbled on to an article published last week in one of the world’s most prestigious medical journals that goes a long way to explain why we’ve found our task so difficult. In short, pro-gun members of Congress successfully gutted any funding into firearm injury prevention starting in 1996 and continuing through today.

Illustration by Svilen Milev

Illustration by Svilen Milev

The article, published December 21 in JAMA (the Journal of the American Medical Association), describes how the Centers for Disease Control and Prevention was silenced in the late 1990s when the CDC lost $2.6 million for research into firearm injury — and that was after Congress members failed to completely eliminate the National Center for Injury Prevention and Control as they had tried to do first.

It was no coincidence that the $2.6 million removed from the CDC’s budget in 1996 happened to be the direct amount previously budgeted for firearm injury prevention research. Though that precise amount was added back into the budget as the bill moved forward, it was “earmarked for traumatic brain injury.” The final bill even included the language “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.”

Such expansive language basically shut down any firearm research at the CDC, lest such research be considered something that advocated for gun control and thereby cost them their careers. And it didn’t stop there. Two years after a 2009 study funded by the National Institute on Alcohol Abuse and Alcoholism looked at the association between risk of firearm assault and carrying a firearm, Congress expanded the funding restriction to all agencies at the Department of Health and Human Services, including the National Institutes of Health.

The article is worth a thorough read to learn just how successfully pro-gun members of Congress and the gun lobby have managed to completely shut down well-funded scientific research into prevention of injury and death related to guns. It’s true that violent crime and gun-related crime has been on a continual decline in the U.S. over the past two decades. But any crime is too much, and it’s reasonable to expect we might have made even more progress had our top public health researchers and health-related government agencies been allowed the opportunity to research how.

We will be gradually updating our website with reports and research related to gun violence both within the U.S. and across the world. This is our first entry of this sort in which we’ve summarized a UN report on murders across the world.

Photo by Mateusz Stachowski.

Photo by Mateusz Stachowski.

You can download the pdf here of the global study on homicide, commissioned by the United Nations Office on Drugs and Crime in 2011. This study seeks to provide a global overview of homicides by using a comprehensive collection of cross-national and time series homicide statistics. The statistical evidence and analyses in the study are meant to increase our understanding of the trends and patterns of homicide. The goal is to use the data to help develop effective policies that would curb lethal violence and its side effects.

Two conclusions the authors determined regarding firearms based on the data:

  • A significant body of research indicates that firearm availability predominantly represents a risk factor rather than a protective factor for homicide.
  • Countries in the Americas show a strong correlation between homicide rates and the percentage of homicides by firearms.

Things to note before reading study

  • For the purposes of the study the term “homicide” refers to “intentional homicides” in which the perpetrator intended for their actions to cause death or serious injury. This EXCLUDES: deaths related to crimes of passion, deaths related to negligence or recklessness by the perpetrator as well as deaths that were considered justifiable such a self defense.
  • The term “The Americas” refers to a region of multiple countries in both North America and South America. The data from the United States is included in the data for this region. When referring to Northern America, they mean Bermuda, Canada and the United States. More »

On Friday, December 21st (just after a a Pennsylvania man shot and killed three individuals, wounded three State Troopers, and then killed himself) Wayne LaPierre, CEO of the National Rifle Association, delivered a prepared statement regarding the school shooting in Newtown, Conn. A complete transcript of the statement is available here, but the video of LaPierre’s remarks better reflects his disposition, and the mood in the room.

Parents Against Gun Violence have issued our this response to the NRA statement:

“NRA CEO Wayne LaPierre identifies violent video games and inadequate mental healthcare as contributing factors to school shootings, and concludes with a call on Congress to place armed guards in every school in the country. He says ‘The only thing that stops a bad guy with a gun is a good guy with a gun.’ Unfortunately, the armed campus police force at Virginia Tech were unable to stop Seung-Hui Cho from shooting 59 people there; the armed school police officer Neil Gardner was unable to stop Eric Harris and Dylan Klebold from killing 13 at Columbine. And at Fort Hood, 40,000 American soldiers were unable to stop one man with a handgun before he had shot 42 people. The idea of armed guards protecting schools is not a new one; it has been tried and it has proven ineffective against well armed murderers. We are not opposed to guards in schools, but we believe a more comprehensive solution is necessary.”

Below is the video of the NRA statement:

On an episode of Meet the Press that aired Sunday, December 16th, two days after the Newtown shooting, Senator Dianne Feinstein announced that she would bring a new assault weapons ban to the floor in 2013. Feinstein was one of the authors of the 1994 assault weapons ban, which expired in 2004.

The rationale behind such a ban would be to reduce access to the types of gúns that would make it easy for one person to kill many people quickly. The 1994 ban placed restrictions on firearms that had certain characteristics of military weapons—for example, rifles with bayonet lugs, flash suppressors and pistol grips. Some gun enthusiasts derided the 1994 ban as a “cosmetic ban” because it prohibited certain guns that looked dangerous, while allowing other, equally deadly weapons to remain legal.

Whether you support Senator Feinstein’s bill or not, it’s important to understand what she proposes to ban, and it would be easier to assess the relevance of such a ban if the bill logically differentiated among weapons based on their capacity to kill. Most Americans know enough about guns to have formulated at least a vague opinion about what should and shouldn’t be legal. Through popular television programs, movies and video games, even people who have never fired a gun have developed some notion about the difference between, say, an M-16 and a snub-nosed revolver. But there are a huge variety of guns sold on the civilian market in the U.S., many of which are not well understood by the general public. This overview, while not comprehensive, is designed to clarify the significant differences between various types of firearms, with an emphasis on the weapon’s potential to kill many people quickly.

Much of the recent debate about which guns to ban has emphasized differences between handguns and rifles. That distinction is more complex than it might seem. We think of handguns as smaller weapons that shoot smaller bullets1. But some pistols have the same caliber, rate of fire and capacity as military rifles. At close range, specialized handguns can be as effective as rifles, either when used for hunting or when used to inflict mass casualties. In 2007, Seung-Hui Cho shot 49 people (32 fatally) at Virginia Tech, armed only with handguns.

A semiautomatic handgun with a high-capacity magazine. Photo © Matt Valentine

A semiautomatic handgun with a high-capacity magazine. Photo © Matt Valentine

Rather than focus on the size of the gun, I’d like to highlight two more relevant factors that make some guns more lethal in mass shooting scenarios than others, which are A) rate of fire and B) capacity. Any gun can be deadly, but all other things being equal, a gun that can fire rapidly for a sustained period without needing to be reloaded clearly has the potential to kill more people than a gun that can only be operated with frequent pauses. More »

Below is a clip from “Meet the Press” in which Senator Dianne Feinstein announces she will re-introduce a bill related to gun ownership when Congress reconvenes.

Visit NBCNews.com for breaking news, world news, and news about the economy

The full-length video of President Obama’s Memorial Address to the Newtown shooting is below.

The transcript of the speech can be read here.

The Newtown, CT, killings of Friday, December 14, 2012, constitute the second worst mass shooting in US history, and have the dubious distinction of doubling the death toll from the Columbine High massacre. At the same time, they form part of a pattern: mass killings are on the rise in the US; five of the 11 deadliest killings in the US have happened since 2007.  And children in the US are threatened not only by high-profile, headline-grabbing incidents of mass violence.  Over 31,000 people in the US died from firearms-related incidents in 2009, 1,337 of them children.  A 1997 study by the Centers for Disease Control found that “the homicide rate for children in the United States was five times higher” than that for children in 25 other high-income countries combined.

This is unacceptable.  As parents, as a coalition of adults who care for children in one of the richest, most developed countries in the world, we have to stand up and say that we can do better as a society.  Every one of our children deserves the right to graduate from high school, to choose a career, to have their own children, to grow old.

We are conservatives, liberals and moderates, gun owners and non-gun owners. What unites us is a conviction that there are many common-sense policies that can reduce gun violence, and especially the risk of harm to children.  For too long, the debate has been captured by a polarized, all-or-nothing struggle.  It is time for the debate to change.

Hours after the Newtown, CT, killings, a coalition of parents and concerned adults across the US started informal discussions on Facebook.  The outcome is this group.  We are committed to:

  • Advocating a re-centered debate, focused on policies that scientific evidence and reasoned dialogue show have the greatest potential to reduce firearm-related deaths among children.
  • Finding and disseminating scientific, peer-reviewed research on the causes of gun violence and gun accidents, and on how to reduce both.
  • Advocating for policy change.  We will focus on the kinds of policies that we believe can build support across the political spectrum, policies supported by evidence and debate.

If you share our goals, we invite you to join us.  We are hopeful that there are tens of millions of American parents and other concerned adults who can find common ground for dialogue, and practicable policies that can make our country safer. Let’s talk about what policies have the greatest chances of reducing the likelihood of a tragedy like the Newtown, CT, shooting from ever happening again. And then let’s demand that our elected representatives make these changes.

If you are interested in this group, please find us on Facebook, or email admin [at] parentsagainstgunviolence [dot] com.