Mass shootings are among the most high-profile examples of gun violence in the United States. But every day, firearms take a quiet toll in towns and cities across the country in the form of violent criminal activity, intimate partner violence, accidental injury, and suicide. Approximately 40,000 U.S. deaths—about 109 per day—are caused by firearms each year, according to Centers for Disease Control and Prevention (CDC) statistics.
Despite that deadly tally, there has been no dedicated federal funding for gun violence and injury prevention for more than two decades—until now. In fiscal year 2020, the Labor, Health and Human Services, Education, and Related Agencies appropriations bill included $25 million for gun violence research, split evenly between the CDC and the National Institutes of Health (NIH). The NIH grants were distributed by a variety of institutes, including the National Institute of Mental Health (NIMH). Among the recipients of the CDC and NIH funding are many psychologists who hope to better understand, and ultimately prevent, deaths and injuries due to firearms.
“When this many of our neighbors and family are dying by firearms, it merits attention. But the field has been neglected,” says Andrew Morral, PhD, a senior behavioral scientist at RAND Corporation and director of the National Collaborative on Gun Violence Research. He received a CDC grant in September 2020 to study household firearms ownership and is hopeful this new dedicated funding may be a turning point. “The federal government has a history of starting research programs to address big safety or public health problems such as smoking, HIV/AIDS, and traffic accidents,” he notes. “We haven’t had anything like that for firearms violence, but I think this could be the start of a real flourishing.”
A history of the funding freeze
In 1993, Arthur Kellermann, MD, then at the University of Tennessee, and colleagues published a highly publicized paper that found keeping a gun in the home was strongly associated with an increased risk of homicide by an intimate acquaintance or family member (The New England Journal of Medicineopens in new window, Vol. 329, No. 15, 1993). After the paper’s publication, the National Rifle Association lobbied for the elimination of the CDC’s National Center for Injury Prevention and Control, which funded the study. In 1996, Congress responded by passing an appropriations bill that stated that “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.” In the 1997 budget, the $2.6 million that the CDC had invested in firearms research the previous year was shifted to research on traumatic brain injuries.
The amendment to the appropriations bill didn’t explicitly ban research on gun violence. But its vague wording made it hard for the federal research agencies to know what was and wasn’t allowed. Equivalent language was later added to the legislation that funded the NIH. In both the NIH and CDC, funding for gun violence and injury research ground to a halt—a chilling effect that lasted for two decades. After mounting public pressure to address gun violence, however, congressional leaders clarified in 2018 that the rule applies specifically to gun control advocacy and does not prevent the CDC from funding gun violence research. That clarification opened the door for research awards in 2020.
While some researchers have continued to do work on firearms violence with funding from private foundations or state grants, the lack of federal funding has set the field back, Morral says. An analysis by David E. Stark, MD, and Nigam H. Shah, MBBS, PhD, found that gun violence was associated with significantly less funding and fewer publications than public health problems of a similar scale. While gun violence and sepsis kill about the same number of people each year, funding for gun violence research from 2004 to 2015 was just 0.7% of that for sepsis, and the publication volume was just 4% of that for sepsis. Gun violence was the least researched of the 30 leading causes of death, and the second-least funded after falls (JAMAopens in new window, Vol. 317, No. 1, 2017).
“Private foundations have been keeping the lights on. But this new federal funding is a big deal for the field,” Morral says.
New research underway
Given the dearth of research funding, there are big gaps in our basic understanding of gun ownership and gun violence. “Without a doubt, we’re way behind in this area of injury prevention research. In the field of suicide prevention, the lack of federal funding has hamstrung us for decades,” says Craig Bryan, PsyD, ABPP, director of the Division of Recovery and Resilience at The Ohio State University College of Medicine. “The majority of suicide deaths in the U.S. involve a firearm, yet we know very little.”
Bryan was awarded an NIMH grant to study the mechanisms underlying the association of firearms availability and vulnerability to suicide. He and his colleagues are recruiting both non-gun owners and gun owners, including those who regularly carry a firearm and those who do not. Some of the participants report having been suicidal in the past. The exploratory study will involve interviews, self-report surveys, and behavioral tasks to investigate how participants respond to predictable and unpredictable threats. “The central idea is to study the psychological processes that contribute to people wanting to acquire a firearm,” Bryan says. “We hope this will help us identify where to focus our future efforts so we’re not just stabbing in the dark.”
Many open questions remain about the psychology of gun ownership. But there’s also a lack of understanding about who owns guns in the first place. Morral is the lead investigator on a CDC-funded project that aims to develop gun ownership estimates for various strata of the population, including groups defined by race, age, gender, marital status, and urban versus rural location. Without such basic data about who owns guns, he says, it’s impossible to identify which policy interventions might be most effective for reducing gun violence and injury in specific populations. “Firearms violence and suicide is very disproportionately distributed across different groups,” he says. “We hope to use these estimates to do more sensitive analyses of the effects of different gun policies.”
While the funding freeze hampered basic knowledge on gun violence, it also blocked the pipeline of new researchers entering the field. Krista Mehari, PhD, an assistant professor of psychology at the University of South Alabama, entered graduate school with a plan to study gun violence, but given the challenge of securing funding, her adviser steered her toward studying violence more broadly. As a postdoctoral fellow, she tried again to focus on guns—and again, faculty urged her toward topics with more available grants. “I was delighted when the CDC announced awards in gun injury prevention,” she says. “It felt like an opportunity to finally do the work I’ve wanted to do for a long time.”
Mehari now has CDC funding to study risky gun-related behaviors and the acceptability of prevention approaches among Black boys and young men (the population at the greatest risk of death by homicide with a firearm, according to research) and among older White men (those who studies show are most at risk of suicide). She and her colleagues will begin with qualitative research to understand attitudes and practices around gun use and violence prevention strategies, which they’ll use to develop a national survey. In both homicide and suicide prevention, there has often been a focus on taking away guns, Mehari says. “The problem is, there’s a cultural disconnect between the people who own and use guns and those who are working to prevent deaths completed with the use of guns. That leads to prevention strategies that aren’t ecologically valid,” she says. “The goal of our project is to try to start bridging that gap.”
Gun control remains a hot-button political issue, and other researchers are also seeking common ground between gun ownership and safety. David Schwebel, PhD, a professor at the University of Alabama at Birmingham, and colleagues have a CDC grant to develop and evaluate an interactive website, called ShootSafe, designed to teach children how to engage safely with firearms to reduce the risk of accidental injuries and deaths from guns. “We know children in our country are using firearms for hunting and shooting recreationally, and it’s not realistic to stop that from happening. So how can we use psychological science to reduce tragic accidents?” says Schwebel, whose background is in pediatric injury prevention. “As psychologists, we already know a good deal about how to change behavior. We’re taking what we’ve learned from things like dog bite prevention or poisoning prevention and applying it to the issue of unintentional firearms injuries.”
This type of research would have been impossible a few years ago, he adds. “We could never have done a project of this size and scope without federal funding.”
APA advocacy efforts
Restoring funding for firearms research didn’t come easily. For years, organizations including APA have been engaged in advocacy efforts to support funding for gun violence prevention. The APA Resolution on Firearm Violence Research and Preventionopens in new window, approved by APA’s Council of Representatives in 2014, calls for a science-based public health approach to gun violence research and prevention. In 2018, APA and more than a dozen medical and public health groups partnered with Giffords, the gun violence prevention organization founded by former U.S. Rep. Gabrielle Giffords, who survived a gunshot to the head in an assassination attempt in 2011. The 2018 partnership was forged in an effort to urge Congress to fund research to address gun violence. In 2019, APA CEO Arthur C. Evans Jr., PhD, spoke at a congressional roundtable event about the need for dedicated federal funding for gun violence prevention research.
While those efforts have begun to pay off, APA will continue to take an active role in advocating for support of gun violence research, says Ben Vonachen, senior director of congressional and federal relations at APA. “The $25 million of federal funding is a good down payment in terms of the need, but it gets our foot in the door,” he says. “Through our advocacy efforts with other partners, we’re hoping to build momentum to increase that amount over time.”
Meanwhile, experts say that psychology has much to offer this public health crisis. “With every mass shooting, there is a growing consensus that we need to do something about this problem,” Morral says. “Research is one of those things, and there is a real need for the methodological expertise of the kind that psychologists bring to the table.”
The opportunities for psychological research are wide-ranging, says Mehari. “In many areas of psychology, things have been so heavily researched that to ask a novel question, you need an intensive study design and a lot of resources. Because of the slower momentum in the field of gun violence prevention, there is so much space to ask and answer a lot of important questions,” she says.
The problem, she adds, is urgent. “We’re losing so many people to gun violence, unnecessarily. And there is so much we don’t know.”
