Kim Mills: For much of the past year, the coronavirus pandemic overshadowed another public health challenge in the United States, that of gun violence. But gun violence did not go away. The nonprofit Gun Violence Archive, which tracks gun deaths and injuries, estimated that guns killed nearly 44,000 Americans in 2020, 24,000 of them by suicide. That’s the highest number of annual gun deaths in the past two decades. And in March and April mass shootings in Atlanta, Boulder, Colorado, and Indianapolis catapulted gun violence to the forefront of the national conversation yet again.
What do we know about the causes of gun violence in the United States? Why is it rising now? Who is most at risk of committing gun violence or of being a target? And on this politically polarized issue, can research offer any insight into effective prevention strategies and hope for solutions?
Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I’m Kim Mills. Our guest today is Dr. Susan Sorenson, a professor of social policy, and health and societies, at the University of Pennsylvania, where she directs the Ortner Center on Violence and Abuse. She holds a PhD in clinical psychology and has an interdisciplinary background in epidemiology, sociology, and psychology. Her research focuses on the epidemiology of the prevention of violence, including gun violence. She has a particular interest in the role guns play in violence against women and in guns as a consumer product. She also served on a panel that developed APA’s 2013 report on gun violence prediction, prevention, and policy.
Thank you for joining us today, Dr. Sorenson.
Susan Sorenson, PhD: Thank you. I appreciate your interest in this issue and appreciate your invitation to be joining you today.
Mills: Great. Well, let’s start by talking about mass shootings that have been in the news quite a bit in the past couple of months, but they’re responsible for only a small percentage of gun deaths in this country. What are the main drivers of gun deaths in the United States?
Sorenson: The most common type of gun deaths in the United States is a suicide. As you noted, there are about two suicides for every homicide, but we tend to focus on the criminal uses of guns. And when somebody thinks about gun violence, they tend to think of homicides. In 2019, the most recent year for which we have national data, there are about 14,000 homicides. The next most common type of gun death were shootings by police. And there were 520 that were marked as that. And then the accidents or what public health people call “unintentionals,” there are about 486, and those that they couldn’t really determine what the nature of the death was or what the intent was were about 346. So overwhelmingly it’s an issue of suicide.
Mills: Well, let’s move to gun violence as a public health issue. What exactly does that mean? And why is it important for how we think about prevention?
Sorenson: Looking at guns as a public health issue is really important for a couple of reasons. One is it takes a consumer product approach. How do we prevent this? Let’s look at the gun itself. Let’s look at its design. Let’s look at its manufacturer. Let’s look how it’s advertised. Let’s look at how it’s distributed, how it’s sold. And then finally let’s look at the purchaser and the user. And almost all of our policies focus on that user component. We’d spend very little effort and energy looking at what we would call more upstream sorts of issues. And that’s in no small part because guns were specifically exempted from the Consumer Product Safety Commission Act of 1976. They were the only consumer product that was treated like that. So we don’t have any safety regulations on guns. To continue this just a bit more, when we talk about a public health approach, we’re talking about population, we’re talking about policy and we’re also talking about prevention as opposed to a more criminal justice or after-the-fact approach that focuses on the individuals and on how to treat and intervene after the fact.
Mills: Do you think that the increasing visibility of mass shootings has changed the way people fear gun violence in their everyday life?
Sorenson: Yes, definitely. Going about our basic activities it’s really important to feel safe. And we’ve had mass shootings at schools, movie theaters, concerts, supermarkets, work, nightclubs, places of worship. These are things that we do every day, just as a regular routine and as a regular matter. And yes, that fear of we’re not safe just doing our lives, has crept in. And I think it does change people’s behavior. We don’t have lots of solid research on it, but this is even cocktail party conversation of what it does. People in the past, I think, would try to avoid certain neighborhoods that they thought were risky or certain circumstances that they would think are risky, but this feels different. The mass shootings make it feel random or that it could happen to anyone. So that lack of control or that lack of ability to protect oneself makes people very, very uneasy.
Mills: So even though the likelihood of becoming a target of a mass shooting is small, it’s the fact that it’s so mundane now, it happens anywhere.
Sorenson: Yes. Yes. That’s well-put.
Mills: So gun sales are at a record high for the second year in a row and include many first-time gun buyers, according to recent news reports. What drives gun sales among both first-time owners and those who already own guns? And do you think this is a temporary spike or might this be a continuing upward trend?
Sorenson: Who will be able to know if it’s an upward trend? Only after we have a trend and after we have time. I too wish I had a crystal ball and could figure that out. But you make a really important point that people have bought a lot of guns. At the beginning of the pandemic people bought a lot of toilet paper. They also bought a lot of guns, and that has continued. It’s really remarkable that our gun sales used to peak right after mass shootings. And now 9 of the 10 highest weeks for background checks in the United States are since the pandemic began.
And within those 10 weeks, Americans—there have been background checks on nearly as many guns as are sold in an entire year for the highest years that we’ve ever had guns. So there has been just a surge in gun purchasing and it’s come around mass shootings, such as the Atlanta spa shooting and then the Colorado supermarket shooting. Sandy Hook is still in there in the top 10. But aside from that, it’s been when COVID first hit and there was a stay at home order, the week of the insurrection in January, around the elections, around political unrest, around the federal election last fall. So it’s an indication that there’s a lot of unrest and fear that people are trying to manage.
Mills: What’s interesting though, since we’re all kind of been locked down for a year, that people feel that they need guns to protect themselves when they’re not even going out to potentially dangerous places. It’s just puzzling.
Sorenson: But I think that’s what’s going on here and that’s what’s been posited as driving gun sales for quite a long time. It’s a fear, because even while gun deaths from crime were at low, low rates, lowest they had been for 40 years, people were buying more and more guns. I think that fear is driven in no small part by a lack of confidence in the government and the lack of trust in information sources and the lack of trust of one another. We don’t have research on that because it’s a really hard stuff to research, but that sense of, “I don’t know what’s going to happen. I’m fearful. I need to protect myself. I need to protect my family.” And this is a step that people take to try and buttress up that feeling.
Mills: So you talked about the lack of research, and I know for many years the Centers for Disease Control and Prevention didn’t fund gun violence research, but that is now beginning to change. How has the lack of research affected the field and do you think the recent changes will make a difference anytime soon?
Sorenson: There’s so many important issues that we don’t have answers to. The researchers in the field of gun violence had been sort of caught in this catch-22, because, “Well, what’s the answer to that?” “Oh, you don’t have the answer. We can’t do policy without the answer, but we’re not going to fund the research.” But I think the most devastating thing has been that we have missed the opportunity to train the next generation of researchers. We have missed an entire cohort, an entire generation of researchers who can carry this field forward, again, focusing on the firearm, not on the user, not on the criminal justice system and the processing, but actually to take that approach that might prevent and reduce gun deaths.
Mills: In 2013, as I mentioned in my intro, you were part of an APA task force that wrote a report on gun violence prediction, prevention, and policy. You wrote about policies to counteract gun violence at every level of the lifespan, the gun lifespan, from design, to manufacture, to sales, to use. What are some of the policies that have been effective and what are others that have not been as effective as we might’ve hoped?
Sorenson: I have to preface my response with the reality of, it’s extremely difficult to do research in this area—in no small part because we can’t do experiments, generally, which is the gold standard in research. You can’t randomly assign people to have a gun or not have a gun and then just wait to see what happens. That just would be completely unethical. And also we lack access to very basic information. And that has been precluded in some cases by federal law, by policies that agencies put in place and sometimes by state law. So we can’t get information on the number of purchasers, on any sort of ongoing basis. We have a really hard time getting access to data. And like I said, it’s sometimes precluded by laws. So the information that we want can be had in some of those data sources. So I think that’s what needs to be done and to have more access to the data, as well as the financial resources to actually study it.
But you asked about specific policies and I’ll just offer a couple of ideas. One is a general statement, and that is that the U.S. population is in substantial agreement around a lot of gun policies, but Congress fails to act. And if our representative democracy were working better, I think a lot of the gun policies such as universal background checks, keeping guns out of the hands of people who shouldn’t have them, would be more in place. One thing I would like to point out as something that appears to be working is keeping guns out of the hands of abusers. And we have some evidence that some of those laws are effective in reducing the homicides that are due to domestic violence.
Mills: So this is the red flag law concept where people will be tagged as having had a history of violence and therefore cannot just walk into Walmart and buy an automatic rifle.
Sorenson: Yeah, and the red flag laws are just in the process of being evaluated because they haven’t been in place very long. And just so you know, nobody can go in and buy an automatic rifle, semiauto, yes, but we haven’t allowed automatic weapons for quite a while. And maybe that’s worth mentioning too. The Valentine’s day massacre in 1929, there were seven men shot during that, and they were using machine guns. And shortly after that, we passed a federal law saying, “We’re not going to allow civilians to have machine guns.” And since then, just in the past few years, we’ve had the Harvest shooting in Las Vegas, we’ve had the Pulse nightclub shooting, we’ve had the Charleston Church shooting, we’ve had all of these others and with many, many deaths and Congress has failed to act. They’ve failed to act. When they acted very quickly after the 1929 Valentine’s day massacre.
Back to the issue of the red flag laws. They have been relatively recently implemented in several states and they’re in the process of being evaluated. And we do know that some of the other laws that are related to violence against women, and that were part of the Violence Against Women Act and the subsequent Lautenberg Amendment, have to do with keeping guns out of the hands of those who have been convicted of a misdemeanor of domestic violence and those who are subject to a protection from abuse order. It’s a civil remedy that’s available in all 50 states, called a restraining order in some places, and they go by different names, but those appear to be having some effect.
Mills: In 1994, Congress did enact a 10-year ban on the sale of assault weapons to civilians. And what I’ve been seeing lately is reports that the ban didn’t really have an effect on the rate of gun homicide. Is that correct?
Sorenson: That’s correct. Because the assault weapons are the kinds of guns that are used more in public mass shootings. The more private mass shootings, if you will, such as those that occur in the home when a man, typically a man kills his wife and children or other family members, and then sometimes kills himself, those are most often carried out with handguns. Most of our homicides and most of our suicides are with handguns. So banning a certain type of weapon such as those that are called assault weapons or assault rifles might affect one type of gun violence such as the public mass shootings, but not necessarily all of the others.
Mills: So much of your research has focused on how guns factor into intimate partner violence, not only increasing the risk of death by an intimate partner, but as a tool of coercion, even when they’re not fired. Can you talk about that research?
Sorenson: I’d be happy to. In some of the research that we did here in Philadelphia, working with the police department, and we got all 911 calls for domestic violence for the city in an entire year. And about 35,000 of those were what we called intimate partner violence. Guns weren’t used very often, but if there was an external weapon used, by that I mean a bat, a knife, a brick, a gun, not hands, fist and feet, but an external weapon, about a third of the time, it was a gun, a gun was involved. And when a gun is used in an intimate partner violence incident, it’s most often a man using it against a woman.
About 85% of the time it’s male on female. The other 15% are female on male, male on male, female on female. So I am going to use gendered pronouns here because that’s what the research indicates. And when the man uses a gun against a woman in an intimate partner violence situation to which police have been called most often it’s to threaten her, to instill fear, it’s not to shoot her, shoot at her or pistol whip her. And that’s important for several reasons.
One is that in state law in Pennsylvania, as it is in many laws, police use visible injury as the indicator as to whether or not an arrest is merited. So when they go and there’s no visible injury to her, they’re less likely to make an arrest. So the abuser has been able to use a gun to harm someone, to frighten someone, to terrorize someone, but without any particular consequence. Also, those who had used a gun in an incident were more likely to be gone by the time police arrived. So they were more likely to flee the scene. So they were harder to bring into the criminal justice system in the first place. And women who had had a gun used against them in this way had astronomically high levels of fear, much higher than those who had been beaten, or had a knife used against them or anything like that. So using a gun against an intimate partner changes the nature of that relationship. And it changes the nature of the climate and the atmosphere in the home. Oftentimes children are witness to this.
So one makes an assessment, just like we would if we were in the street and someone approaches with a gun and said, “Give me your money.” We might acquiesce. We might back down and say, “Is there some other way we can handle this?” We would give them their money. We’d give them whatever they asked for. Whereas if somebody came up with a clenched fist, we might run away, we might try to resist, we might try to escape in some way. But a gun just changes the nature of the situation. So we make an assessment that there’s a credible threat, that it’s realistic and then we change our behavior accordingly. And that’s what happens in the home. That’s what happens in the home. And my concern in addition to that experience is that the coercive use of a firearm sets up a context for ongoing abuse and for chronic abuse, because she’s going to be fearful of leaving because he has a gun. And when we know that when a woman leaves the relationship, that’s when she’s at highest risk of being murdered by her partner.
Mills: Are there potential remedies to this situation?
Sorenson: We have some good laws in place on the federal level. And many states have what’s called enabling legislation that basically mirrors that such that those who have been convicted of a misdemeanor domestic violence, or have a domestic violence restraining order against them, are not allowed to purchase or to possess either a firearm or ammunition. So we’re pretty good at the purchase part because if that information, that locality entered into their state database and that is reported up to the Feds, because the FBI does background checks for most of the states, not all, but most, then you can catch those people who have those misdemeanor convictions for domestic violence or a domestic violence restraining order.
We’re not so good though about the possession part, because it requires the abuser to relinquish any firearms that they have in their possession. And mostly what we have to do is go on that person’s word, because we don’t have a registry of guns. We don’t know if that person has guns. So we’re put in the sometimes untenable position of simply taking the abuser’s word that they don’t have guns.
Mills: I’m going to ask you a political question, just to prep you for this one, one large factor in Congress’s inability or unwillingness to enact restrictions on the sale of firearms and ammunition has been the power of the National Rifle Association. And there’s been a lot of publicity lately regarding problems within the NRA, from financial issues to a lawsuit in New York, to the alleged misspending of funds by NRA’s Wayne LaPierre. In your view, are these problems weakening the NRA and might that make it more likely that we will see some real policy changes regarding guns and ammunition in the near future?
Sorenson: These issues I do believe have weakened the NRA. I do not believe it has weakened the people who are members of the NRA, or who believe very strongly in what the NRA has purported for several decades. The NRA used to be, and many people don’t know this, but they used to be really a sport shooting organization. And in the 1980s, they sort of did a pivot and really got into beating the drum for gun rights and the idea that the government was going to take over your guns and take your guns. So they’ve created a narrative that I’ve never found to have much basis in reality, because we have more guns than we have people in the United States.
And let’s say that that’s true that the government does want to come and get your guns, they’re going to take them away. How could they even do that? I don’t even know who has guns. We don’t have gun registries. We don’t have a magnet that will suddenly pull up specific pieces of metal and pull them out. It’s not feasible. It’s not doable. So as an organizing principle, because you have to remember that the NRA is an advocacy organization and they’ve needed to keep money coming in, like all advocacy organizations do. And if they kept beating that drum, they’re going to come and get it, they’re going to come and get it. It heightens that fear, it heightens that sense of being under siege. But when we literally look at it, I don’t even know how that could happen.
Mills: What are the big questions regarding gun violence that we don’t have answers to?
Sorenson: Having spent my career studying gun violence I will take a different tack to answering this question. And that is to simply say, we know so little. I wish I could be more optimistic. I wish I could be. I am optimistic I should say that particularly with the influx of funding that we’re going to be seeing, and if we can get the access to data, then I’m far more optimistic, but I have to be I think appropriately modest and cautious in interpreting what we know right now. It’s relatively limited.
Mills: Given that we don’t have the research, I think you mentioned before that the legislators will ask, “where’s the data?” and you just come up empty handed, but based on what we do know, what are some of the policy changes that researchers like you believe could actually lower the rate of gun violence in this country?
Sorenson: To lower gun violence in the United States I think we need a multifaceted approach. I think we focused so much on looking for the one law or the two or three laws that are going to solve it. And it’s far more complicated than that. It connects into so much of not just a regular consumer product, but also so much of how people see themselves in the world and how they see America. It’s like when we had motor vehicle crashes. In public health, we started to look at how to reduce those. Well, we didn’t say, “okay, if we can reduce the speed limit, then that’s going to solve everything.”
We also had design issues. So we sit in cars, now they’re designed very, very differently than the ones that a generation or two of people grew up in. We have all sorts of laws and particular interventions around specific things. For example, the graduated driver’s license has substantially reduced motor vehicle crashes and deaths among young people. And we used to think driver’s ed is going to be very effective. We have a strong belief in education. If we just educate people, then they’ll do the right thing. And we found instead, driver’s ed had little to no effect and sometimes the opposite effect of what we wanted, because it was getting younger people behind the wheel sooner with less experience, but more confidence because, heck, they had had driver’s ed. We can pass laws around gun training. We can pass laws around registration of firearms.
We can pass laws that have to do with keeping guns out of the hands of people who we all agree should not have them. We could pass laws around assault weapons, which it’s a value statement as a society that we don’t think this type of firearm belongs in the hands of civilians, but it’s that panoply, it’s that multifaceted approach which gives us a chance of doing something, which gives us a chance of accomplishing something. But looking at one thing or even a handful of things, won’t do it. We have to have a comprehensive approach.
Mills: Well, thank you for joining us today, Dr. Sorenson. This has been very interesting and educational. I do hope that we get the data that you need in order to propose the solutions that will perhaps make us a little bit less lethal as a society. Thank you.
Sorenson: You’re most welcome. And I am optimistic because there are so many people who are coming into this field right now, because they do realize that it is a very, very pressing problem. We will have changes. Data do have a place at the policy-making table. Thank you.
Mills: You can read more about new funding for research on gun violence prevention in the April–May issue of APA’s magazine Monitor on Psychology. Just go to www.apa.org/monitor. And you can find previous episodes of Speaking of Psychology at speakingofpsychology.org or on Apple, Stitcher, or wherever you get your podcasts. And please, if it’s available, leave us a review. If you have comments or ideas for future podcasts, you can email us at speakingofpsychology@apa.org. That’s speaking of psychology, all one word @apa.org. Speaking of Psychology is produced by Lea Winerman, our sound editor is Chris Condayan.
Thank you for listening. For the American Psychological Association, I’m Kim Mills.
Susan Sorenson, PhD, is a professor of social policy, and health and societies, at the University of Pennsylvania, where she directs the Ortner Center on Violence and Abuse. She holds a PhD in clinical psychology and has an interdisciplinary background in epidemiology, sociology, and psychology. Her research focuses on the epidemiology of the prevention of violence, including gun violence. She has a particular interest in the role guns play in violence against women and in guns as a consumer product. She served on a panel that developed APA's 2013 report, Gun Violence: Prediction, Prevention, and Policy.
