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Reducing Firearm Injury and Death: A Public Health Sourcebook on Guns

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Dr. Hargarten, a gun prohibition activist best known for his discredited "food processor through flesh" wound ballistics, has authored a propaganda piece that masquerades as science. Hargarten relies on the publications of other activists and advocacy "researchers" whose work has been throughly discredited in the scientific criminolgic literature. (Better you should rely upon Gary Kleck's meticulous book, Targeting Guns: Firearms and their Control", Aldine, 1997.) Among the flaws in the public health literature upon which Hargarten relies are: Failure to distinguish technically sound from inept studies, inconsistent application of scholarly standards, using speculation to rebut empirical evidence, omission of data or studies with unsupportive findings, pretending that evidence is worthless if it is not perfect, statistical legerdemain, failure to address relevant, contradictory studies; [1,2,3,4,5,6] habitual citation of sources for support when the sources were actually non-supportive; [1(at citations 2 and 15-17), 2(at citation 12), 3(at citation 7)] citation of sources for non-existent statistics;[5 (at citations 11 &13)] citation of sources for a proposition not studied by the sources;[2(at citations 10,12,14,15)] failure to address possible confusion between cause and effect;[3] use of small, unrepresentative, non-probability convenience samples improperly generalized to large populations;[1] the use of simplistic models that fail to control for complicating factors;[3] unawareness of valid measures of gun availability or the limitations of those measures;[3] illogically studying how often gun owners conceal their ownership by studying a sample of only those who have revealed their gun ownership;[4] "adjusting" the study sample to buttress a foregone conclusion;[2] prejudicially truncated data;[5] non-sequitur logic;[5] and characterization of lawful self-defense as "murder."[6] Do not waste your money on this propaganda. Edgar A. Suter MD, National Chair, Doctors for Integrity in Policy Research Inc. [1]Kellermann AL, Rivara FP, Rushforth NB et al. "Gun ownership as a risk factor for homicide in the home." N Engl J Med. 1993; 329(15): 1084-91. [2]Kellermann AL, Rivara FP, Somes G, et al. Suicide in the home in relationship to Gun Ownership. N Engl J Med. 1992; 327: 467-72. [3] Sloan JH, Kellermann AL, Reay DT, et al. "Handgun Regulations, Crime, Assaults, and Homicide: A Tale of Two Cities." N Engl J Med 1988; 319: 1256-62. [4] Kellermann AL, Rivara FP, Banton J, Reay D, Fligner CL "Validating survey responses to questions about gun ownership owners of registered handguns." Am J Epidemiol. 1990; 131(6):1080-4 [5] Kellermann AL. and Reay DT. "Protection or Peril? An Analysis of Firearms-Related Deaths in the Home." N Engl J. Med 1986. 314: 1557-60 [6] Kellermann AL and Mercy JA. "Men, Women, and Murder: Gender-specific Differences in Rates of Fatal Violence and Victimization." J Trauma. 1992; 33:1-5.

Trudy A. Karlson & Stephen W. Hargarten. Reducing Firearm Injury and Death: A Public Health Sourcebook on Guns. 1997. xix +172pp. $24.95 (paper).

"Often the best solutions to injury problems are passive ones. William Haddon Jr, MD, a founder of modern injury control research, urged public health professionals to focus on changing the product, rather than focusing exclusively on changing individual behavior." (p. xvi).

In the 1950s the common belief was that almost all motor vehicles injuries were caused by driver error, by the "nut behind the wheel." Thus policy attention was directed primarily to driver education and enforcement of the traffic laws. This approach was not very successful in reducing vehicular injuries. The approach advocated and subsequently undertaken by injury control experts in the public health community was much broader. They recognized the importance not only of the motorist, but also of the vehicle and the highway environment. These factors were easier to change. Individuals will always make mistakes, and they sometimes behave recklessly. But when they do, should they have to die, or should their actions lead to the death of others? In the highway safety area, a decision was made to try to build a system that made it less likely for people to make errors, and also one that was more forgiving when errors were made. Automobiles now have better braking systems, collapsible steering columns, shatterproof windshields, nonrupture gas tanks, seat belts and airbags. Highways and emergency medical systems have also been vastly improved. This public health approach to traffic safety has been remarkably successful. Although there is no evidence that drivers today are in any way better than those of the 1950s, motor vehicle fatalities per mile driven have been reduced by over 75%. Karlson and Hargarten believe that a public health approach could also be effective in reducing firearm injuries. They focus on the gun as a consumer product, examining the sale and distribution of firearms as well as product design. "We know that great results in reducing injuries and deaths can be achieved if changes are made to the product or if access to the product is reduced. Least effective in impact on the population is trying to change how individuals use the product." (p. 125). Guns are among the most dangerous consumer products in the United States--currently an average of 100 people a day are killed with guns, a fatality rate far in excess of any other developed nation. Yet guns are among the least regulated of all products--in the United States there are more safety standards for toy guns and teddy bears than there are for firearms. The Karlson-Hargarten book is a sourcebook on firearms. It provides a brief history of guns and carefully defines terms: e.g. "relative stopping power," "double action," "terminal ballistics," "breech loader," "magazine," and "bore." The book then discusses how firearm design and the firearm distribution system could be changed to reduce gun injuries. As many aspects of automobiles have been altered to reduce their danger, so too could many aspects of firearms be altered--magazine capacity, barrel length, muzzle velocity, trigger pull, safeties, recoil, cartridges, serial numbers, and bullets. One could imagine a firearm which had a low risk not only of accidental discharge but also of lethal assault and suicide. The Karlson-Hargarten book is filled with reasonable policy suggestions which could effectively reduce firearm deaths at low cost to both gun owners and the general public. The following are only a few examples of the many aspects of firearm design and distribution which could be improved: (1) grip safeties which reduce the possibility that young children could inadvertently pull the trigger of a gun; (2) personalized guns which prevent unauthorized individuals from using the firearms--including angry or suicidal adolescents; (3) load-chamber indicators which prevent unintentional killings because the individual "didn't know the gun was loaded"; (4) lowered magazine capacity to reduce multiple killings; (5) the use of less lethal ammunition, such as rubber bullets, to lower the fatality rate due to gun woundings; (6) guns that "fingerprint" or mark each bullet as it is fired to improve bullet identification in crime; (7) state maximum one-gun-per-month purchase laws which reduce the profitability of gun-running from one state to another. The book is objective and easy to read. Public health implications are included for each section of each chapter. The book is not a strident demand for gun control, but a reasoned argument for a broader approach to gun policy--one that has worked well in other injury areas. The Karlson-Hargarten book is one step in the long journey to move the gun debate and gun policy away from the almost exclusive focus on training people in gun use and punishing those individuals who use guns in crime. Reducing Firearm Injury and Death makes it clear that there are numerous other policies which can effectively reduce firearm injuries and death. Anyone interested in firearms policy should read this book.

David Hemenway, PhD Professor of Health Policy Director, Harvard Injury Control Research Center Harvard School of Public Health 677 Huntington Avenue Boston, MA 02115 (617) 432=4493 (617) 432-4494 (fax) hemenway@hsph.harvard.edu