Over the past two decades, the Joyce Foundation has invested more than $25 million to support research on the prevention of gun violence in the United States. That research has helped to define gun violence as a public health issue;1For example, see David Hemenway and Matthew Miller, “Public Health Approach to the Prevention of Gun Violence,” New England Journal of Medicine 368, no. 21(May 2013): 2033–5. understand the risks and benefits associated with firearms;2For example, see David Hemenway, “Risks and Benefits of a Gun in the Home,” American Journal of Lifestyle Medicine 5, no. 6 (2011): 502–511. and evaluate policies and interventions to reduce gun violence.3For example, see Daniel Webster, Cassandra K. Crifasi, and Jon S. Vernick, “Effects of the Repeal of Missouri’s Handgun Purchaser Licensing Law on Homicides,” Journal of Urban Health 91, no. 2 (2014): 293–302 and Cassandra K. Crifasi et al., “Association between Firearm Laws and Homicide in Urban Counties,” Journal of Urban Health 95, no. 3 (2018): 383. With limited public-sector support for gun violence prevention research, studies funded by Joyce and other foundations have built the knowledge base on gun violence and the promising policies and strategies that can prevent it.
Until recently, few studies considered the role of gun owners in preventing gun violence. Opinion research suggests that gun owners are supportive of strengthening gun laws.4Colleen L. Barry et al., “Public Support for Gun Violence Prevention Policies among Gun Owners and Non-Gun Owners in 2017,” American Journal of Public Health 108, no. 7 (2018): 878–881. Authors in this series have pointed to the need for sociological research to better understand gun culture. This essay will describe some of the new research funded by the Joyce Foundation that sheds light on shifts in reasons for gun ownership, perceptions of safety, and behaviors and practices of gun owners and users. The findings suggest that more work needs to be done to make gun users part of the solution to gun violence.
What we know: Gun violence in the United States“Understandably, mass shootings get an outsize amount of attention from the media and the public, but in fact they account for a small fraction of overall gun violence.”
There is little doubt that the United States has a gun violence problem. Over 100,000 Americans are killed or injured by guns every year. But it is more accurate to say that the United States has multiple gun violence problems. Understandably, mass shootings get an outsize amount of attention from the media and the public, but in fact they account for a small fraction of overall gun violence. The daily toll of gun violence—more than 100 deaths—results from suicides and homicides. In 2016, there were over 38,000 gun deaths: nearly two-thirds were suicides. More than 14,000 were homicides.5Centers for Disease Control and Prevention, WISQARS Fatal Injury Reports. Nonfatal shootings are hard to quantify with accuracy, but the data suggest that number is between 50,000 and 185,000 annually.
Our gun violence problem sets the United States apart in the developed world. We have less than 5 percent of the world’s population, yet almost 15 percent of noncombat-related gun violence.6The Global Burden of Disease 2016 Injury Collaborators. “Global Mortality From Firearms, 1990–2016,” JAMA 320, no. 8 (2018): 792–814. In the United States, we are 25 times more likely to be killed in a homicide with a gun than in comparable countries.7Erin Grinshteyn and David Hemenway, “Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010,” American Journal of Medicine 129, no. 3 (2016): 266–273. Research over several decades finds that the easy accessibility of guns accounts for our high rates of gun violence.8Grinshteyn and Hemenway, “Violent Death Rates.”
In addition, guns are not registered to their owners in the United States, making a precise census of guns in circulation impossible. A recent survey estimates that there are roughly 265 million guns in civilian hands,9Deborah Azrael et al., “The Stock and Flow of US Firearms: Results from the 2015 National Firearms Survey,” RSF: The Russell Sage Foundation Journal of the Social Sciences 3, no. 5 (2017): 38–57. which would make the United States stand out with the highest rate of civilian gun ownership in the world.10Aaron Karp, Estimating Global Civilian Held Firearms Numbers (Small Arms Survey, June 2018). About 22 percent of Americans own one or more firearms, with just 3 percent owning 50 percent of all civilian firearms.11Azrael et al., “The Stock and Flow of US Firearms.” The level of household gun ownership has remained fairly flat for the past 20 years, after declining from a peak of roughly 50 percent in the 1970s to around one-third of households today.12Tom W. Smith and Jeasok Son, General Social Survey: Trends in Gun Ownership in the United States, 1972–2014 (NORC at the University of Chicago, March 2015).
The impact of gun violence is not shared equally. Homicides and nonfatal shootings disproportionately impact young men of color. Compared to white young men ages 15–34, the rate of gun homicides for black young men is 11 times greater.13Centers for Disease Control and Prevention, WISQARS Fatal Injury Reports. WISQARS Fatal Injury Reports. By contrast, gun suicide disproportionately impacts older white men.14Garen J. Wintemute, “The Epidemiology of Firearm Violence in the Twenty-First Century United States,” Annual Review of Public Health 36 (2015): 1, 5–19. Women are less likely to die from gun violence than men, but women who are victims of domestic violence are five times more likely to be killed when there is a gun in the household.15Jacquelyn C. Campbell et al., “Risk Factors for Femicide in Abusive Relationships: Results from a Multisite Case Control Study,” American Journal of Public Health 93, no. 7 (July 2003): 1089, 1092.
Despite the body of research about the risks associated with firearms, most Americans believe having a gun makes them safer. This represents a dramatic shift in public opinion over the years. While in 2000 about 35 percent of Americans said that having a gun in the home makes it safer, by 2014, almost two-thirds believed the same.16Gallup, https://news.gallup.com/poll/1645/guns.aspx. This shift in opinion cuts across demographic groups, including African Americans, Hispanics, young people, and women. Today, most gun owners say they own guns for protection.17Azrael et al., “The Stock and Flow of US Firearms.” The misalignment between known risk and perceived risk is a fundamental challenge to the goal of preventing gun deaths and injuries.
At the Joyce Foundation, we’ve turned to research to help address this challenge. Specifically, we’ve sought to learn from gun owners by asking them directly about why they own guns and how they use them, with the goal of informing and improving efforts to reduce gun violence. Two examples, the National Firearms Survey and the Chicago Youth Gun Survey, have yielded important insights on two critical challenges: guns in the home used in suicides; and homicides and nonfatal shootings committed with illegally owned guns.
Guns in the home and suicide
Suicides account for the majority of gun deaths in the United States, and they are on the rise. Since 1999, suicide rates have increased in nearly every state, up by more than 30 percent in half the states. There is ample evidence that availability of guns is a risk factor for suicide.18For example, see Matthew Miller et al., “The Association Between Changes in Household Firearm Ownership and Rates of Suicide in the United States, 1981–2002,” Injury Prevention 12, no. 3 (2006): 178–182; Matthew Miller et al., “Firearms and Suicide in US Cities,” Injury Prevention 21, no. E1 (2015) E116–E119; Matthew Miller, Sonja A. Swanson, and Deborah Azrael, “Are We Missing Something Pertinent? A Bias Analysis of Unmeasured Confounding in the Firearm-Suicide Literature,” Epidemiologic Reviews 38, no. 1 (2016): 62–69. Nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date.19David Owens, Judith Horrocks, and Allan House, “Fatal and Nonfatal Repetition of Self-Harm: Systematic Review,” British Journal of Psychiatry 181, no. 3 (2002): 193–199. However, 85 percent of those who attempt suicide with a firearm will die in that attempt.20Rebecca S. Spicer and Ted R. Miller, “Suicide Acts in 8 States: Incidence and Case Fatality Rates by Demographics and Method,” American Journal of Public Health 90, no. 12 (2000); 1885. Half of all completed suicides are committed with a firearm. But many suicides are impulsive acts, prompted by a temporary crisis.21Thomas R. Simon et al., “Characteristics of Impulsive Suicide Attempts and Attempters,” Suicide & Life-Threatening Behavior 32, no. S1 (2001): 49–59. Restricting access to lethal means—firearms—even temporarily during a crisis can reduce suicide attempts and completions.“While the risk of suicide rises with age, the availability of firearms increases completed suicides among younger people.”
Gun suicides are generally committed with firearms owned legally. While the risk of suicide rises with age, the availability of firearms increases completed suicides among younger people. Between 2007 and 2016 there were nearly 1,000 firearm suicides per year of children and young adults under 21. In the case of young victims, most often the guns belong to their parents or other close relatives.22Renee M. Johnson, “Who are the Owners of Firearms Used in Adolescent Suicides?” Suicide & Life-Threatening Behavior 40, no. 6 (2010): 609–11. For these reasons, gun storage makes a big difference in reducing the risk of completed suicides, especially for children and adolescents.23David C. Grossman et al., “Gun Storage Practices and Risk of Youth Suicide and Unintentional Firearm Injuries,” JAMA 293, no. 6 (2005): 707–14.
Despite this clear evidence, we now know most gun owners are not aware of the risks and therefore do not take steps to reduce them. Researchers have analyzed data from the 2015 National Firearms Survey, a nationally representative web-based survey conducted by the firm GfK. The survey oversampled firearm owners and veterans to ensure reliable estimates. The data show:
- Most gun owners—almost two-thirds—report having guns for protection. Eighty percent of handgun owners cite protection from strangers as a reason for ownership.24Azrael et al., “The Stock and Flow of US Firearms.”
- Only 15 percent of US adults believe a gun in the home is a risk factor for suicide. Among gun owners with children, fewer than 10 percent agreed that guns in the home increase suicide risk.25Andrew Conner, Deborah Azrael, and Matthew Miller, “Public Opinion About the Relationship Between Firearm Availability and Suicide: Results From a National Survey,” Annals of Internal Medicine 168, no. 2 (2018): 153–155.
- Courting tragedy, 20 percent of gun owners with children store their guns loaded and unlocked.26Deborah Azrael et al., “Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey,” Journal of Urban Health 95, no. 3 (2018): 295.
- Few firearms training classes cover suicide risk or prevention.27David Hemenway et al., “Firearms Training: What is Actually Taught?” Injury Prevention, October 7, 2017. Instead, research by Harel Shapira of the University of Texas finds that many of these training classes reinforce the idea of the need for a gun by promoting a vision of America grounded in fear.28Harel Shapira and Samantha J. Simon, “Learning to Need a Gun,” Qualitative Sociology 41, no. 1 (2018): 1–10.
The data paint a sobering picture for anyone working to reduce firearm suicides. Education about the risks of access to lethal means for suicide, the risk of unsecured firearms in the home, and the ways to limit those risks is a critical part of the solution. Moreover, gun owners and those close to them need to be at the table when solutions are discussed. Researchers are identifying promising models to educate gun owners to reduce risk, including:
- The Gun Shop Project works with gun stores to disseminate information about suicide risk and safe storage of firearms.29Catherine Barber, Elaine Frank, and Ralph Demicco, “Reducing Suicides through Partnerships between Health Professionals and Gun Owner Groups—Beyond Docs vs Glocks,” JAMA Internal Medicine 177. no. 1 (2016): 5–6.
- A new policy, known as the extreme risk protection order, creates a civil legal mechanism to remove guns from persons at high risk of harm to themselves or others. Research by Jeff Swanson at Duke University found that a similar law in Connecticut prevented approximately 70 suicides over a 15-year period, or one suicide prevented for every 10-20 firearms removed.30Jeffrey W. Swanson et al., “Implementation and Effectiveness of Connecticut’s Risk-Based Gun Removal Law: Does it Prevent Suicides?” Law and Contemporary Problems 80 (2017): 179–208. This research is informing policymakers and advocates to adopt and implement extreme risk protection orders across the country. Speak for Safety is a public education campaign in California to increase awareness about the tool as an intervention to prevent suicide and other violence.
- Training for clinicians on counseling patients about removing access to lethal means, known as the CALM model,31Carol Runyan et al., “Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality,” Western Journal of Emergency Medicine 17, no. 1 (2016): 8–14. is shown to be an effective intervention for patients at risk for suicide.
Homicides, nonfatal shootings, and illegally owned guns“The vast majority of these guns are illegally possessed by persons who are disqualified from firearm ownership because of a prior felony conviction, a history of misdemeanor domestic violence or substance abuse, or because they are minors.”
Homicides are disproportionately committed in urban areas and are disproportionately committed with guns. The vast majority of these guns are illegally possessed by persons who are disqualified from firearm ownership because of a prior felony conviction or a history of misdemeanor domestic violence or substance abuse, or because they are minors. (Some states have broader prohibitions.) This is also true in the case of nonfatal shootings. Just as we need to better understand perceptions and beliefs of legal gun owners in order to address firearm suicides, we also need to understand people who use guns illegally if we hope to make a dent on homicides and nonfatal shootings.
A recent research report by the Urban Institute, We Carry Guns to Stay Safe, offers a compelling example.32Jocelyn Fontaine et al., We Carry Guns to Stay Safe (The Urban Institute, October 4, 2018). The research used a survey of young adults ages 18–26 in four Chicago neighborhoods that suffer from high rates of gun violence to understand the behaviors and perceptions of these young people. The research was unique because it collected data from young adults who live in violent neighborhoods and have direct experience with gun violence.
Guns are a fact of life in Chicago’s most violent neighborhoods. Fully one-third of respondents said they’ve carried a gun; among the young men, half said they’ve carried a gun. Almost all carry illegally. Guns are easy to get—69 percent said it would take them a matter of hours to get their hands on a gun. Young people report that they get guns through informal transactions on the street, theft, and via straw purchases (a transaction in which a person buys a firearm for someone who is legally prohibited from purchasing or possessing). The easy availability of guns fuels Chicago’s gun violence.
Like their counterparts who own guns legally, young adults in Chicago also report that they carry guns for their own protection, or for the protection of their friends or family members. Yet, these young people are more often than not also victims of gun violence. Violent victimization among the respondents was very common. More than a third had been shot or shot at, and 85 percent knew someone close to them who had been shot or shot at. Young adults who have suffered victimization were 300 percent more likely to report carrying a gun. The risk of victimization is at odds with the belief that guns are needed for protection.
Another risk associated with illegally carrying guns is the threat of arrest and prosecution. Here too, we learned that young people in Chicago discount this potential consequence. Only 16 percent of those who carry guns said they thought it was likely they’d get caught for carrying a gun illegally, and just 10 percent said they were likely to get caught if they shot at someone. Deterrence by the criminal justice system is not seen as effective. In addition to the belief that carrying a gun illegally is not likely to lead to arrest, the survey also found a profound distrust in the police, with fewer than 10 percent answering that they see the police as honest, fair, or respectful. When young people do not trust law enforcement to protect them, and do not fear getting caught, there is little to prevent them from carrying guns illegally. The survey of young people who carry guns illegally in Chicago points to a constellation of challenges: fear of violence in dangerous neighborhoods; carrying guns illegally and experiencing victimization; and a lack of trust in law enforcement and little deterrence, meaning violence often goes unpunished.
Once again, addressing these perceptions and behaviors is a necessary step to reducing the violence. There is promising work underway, including:
- Initiatives to improve trust between police and communities hard hit by gun violence
- Programs that intervene with young people at the highest risk of violence, including focused deterrence models33Anthony A. Braga and David L. Weisburd, “Focused Deterrence and the Prevention of Violent Gun Injuries: Practice, Theoretical Principles, and Scientific Evidence,” Annual Review of Public Health 36 (March 2015): 55–68. and cognitive behavioral therapy to help young people react to situations without resorting to violence
- Outreach in high-violence neighborhoods to interrupt and deter retaliatory violence34Jeffrey A. Butts et al., “Cure Violence: A Public Health Model to Reduce Gun Violence,” Annual Review of Public Health 36 (2015): 39–53.
There is no single approach that will end gun violence in the United States. Laws and policies to reduce the easy availability of guns are a critical piece of the solution. But while stronger gun laws are necessary, they will not be sufficient so long as we have nearly 300 million guns in circulation. Research supported by the Joyce Foundation and others identifies that guns as a source of protection is a powerful cultural idea that cuts across demographic groups. However, our research also establishes that this widely held idea is contrary to the evidence. This presents a fundamental challenge to the goal of reducing gun violence. Research to understand the perceptions, attitudes, and behaviors of gun users is an important piece of the puzzle. In addition to supporting research, funders should consider projects that educate gun owners and would-be gun owners on the risks associated with guns and ways to mitigate those risks, initiatives that engage gun owners in developing these messaging strategies, and projects that consider the ways different communities and demographic groups experience and use guns. But we should start by admitting that we have a lot to learn.