American Journal of Medicine, internal medicine

New Research in AJM: ‘Guns Do Not Make a Nation Safer’

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With each massacre of innocent citizens, the demand for action on gun control by the US Congress intensifies.

After the tragic Sandy Hook Elementary School shooting in December 2012,  it appeared as if the national outrage over the massacre of 20 children and 6 school staff would finally push the Congress into action, but sadly, in April 2013, the most recent attempt at common sense gun control was thwarted by a Republican Party filibuster.

This week, a lone gunman opened fire in a Washington DC naval facility, killing 12 people and injuring 8 others before being killed by authorities. Within hours of the shooting, Senator Diane Feinstein, who sponsored gun control legislation earlier this year, called on Congress to revive gun control efforts.

Serendipitously for gun control advocates, The American Journal of Medicine released Gun Ownership and Firearm-related Deaths by Drs. Sripal Bangalore and Franz Messerli today.

More Guns Don’t Make a Nation Safer

Appearing in the October 2013 issue of the Journal, the new research study reports that countries with lower gun ownership are safer than those with higher gun ownership, debunking the widely quoted hypothesis that guns make a nation safer.

Researchers also evaluated the possible associations between gun ownership rates, mental illness, and the risk of firearm-related death by studying the data for 27 developed countries.

A popular notion in the US, where there are almost as many guns as people, is that “guns make a nation safer,” although there has been little evidence either way. Shooting sprees in Aurora, Tucson, Oak Creek, at Virginia Tech, at the Navy Yard in DC, and other locales  have demonstrated that there may be a relationship between mental illness and easy access to guns, and that lack of treatment for mental illness may be more of a pressing problem than mere availability of guns.

Ever since the second amendment stating “A well regulated militia being necessary to the security of afree State, the right of the people to keep and bear arms shall not be infringed” was passed in 1791, there has been a fierce debate over guns in the US. At one end is the argument that gun control laws are an infringement on the right to self-defense and on constitutional rights, and that there is no evidence that banning assault weapons would reduce crime. At the other end is the view that fewer firearms would reduce crime rates and overall lead to greater safety.

Bangalore and Messerli examined data for 27 developed countries. The gun ownership data were obtained from the Small Arms Survey, and the data for firearm-related deaths were obtained from a European detailed mortality database (World Health Organization), the National Center for Health Statistics, and others. The crime rate was used as an indicator of safety of the nation and was obtained from the United Nations Surveys of Crime Trends.

Gun Ownership and Death

“The gun ownership rate was a strong and independent predictor of firearm-related death,” says Bangalore. “Private gun ownership was highest in the US. Japan, on the other end, had an extremely low gun ownership rate.

Similarly, South Africa (9.4 per 100,000) and the US (10.2 per 100,000) had extremely high firearm-related deaths, whereas the United Kingdom (0.25 per 100,000) had an extremely low rate of firearm-related deaths. There was a significant correlation between guns per head per country and the rate of firearm-related deaths with Japan being on one end of the spectrum and theUS being on the other. This argues against the notion of more guns translating into less crime. South Africa was the only outlier in that the observed firearms-related death rate was several times higher than expected from gun ownership.”

What Is the Role of Mental Illness?

The investigators also evaluated whether mental illness, and not merely the access to guns, is the driving force for criminal activities. They used age-standardized disability-adjusted life-year rates due to major depressive disorder per 100,000 inhabitants with data obtained from the World Health Organization database as a presumed indicator for mental illness burden in each country to assess whether there was a correlation between mental illness burden of a country and the crime rate in a country, but found no significant correlation between mental illness and crime rate.

Says Messerli and Bangalore, “Although correlation is not the same as causation, it seems conceivable that abundant gun availability facilitates firearm-related deaths. Conversely, high crime rates may instigate widespread anxiety and fear, thereby motivating people to arm themselves and give rise to increased gun ownership, which, in turn, increases availability. The resulting vicious cycle could, bit by bit, lead to the polarized status that is now the case with the US.”

They conclude that, “Regardless of exact cause and effect, the current study debunks the widely quoted hypothesis that countries with higher gun ownership are safer than those with low gun ownership.”

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