For decades, researchers have urged journalists to avoid framing gun violence solely as a crime issue and provide a broader public health context. Yet, as evidenced by the findings of a recent study of local TV news in Philadelphia, the focus on the crime angle remains very much at the forefront of gun violence coverage.

The researchers’ call for change was further underscored on June 25, when the U.S. surgeon general declared firearm violence a public health crisis for the first time in a 40-page advisory, calling on the nation to take a public health approach to address gun violence, much like it has done before to address tobacco and car crashes.

In “Public health framing of firearm violence on local television news in Philadelphia, PA, USA: a quantitative content analysis,” published in BMC Public Health in May 2024, researchers analyzed 192 TV news clips aired on four local news stations between January and June 2021 and found that 84% contained at least one element that could be harmful to communities, audiences and gun violence survivors. Some of those elements are visuals of the crime scene, not following up on the story, naming the treating hospital and the relationship between the injured person and the shooter.

Meanwhile, public health elements such as root causes of gun violence, solutions and sources other than law enforcement officials were missing from most news clips.

“The main message is that the majority of reporting on firearm violence, at least in TV news, has many harmful content elements and we have to do better,” says the study’s lead author, Dr. Jessica Beard, director of research at The Philadelphia Center for Gun Violence Reporting, a trauma surgeon at Temple University Hospital and an associate professor at the Lewis Katz School of Medicine at Temple University. “The public does not have an accurate understanding of what gun violence is and the policy implications are huge.”

Beard was part of a panel on covering gun violence as a public health emergency at the Association of Health Care Journalists’ annual conference in New York City earlier this month. She also spoke with The Journalist’s Resource after the panel.

Previous studies have shown that when the news media covers community gun violence as a single incident in isolation, audiences are more likely to blame victims. This approach also reinforces racist stereotypes and suggests that policing is the most effective way to prevent violence, undermining public health measures that could curb gun violence, Beard and her co-authors of the BMC Public Health study write.

This type of coverage also has a negative effect on people who are injured in shootings, they point out.

Injured people say that graphic content, inaccuracies and mention of treating hospitals resulted in distress, harm to their reputation and threats to their personal safety, according to a 2023 study by the same research team, which included interviews with 26 adults who had recently sustained a gunshot wound. They said that news reports that neglected their personal perspectives left them feeling dehumanized and compounded their trauma.

“Some people were afraid to get discharged from the hospital,” Beard says.

More about the study and its findings

The researchers chose to study TV news because more people in the U.S. get their news from TV than other legacy sources such as radio and print, according to a 2023 survey by Pew Research Center. (That same survey found that more Americans get their news from digital devices than from TV, and there’s a need for research on firearm violence content in digital news, the authors note.)

They focus on Philadelphia for several reasons. The city is the birthplace of Eyewitness News, which launched in 1965, and Action News, which launched in 1970. The two newscasts pioneered reporting approaches that have been criticized for the way they are produced and for casting a negative light on Black communities, the authors write. A 2022 story by The Philadelphia Inquirer delves deep into this history.

Moreover, the epidemic of gun violence in Philadelphia reflects a trend across the country where shooting rates have increased since the onset of the COVID-19 pandemic, disproportionately affecting young people and Black people. A June report from the CDC’s Morbidity and Mortality Weekly Report finds that between January 2019 and September 2023, rates of emergency medical services encounters for gun-related injuries were highest among males, non-Hispanic Black people and people between 15 and 24 years old.

The study compares Philadelphia news clips based on two main characteristics: news clips that focused on a single incident in isolation, called episodic framing, and those with more of a public-health approach, exploring the broader social and structural context in which the violence occurs, called thematic framing.

Among the findings:

• Nearly 80% of the stories used episodic framing.
• In 21% of the clips, a law enforcement official was the main interview source.
• In 50.5% of the clips where the journalists were the only news narrators, police were the predominant source of information on firearm violence.
• More than 84% of the stories contained at least one harmful element, such as a visual of the crime scene, not following up on the story, the number of gunshot wounds, the name of the treating hospital and the relationship between the injured person and the shooter. About 7% of the clips included video or audio of the shooting.
• The 192 news clips mentioned a total of 433 injured people.
• More than 80% of the clips mentioned an injured person, although in 67%, the only information about injured people was age or gender.
• None of the 192 news segments included a health or public health professional or an injured person as the main interview source.
• Only 10% of the clips included discussions about public health solutions.
• And only five stories (2.6%) used the word “prevent.” Another four stories (2.1%) offered resources related to firearm prevention.

The authors point out that the study findings may not be generalizable to all U.S. cities, to national TV news, or to print, radio, or social media content.

Also, it’s still not clear whether harmful reporting on community firearm violence increases rates of gun violence. The connection between the two is complex, Beard says, adding that she’s hoping to explore and study the topic in the future.

In their 2023 study, Beard and colleagues asked injured participants if they would be willing to speak with a journalist about their shooting incident and what would they tell the journalist.

One participant said, “You report the gun violence, but why not do a follow-up report […] for the victims, the survivors, the families that had to bury these people, the whole process? Just don’t do a guy got shot over there, a guy got shot over here. You’re making people more fearful. You’re more fearful, you’re going to arm yourself more.”

The authors underscore the study participant’s point: Reporting on firearm violence with limited information and no follow-up stories may perpetuate fear, which may contribute to increasing firearm use and, in turn, the increasing incidence of firearm violence.

The BMC Public Health study was funded by the Stoneleigh Foundation, Lehigh University Research Investment Programs, the National Institute on Minority Health and Health Disparities of the National Institutes of Health, and the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.

Gun violence as a public health issue

Two days after the Pulse nightclub mass shooting, where 49 people were killed by a lone gunman in Orlando, The American Medical Association adopted a policy calling gun violence “a public health crisis,” which requires a comprehensive public health response.

In addition to death, gun violence can result in long-term physical, mental and financial burdens among injured individuals, studies show, including a 2023 study published in JAMA Network Open. It impacts communities, causing fear and economic decline. And compared with infectious diseases, it poses a larger burden on society in terms of potential years of life lost, according to a 2020 report by the Educational Fund to Stop Gun Violence (now the Johns Hopkins Center for Gun Violence Solutions).

Gun violence affects the health of entire communities, said Dr. Ruth Abaya, an attending physician in the Children’s Hospital of Philadelphia emergency department, during the panel on covering gun violence as a public health emergency at the Association of Health Care Journalists.

“We’re seeing young people who have crippling anxiety that is limiting their abilities to participate in daily life, they’re being medicated and even being hospitalized, and that’s directly related to this other public health crisis of gun violence,” said Abaya, who’s also the senior director of health systems and CVI — community violence intervention — integration at The Health Alliance for Violence Intervention. “And I’m also seeing young people with other unrelated chronic diseases like asthma that’s out of control because their caregiver was killed in a violent incident.”

Recommendations for journalists

The study’s findings are not surprising to Rick Brunson, a senior instructor of journalism at the University of Central Florida’s Nicholson School of Communication and Media.

Brunson, who worked as a reporter and editor in Central Florida for 20 years, including at a local TV station, mentions several reasons why many TV stations’ coverage of gun violence lacks a broader public health context.

Commercial news stations’ economic lifeblood depends on ratings, and as much as audiences may say they are put off by coverage of crime and violence, stations’ internal research shows that people watch crime news, he says.

Also, with the plethora of streaming options and multiple screens, viewers are distracted and TV stations are often vying for their attention, which results in newscasts packed with videos and short stories without space for context and explanation.

And there’s the broader, growing trend of news avoidance among audiences.

“When they watch the news, it just makes them feel despair and exhaustion, especially the focus on crime coverage and because there’s no context,” Brunson says. “They’re just presented with problem after problem after problem. Violence after violence.”

“The question for news directors to ask in the face of this where people are just avoiding the news and you’re seeing your audience erode more and more, year after year, is can the news business also be in the hope business?” Brunson says. “It’s going to take some serious consideration and the reversal of the kind of coverage that you put on your air.”

Even though there are widely accepted journalistic guidelines to protect victims and audiences in cases of suicide, mass shootings, sexual assault, abuse, and crime involving minors, no such guidelines crafted by journalists and public health practitioners exist for reporting on community firearm violence, Beard and her colleagues note in their study.

They say their research aims to lay the foundation for understanding harmful content in TV news clips and share several recommendations, including the practice of trauma-informed reporting.

Trauma-informed journalism recognizes the need for journalists to better understand how trauma can affect survivors and how to avoid reporting that could cause additional harm to vulnerable people and those who have experienced trauma. The practice also helps journalists to protect their own mental health.

When covering firearm violence, trauma-informed reporting would involve engaging with survivors using trauma-informed principles, including giving them control over the narrative of their injuries. It also minimizes harmful elements such as graphic visuals.

“This type of reporting could humanize firearm-injured people and build empathy in audiences, deconstructing the existing racialized news narratives around firearm violence in cities,” the authors write.

They also recommend:

• Public health practitioners partner with firearm violence survivors to offer alternative perspectives to journalists reporting on firearm violence.
• Journalists seek training in trauma-informed practices and solutions journalism.
• Newsrooms adopt a public health approach to reporting on firearm violence, provide resources to audiences and use the public health framing.

To help journalists and newsrooms meet these recommendations, the Philadelphia Center for Gun Violence Reporting and Frameworks Institute created a free gun violence reporting toolkit, which provides more information on trauma-informed reporting, the drivers of gun violence, and tips for more complete news coverage of gun violence.

Brunson advises reporters to seek out public health professionals as a source to help add context to their reporting and to read BMC Public Health study.

“People are always trying to tell us what to do,” Brunson says. “But we should take that as a compliment because the folks like the people who did this study acknowledge that they’re doing it because the media has influence, and journalists help shape and frame public debate and discussions and the problems that get looked at. Policymakers look at what journalists are doing.”

Additional research

Systematic disparities in reporting on community firearm violence on local television news in Philadelphia, PA, USA
Jessica H. Beard, et al. Preventive Medicine Reports, April 2024.

“Like I’m a nobody:” firearm-injured peoples’ perspectives on news media reporting about firearm violence
Jessica H. Beard, et al. Qualitative Research in Health, June 2023.

Firearm Injury — A Preventable Public Health Issue
Jay Patel, et al. Lancet Public Health, November 2022.

Making the News: Victim Characteristics Associated with Media Reporting on Firearm Injury
Elinore J Kaufman, et al. Preventive Medicine Reports, December 2020.

Resources

• To help journalists with better reporting of gun violence, PCGVR has created a free gun violence reporting toolkit.
• “Firearm Violence: A Public Health Crisis in America” is the U.S. Surgeon General’s 2024 advisory, a first of its kind for gun violence.
• The American Public Health Association’s Gun Violence page links to several useful resources.
• The Dart Center for Journalism & Trauma, the Canadian Broadcasting Corporation (CBC/Radio-Canada), and the Canadian Journalism Forum on Violence and Trauma recently launched a news industry toolkit on trauma-aware journalism.
• This fact sheet by the American Public Health Association lists some of the recommended public health responses to gun violence.

The post Research highlights need for public health approach in news reporting of gun violence appeared first on The Journalist's Resource.

This research roundup on the effectiveness of gun buyback programs was originally published in January 2020. We have updated it as of October 2022 with new research.

Voluntary gun buyback programs allow gun owners to trade their firearms to government entities — usually law enforcement — for vouchers that can be redeemed for cash or other items of value, such as tickets to professional sporting events. Guns can usually be exchanged “no questions asked.” In other words, people who turn over their firearms are not subject to background checks or criminal inquiries and, in some cases, do not have to provide identifying information.

Early research on gun buybacks, mostly from the 1990s, largely finds these programs ineffective at curbing gun violence. Recent research frames gun buybacks in a somewhat mixed but more favorable light.

On their own, buybacks might not be effective if the goal is to use them to directly reduce violent crime. But research shows buybacks can help if they’re part of a broader effort to reduce gun violence. They can also influence public perception of how authorities are dealing with gun violence and serve as opportunities to educate communities about gun violence reduction strategies, according to researchers.

When candidates for elected office voice support for mandatory buybacks, they usually mean they would push for legislation requiring Americans with high-capacity assault weapons to trade them to a government entity.

There are no government estimates on what a national gun buyback program might cost, but an analysis from The Trace, a national news outlet that covers guns, estimates the total direct cost for a rifle buyback program would range from nearly $1 billion to $87 billion.

Another estimate, from the Institute of Labor Economics, puts the cost of a national buyback program aimed at the types of handguns most often used in violent crime at $7.6 billion. These estimates don’t represent comprehensive economic analyses. For example, they don’t account for labor costs for law enforcement and other government personnel.

Two new studies

The core question that academic research seeks to answer is whether gun buybacks reduce gun violence. There is not an avalanche of new research, but there are two studies published within the past two years that focus on, or include, gun buyback programs in the U.S.

Both studies bolster the research findings from the past decade.

The most recent study, an August 2021 analysis published in the Annals of Surgery, examines the results of 19 studies on whether buyback programs reduce gun violence. After searching for research published from January 1900 to June 2018, the authors focus on 7 studies conducted in Australia and 12 from the U.S. The U.S studies go back to at least 1994, and are as recent as 2017.

The authors conclude that “gun buybacks are, necessarily and by design, anonymous, making it very challenging to study individual outcomes of these programs. Evidence suggests that there may be a small, improved impact in suicide prevention in older, white males, but no effect on interpersonal gun violence or homicides.”

Crucially, the authors note that the “benefits of gun buyback programs may not be measurable in a standardized scientific method. The lack of scientific data is not a referendum on the effectiveness of the programs, but rather a call for more rigorous data and evaluation of these programs.”

Another study, a working paper published in May 2021 by the National Bureau of Economic Research, ponders whether gun buyback programs have “misfired.” The authors analyze federal data on gun crime within the jurisdictions of the 245 U.S. law enforcement agencies that serve at least 50,000 people. They supplement this data with public records on the number of firearms recovered at each of 335 gun buyback events held from 1991 to 2015 in 277 cities. Worcester, Massachusetts, held the most gun buybacks over the period studied — 14 buyback events.

The gun buybacks analyzed “have done little to reduce gun crime or firearm-related violence,” the authors write. One potential reason: Gun buybacks do not usually recover a large share of guns circulating in a community. A 2014 buyback in Somerville, Massachusetts, recovered 15 firearms, compared with more than 1,500 gun permits issued there, according to the authors. Buyback prices may rarely exceed the value gun owners place on keeping a gun, the authors suggest. For example, a gun owner might place a higher value on keeping their gun for self-defense compared with the dollars a municipality offers. Gun buybacks also tend to attract people who live farther from cities and have higher median incomes, “populations with relatively lower crime risk,” the authors write.

“Our results suggest that [gun buyback programs] have been an inefficient use of taxpayers’ dollars in the United States,” the authors conclude. “Perhaps alternative firearm-related policies, such as safe storage laws or stricter background checks would be more effective at deterring gun violence. Our findings also suggest that prior city [gun buyback programs] have been poorly designed to achieve their policy objectives.”

Key context

The general idea behind gun buyback policies is that gun violence can be lessened by reducing the number of guns in civilian hands. In absolute and relative numbers, Americans lead the world in firearm ownership.

The U.S. accounts for nearly 46% of all civilian-held firearms in the world, according to the Small Arms Survey, a research project from the Graduate Institute of International and Development Studies in Geneva. There are about 121 firearms for every 100 U.S. civilians. Yemen has the second-highest rate of firearm ownership, with about 53 firearms for every 100 civilians. Canada’s rate is about 35 while Mexico sits at about 13 per 100 civilians.

Around one-third of adult Americans own guns, meaning there are more than 81 million gun owners, according to a 2021 survey led by William English at Georgetown University. Gun ownership in the U.S. is concentrated, with 3% of Americans owning half of all guns in the country, finds a 2015 survey from researchers at Harvard and Northeastern universities. Delaware has the nation’s lowest gun ownership rate — 5.2% — while Alaska has the top rate at 61.7%, according to a nationally representative survey of 4,000 U.S. adults from the 50 states and the District of Columbia, published in June 2015 in Injury Prevention.

“We showed that exposure to social gun culture was robustly associated with gun ownership and to our knowledge, this is the first study to establish empirical evidence of the relation between social gun culture and gun ownership,” write the authors of the Injury Prevention study.

There are two threads through the research on gun buyback programs. First, certain types of guns are more likely to be used for certain types of crimes. While mass shootings committed with assault weapons draw national media attention, those crimes are quite rare. Most homicides aren’t from mass shootings, and homicides are usually committed with handguns, according to the National Institute of Justice, the research arm of the U.S. Department of Justice.

Second, gun violence isn’t just about homicides. Nationally, almost two-thirds of gun deaths are suicides, according to 2017 data from the Centers for Disease Control and Prevention. Firearm suicide attempts result in death 85% of the time, compared with 3% of attempts involving a drug overdose, according to a 2016 report from Harvard Public Health, the magazine of the T.H. Chan School of Public Health.

“What makes guns the most common mode of suicide in this country? The answer: They are both lethal and accessible,” writes Madeline Drexler, editor of Harvard Public Health and the report’s author.

Formative findings

Philadelphia was one of the first U.S. cities to try gun buybacks with several programs in the early 1970s. Baltimore offered $50 per gun in 1974 — roughly $275 in today’s dollars — netting more than 13,000 firearms over three months.

By the late 1990s, municipalities in the U.S. had conducted more than 100 buyback programs. Seattle’s gun buyback program in fall 1992 was among the first to be evaluated via peer-reviewed research. Gun owners turned over 1,172 firearms, almost all of which were working handguns, according to a 1994 evaluation published in Public Health Reports. Participants received a bank voucher worth $50, no matter how many firearms they turned over to the Seattle Police Department. About three-fourths of participants were men. The evaluation didn’t find statistical evidence that the program had an effect on gun violence.

“Gun buyback programs are a broadly supported means to decrease voluntarily the prevalence of handguns within a community, but their effect on decreasing violent crime and reducing firearm mortality is unknown,” the authors write.

Another early evaluation looked at a gun buyback program in Sacramento in August 1993. The program allowed people to turn in firearms to police in exchange for tickets to a Kings basketball game. There were 127 participants, according to an evaluation that appeared in Injury Prevention in September 1998.

Researchers heard from 92 participants via a mail survey that sought, in part, to understand why they turned in firearms. Nearly half said they were concerned children might find and use the gun. (A large percentage of participants in a long-running gun buyback program in Worcester, Massachusetts also cite child safety reasons for turning in their guns.) Some 41% of respondents had no gun in their household after participating in the Sacramento program. Still, those “who still owned guns often kept them loaded and easily accessible,” the authors write.

Milwaukee instituted its own series of buyback programs from 1994 to 1996. An evaluation published in Injury Prevention in June 2002 looked at whether the types of handguns recovered from those buybacks were the same as those typically used in homicides and suicides. The authors compared 941 handguns recovered during the buybacks to 369 handguns used in homicides or suicides from 1994 to 1997.

Two-thirds of handguns used in homicides in Milwaukee and 40% of handguns used in suicides were semiautomatic, compared with one-third of buyback handguns. Most guns turned in to the city were revolvers. Semi-automatic guns automatically load cartridges and fire one bullet per trigger pull. Revolvers have rotating cylinders and each cartridge has to be manually loaded. Three-fourths of handguns recovered during the Milwaukee buybacks used small-caliber ammunition, while much smaller percentages of guns used in homicides and suicides were small-caliber. Two manufacturers produced 30% of the handguns turned in while 5% of guns used in homicides came from those manufacturers.

“Handguns recovered in buyback programs are not the types most commonly linked to firearm homicides and suicides,” the authors conclude. “Although buyback programs may increase awareness of firearm violence, limited resources for firearm injury prevention may be better spent in other ways.”

Finally, a meta-analysis from August 2008 in Crime & Delinquency found no research showing “significant changes in gun-related crimes due to these programs.”

More recent research

The thinking among academics has shifted a bit in the past few years when it comes to gun buybacks. Garen Winmute, director of the Violence Prevention Research Program at the University of California, Davis, told the news outlet Governing in 2013 that violent crime rates might not be the best measure of success for gun buybacks, and that community engagement and education on gun safety during buybacks also have value.

A meta-analysis from December 2019 in Current Trauma Reports suggests that gun buybacks should be included in broader violence reduction strategies.

“Buybacks in conjunction with other methods have been shown to be successful in reducing the number of firearms that could lead to injury and death,” the authors write. They note that non-Hispanic black men are the most common victims of fatal firearm injury, while gun buyback participants tend to be older white men.

A September 2014 evaluation in Trauma and Acute Care Surgery found that gun buyback programs in Worcester, Massachusetts, New Haven, Connecticut and Phoenix, Arizona were structured differently from programs in the 1990s. Programs in those cities provided gift cards only to people who brought in working firearms, a notable change from earlier programs that offered trades for non-operational guns. In Worcester and New Haven, people turning over assault weapons and sawed-off shotguns got higher-value gift cards.

“The gun buyback program is solely one prong of a multipronged approach in reducing firearm-based interpersonal violence,” the authors conclude.

A 2013 evaluation of a multiyear gun buyback program in Buffalo, New York, found no effect on violent gun crime, including homicides. The authors also note that different parties, like law enforcement officers and politicians, may measure the success of gun buybacks in different ways.

“Given the empirical evidence, police agencies may use gun buyback programs not with the expectation of reducing violent crime, but to satisfy the public’s expectations,” the authors write. “When serious crime problems occur, mayors and police chiefs are under pressure from their constituents to ‘do something dramatic and effective’ about the violence.”

Mandatory buybacks in Australia

In April 1996, a man armed with a semiautomatic rifle killed 35 people and wounded 23 others in Port Arthur, Tasmania. Australian legislators acted swiftly, agreeing less than two weeks after the massacre to outlaw semiautomatic and pump-action rifles through the National Firearms Agreement. A mandatory buyback at “fair value” followed that fall. Experts set the price the government would pay for each type of gun — which amounted to $359 per gun, on average. By 1997, nearly 650,000 banned guns had been turned over, roughly one-fifth of guns in the country, at a total cost of $230 million.

Another buyback in 2003 netted more than 68,000 handguns.

There have been numerous evaluations of Australia’s mandatory buybacks. An investigation of the legislation, published in July 2016 in The Journal of the American Medical Association, reported 13 mass shootings in the 18 years before the legislation and none in the 20 years following its passage — though in June 2019, there was a mass shooting in Darwin committed with a banned firearm. Firearm deaths also declined faster after the legislation, but suicides and homicides not caused by firearms declined, too. Because suicides and homicides overall declined starting around the mid-1990s, the authors couldn’t attribute the improvement in gun violence statistics to the gun laws.

A RAND Corporation analysis, originally published in March 2018 and updated in April 2021, finds that among five studies published since 2015, only one “provides convincing statistically significant evidence that firearm homicides changed after implementation of the NFA — specifically, that there was an absolute reduction in female firearm homicide victimization.”

While the science isn’t settled as to whether Australia’s gun control legislation was the reason for lower rates of gun violence, the fact remains that the country largely avoided mass shootings for more than two decades following the Port Arthur massacre. From the RAND analysis: “There is evidence suggesting that the NFA may have contributed to a complete reduction in mass shootings that lasted for 23 years, although low numbers of such events, coupled with challenges inherent in studying a nationwide policy on national outcomes, limit strong conclusions and raise skepticism by critics.”

A November 2019 paper in Prevention Science takes a slightly different approach from other analyses. The authors try to look at a world where Australia’s buyback program never happened. They use homicide and other fatality data from other countries to create gun-death data for a fictional Australia, sans the 1996 buyback. Their findings suggest that “the universal and abrupt nature of the Australian Gun Buyback program significantly reduced Australia’s homicide rate in the decade following the intervention.”

Subject experts

David Kennedy, professor, John Jay College of Criminal Justice.

Lorraine Mazerolle, professor of criminology, The University of Queensland, Australia.

Richard McCleary, professor of criminology, University of California, Irvine.

Scott W. Phillips, associate professor, SUNY Buffalo State.

James J. Sobol, associate professor, SUNY Buffalo State.

Garen Wintemute, director, Violence Prevention Research Program at the University of California, Davis.

The post Gun buybacks: What the research says appeared first on The Journalist's Resource.

Recent mass shootings, including one in which 19 elementary school children were killed in Uvalde, Texas, have pushed some journalists to suggest news outlets should publish, or consider publishing, graphic images from those shootings to show the unvarnished reality of what fired bullets do to human bodies.

The media debate that took off in late May was notable for its emotion and urgency, particularly in the language from journalists who have extensively covered gun violence.

A few examples:

• David Boardman, dean of the Klein College of Media and Communication at Temple University and former executive editor of the Seattle Times, told Philadelphia Magazine on May 26 that “we, as journalists, have to face up to the fact that our textual description of this sort of heinous crime, and pictures of these innocent young children, in their angelic form, isn’t moving citizenry and isn’t moving, certainly, the political machine the way it needs to be moved.”

• Sewell Chan, editor in chief of the Texas Tribune, told Vanity Fair, also on May 26, that he is “sympathetic to those who argue that we need to be confronted with the raw images of lives shattered by gun violence,” but “also concerned that could come across as exploitative or unethical or unseemly.”

• CNN host Jake Tapper on May 25, the day after the killings in Uvalde, which also left two teachers dead, said this: “There are images of these shootings that law enforcement — and, frankly, we in the news media — that we don’t share with you because they’re so horrific. They’re so awful. But maybe we should. Maybe the shock to the system would prompt our leaders to figure out how to make sure society can stop these troubled men, and it’s almost always men, from obtaining these weapons used to slaughter our children.”

• John Temple, who as editor of the defunct Rocky Mountain News in Denver published a photo of a dead student following the Columbine High School mass shooting in 1999, also offered a note of pause, writing in The Atlantic on June 6: “I worry that making public photos of obliterated children will motivate others to see how much damage they can cause, will normalize unthinkable violence, and will be used in a hateful way, against the families of the dead or as threats to others. Rather, I would look for photographs that won’t make people turn away, that will hold their gaze.”

President Joe Biden signed legislation on June 25 that expands criminal and mental health background checks for some people who want to buy a gun, and uses grant funding to incentivize states to enact red flag laws, among other measures. It’s the most extensive federal gun-related legislation in decades.

Still, the legislation falls short of more sweeping measures Democrats have pushed in the past. While the two major parties found slivers of common ground, when it comes to addressing gun violence the political climate remains divisive.

Likewise, the media debate about whether to publish graphic images is not over.

To publish or not to publish?

Newsroom debates over the appropriateness and consequences of publishing graphic images are not new. But following Uvalde, the tenor seems to have reached a pitch not necessarily unheard of, but perhaps more public and coming from more influential journalists than ever before.

Relatedly, there is the question of whether to show images that depict the reality of everyday gun violence in many American communities. In February, the American Academy of Pediatrics reported firearm injuries have surpassed car crashes as the leading cause of death for people 19 and younger in the U.S.

Beneath this difficult debate about journalism ethics, editorial control and dignity for the dead lies a serious consideration awaiting some newsroom in the U.S. the next time a mass shooting occurs:

To publish or not to publish graphic images?

In conversations over the past two weeks, The Journalist’s Resource gathered insights from a dozen experts to help answer that question.

And the answer is that there is no clear answer. But many other questions emerged for newsroom leaders to consider before publishing or broadcasting graphic images from a shooting. The outcome will hinge on context: what the image or images depict and the connections the news outlet has with local communities, to name two factors.   

The experts we talked with include a lawyer for The New York Times, a former longtime editor of a community newspaper in Minnesota and several academic media scholars, some of whom are former journalists. Many have published peer-reviewed research on how news outlets use images and how the public interprets them, with some of that research highlighted below.

Access to graphic images — whether a photojournalist would be able to take graphic images from a mass shooting — is something that came up during our conversations. As Temple, the former Rocky Mountain News editor, put it in The Atlantic, “editors can’t publish photos they don’t have.”

Several people we spoke with echoed that sentiment.

“In general, it’s highly unlikely as a journalist that you’re going to really get graphic, graphic footage — I mean like dead bodies,” says Karen McIntyre, a former local news reporter in northern California who is now an associate professor of multimedia journalism at Virginia Commonwealth University. “It’s just highly unlikely that you would be there before that would be all caution-taped off.”

On the other hand, McIntyre and others acknowledged it is plausible to imagine a scenario in which journalists covering a public event, such as a protest, parade or school board meeting, suddenly find themselves covering a mass shooting and serving as history’s first responders.

If the question does arise for a newsroom in the weeks, months or years ahead, the following questions and thoughts can help editors arrive at an answer that fits their organization’s standards and works for the communities they serve.

Everyone we asked agreed newsrooms should have these conversations and make a plan for how to handle graphic images before facing the choice of whether to publish.

Can we legally publish graphic images?

If your news outlet owns the image rights — if, for example, a staff photographer or freelancer takes the pictures or video — or obtains an image or video following regular journalistic standards, then yes.

“Typically, in the United States, there isn’t an issue,” says Al-Amyn Sumar, counsel at The New York Times Company and an adjunct professor at the Craig Newmark Graduate School of Journalism at the City University of New York. “If you were to get an invasion of privacy claim, you would say that the photograph is newsworthy, which is usually a total defense. The kinds of photos we’re talking about are taken in public places where the law tends to say there was no kind of expectation of privacy.”

The question at issue is almost certainly ethical rather than legal, Sumar says.

Are we asking the right fundamental question?

The framework for our interviews with experts assumed newsrooms would want to consider a range of potential consequences before showing graphic images.

Most experts we spoke with implicitly accepted this framework. They dove into a variety of dilemmas, including concerns about glorifying mass shooters.

“We know that these images act as a contagion for them to be outdone,” says Nicole Dahmen, an associate professor of journalism at the University of Oregon. “Somebody out there wants to outdo them and that’s a real risk of publishing these photos.”

However, one expert offers a different perspective: Barbie Zelizer, director of the Center for Media at Risk at the University of Pennsylvania’s Annenberg School for Communication.

Zelizer, who was a Reuters wire reporter in the Middle East early in her career, pinpoints an essential question: Is the event newsworthy?

“The point that needs to be made, and that should be made, and that has not yet been made, is the idea that the appropriateness of images is misplaced,” she says. “We don’t talk about the appropriateness of news. My argument has always been if we make an assumption about when something is newsworthy in terms of the words it uses, it should be the same in terms of the pictures it shows.”

In short, if an event is newsworthy enough to cover in text, it is newsworthy enough to cover in images, even if those images are more graphic than news audiences are used to seeing. Zelizer calls herself “a minority voice in this,” but says that while considerations about consequences are not without value, consequences are essentially unknowable.

“In a funny way, the tabloids have it right,” she says, “in the sense that the tabloids don’t censor themselves, they don’t harness what their representations are going to look like in accordance with questions of appropriateness or privacy.”

If you agree with Zelizer, the answer as to whether to publish becomes clearer. The more productive question, she says, centers on how images are displayed in print and online, which we discuss later on.  

What are your motivations?

By far the most common point the experts made was that a newsroom should honestly examine their motivations for wanting to publish photographs or video of dead, dying or seriously wounded shooting victims.

If the motivation is to drive website clicks or increase newspaper subscriptions, those are flat out not good reasons to publish graphic images, and could backfire.

But most news outlets will likely start from a place rooted in altruism. Some of the media debate so far has resonated as journalists, fed up with covering mass shootings, wanting politicians to “do something” about gun violence in the U.S. To “shock” the system, as Tapper said.

Yet an image that seems shocking inside a newsroom may not have a shocking effect once published, according to several people we spoke with.

“There’s a whole slew of studies on cognitive dissonance theory,” says Samuel Robert Lichter, professor of communication and director of the Center for Media and Public Affairs at George Mason University. “When confronted with a new piece of evidence that goes against what you believe, instead of changing your opinion, you tend to try one of many different strategies to avoid it.”

Jim Pumarlo, who as editor of the Red Wing Republican Eagle covered communities southeast of the Twin Cities from 1982 to 2003, says “there’s so many other ways that you can deliver the story, in word and in photos without going to that final, real graphic one.”

A more forceful case for publication could be made if a news outlet believes their role is simply to preserve history, others say.

“That’s probably the most compelling reason for publication of these kinds of images, is that they should be lodged in the evidentiary record,” says Jessica Auchter, research chair in visual culture in international studies at Laval University in Quebec City and author of the 2021 book Global Corpse Politics: The Obscenity Taboo. “The historical record is composed of both text and images and there is something of value added to the historical record to having this in image form, in addition to reporting on it in text.”

In that case, it doesn’t matter whether an image fails to affect policy — an unknowable outcome in the first place. Editorial leaders at The New York Times, while discussing whether to publish pictures showing the human consequences of the war in Ukraine, factored their role as purveyors of the historical record into their decision to publish.

“There was a photographer, Lynsey Addario, who had taken some particularly graphic images and we decided to publish them, of victims of the war, including dead bodies,” Sumar says. “And the point was made that publishing these kinds of photos can be important, because they’re evidence of potential war crimes.”

A note to national news outlets considering publishing graphic images from a small town: Think locally. 

The descent of “newspapers in glitzy markets like New York, Washington, Los Angeles and San Antonio” is something that Craig Garnett, editor and publisher of the Uvalde Leader-News, recently wrote about with palpable frustration. 

“In the blink of an eye, a force of state, national and world media launched an invasion of our city to rival the armed assault on a small nation,” Garnett writes. “Our grocery stores filled with unrecognizable faces and languages, giant trucks sprouted with satellite dishes and antennas squeezed into our back streets and news reporters and cameramen began probing our populace with hundreds of microphones and cameras.”

Pumarlo, the former Republican Eagle editor, offers this advice for a national outlet considering publishing graphic images from a shooting in a small town: 

“Connect with some locals and get a feel. At least reach out and give the rationale,” he says, “show that they do have some feelings for the impact of what has happened on the local community. And that they’re not just sitting in New York or Los Angeles or Washington, D.C. or wherever, and making these decisions without any feeling of what’s the impact on the town.” 

Do you have consent?

Most experts we spoke with agree it is essential for journalists to make their best effort to get consent of the victim in a photo or their surviving family.

This includes talking with people likely to be directly affected about the range of things that could happen once a graphic image of their slain relative is out there.

“It would really, I think, be the responsible, ethical thing for journalists to explain that these images will show up on 4chan,” says Jennifer Midberry, an assistant professor of journalism at Lehigh University who researches the ethics of photographing marginalized populations and worked as a visual journalist for the Associated Press, The Philadelphia Daily News and other news organizations from 1999 to 2005. “There’s going to be a lot of hurtful memes, it’s going to be nasty. It could also, though, lead to gun control laws that would make the family feel like at least their child didn’t die in vain. You have to really talk about the spectrum of things to expect.”

Another familiar refrain from the people we spoke with: Remove the breaking news pressure. The decision whether to publish a graphic photo doesn’t need to be made at the exact moment families are dealing with the unexpected, violent loss of a loved one.

“In a breaking news context, I don’t know that the images of deceased people on the ground is something that should be rushed to be published,” says Kaitlin Miller, an assistant professor in the College of Communication & Information Sciences at The University of Alabama.

What is the race or ethnicity of the victims in images?

It’s not a hard and fast rule and it’s not exclusive to U.S.-based media, but news outlets are sometimes more apt to publish graphic images from conflicts and tragedies that happen far away from their coverage areas.

“The problematic side of this tendency is that the media treats suffering bodies unequally depending on their cultural and geographical closeness,” Jenni Mäenpää, a postdoctoral researcher at the University of Helsinki who has studied how news outlets make decisions about images, explains by email.

The more anonymous an image is — the harder it is to identify the people in them — the more graphic it will tend to be, says Zelizer, who is also co-editor of Journalism: Theory, Practice and Criticism, a peer-reviewed journal, and wrote the 2010 book About to Die: How News Images Move the Public.

Zelizer’s point is evident in the 2015 image of Aylan Kurdi, a drowned Syrian boy photojournalist Nilüfer Demir photographed lying face down on an Aegean beach in southwest Turkey.

The consideration is whether your news outlet is only showing people from certain backgrounds in certain situations — as crime victims, for example. Or, does your outlet successfully represent a range of people across a breadth of human experiences?  

“There has been some discussion in the past about whether our standards have been applied consistently,” says Sumar, the Times lawyer. “In my experience, we try very hard to apply them consistently and we have, in the past, published photos of victims of all races. But that’s something that you have to be attentive to.”

How will we display the image?

There is no way to gauge what will happen to an image after it is published — the extent to which it will be misused and manipulated, or whether it will spur policy change. But news outlets should strive to provide as much context about the image as possible.

Here are some ideas from Dahmen, the University of Oregon professor:

• Use a single, powerful photo rather than multiple photos.
• Before showing the image, warn viewers it will be difficult to see.
• If printing the image, remove any advertisements from the page.
• If showing the image on television, allow it to speak for itself on screen for a period of time without distracting chyrons or in split screens with hosts or guests.
• If publishing digitally, put the image on a single page that can only be accessed from a link that clearly identifies the news outlet.
• Do not send the image via the news organization’s official social media channels.

Again, these are ideas from one person who has spent her career thinking deeply about the shortcomings and potential of journalism. E. Alison Holman, a professor of nursing at the University of California Irvine who has studied how viewers respond physically and mentally to graphic news images, agrees that trigger warnings are essential.

Holman adds that “there’s so much variation in how people respond to these things. There’s no one-size-fits-all answer to any of this.”

Auchter, the Laval University research chair, is less certain about trigger warnings. She suggests that people should feel disrupted. That there is an argument to be made in favor of an average person who is enjoying their morning coffee suddenly having to confront a difficult image conveying a tragic truth — without the ability to avoid it.

“We often assume that trigger warnings are objectively neutral, it’s just something you have to click through to get to it,” Auchter says, “but we forget they are actually shaping the story by telling us how we should respond and how to interpret these images, as much as they are just providing that barrier before we get to the image.”

Lichter, the George Mason University professor, offers that the viral nature of social media could be a force for positive change, by bringing attention to the issue of gun violence to a wider audience than was possible before computers and smartphones.

And not everyone is convinced that a single image is the right call.

“The professional gravitation toward that iconic image, is that really what we need?” asks Zelizer. “Or do we need more images? I think we need more images, because I think more images do more for us understanding what’s going on than one iconic image.”

Dahmen also advises against publishing crime scene photos obtained from law enforcement, assuming the police agency would also release the photos. Law enforcement photos leaked to a journalist would also give Dahmen pause because, she says, “being the one who had the crime scene photos, being the one who got to publish them, it’s all going to drive likes, subscriptions and the financial business model of journalism — it’s not serving the public interest for the journalists to reprint those.”

Dahmen equates the scenario to a news outlet publishing a terrorist manifesto. Others we spoke with disagreed that law enforcement crime scene photos should be off limits.

Miller, the University of Alabama professor, agrees with Dahmen’s recommendations. She adds that an image “needs to be surrounded by a greater context, solution and an understanding of why these things are happening and where we need to move forward.”

Are you ready and able to explore solutions to gun violence?

Lauren Kogen, an assistant professor at the Klein College of Media and Communication at Temple University, sums up the solutions-oriented sentiment we heard over and over in our conversations:

“The ethical thing to do, as a news outlet, is to make darn sure that you’re providing [audiences] with the information that they would need as democratic voting citizens to go out there and create change,” she says, “to leave your news audience feeling powerless, to feel like there aren’t any solutions, then you are getting into the realm of being sensationalist.”

It’s not just a matter of ethics. Research shows audiences want solutions journalism, says McIntyre, the Virginia Commonwealth professor.

Solutions-oriented stories about policies that have worked in the real world to reduce gun violence — or that focus on community groups working to reduce firearm deaths, or explore systemic breakdowns that allow gun violence to perpetuate — are essential but often lacking, according to several people we spoke with.

“In the medical community, gun violence is considered a public health issue,” says Midberry, the Lehigh University professor. “But by and large, in U.S. news media it’s not discussed as a public health issue. It’s largely discussed as criminal justice. What we have seen from preliminary research we’ve done, which is aligned with previous research, is that there’s not as much reporting on potential solutions to these problems, compared to the volume of the coverage of the crime itself.”

Are you taking care of your journalists?

In the past, when the tough-it-out mentality reigned supreme in most news organizations, reporters often suffered in silence after covering difficult stories or witnessing traumatic events. But today, as journalists can connect in more ways than ever and more reporters are openly sharing their own experiences with trauma, discussions about secondary trauma and self-care have become less taboo.

Holman offers several pieces of advice drawn from her experience teaching nurses. These tips dovetail with research-based self-care tips we have previously compiled.  

• Organizations need to give time and resources to help reporters process their own trauma.
• Journalists need to schedule breaks into their workdays and also make time for rest and relaxation.
• Crucially, reporters need to remember why they love gathering the news.

“If you feel like what you’re doing has purpose, has meaning — not just for you, but for other people — and you’re making a contribution, that’s going to be good for your mental health, ultimately,” says Holman. “That’s something I think is really important to keep in mind — to remember that you are doing this for a reason.”

What the research says

The Power of Images? Visual Journalists’ Assessment of the Impact of Imagery
Nicole Smith Dahmen, Kaitlin Miller and Brent Walth. Visual Communication Quarterly, March 2021.

In the authors’ words: “Study findings show that most participants believe images can be agents for change, but they have not necessarily seen higher-level impacts. A key finding reveals that participants believe graphic images are not inherently more powerful vehicles for journalistic impact than less graphic images.”

Distributing Ethics: Filtering Images of Death at Three News Photo Desks
Jenni Mäenpää. Journalism, February 2021.

In the author’s words: “If death is made invisible or aestheticized in media imagery, the media fails to show the world as it is. This may shape the societal understanding of violent death in a way that people do not feel an urgent need for action, for instance, in cases of injustice.”

Compassionate Horror or Compassion Fatigue? Responses to Human-Cost-of-War Photographs
Jennifer Midberry. International Journal of Communication, 2020.

In the author’s words: “More specifically, this study suggests that reaction-to-loss is a particularly useful type of human-cost-of-war visual frame because it taps into media consumers’ emotions without causing as much distress as graphic violence. Another implication is that feelings of helplessness appear to mitigate people’s desire to engage with imagery of war.”

Media Exposure to Collective Trauma, Mental Health, and Functioning: Does It Matter What You See?
E. Alison Holman, Dana Rose Garfin, Pauline Lubens and Roxane Cohen Silver. Clinical Psychology Science, October 2019.

In the authors’ words: “Using data from a representative national sample, we demonstrated that both the quantity and the visually graphic nature of media exposure to a community trauma were independently associated with subsequent mental health and functional impairment.”

Solutions Journalism: The Effects of Including Solution Information in News Stories about Social Problems
Karen McIntyre. Journalism Practice, August 2019.

In the author’s words: “For journalists, these findings indicate that individuals will like stories more (feel less negative and have more favorable attitudes) if reporters include discussion of an effective solution to the problem.”

“This is Still their Lives”: Photojournalists’ Ethical Approach to Capturing and Publishing Graphic or Shocking Images
Kaitlin Miller and Nicole Dahmen. Journal of Media Ethics, February 2020.

In the authors’ words: “This research uses in-depth interviews with photojournalists to explore the decision-making process and ethical considerations involved in capturing and publishing such images. Research found participants justify taking and publishing graphic images as a way to empower subjects, while also informing audiences.”

Visually Reporting Mass Shootings: U.S. Newspaper Photographic Coverage of Three Mass School Shootings
Nicole Smith Dahmen. American Behavioral Scientist, February 2018.

In the author’s words: “Given contagion effects, this study finding raises serious concerns about current practices in news media publication of perpetrator photos. Although the Society of Professional Journalists’ Code of Ethics encourages news media members to seek truth and report it, the code also emphasizes moral imperatives to ‘balance the public’s need for information against potential harms’ and ‘avoid pandering to lurid curiosity.’”

News You Can Use or News That Moves?
Lauren Kogen. Journalism Practice, November 2017.

In the author’s words: “The literature reviewed here illustrates that eschewing solutions-oriented information — defined as information related to cause, context, solutions, or general steps that could be taken to address social ills — can have the effect of disengaging audiences, creating compassion fatigue, and even stirring up resentment for a population that seems to keep finding itself on the edge of disaster.”

Iconic Photographs and the Ebb and Flow of Empathic Response to Humanitarian Disasters
Paul Slovic, Daniel Västfjäll, Arvid Erlandsson, and Robin Gregory. Proceedings of the National Academy of Sciences, January 2017.

In the authors’ words: “The iconic image of a young Syrian child, lying face-down on a beach, woke the world for a brief time, bringing much-needed attention to the war and the plight of its many victims. But this empathic response was short-lived.”

Caution — Graphic Images: The Politics of Obscene Dead Bodies
Jessica Auchter. Critical Studies on Security, June 2016.

In the author’s words: “Perhaps not pre-framing the encounter with the image would leave room for us to not be disturbed by the image, so that we can question our lack of disturbance, rather than feel self-righteous at our pre-formed disturbance that seems to linger only as long as the exposure to the image itself.”

Contagion in Mass Killings and School Shootings
Sherry Towers, et. al. PLOS ONE, July 2015.

In the authors’ words: “We find significant evidence that mass killings involving firearms are incented by similar events in the immediate past … We find that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings and mass shootings.”

Source list

Jessica Auchter, research chair in visual culture in international studies at Laval University in Quebec.

Nicole Dahmen, associate professor of journalism at the University of Oregon.

E. Alison Holman, professor of nursing at the University of California, Irvine.

Lauren Kogen, assistant professor at the Klein College of Media and Communication at Temple University.

Samuel Robert Lichter, professor of communication and director of the Center for Media and Public Affairs at George Mason University.

Jenni Mäenpää, postdoctoral researcher at the University of Helsinki.

Karen McIntyre, associate professor of multimedia journalism at Virginia Commonwealth University.

Jennifer Midberry, assistant professor of journalism at Lehigh University.

Kaitlin Miller, assistant professor in the College of Communication & Information Sciences at The University of Alabama.

Jim Pumarlo, newsroom trainer and editor of the Red Wing Republican Eagle from 1982 to 2003.

Al-Amyn Sumar, counsel at The New York Times Company and adjunct professor at the Craig Newmark Graduate School of Journalism.

Barbie Zelizer, director of the Center for Media at Risk at the University of Pennsylvania’s Annenberg School for Communication and a spring 2004 fellow at Harvard Kennedy School’s Shorenstein Center, home of The Journalist’s Resource.

Learn more about trauma-informed reporting, research-based tips for journalists under stress, and 7 things journalists writing about guns should know.

The post Should news outlets show graphic images of mass shooting victims? Researchers and other experts weigh in. appeared first on The Journalist's Resource.

Mass shootings in the U.S. often attract national media coverage. They’re horrific, they upend the lives of numerous victims and families, and they’ve become increasingly common over the past two decades.

Less covered nationally, but deserving of more media attention, is the everyday toll of gun violence — particularly injuries, which incur tens of billions of dollars in hospital costs and lost work time every year.

To offer a sense of the economic costs of firearm injuries, we looked into recent academic papers on the topic. Here are some quick takeaways from the research:

• There are more than 100,000 firearm injuries in the U.S. each year, according to federal estimates, but there is no national database that counts firearm injuries.
• The cost of emergency department visits and inpatient admissions related to firearm injury totals almost $3 billion per year.
• Work-loss costs, calculated in terms of lost wages and other factors, are roughly $50 billion yearly, according to academic research and other estimates, which also figure the value of lost quality of life at more than $200 billion per year in the U.S.
• Young adults — young men in their 20s in particular — have the highest firearm injury rates. One reason for the billions of dollars in economic costs from firearm injuries is that younger people have more of their lives left to live. Think of it like this: The average lifespan in the U.S. is 78 years. Many people retire in their mid-60s. Someone shot and debilitated at age 55 will miss out on the opportunity for roughly a decade of work. But someone shot and debilitated at age 25 will miss out on about 40 years of potential work, and experience decades of diminished quality of life.
• People who are uninsured, use public insurance or decide to pay hospital bills out of pocket represent a huge portion of firearm injury medical costs. About 41% of firearm injury patients who arrive at an emergency department pay for care themselves. Those publicly insured or uninsured account for $44 million, or 67%, of readmission costs after an initial hospital intake for firearm injury.
• Handgun injuries are the most expensive in terms of overall medical costs — more than $183 million yearly among those admitted to a hospital and $19,175 per hospital admission.
• Roughly half of hospitalizations for firearm injury are among Black patients. Black and Hispanic people are more likely to suffer a firearm injury due to assault than people of other races and ethnicities. White patients are most likely to suffer a firearm injury due to self-harm or accident.
• Thousands of children each year suffer firearm injuries and are admitted to a hospital, with annual hospitalization costs totaling nearly $100 million.

How many people are hurt by firearms? We don’t exactly know.

There are no standard, national data sources that tally mass shootings or firearm injuries.

The FBI tracks active shooter incidents, in which one or more shooters kill or try to kill people in a populated area, but not mass shootings. Mother Jones keeps a current count of mass shootings using the federal definition of a mass killing — a killing in a public place in which three or more people are killed, not including the perpetrator.

There were 10 mass shooting events in the U.S. in 2019, two in 2020, and there have been three this year, the Mother Jones database shows. There were 28 active shooter incidents in 2019, the most recent year FBI data is available.

Journalists also turn to the nonpartisan Gun Violence Archive for information on mass shootings. The archive uses a broad definition of mass shooting — its only criterion is that a perpetrator shoots or kills four or more people during an incident. The archive counts 417 mass shootings in 2019, 611 in 2020 and 132 in 2021, as of April 7. In all, 39,707 people died from injuries caused by firearm discharge in 2019, the most recent year available from the U.S. Centers for Disease Control and Prevention. About one-third — 14,414 — were homicides, while about 60% — 23,941 — were deaths by suicide.

There are twice-to-three times as many firearm injuries as there are firearm deaths each year, according to various estimates. Firearm injuries generally refer to wounds or penetrating injuries sustained from a projectile, such as a bullet or slug, fired from a handgun, shotgun or other firearm. Most survivors of firearm injuries do not harm themselves, according to research highlighted below.

Researchers often use data on hospital emergency department visits and admissions to study firearm injuries. Those data fail to capture some firearm injuries — someone with a minor injury from a firearm discharge may not seek emergency care, for example.

Still, emergency department sample data is widely used in academic literature. The data aren’t perfect — there are potential unknown coding errors and some entries lack key data fields, such as the type of firearm used — but they offer the best available insight on firearm injuries in the U.S.

And, if someone needs immediate medical attention for a firearm injury, that’s the kind of physical trauma likely to amplify economic consequences.

One source for firearm injury data is the National Center for Injury Prevention and Control at the U.S. Centers for Disease Control and Prevention. From 2013 to 2019, people with nonfatal firearm injuries visited emergency departments an estimated 752,351 times, according to the center.

That figure was calculated based on a sample of 16,902 such cases and comes with a large standard error. Generally, standard errors decrease with more sample data. The total number of emergency department visits due to firearm injury is likely between 319,471 and 1,185,231 for 2013 to 2019, according to the injury center. That includes unintentional firearm injuries as well as those resulting from assault, self-harm and law enforcement encounters. There’s not enough sample data for the injury center to estimate recent timeframes shorter than 2013 to 2019, or rates for individual years.  

Those CDC numbers are based on the National Electronic Injury Surveillance System, part of the U.S. Consumer Product Safety Commission. The injury surveillance system collects patient visit data from a sample of 100 hospitals with emergency departments across the country.

Another source of firearm injury data, more common in academic research, is the Nationwide Emergency Department Sample from the U.S. Agency for Healthcare Research and Quality. It’s the largest source of emergency department data in the U.S., estimating characteristics of 145 million such visits each year. One way researchers use this data is to estimate the costs of health care related to treating injuries caused by firearm discharge.

The emergency department dataset isn’t free — at least, not in its entirety. Each year of data from 2016 to 2018 costs $1,000, though the price drops for more distant years going back to 2006. The dataset is one of several that are part of the Healthcare Cost and Utilization Project. Journalists and the public can run individual queries of the data for free through HCUPNet. National, regional and some county-level data are available this way. If you’re a journalist with a more complicated request than the online portal can fulfill, reach out to Karen Carp or Shelby Venson-Smith at the agency for help.

Healthcare costs for firearm injuries are a multi-billion dollar burden

On average, each emergency department visit costs $5,254, with costs for inpatients jumping to $95,887, the authors of the Health Affairs paper find. In total, the authors estimate yearly healthcare costs of $2.8 billion for firearm-related injuries. That includes emergency department visits and inpatient admissions.

An inpatient is a patient a doctor formally admits to a hospital to stay for a length of time.

Some 37.2% of patients in the study treated in an emergency department were admitted to the hospital, while 8.3% died. Nearly half of patients arrived at an emergency department following an assault, with 5.3% due to self-harm.

About 70% had minor or moderate injuries, while 30% had injuries that were serious or severe. People aged 18 to 29 years made up half the sample, and men were nine times as likely as women to arrive at an emergency department with a firearm-related injury. Though it’s not the main focus of the paper, the authors use the CDC data to estimate work-loss costs of $44.5 billion per year due to firearm injuries.  

About 41% of patients pay hospital costs themselves. The authors write that “uninsured or self-pay patients lack negotiating power and thus leverage with payers, either they bear the entire financial burden of their injuries in the form of out-of-pocket spending, or these costs remain unrecovered — thereby adding to the uncompensated care provided by hospitals, physicians, and health care systems.”

Fewer federal dollars, less research

The Health Affairs authors note funding for research on gun violence dried up after a mid-1990s law banned federal research to advocate or promote gun control: “For every hundred articles published on sepsis, only about four are published on gun violence,” they write.

The 1996 provision, written by former Republican Congressman Jay Dickey of Arkansas, didn’t outright ban research on guns but made such research politically unpalatable.

“Precisely what was or was not permitted under the clause was unclear,” write two doctors, Arthur Kellermann and Frederick Rivara, in a February 2013 JAMA Viewpoint article. “But no federal employee was willing to risk his or her career or the agency’s funding to find out.”

From 1998 to 2012, scientific publications on gun violence fell 64% and federal funding for firearm injury research plummeted 96%, according to public health journalist Ted Alcorn, writing in JAMA in January 2017.

But firearm research backed by federal dollars is on its way. A March 2018 Congressional spending bill clarified that the Dickey Amendment did not forbid the federal government from funding research on the causes of firearm violence.

In late 2019, Congress approved $25 million to conduct research on gun violence, to be split evenly between the CDC and the National Institutes of Health. By September 2020, the NIH had awarded $8.5 million in funding for nine investigations, with the CDC putting $8 million toward 16 research projects related to firearm injury and mortality.

A closer look at inpatient costs

Most people admitted to a hospital with firearm-related injuries — 80% — were aged 15 to 44. Men were much more commonly hospitalized than women — 18.2 men per 100,000 people in the U.S., compared with 2.1 women per 100,000. Roughly half of hospitalizations for firearm injury were among Black patients — 39.7 per 100,000.

Black and Hispanic patients were more likely to suffer a firearm injury due to assault, while white patients were most likely to be unintentionally injured by a firearm discharge, or because of self-harm.

The roughly 30,000 hospitalizations for firearm-related injuries each year total $622 million in average admission costs, the authors find. In 60% of cases, the type of firearm used was unknown.

For admissions where the firearm type was known, handgun discharge accounted for 70% of injuries and $183 million in annual hospital stay costs, followed by shotgun injuries at about $50 million.

The hospital admission data do not describe firing mechanisms, such as automatic or semi-automatic.

Associated Press style, which The Journalist’s Resource follows, notes that the terms “assault rifle” and “assault weapons” should be avoided. They are “highly politicized terms that generally refer to AR- or AK-style rifles designed for the civilian market, but convey little meaning about the actual functions of the weapon,” according to the style guide. “Avoid the terms preferred by advocates and gun manufacturers, such as military-style rifles or modern sporting rifles.”

Tracking patients over time

While the Health Affairs and Injury Epidemiology papers are instructive as to overall health care costs for firearm-related injuries, the national data they use are a snapshot. Researchers can’t track the outcomes of patients in those samples across time.

Comparing the six months before and after the injury, costs spiked from $3,984 per member to $17,806 for those released from an emergency department.

For those hospitalized, healthcare costs went from $4,118 before a firearm injury to $92,151 after the injury. Out-of-pocket costs for patients — even with insurance —  increased 133%, to $2,526, for each patient discharged and 644%, to $3,020, for those hospitalized.

“The burden of firearm injury on the health care system is large and quantifiable,” the authors conclude.

A closer look at readmission costs

Using 2013 and 2014 data from the Nationwide Readmissions Database, a sample set of about half of all U.S. hospitalizations, the researchers analyzed 45,462 patients admitted for a firearm injury. Of those, 7.6% were readmitted within 30 days. Among readmissions, 16.8% went to a different hospital.

The authors observe higher rates of readmission for patients publicly insured or uninsured, those with a self-inflicted firearm injury, those over age 65 and those who had major surgery. About 20% were readmitted for infection.

Patients were more likely to be readmitted to a different hospital if they had been originally treated at a for-profit hospital. Those readmitted to a different hospital also tended to be younger and less severely injured. The authors calculate an additional $65.5 million per year in readmission costs overall. Patients publicly insured or uninsured account for $44 million of the yearly readmission costs, the authors find.

Pediatric hospital admissions

Of the 12,799 children who survived their initial admission and were discharged, 6% were readmitted within 30 days and 12% of readmissions were to a different hospital.

Total cost of hospitalization for children injured by firearm discharge: $382 million, nearly $96 million per year studied. The authors attribute $40 million of the total to readmissions. They assume one or more parents or guardians will need to take time off work to care for a child injured by a firearm, adding $38 million in lost productivity.

Opportunity costs: Work loss and quality of life

Health economists think of lost productivity in terms of opportunity costs. Dollar amounts are often derived from average wages for the age and sex of the person injured by a firearm discharge, the severity of the injury and other factors. The inability to work for a period of time is an opportunity cost — in other words, someone injured by a firearm temporarily or permanently loses the opportunity to work.

And work doesn’t necessarily mean traditional paid employment. Economists often calculate the value of unpaid household work and caregiving costs for the injured when tallying firearm injury costs. Society incurs the highest amount of lost productivity when people die from firearm injuries, particularly those who are younger, because they will have lost a higher number of potentially productive years.

The nonprofit, nonpartisan Pacific Institute for Research and Evaluation is one go-to source for information on the economic costs of gun injuries and deaths. Academic researchers use their data, and so does the CDC, though the agency only offers national cost estimates related to gun injuries from 2010.

Ted Miller, a senior researcher at the Pacific Institute who helped develop the cost formula the CDC uses, worked with Everytown for Gun Safety on their February 2021 report about the economic costs of firearm violence. The report is the most recent, comprehensive analysis of the national costs of firearm injuries and fatalities. Media outlets have covered or cited the report numerous times since it was published.

Everytown is a nonprofit organization that advocates for gun control and is largely financed by former New York City Mayor Michael Bloomberg. The total annual cost of gun violence was $280 billion in 2018, according to the report.

Miller and Everytown attribute $51.2 billion to work loss, with the bulk of the total costs — $214.2 billion — coming in the form of quality-of-life losses.

Quality-of-life encompasses the “intangible costs that quantify — based on jury awards and victim settlements — the pain, suffering, and lost overall well-being that a person and their family experience due to gun death and injury,” according to the report.

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The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255.

For journalists covering topics related to suicide, see ReportingOnSuicide.org. Use this app to check if your story meets suicide reporting guidelines that experts recommend.

Plus, explore our coverage of how journalists perpetuate the myth that suicides rise during winter holidays, how news coverage of celebrity suicides often falls short of expert guidelines and 7 things journalists should know when reporting on guns.

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Updated April 14, 2021 to reflect new information on how journalists and the public can access Healthcare Cost and Utilization Project data.

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In the lead-up to the 2020 elections, the Journalist’s Resource team is combing through the Democratic presidential candidates’ platforms and reporting what the research says about their policy proposals. We want to encourage deep coverage of these proposals — and do our part to help deter horse race journalism, which research suggests can lead to inaccurate reporting and an uninformed electorate. We’re focusing on proposals that have a reasonable chance of becoming policy. For us, that means at least 3 of the 5 top-polling candidates say they intend to tackle the issue. Here, we look at what the research says about the so-called “boyfriend loophole” in federal gun law.

Candidates in favor of closing the boyfriend loophole

Michael Bennet*, Joe Biden, Michael Bloomberg*, Pete Buttigieg*, John Delaney*, Amy Klobuchar*, Bernie Sanders*, Tom Steyer*, Elizabeth Warren*

What the research says

Certain people convicted of a misdemeanor domestic violence offense cannot legally own a gun under federal law — but others can, and the difference comes down to how the law defines “intimate partner.” Limited research indicates federal and state laws restricting guns from people who commit misdemeanor domestic violence crimes, such as hitting a spouse, can prevent intimate partner homicides. But academics stress that more research is needed.

Key context

Federal law prohibits a person convicted of a misdemeanor domestic violence crime involving the use or attempted use of physical force or a deadly weapon from legally owning any type of gun. Former U.S. Sen. Frank Lautenberg of New Jersey introduced the legislation as part of an omnibus spending bill that President Bill Clinton signed into law in 1996.

The Lautenberg Amendment amended the Gun Control Act of 1968, which previously barred people convicted of a felony domestic violence offense from legally owning a gun.

The so-called “boyfriend loophole” hinges on how the Lautenberg Amendment defines “intimate partner.” For a person convicted of misdemeanor domestic violence to be barred from owning a gun, that person has to be a current or former spouse of the victim, have lived or be living with the victim, or have a child with the victim. The boyfriend loophole means someone dating the victim who has never lived with the victim and doesn’t have a child with the victim can legally own a gun — even after he or she has been convicted of a misdemeanor domestic violence crime.

Nineteen states have effectively closed that loophole, including California, New York, Illinois and Texas. The Rand Corp. maintains a state-by-state database of firearm laws. The version of the Violence Against Women Reauthorization Act of 2019 that passed the House in April 2019 would close the boyfriend loophole, but there’s been no action on the Senate version since it was introduced there in November.

It’s called the “boyfriend loophole” as shorthand for the fact that men are more likely than women to perpetrate domestic violence, but the federal laws apply regardless of the sex or sexual orientation of the perpetrator.

The rate that women are victims of intimate partner violence is five times higher than the rate for men, according to data from the Bureau of Justice Statistics. Researchers at the Centers for Disease Control and Prevention, analyzing national data from 2003 to 2014, found in a July 2017 research report that more than half of women killed during that period were killed by intimate partners.

In another recent paper, published in March 2019 in Violence and Gender, researchers analyze national data from 2010 to 2017, finding that “More than two-thirds of intimate partner homicides involve a male perpetrator and a female victim, in comparison with one-fifth of incidents in which the genders are reversed. Moreover, nearly half of all female homicide victims are killed by an intimate partner, compared with only 5% of male homicide victims.”

Intimate partner homicide victims under 18 are likely to be girls or young women killed by a firearm, according to an April 2019 paper in JAMA Pediatrics that examines data from 32 states from 2003 to 2016. Nearly 7% of the 2,188 adolescent homicide victims in the sample — average age of about 17 — were killed by intimate partners, and nearly two-thirds of those victims were killed by a firearm.

“Adolescents, particularly girls, in dating relationships may face risk of homicide, especially in circumstances of a breakup or jealousy and when perpetrators have access to firearms,” the authors write.

People experiencing domestic violence who want crisis intervention, safety planning and other help can reach out to the federally funded National Domestic Violence Hotline. loveisrespect, a project of the hotline, was designed to help teens experiencing domestic violence.

Formative findings

State laws that restrict people who’ve had domestic violence restraining orders brought against them from obtaining firearms were associated with a 25% reduced risk of intimate partner homicides by gun, and an overall 19% reduced risk of intimate partner homicide, according to study of data from 1979 to 2003 in 46 of the largest U.S. cities, published in November 2009 in Injury Prevention.

Violence between unmarried partners might be a pressing policy issue. A review of more than 31,000 intimate partner violence incidents reported to Philadelphia police in 2013 found that 82% of those incidents involved current or former boyfriends or girlfriends. But place matters. More than half of the adult population in Philadelphia has never been married, the largest percentage of the 10 largest U.S. cities, the authors note in their paper, published in February 2018 in Preventive Medicine. Other large cities like Chicago and Los Angeles are close behind.

“And when it comes to fatalities, women in the United States are more than twice as likely to be shot and killed by their male intimate as they are to be fatally shot, stabbed, bludgeoned, strangled, or killed in any other way by a stranger,” writes one of the authors, University of Pennsylvania social policy and public health professor Susan Sorenson, in a different paper on the same topic.

Recent research

The Lautenberg Amendment may have saved lives. A July 2015 analysis in the Journal of Policy Analysis and Management finds evidence that the law led to 17% fewer women being killed by an intimate partner with a gun, without any concurrent increase in homicides against women committed using other weapons. The author, University of Connecticut public policy professor Kerri Raissian, stresses the need for more research.

“The federal law is distinct from state laws in several ways: It is retroactive and permanent, there are no public service exemptions, the penalties for violation are usually much larger than those allowed by state laws, and sizable federal resources — especially those related to enhancing the background check system — likely bolster the effectiveness of the law,” Raissian writes. “Future work should seek to understand which of these distinctions matters as this might be critical to the success of future gun or family violence legislation. A second important area for future research is investigating why domestic batterers are sensitive to federal gun restrictions.”

State-level gun restrictions related to intimate partner violence that took effect from 1991 to 2015 were associated with 14% lower rates of intimate partner homicide by gun, and nearly 10% lower intimate partner homicide rates overall, according to an October 2017 analysis in the Annals of Internal Medicine.

The authors of that paper note another loophole in the Lautenberg Amendment:

“Although the federal statute prohibits certain [intimate partner violence] offenders from possessing firearms, it does not explicitly require them to surrender guns already in their possession. In other words, in some states, a person may technically be prohibited from possessing a firearm, but it is up to the person to go to a police station to relinquish the weapon.”

Further reading

Fox in the Henhouse: A Study of Police Officers Arrested for Crimes Associated With Domestic and/or Family Violence

Philip Matthew Stinson Sr. and John Liederbach. Criminal Justice Policy Review, August 2012.

The gist: “Our data on police arrested for crimes associated with domestic and/or family violence demonstrates how some officers escape appropriate penalties due to loopholes and the impact of the discretionary decisions of actors in the system.”

Expert sources

Avanti Adhia, senior fellow, Harborview Injury Prevention & Research Center, University of Washington.

James Alan Fox, professor of criminology, law and public policy, Northeastern University.

Kerri Raissian, associate professor of public policy, University of Connecticut.

Susan Sorenson, director, Ortner Center on Violence & Abuse, University of Pennsylvania.

Philip Matthew Stinson Sr., professor of criminal justice, Bowling Green State University.

*Dropped out of race since publication date.

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In the lead-up to the 2020 elections, the Journalist’s Resource team is combing through the Democratic presidential candidates’ platforms and reporting what the research says about their policy proposals. We want to encourage deep coverage of these proposals — and to do our part to help deter horse race journalism, which research suggests can lead to inaccurate reporting and an uninformed electorate. Our criteria for the proposals we’re covering is simple: We’re focusing on proposals that have a reasonable chance of becoming policy, and for us that means at least 3 of the 5 top-polling candidates need to have indicated they intend to tackle the issue. Here, we explore what the research says on universal background checks and permit-to-purchase gun legislation.

Candidates favoring universal background checks

Michael Bennet*, Joe Biden, Cory Booker*, Pete Buttigieg,* Julián Castro*, John Delaney*, Tulsi Gabbard*, Kamala Harris*, Amy Klobuchar*, Bernie Sanders*, Tom Steyer*, Elizabeth Warren*, Marianne Williamson*, Andrew Yang*

Candidates favoring gun permits

Cory Booker*, Pete Buttigieg*, Julián Castro*, Kamala Harris*, Amy Klobuchar,* Bernie Sanders*, Tom Steyer*, Elizabeth Warren*, Marianne Williamson*, Andrew Yang*

What the research says

In general, academic studies do not show that background checks alone for firearm purchases substantially reduce firearm deaths.

Instead, a growing body of research suggests that universal background checks can be effective when combined with licensing strategies, such as permit-to-purchase. Under permit-to-purchase regulations, a gun buyer must pass a background check to obtain a permit to purchase a firearm.

Key context

There are two markets for legal gun sales in America. One market is regulated. The other isn’t.

When candidates favor “universal background checks,” they want all legal gun buyers to be subject to a criminal and mental health background check. Today, for certain gun sales, sellers do not have to run a background check on customers. This is sometimes called the “gun-show loophole,” though people buying from federally licensed dealers at gun shows still need to pass a background check. Private sales between people who live in the same state, such as private sales at gun shows or online, do not require a background check — though roughly a dozen states require background checks for all types of gun sales.

The Gun Control Act of 1968 was the first federal legislation that aimed to track firearm commerce. It established the federal licensing system for firearms dealers. The act applies to people who sell guns as a business.

The Firearm Owners Protection Act of 1986 confined the federal government’s authority in enforcing the GCA. For example, the FOPA limits how often federal agents can inspect gun dealers for violations. The FOPA also makes clear that private sales are precluded from regulation. A person who engages in “occasional sales, exchanges, or purchases of firearms for the enhancement of a personal collection or for a hobby, or who sells all or part of his personal collection of firearms” doesn’t need a federal license.

The national instant criminal background check system was established in 1998 as part of the Brady Handgun Violence Prevention Act — sometimes called the Brady Act, Brady Bill or Brady Law — which President Bill Clinton signed in 1993. The act was named for and championed by James Brady, onetime press secretary to President Ronald Reagan. Brady was shot in the head in March 1981 during an assassination attempt on Reagan. Brady lived with physical disabilities for the rest of his life. His death in 2014 was ruled a homicide.

The Brady Law imposed a five-day waiting period before a licensed dealer could transfer a handgun to a buyer. This provision expired, as intended, in 1998. A permanent provision that went into force that year established the federal background check system that now exists. The Bureau of Alcohol, Tobacco, Firearms and Explosives is responsible for enforcing federal gun control legislation. The FBI runs background checks.

There are 36 jurisdictions in which sellers contact the FBI directly for checks. In 13 states, state agencies conduct checks by electronically accessing the NICS, as the national instant criminal background check system is often called. The rest of the states have a mix of checks that either the state or FBI conducts, depending on the type of gun being purchased.

Federally licensed and private vendors both sell at gun shows. The most recent analysis of how gun owners got their firearms was published in 2017 in the Annals of Internal Medicine and included 1,613 adult gun owners who took a nationally representative, web-based survey. This survey found 22% of participants obtained firearms within the last two years without a background check. News outlets and academic researchers regularly cite this survey as the best available recent estimate. The analysis was primarily funded by organizations that support stricter gun control, but the authors note in their paper that the “funders did not play a role in the design, conduct, or reporting of the research or in the decision to submit the manuscript for publication.”

A Pew Research poll from October 2019 finds 93% of Democrats and 82% of Republicans “favor background checks for private gun sales and sales at gun shows.” Support for other proposals, like assault weapons bans, tend to fall along partisan lines, with Democrats more widely supportive than Republicans, according to Pew.

The ATF keeps an updated list of state gun laws. Eleven states and the District of Columbia require background checks for all commercial firearm transactions, and Nevada will join the list in early 2020, according to the Giffords Law Center to Prevent Gun Violence, an organization that provides technical assistance on gun control policy to legislators and advocates. Background check records are destroyed within 24 hours after the check is completed. This period was previously 90 days, but the Department of Justice shortened the period to no more than 24 hours in the mid-2000s. Five states allow municipalities to enact their own gun laws.

The FBI has completed roughly 328 million firearm background checks since 1998. It conducted about 26 million last year. There are 12 reasons the FBI denies gun sales. From November 1998 through October 2019, the FBI denied nearly 1.7 million gun sales. More than half of those denials were because the potential purchaser had been convicted of a crime punishable by more than one year in prison, or a misdemeanor punishable by more than two years.

If the FBI cannot complete a background check within three days, a federally licensed dealer may — but isn’t required to — complete the sale. From 2006 to 2015, there were roughly 6,700 guns sold to people with domestic violence records after the FBI did not meet the three-day deadline, according to an analysis from the Government Accountability Office, an independent nonpartisan congressional watchdog. Several states allow the three-day federal deadline to be extended. In Utah, a gun purchase can’t happen until an NICS background check is completed.

The number of firearms sold after the three-day deadline to people who should have been denied has doubled in recent years, according to a Wall Street Journal analysis. The U.S. Senate hasn’t taken up a bill the House passed earlier this year that would extend the deadline to at least 10 days.

Gun buyers who are denied on the regulated gun market may turn to the unregulated market. Some three-quarters of people incarcerated for gun crimes got their firearms from someone who did not legally have to conduct a background check, according to a 2017 review of research and state gun laws published in the Journal of Law, Medicine and Ethics.

To recap, some legal gun sales are regulated while other gun sales are unregulated. Between one-fifth and one-quarter of legal gun sales are unregulated, according to the latest research. A gun store owner has to be federally licensed, run background checks on customers and record firearm sales. Someone selling a gun online doesn’t need to run a background check or record the sale. Licensed and unlicensed vendors sell side by side at gun shows. Another bill the U.S. House passed in early 2019 would require background checks for private sales, but that bill hasn’t moved in the U.S. Senate since March.

Formative findings

One of the first studies to look into the Brady Law was published in August 2000 in the Journal of the American Medical Association. The authors analyzed firearm homicides and suicide rates from 1985 to 1997 in the 32 states that did not have comparable legislation. As a control, they also analyzed those rates in the 18 states that already had similar legislation. The authors found homicide and suicide rates didn’t change much after the law was passed. Only the rate of firearm suicides for people aged 55 and older declined. This relationship was particularly evident in states with waiting periods and background checks, as opposed to only background checks. In a blog post, the authors characterize the Brady Law as having a “useful — but modest” effect on keeping guns out of the hands of people who the federal government prohibits from having them. They note that the secondary gun market is unregulated, as it remains today.

A task force of doctors from government agencies and academia in 2005 published a comprehensive literature review in the American Journal of Preventive Medicine on whether firearm laws reduce violence. The authors found four studies, including the one mentioned above from JAMA, that explored background checks. They note that the suicide reduction observed among people age 55 and older seems linked to waiting periods and not necessarily to felony restrictions. Yet another early study, published in the American Journal of Public Health and mentioned in the literature review, found that denying handgun sales to felons was associated with a 20% to 30% lower risk of those felons committing new gun-related or violent crimes.

The JAMA and AJPH studies aren’t necessarily contradictory. They simply take different approaches. The JAMA study looked at violence that happened before and after the Brady Law. The AJPH study tried to peer at the other side of the coin — at violence that didn’t happen.

Recent research

There is not much recent, federally-funded research on gun violence. In 1996, Congress passed legislation that prohibited the Centers for Disease Control and Prevention from using federal funds to “advocate or promote gun control.” That means there is little federal funding to examine gun violence on a national scale.

In February 2019, researchers writing in the Annals of Epidemiology examined California’s longstanding background check law. The authors looked at elements of the law that require criminal background checks for almost all gun sales in the state and prevent nearly everyone convicted of violent misdemeanors from buying a firearm for a decade. There was no association between these laws and changes in the firearm homicide rate in California, according to the paper. The authors note incomplete data and potential lack of enforcement could affect their findings.

Another study from July 2018, published in Epidemiology, likewise found no apparent association between repeals of comprehensive background check laws in Indiana and Tennessee and changes in firearm suicide and homicide rates in those states.

One study from 2016 published in The Lancet analyzed firearm-related deaths in all states from 2008 to 2010. This study considered how different gun control laws — 25 in all — affect firearm death rates. The study was cross-sectional, meaning it offered a snapshot in time. The authors found that federally-mandated, universal background checks — sometimes called comprehensive background checks — could reduce firearm deaths in the U.S. by 57%. But behavioral scientists at RAND Corp., a nonprofit, nonpartisan research and analysis organization, took exception to the paper, citing “a number of serious analytical errors that we suspected could undermine the article’s conclusions.”

RAND authors Terry Schell and Andrew Morral write: “Our corrected analyses found no statistically significant evidence for any of the article’s major conclusions.” The lead author of The Lancet paper, Bindu Kalesan, and her co-authors responded, describing Schell and Morral’s analysis as “a skewed reading of the evidence, and a singular view of common sense.”

The research is clearer that background checks can reduce gun violence when those checks are done in tandem with permit-to-purchase programs. A June 2018 study in the Journal of Urban Health found that for large, urban counties, permit-to-purchase laws were associated with a 14% drop in firearm homicides. Comprehensive background checks alone, meanwhile, were associated with increases in firearm homicide in large urban areas. Ten states and the District of Columbia have permit-to-purchase laws, according to the authors. This permitting process, “may include a more thorough background check which law enforcement can take 30 days or more to complete,” they write.

Connecticut passed a permit-to-purchase law in 1995. Over the next decade, the law was associated with a 40% drop in firearm homicide rates, according to August 2015 research in the American Journal of Public Health. In Missouri, firearm homicide rates increased 23% in the three years after Missouri repealed its permit-to-purchase requirement in 2007, according to an April 2014 study in the Journal of Urban Health.

“Given the body of evidence on the effectiveness of licensing laws and the increasing levels of support among the population, including gun owners, policy makers should consider handgun purchaser licensing as a complement to [comprehensive background check] laws,” conclude Johns Hopkins University researchers Cassandra Crifasi, Alexander McCourt and Daniel Webster in their June 2019 white paper on permit-to-purchase programs.

Further reading

Gun Control: National Instant Criminal Background Check System Operations and Related Legislation

Congressional Research Service, October 2019

The gist: “This report provides an overview of federal firearms background check procedures, analysis of recent legislative action, discussion about possible issues for Congress, and related materials.”

No Silver Bullet: Firearm Laws and Pediatric Death Prevention

Lois Lee and Judy Schaechter. Pediatrics, August 2019.

The gist: “As meaningful as universal background checks appear, there is no single silver-bullet policy that will lead to significant reductions in pediatric gun deaths throughout the pediatric age range. Rather than the effect of 1 law, it is more likely that the synergistic effects of multiple laws targeting different aspects of firearm regulations will be required to substantially decrease firearm fatalities in the United States.”

Media Coverage and Firearm Acquisition in the Aftermath of a Mass Shooting

Maurizio Porfiri, Raghu Ram Sattanapalle, Shinnosuke Nakayama, James Macinko and Rifat Sipahi. Nature Human Behaviour, Letters, June 2019.

The gist: “Our results demonstrate that media coverage may increase public worry about more stringent firearm control and partially drive increases in firearm prevalence.”

Few Individuals Denied Firearms Purchases Are Prosecuted and ATF Should Assess Use of Warning Notices in Lieu of Prosecutions

U.S. Government Accountability Office, September 2018.

The gist: “Federal and selected state law enforcement agencies that process firearm-related background checks through the [NICS] collectively investigate and prosecute a small percentage of individuals who falsify information on a firearms form (e.g., do not disclose a felony conviction) and are denied a purchase.”

Effects of Policies Designed to Keep Firearms from High-Risk Individuals

Daniel Webster and Garen Wintemute. Annual Review of Public Health, January 2015.

The gist: “Mounting evidence indicates that certain laws intended to increase the accountability of firearm sellers to avoid risky transfers of firearms are effective in curtailing the diversion of guns to criminals, in particular the more rigorous [permit-to-purchase] handgun laws, comprehensive background checks, strong regulation and oversight of gun dealers, and laws requiring gun owners to promptly report lost or stolen firearms.”

Firearm Legislation and Firearm-Related Fatalities in the United States

Eric Fleegler, Lois Lee, Michael Monuteaux, David Hemenway and Rebekah Mannix. JAMA Internal Medicine, May 2013.

The gist: “A higher number of firearm laws in a state are associated with a lower rate of firearm fatalities in the state, overall and for suicides and homicides individually.”

State Background Checks and Firearms Homicides

Rick Ruddell and G. Larry Mays. Journal of Criminal Justice, March-April 2005.

The gist: “The large number of firearms circulating within the United States makes it likely that a motivated — but ineligible — person could obtain a firearm over the long-term in the secondary firearms market. Effective state background checks, however, may temporarily frustrate an unauthorized person from obtaining a firearm that, in turn, may contribute to lower firearms homicide rates.”

Subject experts

Philip Cook, professor emeritus, Duke University.

Cassandra Crifasi, assistant professor, Johns Hopkins University.

Gretta Goodwin, Homeland Security and Justice director, Government Accountability Office.

Bindu Kalesan, assistant professor, Boston University School of Medicine.

Louis Lee, senior associate in medicine, Boston Children’s Hospital.

Jens Ludwig, Crime Lab director, University of Chicago.

Matthew Miller, professor, Northeastern University.

John Vernick, professor, Johns Hopkins University.

Daniel Webster, professor, Johns Hopkins University.

Garen Wintemute, Violence Prevention Research Program director, University of California Davis.

*Dropped out of race since publication date.

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A wholesale change in policing tactics earlier this decade in Camden, New Jersey — a city that historically has struggled with violent crime — is associated with the city’s major trauma center treating lower rates of gunshot patients in recent years, finds new research in Preventive Medicine Reports.

Camden disbanded its police force in 2013 after one of the city’s most violent years on record. Camden County took over and in May 2013 formed a new department, the Camden County Police Department, to patrol the city. There were 175 officers in Camden in 2011 but by 2014 the force was up to 411, according to an analysis in Governing. CCPD also instituted community-based policing tactics along with new technology.

In the paper, analysts from Cooper University Hospital — a Level 1 trauma center near the Camden waterfront — compare 940 cases of patients with gunshot wounds treated at the hospital from 2010 to 2017. The data include 444 people shot within 1,215 days before CCPD was established and 496 shot within 1,705 days afterward.

The authors observe that on average there were 34 gunshot patients treated every three months before the policing changes, and 26 quarterly gunshot patients after. To account for population fluctuations during the study period, they standardize those numbers and report a final decline from 44 to 35 gunshot patients per quarter, per 100,000 people — a 22% drop following the policing changes. The authors acknowledge the percent drop they report in the paper, 24%, is inaccurate and appears due to an oversight during editing.

The quarterly average number of days that patients with gunshot wounds spent at the hospital dropped 31%. Health care costs for treating gunshot patients fell $254,000 per quarter.

The authors write that policing changes like those Camden pursued “could alleviate the burden of firearm-related injuries in similar communities and save millions in taxpayer dollars. This money could be reallocated towards programs that can continue to decrease firearm-related injuries.”

While the rate of gunshot patients at Cooper declined substantially, the firearm injury fatality rate per 100,000 people increased from 13.5% to 17.3% among patients the hospital treated. The authors put forward several theories to explain the increase, but they’re most confident it’s connected to a policing tactic CCPD mandated called “scoop and run.” Sometimes called “scoop and go,” this tactic emphasizes getting victims to doctors as soon as possible. Police take critically wounded victims to the hospital, instead of waiting for an ambulance.

“Delay in trauma treatment is very important and it’s minimized with ‘scoop and go,’” says Justin Frisby, one of the paper’s authors. “You give hope for people to get into the trauma center with less interventions.”

Rather than gunshot victims dying at the scene, “scoop and go” gives victims the chance to receive potentially life-saving medical treatment. But it also means the most critically wounded patients, who have a lower chance of survival, may still die even if they make it to the trauma center.

A history of violence

Camden is a city of about 77,000 across the Delaware River from Philadelphia. Violence peaked there in 2012.

In the city police department’s last year of existence, it reported 86 criminal homicides per 100,000 people to the FBI’s Uniform Crime Reporting Statistics program — the highest recorded rate in nearly two decades. The overall violent crime rate, including crimes like assault, rape, robbery and murder, was 2,566 per 100,000 people in 2012. At the time, just a dozen officers might have been patrolling the city in any given night, according to Governing.

The criminal homicide rate in Camden in 2012 was outpacing rates in much larger historically violent cities. Detroit, for example, had a criminal homicide rate of about 55 per 100,000 people, while Baltimore and St. Louis were each at about 35 criminal homicides per 100,000 in 2012, according to FBI UCR data.

In the years that followed, Camden became a city with one of the most progressive police departments in the country. CCPD rewrote its use-of-force guidelines “to ensure officers respect the sanctity of life” by exercising “the utmost restraint” in situations when they might need to use force. Patrol officers started wearing body cameras. The department also put more eyes on Camden in the form of hundreds of street cameras, a video observation platform covering a six-block radius, and monitoring technology that alerts police when and where shots are fired.

All that new technology came with a $4.5 million price tag. Cooper analysts show some return on that investment is coming in the form of health care savings — about $1 million per year. Most medical costs for gunshot patients during the study period were paid through public insurance like Medicaid and Medicare, according to the authors. The actual savings could be much higher.

“Costs are only for the initial encounter and do not capture readmissions, long term care, rehabilitative services, and other post-treatment costs,” the authors write. “As we expect these costs to be high, we believe our study is a conservative estimate compared to the overall total cost these patients have on the healthcare system and society.”

The new paper reflects overall trends in Camden’s violent crime reduction since 2012. The criminal homicide rate had fallen by roughly three-quarters by 2018, according to CCPD data, while the number of criminal homicides caused by shootings decreased 68% since 2012. Overall crime is now at a 50-year low in Camden, and some residents credit improved relations with police.

The drop in violent crime means Camden might be catching up to most of the rest of the country. Violent crime rates in U.S. cities have fallen dramatically since the 1990s, according to Americanviolence.org, a project led by Princeton University sociology professor Patrick Sharkey that supplements FBI UCR crime statistics with data from the non-partisan Gun Violence Archive.

Despite the statistical improvements, violence remains a part of everyday life for many Camden residents and police. Last summer, two detectives were ambushed and shot at while at a traffic light during National Night Out, a campaign with roots in the Philadelphia suburbs meant to strengthen bonds between police officers and the communities they serve.

Yet in the year she has worked at Cooper, Emily Schultz — another author on the new paper — has seen signs of growth in parts of Camden.

“There is a new health science building along the waterfront,” Schultz says. “There are new businesses, restaurants and stores, so it’s growing and developing pretty quickly.”

Study limitations

The authors note several limitations in their paper. There is the possibility that some gunshot cases were misclassified in Cooper’s trauma database.

“However, as our institution is required to have a dedicated database manager for all traumas presenting to the trauma bay, we believe the database information is accurate,” the authors write.

Because Cooper is a Level 1 trauma center, it can handle comprehensive care for any injury. As the only such trauma center in the county, the authors cannot be sure that every gunshot patient at Cooper during the study period came from Camden city. There also might be factors at play that contributed to the violent crime reduction, beyond the changes in policing.

“There’s no such thing as a perfect study, especially looking retrospectively,” Frisby says. “We couldn’t rule out every other variable. But there’s definitely a relationship between the policing tactics and reduced incidence of gunshot wounds in Camden.”

The authors also don’t compare gunshot wound patients who ended up at Cooper against police reports. In addition to scoop-and-go, the authors speculate that new types of firearms might have contributed to the increase in mortality from shootings. They also offer that because there were more police on Camden’s streets, gun violence might have moved indoors where shots may be fired at a closer, more lethal range. But without specifics from police reports, the authors do not draw conclusions.

Still, they write that Camden’s policing changes could serve as a broad template for reducing firearm injuries in similar cities — but the devil is in the details.

“Every city is different,” Frisby says. “It’s difficult to apply one set policy to every city.”

Certain surveillance technology, for example, may run afoul of civil liberties watchers. Last year, Seattle dismantled a $3.6 million wireless police surveillance network that a representative from the American Civil Liberties Union of Washington said was wrapped up in “a brave new world where data and algorithms can be used against you without transparency,” according to The Seattle Times.

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President Donald Trump addressed the nation from the White House on Aug. 5, after shooters in separate incidents killed a combined 31 people in Dayton, Ohio and El Paso, Texas. In his remarks, Trump reiterated his call for states to pass so-called “red flag” gun-control laws to help prevent mass shootings.

“We must make sure that those judged to pose a grave risk to public safety do not have access to firearms, and that if they do, those firearms can be taken through rapid due process,” Trump said.

Red flag laws — also known as risk warrant and extreme risk protection order laws — allow courts, through due process, to temporarily take firearms from people whom family, friends or others report as potentially dangerous to themselves or others.

Trump and other politicians have suggested red flag laws in response to past mass shootings. After an armed student shot and killed 17 people at Marjory Stoneman Douglas High School in Parkland, Florida, a flood of states passed red flag laws. Seventeen states, along with the District of Columbia, now have them. While research has associated red flag laws with lower suicide rates, there does not appear to be any peer-reviewed research on whether they can prevent mass shootings.

Red flag laws associated with fewer suicides

There is a lack of recent, federally funded research on gun violence because, in 1996, Congress passed legislation that prohibited the Centers for Disease Control and Prevention from using funds to “advocate or promote gun control.” That means there is little federal funding to examine gun violence on a national scale. But that doesn’t mean there isn’t research on red flag laws.

One study published in Psychiatric Services in 2018 looks at how red flag laws affected suicide rates in Connecticut and Indiana. Nationally, almost two-thirds of gun deaths are suicides, according to 2017 data from the CDC.

Connecticut passed the nation’s first red flag law in 1999. But the law wasn’t strongly enforced until after the mass shooting at Virginia Tech in April 2007, according to the paper’s authors, Aaron Kivisto and Peter Phalen of the University of Indianapolis. Indiana’s law was enforced immediately after the state legislature passed it in 2005, according to the authors.

Kivisto and Phalen find that Indiana’s law was associated with a 7.5% drop in firearm suicides in the decade after its passage. Connecticut’s law, they find, was associated with a 1.6% reduction in firearm suicides after it was passed — that jumped to 13.7% after the state started enforcing the law in earnest eight years later.

“Even though risk-based firearm seizure laws have typically been enacted in response to mass homicides, the laws have functioned primarily as a means of seizing firearms from suicidal individuals,” Kivisto and Phalen write.

Other recent research led by Jeffrey W. Swanson at Duke University also analyzes how the Connecticut and Indiana have affected suicides. Swanson’s research takes a slightly different approach than Kivisto and Phalen in that it looks at the prevention of suicide by firearm as a function of gun seizures. In both Connecticut and Indiana, Swanson and his colleagues find that roughly one suicide is prevented for every 10 gun seizures.

While the research has found that these laws can save lives, Swanson writes that other questions still need answers. For example: How do these laws work best? Are there potential adverse consequences? How big of an impact can red flag laws have?

“These questions form an agenda for the next generation of research studies — an important next step in bringing this life-saving legal policy to scale,” Swanson concludes.

Again, there does not seem to be any peer-reviewed research on whether red flag laws can prevent mass shootings. According to a December 2018 report from the Federal Commission on School Safety, led by U.S. Secretary of Education Betsy DeVos, “available evidence suggests that the older risk warrant laws may have a positive impact on suicide prevention. We do not know whether they impact gun violence more generally, and it appears no studies have yet evaluated the more recent [extreme risk protection order] laws in other states.”

September 5, 2019 update: Since this article originally ran, there has been at least one preliminary piece of research published on red flag laws specifically as a counter to mass shootings. In “Extreme Risk Protection Orders Intended to Prevent Mass Shootings: A Case Series,” published August 20 in the Annals of Internal Medicine, the authors review 159 red flag law cases in California. They identify 21 cases in which a judicial officer issued a firearm restraining order after a person who would soon have access to guns declared or indicated they were going to commit a mass shooting.

The authors caution against drawing a causal relationship between red flag laws and preventing mass shootings, but they conclude that “the cases suggest that this urgent, individualized intervention can play a role in efforts to prevent mass shootings, in health care settings and elsewhere. Further evaluation would be helpful.”

Preventing all types of gun violence

Vox has tallied more than 2,000 mass shootings since 20 children and six staff members were killed at Sandy Hook Elementary School in December 2012. The news outlet defines mass shootings as “events in which four or more people, excluding the shooter, were shot but not necessarily killed at the same general time and location.” The FBI uses a similar description, though there is no standard definition for mass shootings.

Since 2013, there has been only one week without a mass shooting, according to the Vox analysis. While mass shootings receive wide media attention, they represent a small percentage of gun deaths. Writing in the Journal of Crime and Justice, Jaclyn Shildkraut at the State University of New York at Oswego — along with Jaymi Elsass and Kimberly Meredith from Texas State University — find that “race/ethnicity and victim counts are the most salient predictor of whether or not a shooting was covered.”

There is not much academic research on preventing mass shootings. After Parkland an interdisciplinary group of 19 experts released an 8-point proposal for preventing gun violence at schools, writing that “prevention entails more than security measures and begins long before a gunman comes to school.”

Universal background checks, removing guns from people with a history of violence and red flag laws are most strongly associated with reducing firearm homicides, according to a Rockefeller Institute of Government policy brief from March 2019 by Michael Siegel and Claire Boine, both of Boston University.

Mass shootings and mental illness

Politicians sometimes bring up mental illness after mass shootings. President Trump drew a stark line connecting mental health and physical violence during his Aug. 5 remarks at the White House.

“Our future is in our control,” he said. “America will rise to the challenge. We will always have, and we always will, win. The choice is ours and ours alone. It is not up to mentally ill monsters.”

In an analysis of 160 mass public shootings across the country during the 1990s, Grant Duwe, director of research at the Minnesota Department of Corrections, found in 60% of cases studied the killers had a psychiatric diagnosis. Another study that analyzed 305 violent incidents committed by people with a history of violence found psychosis immediately preceded 12% of those incidents.

Duwe and others have urged against stigmatizing people with mental illness.

“Although these statistics should not be used to stigmatize populations, they do provide some justification for increased mental health treatment access and screening, which is sorely lacking in the United States,” Duwe writes in a separate paper in Current Opinion in Psychology from February 2018.

People with mental illness are actually much more likely to be victims than perpetrators of violence, according to a wide body of research, including a paper from 2017 in the Annual Review of Clinical Psychology that found guns are “not, by and large, a mental health problem.” Other research has estimated that to prevent one random homicide by a person diagnosed with schizophrenia, 35,000 people with schizophrenia would need successful risk management treatment.

Megan Ranney from Brown University and Jessica Gold from Washington University in St. Louis have noted that mass shootings are more correlated with domestic violence than mental illness. “If we are going to talk about the role of mental health in mass shootings, let’s talk instead about mental health in the aftermath,” they write in a piece published Aug. 7 in Time.

While research doesn’t seem to exist on whether red flag laws affect rates of mass shootings, research does show that these laws can still save lives. “The evidence on suicide prevention is a good enough reason for states to enact [extreme risk protection order laws] and for the federal government to incentivize them with infrastructure grants,” Swanson writes in an Aug. 9 article in The Washington Post.

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Jon Vernick is a professor at Johns Hopkins University’s Bloomberg School of Public Health and co-director of the Johns Hopkins Center for Gun Policy and Research. His research centers on the nexus between the law and public health, with a focus on firearms and other injury prevention. He has authored over 100 publications on topics such as the effect of gun permit law implementation on subsequent homicides, the impact of universal background check laws, and issues physicians must consider before discussing firearm safety with their patients.

Earlier this month, Vernick participated in a panel discussion on the intersection of gun violence and public health at Health Journalism 2019, the annual conference of the Association of Health Care Journalists (AHCJ). Afterward, we sat down with him to and ask about his tips for reporting on gun violence and gun policy. He offered six tips for journalists on the beat.

Tip #1: When reporting on the results of a public opinion poll about gun policy, focus on the specific phrasing of questions.

Vernick explained that responses to public opinion polls can vary widely depending on the phrasing of the question. For example, people are less likely to support the broad proposition of stricter gun policies, but more likely to support specific policies that have the effect of restricting access to guns, such as requiring background checks for all guns purchased.

Vernick added: “And that’s how policy works in this country; we don’t pass laws in general, we pass them specifically. And so I encourage journalists to not get too hung up on the broad trends, and instead focus on the relevant policies.”

Tip #2: Know how gun licensing and registration works in the U.S.

Vernick said he sometimes quizzes his students about ways of arriving at a national estimate for the number of guns in the U.S. “The students will raise their hands and say, ‘Well, can’t you just count the number of registrations?’” Vernick said. “And I have to explain to them that we don’t actually register guns in the United States. Federal law actually prohibits the federal government from registering guns, and then only a handful of states register guns.” (States with some form of a registration policy include Hawaii, California, New York, Maryland, Connecticut and New Jersey. The District of Columbia also has one.)

“So then a student will raise their hand and say ‘Well, how about just counting the licenses, because that would tell us how many gun owners there are at least?’ and I say, ‘Well we don’t even license [all] gun owners in the U.S.,’” he added. “Only about 10 states license gun owners, require a permit to purchase prior to obtaining a gun. So, there’s some basic stuff about the laws that I think is misunderstood in talking about this.”

Tip #3: Have some knowledge of guns, too – the different kinds, and how they work.

“This is the kind of thing that drives the gun owner group crazy, when they think that a reporter is writing about their issue with their guns and doesn’t understand the basic facts about how they work,” Vernick said. For example, Vernick stressed the difference between assault weapons, which are semi-automatic, and machine guns or fully automatic weapons.

We’ve covered this at Journalist’s Resource before, in our tip sheet titled “7 Things Journalists Should Know About Guns.” In the piece, Alex Yablon, who covers the business of guns and gun policy at The Trace, suggests asking law enforcement for the make and model of the gun used in a particular crime. “That’s going to be the easiest way to avoid tripping up on any of these things,” he said.

Tip #4: When covering gun violence, include details on how firearms were acquired.

“I always hope that when journalists are covering gun violence, whether it’s homicide or suicide, they will focus on how the gun was acquired — how did it fall into the hands of the high-risk person? — because that often will teach us what policy solutions are most appropriate,” Vernick said. “If it was the gun that was stored improperly in the home that the young person commits suicide with, or shoots a sibling or a playmate with, that teaches us one thing. If it was a gun that was bought in a state that has looser laws and was brought into a state with stronger laws, that teaches us something. So that could be hard. That’s often the day two story. But I think it’s really important.”

Tip #5: Avoid repeating the common misconception that the Dickey Amendment bans federally funded gun violence research.

There’s a common notion that there’s no recent academic research on gun violence because Congress banned the U.S. Centers for Disease Control and Prevention from funding research projects that “may be used to advocate or promote gun control.” The National Rifle Association (NRA) had lobbied for the ban, put in place by a provision authored by former Republican Congressman Jay Dickey of Arkansas. Adopted in 1996, it became known as the Dickey Amendment.

“Well it turns out that CDC wasn’t advocating for gun control. It was doing research on gun control, and it’s still allowed to do research on gun control,” Vernick explained. “But the fact that that language exists in the Dickey Amendment, and the fact that CDC had to defend itself before Congress and perceived this as a threat to its funding had a chilling effect. Now CDC still collects data about gun violence — very, very important data — and they still do some research on risk factors, but the amount of that research is not proportional to the magnitude of the problem.”

Tip #6: Avoid false equivalence.

If you’re reporting the facts of an evidence-based study, don’t try to “balance” the coverage with an opposing opinion. “I think journalists actually do a good job already of balancing — maybe too good a job, depending on your perspective,” Vernick said. “At least in my experience, journalists bend over backward to give organizations like the NRA or other gun-owning or opposition groups a chance to comment, sometimes on things that they don’t know very much about. And so when I will do a research study and the studies get coverage, I sometimes wonder if it’s necessary to have a non-researcher from the NRA or another group respond.”

Looking for research on gun violence prevention? Vernick recommended the work of the following scholars:

• Cassandra Crifasi, an assistant professor at the Johns Hopkins Bloomberg School of Public Health
• Shani Buggs, a postdoctoral fellow with the Violence Prevention Research Program at the University of California, Davis
• Rose Kagawa, an assistant professor in the department of emergency medicine at the University of California, Davis
• Garen Wintemute, director of the Violence Prevention Research Program at the University of California, Davis

Want more health reporting tips from the experts? We also have tip sheets on covering medical research and rural health.

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Three days after the mass shooting in a Pittsburgh synagogue on Oct. 27 — and eight days before the mass shooting at a Thousand Oaks, Calif., dance bar on Nov. 7 — journalist German Lopez spoke at the Shorenstein Center on Media, Politics and Public Policy on the issue of gun violence in America. Lopez is a senior correspondent at Vox focusing on criminal justice, guns and drugs.

Following his talk, Lopez sat down with Journalist’s Resource to discuss gun violence in the U.S., where mass shootings are occurring with alarming frequency, and what journalists can do to improve their coverage.

Though definitions of what constitutes a mass shooting vary, Lopez prefers the simplicity of the Gun Violence Archive’s categorization, which considers an event in which four or more people are shot in a single incident a mass shooting. Under this definition, there’s nearly one for every day in the year, Lopez said.

U.S. law considers “mass killings” to mean three or more killings in a single incident. The FBI takes a narrower definition for “active shooter incidents,” which they consider to be “one or more individuals actively engaged in or attempting to kill people in a populated area.”

Critics say wider definitions of mass shootings may distort the public’s understanding by conflating incidents of gang violence, domestic abuse and robbery with indiscriminate public attacks.

The news media also might be partly responsible for what Lopez labeled a “self-perpetuating” aspect of mass shootings, according to research. “There is evidence that when there’s a mass shooting that gets widespread coverage, mass shootings become more likely shortly thereafter, just because there are copycats out there,” he said.

To deter fame-seeking copycat mass shooters, Lopez offered a few suggestions.

First, think twice before publishing the names of mass shooters. Lopez recommended asking yourself, “Is there a news value in getting this person’s name out there?” If not, then don’t.

He also suggested avoiding non-stop broadcast coverage of mass shootings. “What you see on cable news a lot is just non-stop coverage of the specific mass shootings and the very particular details that come out of it,” Lopez said.

“That seems to perpetuate the glorification of this mass shooting, instead of just focusing on the issues at large that a lot of people are thinking about in that moment,” like gun control, and other forms of gun violence.

Lopez continued, “If you do want to focus on mass shootings in particular, there’s a lot of work you can do there. You can talk to experts about why these keep happening, you can start walking through … not even just gun control policies, but other policies that might be effective for preventing mass shootings. There’s a lot of journalism you could do there that doesn’t focus just on the latest mass shooting to happen and the specific details that came out of that.”

Lopez also suggested zooming out to discuss other gun violence issues rather than focusing on details of a particular mass shooting. “It’s a moment to cover all the gun violence in domestic violence, or in minority communities, that often goes ignored,” he said.

Even while examining links between different types of gun violence, it’s important for journalists to maintain distinctions, too, Lopez said. He suggested breaking down gun violence in the U.S. by type – for example, homicide, suicide, mass shootings, accidents, violent injuries. “You can then start walking through those categories, and how they’re connected, and what the different solutions for them are, while still educating people in general on gun violence,” he said.

“Domestic [gun] violence is something that, particularly [in light of] the #MeToo movement, if you put it in that context, still gets a lot of attention, and that’s a way that you can continue focusing on gun violence and giving those issues attention,” Lopez said.

Lopez pointed out a few other angles for journalists to pursue in their coverage of gun violence:

• Stories about interventions launched by cities, states and countries that have lowered their suicide rates. For example, the Economist wrote about Japan, which saw success after a 2007 intervention aimed to reduce suicide rates by 20 percent over ten years.
• More comprehensive coverage of the trend of “deaths of despair,” focusing on suicide and alcohol rather than the opioid epidemic. Alcohol is linked to 88,000 deaths each year in the U.S. – more than all drug overdoses combined, according to the Centers for Disease Control and Prevention (CDC).
• Covering research that highlights possible solutions to gun violence that don’t focus on gun control. For example, focused deterrence policing (in which efforts are targeted on specific issues within a community), higher alcohol taxes and programs that eliminate blighted housing or raise the age at which students can drop out of school.

There’s a common notion that there’s no recent academic research on gun violence because Congress banned the CDC from funding research projects that “may be used to advocate or promote gun control.” The National Rifle Association had lobbied for the ban, put in place by a provision authored by former Republican Congressman Jay Dickey of Arkansas. Adopted in 1996, it became known as the Dickey Amendment.

Lopez, who relies heavily upon research in his reporting, said there are still some institutions producing “good work” on the subject, including the Injury Control Research Center at Harvard, Johns Hopkins University’s Center for Gun Policy and Research and the Violence Prevention Research Program at the University of California, Davis.

It’s part of Lopez’s job to share this research with the public. While he acknowledges that he “definitely” takes a stance, often in favor of gun control, he doesn’t consider himself an advocate.

“I am reporting what the research shows and then trying to translate that to a more readable format, because a lot of these studies just frankly are unreadable for lay people,” he said. “I think doing that responsibly, I do have to come to the conclusion sometimes that this research does land on a certain answer.”

The image in this post by Mathias Wasik was obtained from Flickr and is published under a Creative Commons license.

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Households with guns have a higher likelihood of gun injury, including homicide and suicide. Research indicates that around 7 percent of children in the United States live in homes with at least one loaded, unlocked firearm, which is more than twice as high as a previous estimate from 2002. Safe storage is one strategy that can limit unauthorized users’ access to firearms.

This roundup features research that puts numbers to firearm storage trends in the U.S. Some of this research highlights specific characteristics associated with safe gun storage. Safe gun storage includes securing guns in a locked safe or cabinet and using safety devices like trigger or cable locks.

A few studies also touch on potential strategies to promote safe gun storage, identifying partners for communicating safe storage practices, considering the feasibility of temporary storage at gun retailers and evaluating the success of prior interventions, such as the distribution of free gun locks.

“Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey”
Azrael, Deborah; et al. Journal of Urban Health, 2018. doi: 10.1007/s11524-018-0261-7.

This study looks at data from a nationally representative survey of 3,949 U.S. adults to better understand gun ownership and storage practices in households with children.

Findings:

• “Approximately 7 percent of US children (4.6 million) live in homes in which at least one firearm is stored loaded and unlocked, an estimate that is more than twice as high as estimates reported in 2002, the last time a nationally representative survey assessed this outcome.”
• “Among gun-owning households with children, approximately two in ten gun owners store at least one gun in the least safe manner, i.e., loaded and unlocked.”
• “Three in ten store all guns in the safest manner, i.e., unloaded and locked.”
• “The remaining half store firearms in some other way.”
• “Although firearm storage practices do not appear to vary across some demographic characteristics, including age, sex, and race, gun owners are more likely to store at least one gun loaded and unlocked if they are female vs. male; own at least one handgun vs. no handguns; or own firearms for protection vs. do not own for protection.”

“Storage Practices of US Gun Owners in 2016”
Crifasi, Cassandra K.; et al. American Journal of Public Health, 2018. doi: 10.2105/AJPH.2017.304262.

This study looks at nationally representative survey data from 1,444 U.S. gun owners about storage practices and factors associated with safe storage. The authors define safe storage practices as all guns being “stored in a locked gun safe, cabinet, or case; locked into a gun rack; or stored with a trigger lock or other lock.”

Findings:

• “Forty-six percent of gun owners reported safely storing all of their guns.”
• “Factors associated with higher odds of reporting safe storage were having a child in the home … only owning handguns … and reporting that storage decisions were influenced by a gun safety course … or discussions with family members.”
• “Gun owners ranked law enforcement, hunting or outdoors groups, active-duty military, and the National Rifle Association as most effective in communicating safe storage practices.” Physicians and celebrities were viewed as least effective.

“Who Owns Guns and How Do They Keep Them? The Influence of Household Characteristics on Firearms Ownership and Storage Practices in the United States”
Hamilton, David; et al. Preventive Medicine, 2018. doi: 10.1016/j.ypmed.2018.07.013.

Looking at data collected nationally through the federally-sponsored 2004 Behavioral Risk Factor Surveillance Survey, which has a sample size of 293,992, this paper looks at the demographics associated with gun ownership and safe storage practices.

Findings:

• “Close to one-third (32.6 percent) of all U.S. households reported owning a gun in 2004. More than one in five (22.3 percent) gun-owning households kept at least one of their guns loaded. Of those, three-fifths (60.7 percent) stored their loaded weapons unlocked. Altogether, one in 14 American households (7.3 percent) had a loaded firearm in or around their homes, and nearly one in 20 (4.4 percent) lived with a gun that was unsecured.”
• Men are more likely to own guns than women, and veterans are more likely to own guns than civilians. There was not much difference in gun ownership between households with children and those without.
• Gun-owning households with children are less likely to leave a loaded gun unsecured than those without children.
• Women are more likely than men to store their guns safely, and veterans are more likely than non-veterans to store their weapons unsafely.
• Married people are more likely to store guns safely than unmarried people, but they are also more likely to have guns than unmarried people.

“Associations between Active Shooter Incidents and Gun Ownership and Storage among Families with Young Children in the United States”
Morrissey, Taryn W. Preventive Medicine, 2017. doi: 10.1016/j.ypmed.2017.04.002.

How does an active shooter incident affect gun ownership and storage practices in the state in which it occurred? This study attempts to answer this question, using data from a longitudinal, interview-based study that followed a baseline sample of 10,700 children from 2001 to 2008, as well as information on active shooter incidents from a 2013 report.

Findings:

• “The lone statistically significant finding is that those interviewed in the 2 months following an active shooter incident anywhere in the country were 23 percentage points more likely to lock their guns than those interviewed in the 2 months prior.”
• When the analysis factored in the severity of the shooting, “the experience of an active shooter incident in the prior month anywhere in the U.S. was associated with an 18 percentage point increase in storing guns locked.”
• “Further, each fatality at the shooting event increased the likelihood of storing guns locked by 11 and 79 percentage points depending on whether the event had occurred anywhere in the U.S. or within the same state.”

“Effectiveness of Interventions to Promote Safe Firearm Storage”
Rowhani-Rahbar, Ali; et al. Epidemiologic Reviews, 2016. doi: 10.1093/epirev/mxv006.

This paper reviews seven studies published between 2000 and 2012 that tested various interventions intended to promote safe gun storage practices.

Findings:

• The three studies that provided gun owners with a free gun lock found that strategy was linked to significant improvements in safe storage practices.
• The four studies that focused on other types of interventions found them less successful. Though two out of these four studies offered an economic incentive for purchasing a safe storage device, they didn’t improve storage practices. The only study that saw a significant improvement in storage practices involved office-based verbal counseling by family physicians.

“Firearm Storage in Homes with Children with Self-Harm Risk Factors”
Scott, John; et al. Pediatrics, 2018. doi: 10.1542/peds.2017-2600.

Do gun storage practices differ in homes where children have self-harm risk factors, such as depression, attention-deficit hyperactivity disorder and other mental health conditions? This study compares survey data from a nationally representative sample of 3,949 U.S. adults.

Findings:

• Firearm ownership was roughly the same regardless of whether or not children in the home had a history of self-harm risk factors. Among homes where children had a history of self-harm risk factors, 43.5 percent had a firearm present. Meanwhile, 42.3 percent of the homes in which no child had self-harm risk factors had firearms.
• Homes where kids had a history of self-harm risk factors practiced safe gun storage at a slightly higher level compared with households with children who didn’t have self-harm risk factors – 34.9 percent compared to 31.8 percent.

“Firearm Storage Practices Among American Veterans”
Simonetti, Joseph A.; et al. American Journal of Preventive Medicine, 2018. doi: 10.1016/j.amepre.2018.04.014.

Veterans are at a higher risk of suicide than civilian adults. Limiting access to lethal, commonly used methods of suicide (e.g., firearms) is one component of suicide prevention. This study attempts to inform potential suicide prevention initiatives among veterans by analyzing survey responses from veterans as to gun storage practices and how they’re correlated with specific ownership characteristics.

Findings:

• Of the 1,044 veterans surveyed, 44.9 percent were firearm owners.
• “One in three Veteran firearm owners stores at least one firearm loaded and unlocked.”
• Male veterans were more likely to store at least one firearm loaded and unlocked compared to female veterans. Veterans with children in the house were also less likely to have a loaded and unlocked gun than those without.

“Gun Retailers as Storage Partners for Suicide Prevention: What Barriers Need to be Overcome?”
Pierpont, Lauren A.; et al. Injury Prevention, 2018. doi: 10.1136/injuryprev-2017-042700.

Gun retailers could offer temporary firearm storage to get firearms out of the house when someone is at risk of attempting suicide. This study asked gun retailers about their perceptions of the obstacles to providing temporary safe gun storage.

Findings:

• Over half of the 95 retailers who responded to the questionnaire thought federal laws make it harder to offer temporary storage.
• Twenty-five percent thought state laws were an obstacle.
• Over 60 percent said legal liability in storing and returning guns was a barrier.
• Other obstacles were cost, space and logistical issues.

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A common criticism aimed at journalists is their tendency to portray some groups in the United States as “the other” — framing stories as though certain groups aren’t part of the world where journalists themselves and the bulk of their audiences live. Think rural America.

Scholars have documented this approach and Journalist’s Resource has created tip sheets to help newsrooms become aware of this habit and its implications. For example, several months ago, we interviewed journalist Sarah Smarsh, who writes about class and middle America, and asked her to help us explain how reporters can improve their coverage of rural communities.

Here we’ve gathered research to help journalists consider how they cover another group with whom some appear to have trouble relating: people who own and use firearms. Americans use them for hunting, sport and personal protection or collect them as a hobby. Members of both the Cub Scouts and Boy Scouts of America — longstanding organizations that serve millions of children a year — learn to load and use guns.

Ben Hallman, a former deputy editor of The Trace, a nonprofit news organization that focuses on gun violence, has written about the news media’s shortcomings in this area. Reporters “frame stories in ways that make it clear they see gun-owning Americans … as distinctly other,” he explains in a piece he wrote for the Columbia Journalism Review.

According to survey data from the Pew Research Center, more than 4 in 10 U.S. adults live in a gun-owning household. In rural areas, the number is almost 6 in 10. In the Northeast, 27 percent of people live in a home with a gun, compared with 45 percent in the South.

Trent “Tate” Steidley, an assistant professor in the University of Denver’s Department of Sociology and Criminology, told Journalist’s Resource that news reports often don’t present a complete picture of gun owners.

For example, gun owners are “by and large, white, Protestant, middle-aged to older males with moderate to conservative leanings,” but news stories often fail to reflect that, said Steidley, who has studied media coverage of gun owners and teaches a course called “Guns and Society.” He said the media’s focus on gun violence in heavily populated areas makes it appear as though gun owners generally live in major cities and use their weapons to harm others.

“The types of things covered in news tend to focus on violence in big cities like Chicago and New York, but most gun owners live in rural areas,” he said in a telephone interview. “There’s a big disconnect between those two facts.”

A study published in the journal Written Communication spotlights other problems with the way gun owners are portrayed. Doug Downs, an associate professor in Montana State University’s Department of English, analyzed newspaper articles, editorials and letters to the editor from 31 major newspapers in the U.S. and Canada between October 1999 and April 2000. He found that newspapers rarely covered gun owners outside of courtrooms, morgues and protests and tended to represent them as a monolithic group. Gun owners often “are explicitly or implicitly characterized as selfish, incompetent, and irresponsible, caring more about guns than people,” Downs explains in the journal article, published in 2002.

Another key finding: Newsrooms appear to be “silencing perspectives on gun ownership that would show it more favorably than do the frames of a cosmopolitan worldview,” he writes.

A study that Steidley led looks specifically at how the news media cover the National Rifle Association (NRA). He and his co-author, Cynthia Colen, an associate professor at Ohio State University, examined how the New York Times responded to press releases from the NRA and the Brady Campaign to Prevent Gun Violence between January 2000 and June 2011. Their findings indicate that press release packages from the Brady Campaign resonate more with the Times, and that the newspaper is willing to share information to facilitate the efforts of the Brady Campaign but not the NRA.

When Steidley and Colen examined press releases from the Brady Campaign, they found that an increase of one press release per week containing a message emphasizing the tragic outcomes of gun violence improved the odds of Brady being included in the Times’ coverage by 52.2 percent. An increase of one Brady press release per week announcing administrative information — annual meetings and conventions, for instance — increased the odds the organization would be included in coverage by 56.1 percent, according to the study, published in Social Science Quarterly in 2017.

Meanwhile, “regardless of the type or frequency of packages used in weekly NRA press releases, press releases do not predict media coverage of the NRA,” the authors write.

“It may be that the Brady Campaign packages are more effective because rights to safety and firearm regulation are likely to resonate with urban residents,” the researchers write. “On the other hand, packages used in NRA press releases framing gun ownership as normal are meant to reverberate with rural residents in ‘middle America.’ Such findings would confirm … [earlier research] finding that NYT reporters covering the NRA have little resonance with its culture, and have little desire to understand it.”

Researchers at the Johns Hopkins Bloomberg School of Public Health take issue with the media’s portrayal of one type of gun user: Mass shooters who appear to have a serious mental illness (SMI). A research team led by Emma “Beth” McGinty, deputy director of John Hopkins’ Center for Mental Health and Addiction Policy Research, analyzed a random sample of 1,280 print and broadcast news stories about mental illness and gun violence between 1997 and 2012.

Here’s what they found: Fewer than 10 percent of the news stories examined mention five key facts about SMI — that most people with SMI are not violent, for example, and that predicting violence among people with SMI is difficult.

“News media coverage of gun violence by persons with SMI may lead the public to view SMI as an important cause of gun violence, when in reality other factors — such as criminals’ easy access to firearms — are more strongly associated with violent crime,” McGinty and her colleagues write in an article published in the American Journal of Public Health in 2014. “Even though this heightened public attention to the issue may raise public support for gun violence prevention policies, it may also exacerbate negative attitudes about persons with SMI.”

Steidley suggested journalists read The National Rifle Association and the Media: The Motivating Force of Negative Coverage, a book written by the late Brian Anse Patrick, who was a scholar of propaganda and tenured professor of communication at the University of Toledo. While Patrick was openly pro-gun and sharply critical of the mainstream press — and those biases are evident in the book — his research is based on work he completed for his doctoral dissertation, reviewed by a team of faculty at the University of Michigan.

Included in the book are interviews with journalists, which offer a look at how some members of the media view and approach gun issues.

Looking for more research on guns? Check out our write-ups on concealed carry on college campuses and how state policy affects how guns move between states.

Some other resources that may be helpful:

• This 2017 report from the Pew Research Center examines gun ownership in the U.S. and Americans’ attitudes toward gun ownership.
• This 2018 report from the U.S. Government Accountability Office looks at how often U.S. Attorney’s Offices prosecute people who give false information on firearm-related background checks. In fiscal year 2017, the federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) referred about 12,700 cases for investigation. Of those, 12 had been prosecuted as of June 2018.
• The ATF publishes reports on the number of firearms manufactured and exported each year. In 2017, federally licensed manufacturers made 3.6 million pistols, 713,577 revolvers, 2.5 million rifles and 635,239 shotguns, according to ATF data.

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Deaths resulting from injuries – both violent and unintentional – are on the rise in the U.S., according to an August 2018 research letter published in JAMA Surgery.

Injuries are the leading cause of death among people under age 44, and the third-highest ranking cause of death overall, Angela Sauaia, corresponding author on the paper and professor of public health, medicine and surgery at the University of Colorado, told Journalist’s Resource.

Sauaia’s research team, based out of the Denver Health Medical Center and the University of Colorado, looked at an online database that collects statistics on fatal injuries. The database, WISQARS (Web-based Injury Statistics Query and Reporting System) uses information from the U.S. Centers for Disease Control and Prevention’s National Vital Statistics System, which collects death certificate data (among other vital statistics) across the country and in five territories.

The study team analyzed data collected for all ages between 2000 and 2016 to look at changes in fatal injuries over time and by race/ethnicity and type. Injury type was broken into three categories: homicides, suicides and unintentional (this last category includes falls and motor vehicle fatalities, among other accidents). Sauaia stressed that the research is “certainly an underestimation of the problem” given that most injuries, both violent and accidental, are not fatal.

Here’s what the team found:

• Overall fatal injury rates increased significantly from 2014 to 2016, reversing earlier reductions.
• Breaking the analysis down further, violent and unintentional injury fatalities each spiked between 2014 and 2016. These sharp increases applied to all the racial/ethnic groups studied.
• In a phone interview with Journalist’s Resource, Sauaia put numbers to the recent increases, noting that there were 64,876 fatalities due to violent injuries in 2016, and 161,374 fatalities due to nonviolent injuries that year. By comparison, in 2014, there were 59,213 fatalities due to violent injuries and 135,928 fatalities due to nonviolent injuries.
• Motor vehicle-associated fatalities increased between 2014 and 2016, “after more than a decade of steady, significant declines,” the paper notes.
• Black individuals experienced the sharpest spike in homicide fatality rates between 2014 and 2016. They also had the highest rates of homicide fatalities of all the racial/ethnic groups throughout the entire study period.
• Two-thirds of homicides studied were firearm related.
• Firearm-related suicides increased significantly from 2006 to 2016, after a decrease from 2000 to 2006. Analyzed by race, suicides increased for white and black individuals from 2006 onward. For Latino individuals, suicides began to increase starting in 2013.
• Firearms were involved in about half of all suicide fatalities throughout the entire time period.

“To see these upward trends was surprising and disturbing,” Sauaia said, given that they had observed survival gains earlier in the 2000s.  “We need to figure out why we had these upturns,” she continued. The study did not offer potential explanations for these trends.

Though further research is needed to clarify the drivers of these trends, Sauaia argued that “several policy solutions are obvious and can be implemented right away.”

“I used to say that you don’t have to understand why fire burns you before you remove your hand … We don’t need to know causes before we can start implementing potential solutions,” she said.

Given the high fatality rate associated with firearm-related injuries (1 in 3 people injured by a firearm dies), and the increasing prevalence of these fatalities, her first top-of-mind policy suggestion is to designate federal funds for gun research.

Currently, the Dickey Amendment prevents CDC research funding from supporting projects that “may be used to advocate or promote gun control.” The National Rifle Association lobbied for the amendment, authored by Jay Dickey, a former Republican U.S. Representative for Arkansas’ 4^th congressional district. It was adopted in 1996, and remains in place despite congressional attempts to eliminate it.

“We need money to assess causes, to implement solutions, to evaluate the solutions and determine whether they work,” Sauaia said. She noted that her research was funded in part by her university and in part was uncompensated work undertaken over “a lot of weekends.”

She also suggested implementing what she considers to be an uncontroversial gun control policy – smart guns. Sauaia elaborated that smart guns would only unlock for an authorized user – the gun’s owner, who has been checked and deemed mentally stable and emotionally capable of using it.

“Children should not have access to loaded, unlocked guns,” she said. “We do have the technology. Our phones are smart, why don’t we have guns that are smart?”

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Teen boys from low-income neighborhoods were less likely to have threatened or injured someone with a weapon if they had hopes and goals for the future, a new research letter published in JAMA Pediatrics finds.

The study surveyed 866 males aged 13-19 in Pittsburgh, who were enrolled in a violence prevention trial. Over three-quarters of the respondents were black. The researchers asked the respondents to rate their views about a number of attitudes toward the future, including whether they expect good things to happen, whether they are excited about the future, and whether they believe they will make a difference in the world. They also asked about the teens’ experience with violence over the previous nine months.

They found that kids with positive views of the future were less likely to have threatened or injured someone with a weapon in the past nine months.

However, there was not a significant link between attitudes toward the future and the likelihood that respondents had been in a physical fight over the past nine months.

One possible explanation for these findings–that hopes for the future lowered the likelihood of threatening or injuring someone with a weapon, but did not lower the likelihood of involvement in a fight–is that kids with a positive outlook toward the future might be “more hesitant to be involved in severe forms of violence, such as perpetrating weapons-related violence,” which often carries severe consequences too, Alison Culyba, lead author of the study and assistant professor of pediatrics at the University of Pittsburgh School of Medicine explained in a phone interview with Journalist’s Resource.

She continued, “The reality is that violence is often a part of their lives or the lives of their peers. Being in a fight is something experienced incredibly commonly, especially in these settings.” Having a positive outlook toward the future might not be enough to ward against all forms of violence, she said, adding that affirmative responses to whether teens were in a fight could include those who were victims or bystanders in fights, as well as perpetrators.

Culyba noted that her work differs from the majority of research on children and violence, which focuses on identifying risk factors, rather than factors that protect kids from violence. She suggested that future research might follow children for longer periods of time to better understand the relationship between positive views of the future and the experience of violence. This research, she suggested, could help identify the time points most critical for intervention to improve aspirations and hopes for the future and potentially reduce violence.

These interventions would “come from a strengths-based model,” she explained, aiding youths in identifying their goals and aspirations and applying their assets. She offered the examples of job and training opportunities.

Culyba noted the importance of investing in communities, too. In communities where violence is common, often there “aren’t as many opportunities to be engaged in productive, pro-social ways.” Improving access to such types of engagement goes hand in hand with strengthening views about the future, she said.

The headline and introduction of this post have been updated for clarity. 

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In the wake of a school shooting, conversation can quickly turn from grief to prevention. School administrators, parents and politicians debate ideas ranging from restricting access to guns to arming teachers.

But what are schools already doing to prepare against gun violence? How do these preparations affect their students? Are these measures effective?

We’ve collected recent research that addresses these questions, along with a legal analysis of the issue and additional resources offered by national organizations.

“Crime, Violence, Discipline, and Safety in U.S. Public Schools: Findings from the School Survey on Crime and Safety: 2015–16”
Diliberti, M.; Jackson, M.; Kemp, J. U.S. Department of Education, National Center for Education Statistics, 2017.

Introduction: “This report presents findings on crime and violence in U.S. public schools, using data from the 2015–16 School Survey on Crime and Safety (SSOCS:2016). First administered in school year 1999–2000 and repeated in school years 2003–04, 2005–06, 2007–08, 2009– 10, and 2015–16, SSOCS provides information on school crime-related topics from the perspective of schools. Developed and managed by the National Center for Education Statistics (NCES) within the Institute of Education Sciences of the U.S. Department of Education and supported by the National Institute of Justice of the U.S. Department of Justice, SSOCS asks public school principals about the prevalence of violent and serious violent crimes in their schools. Portions of this survey also focus on school security measures, disciplinary problems and actions, school security staff, the availability of mental health services in schools, and the programs and policies implemented to prevent and reduce crime in schools.”

“School Shooting Simulations: At What Point Does Preparation Become More Harmful than Helpful?”
Rygg, Lauren. Children’s Legal Rights Journal, 2015.

Introduction: “This article will first discuss the background of school shootings in Part II, from the 1990s, to the most recent tragedies including Newtown, Arapahoe, and others. Part III will examine the legislative proposals and enacted legislation for the active shooter drills in various states, as well as any citizen complaints that have arisen as a result. Next, Part III will also explore how teachers are required to respond in these drills. Part IV will then discuss the efficacy of active shooter drills, whether this is the best approach to school safety, and the possibility of alternatives. Part V will look at the impact the legislation has for current and future students as well as potential results and overreached boundaries of the school districts, and any potential legal consequences.”

“Parents’ Expectations of High Schools in Firearm Violence Prevention”
Payton, Erica; Khubchandani, Jagdish; Thompson, Amy; Price, James H. Journal of Community Health, 2017. DOI: 10.1007/s10900-017-0360-5.

Abstract: “Firearm violence remains a significant problem in the U.S. (with 2,787 adolescents killed in 2015). However, the research on school firearm violence prevention practices and policies is scant. Parents are major stakeholders in relation to firearm violence by youths and school safety in general. The purpose of this study was to examine what parents thought schools should be doing to reduce the risk of firearm violence in schools. A valid and reliable questionnaire was mailed to a national random sample of 600 parents who had at least one child enrolled in a public secondary school (response rate = 47 percent). Parents perceived inadequate parental monitoring/rearing practices (73 percent), peer harassment and/or bullying (58 percent), inadequate mental health care services for youth (54 percent), and easy access to guns (51 percent) as major causes of firearm violence in schools. The school policies perceived to be most effective in reducing firearm violence were installing an alert system in schools (70 percent), working with law enforcement to design an emergency response plan (70 percent), creating a comprehensive security plan (68 percent), requiring criminal background checks for all school personnel prior to hiring (67 percent), and implementing an anonymous system for students to report peer concerns regarding potential violence (67 percent). Parents seem to have a limited grasp of potentially effective interventions to reduce firearm violence.”

“Danger K12: Are U.S. Schools Really Safe?”
Adkins, Vernita Lynn; et al. Paper presented at the conference of the International Journal of Arts & Sciences, 2016. ISSN: 1943-6114 :: 09(01):53–64.

Abstract: “Through a meta-analysis of the literature, this article addresses the essential components within a federal comprehensive public school safety system and proposes the implementation of a comprehensive school safety program for students in the U.S. K-12 public school system. Review of the literature explores two questions: 1) What constitutes a comprehensive safety plan for students in the K-12 public school system? 2) Why has a comprehensive federal school safety plan not been implemented for students in the U.S. K-12 public school system? The authors contend that addressing school safety in a comprehensive manner will help solve the current inconsistent implementation of school safety policies and procedures. We also contend that the current Safe Schools Improvement Act, amended  in 2013 and the 2015 amendment proposal, focusing only on bullying and harassment, is inadequate to address the myriad of safety issues that impact schools.”

“Playing at Violence: Lock-Down Drills, ‘Bad Guys’ and the Construction of ‘Acceptable’ Play in Early Childhood”
Delaney, Katherine K. Early Child Development and Care, 2017. DOI: 10.1080/03004430.2016.1219853.

Abstract: “This study examines how acceptable play was framed for a class of pre-Kindergarten children by their teacher and classroom aide. Using comic subjectivity theory, the author explores how children’s playing at pretend violence (bad guy and pretend gun play) is forbidden, but playing at real violence (in the form of active-shooter lock-down drills) positioned the children in the classroom as victims of violence, rather than agentic powerful players. As gun violence in the United States continues to invade school spaces, this paper critically examines how ‘acceptable’ play for young children is being framed and defined by outside forces rather than pedagogical and professional knowledge.”

“Adding Security, but Subtracting Safety? Exploring Schools’ use of Multiple Visible Security Measures”
Tanner-Smith, Emily E.; et al. American Journal of Criminal Justice, 2018. DOI: 10.1007/s12103-017-9409-3.

Abstract: “In response to continued concerns over crime and violence, schools are increasingly employing visible security measures such as cameras, metal detectors, and security personnel. These security measures are not mutually exclusive, but few studies have considered the relationship between the use of multiple forms of security and youth’s exposure to drugs, fighting, property crime, and firearms at school. To address this issue, we analyzed nationally representative school administrator-reported data from the School Survey on Crime & Safety, using a quasi-experimental design with propensity scores to adjust for potential confounding factors. The results indicated that utilization of multiple security measures reduced the likelihood of exposure to property crime in high schools, but most other security utilization patterns were associated with poorer school safety outcomes. Our findings provide guidance to policymakers in considering whether to use — or expand — visible school security measures in schools.”

“Law Enforcement Executive and Principal Perspectives on School Safety Measures: School Resource Officers and Armed School Employees”
Chrusciel, Margaret M.; et al. Policing: An International Journal of Police Strategies & Management, 2015. DOI: 10.1108/PIJPSM-11-2014-0115.

Findings: “There is a large amount of support for school resource officers from both law enforcement executives and principals. However, in general, both groups of respondents do not believe armed administrators or armed teachers to be an effective school safety strategy.”

“Impacts of Metal Detector Use in Schools: Insights from 15 Years of Research”
Hankin, Abigail; Hertz, Marci; Simon, Thomas. Journal of School Health, 2011. DOI: 10.1111/j.1746-1561.2010.00566.x.

Results: “Each of the papers reviewed utilized data that originated from self-report surveys. Four of the studies consisted of secondary analyses of national databases, with the other 3 utilizing local surveys. The studies varied as to the outcome, ranging from student/staff perceptions of safety at school to student self-reports of weapon carrying and/or victimization, and showed mixed results. Several studies suggested potential detrimental effects of metal detectors on student perceptions of safety. One study showed a significant beneficial effect, linking metal detector use to a decrease in the likelihood that students reported carrying a weapon while in school (7.8 percent vs. 13.8 percent), without a change in weapon carrying in other settings or a decline in participation in physical fights.”

“Reducing the Risks of Firearm Violence in High Schools: Principals’ Perceptions and Practices”
Price, James H.; et al. Journal of Community Health, 2016. DOI: 10.1007/s10900-015-0087-0.

Abstract: “This study assessed the perceptions and practices of a national sample of secondary school principals regarding reducing firearm violence in high schools. Data were collected via three-wave postal mailings. A 59-item valid and reliable questionnaire was mailed to a national random sample of 800 secondary school principals. Of the 349 principals (46 percent) that responded, 17 percent reported a firearm incident at their school in the past 5 years. Principals perceived inadequate parental monitoring (70 percent), inadequate mental health services (64 percent), peer harassment/bullying (59 percent), and easy access to firearms (50 percent) as the main causes of firearm violence in schools. The three barriers to implementing firearm violence prevention practices were: lack of expertise as to which practices to implement (33 percent), lack of time (30 percent), and lack of research as to which practices are most effective (30 percent). Less than half of schools trained school personnel regarding firearm violence issues. The findings indicate that firearm incidents at schools may be more common than previously thought. A significant portion of principals are at a loss as to what to implement because of a lack of empirical evidence on what is effective. More research is needed to find the most effective school interventions for reducing firearm violence.”

Other resources:

• The National Association of School Psychologists and National Association of School Resource Officers produced “Best Practice Considerations for Schools in Active Shooter and Other Armed Assailant Drills,” last updated in 2017. Both associations have numerous other resources on the subject.
• The National Center for School Crisis and Bereavement offers disaster preparedness resources.
• On Journalist’s Resource, we’ve gathered relevant research on mass violence.

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