Over the last 10 years, influenza has claimed on average just short of 33,000 lives a year in the United States. Motor vehicle accidents take just over 35,000 lives each year. Cancers of the urinary system kill just over 32,000.
Gun violence claims an average of about 33,000 lives a year.
All but one of the above causes of death have a large and active community of medical or public health researchers exploring ways to reduce or prevent fatalities. Fueled largely by federal funds, these researchers publish articles and attend conferences to share their findings.
Most years, the collective effect of that research may be to shave death numbers at the margins. But every once in a while, federally funded research leads to breakthroughs, and fatality statistics in some corner of medicine or public health plummet.
Gun violence is the exception. New research finds that, given the number of U.S. fatalities linked to firearms, public health research on them is very underpowered.
Given its role in U.S. deaths, research aimed at curbing gun violence could be expected to command about $1.4 billion yearly in federal funding, the authors of a new study reckoned. In fact, from 2004 to 2015, the federal government spent an average of $22 million annually to support research on gun violence.
That's a meager 1.6% of the amount the study authors expected to be spent.
Not surprising, that deficit translates directly into fewer articles published on the subject.
In a research letter published Tuesday in JAMA, Dr. David E. Stark, a researcher at New York's Icahn School of Medicine at Mount Sinai, and Nigam H. Shah of Stanford University estimated that, given its importance as a cause of death, there should have been about 38,897 scholarly articles published on the subject of gun violence. When they scoured Medline, the federal government's comprehensive digital catalog of biomedical and public health publications, they found only 1,738 such articles.
"Gun violence killed about as many individuals as sepsis," the authors wrote. But while sepsis — a complication of infection that can be fatal — has a designated "World Sepsis Day" and has been the subject of high-level federal meetings, gun violence research bumps along on a shoestring.
"Funding for gun violence research was about 0.7% of that for sepsis and publication volume about 4%," Stark and Shah wrote. "In relation to mortality rates, gun violence research was the least-researched cause of death and the second-least funded cause of death after falls."
That mismatch did not occur by happenstance. In a 1996 funding bill, gun rights advocates and their allies on Capitol Hill forbade the use of any money appropriated for the Centers for Disease Control and Prevention "to advocate or promote gun control." Over the ensuing years, that ban was extended to other agencies, including the National Institutes of Health.
The prohibition did not explicitly ban research on guns and public health. But what agency head was going to risk a run-in with lawmakers over research that might underscore the wisdom of a change in the design, sale or use of guns? The ban cast "a pall over the research community," Stark and Shah wrote.
The Obama administration has increased research funds for gun violence and backed a wide range of initiatives aimed at making firearms safer. But the future of those efforts is uncertain at best under President-elect Donald Trump, who has expressed skepticism about measures that would extend limits on access to firearms.
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